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CNS Flashcards

1
Q

What are 7 signs/symptoms of opioid overdose?

A
  1. Constipation
  2. N/V
  3. Pruritus
  4. Flushing
  5. Orthostatic hypotension
  6. Respiratory depression
  7. Sedation
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2
Q

What are 5 interactions of opioids?

A

CNS depressants:
1. alcohol
2. antihistamines
3. barbiturates
4. benzodiazepines
5. MAOIs

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3
Q

What are 2 contraindications of non-opioid analgesics?

A

Acetaminophen: liver disease
Tramadol: sensitivity to opioids

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4
Q

What are 3 nursing implications of non-opioid analgesics?

A
  1. assess for alcohol use
  2. assess pain
  3. assess RR & temp
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5
Q

What is the daily limit for acetaminophen?

A

4000mg

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6
Q

What schedule drug is tramadol?

A

4
controlled substance

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7
Q

What is used for management of maligant hyperthermia?

A

dantrolene (skeletal muscle relaxation)

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8
Q

What is the indication for muscle relaxants?

A

relief of painful muscle spasms

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9
Q

What medications can be used to treat insomnia?

A

Benzodiazepines
(end in -pam or -lam)
Nonbenzodiazepines
(lunesta, ambien, rozerem)

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10
Q

What are 4 signs/symptoms of benzodiazepine overdose?

A
  1. drowsiness
  2. dizziness
  3. cognitive impairment
  4. lethargy
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11
Q

What is the treatment for benzodiazepine overdose?

A

flumazenil

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12
Q

What are 4 indications for benzodiazepines?

A
  1. sleep induction
  2. relief of agitation/anxiety
  3. skeletal muscle relaxation
  4. acute seizure disorders
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13
Q

What is the difference between benzodiazepines and nonbenzodiazepines?

A

nonbenzos = long-term treatment
benzos = short-term treatment

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14
Q

What are 5 interactions with benzodiazepines?

A
  1. alcohol
  2. opioids
  3. grapefruit
  4. kava
  5. valerian
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15
Q

What is a nursing implication for diazepam IV?

A

administer slowly, don’t mix with other drugs

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16
Q

What is a nursing implication for ambien?

A

take at bedtime on empty stomach, no crushing

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17
Q

What is patient ed that should be included with benzodiazepines?

A

can experience withdrawal after prolonged use

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18
Q

What are the 3 classes of antiepileptic drugs?

A

barbiturates
hydantoins
lminostilbenes

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19
Q

What 2 things should be considered with admin of antiepileptic drugs?

A

IV forms require dilution and slow infusion
there is no antidote

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20
Q

What are the 3 indications for CNS stimulants?

A
  1. ADHD
  2. narcolepsy
  3. acute migraine
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21
Q

What are 11 side effects for CNS stimulants?

A
  1. hypertension
  2. tachycardia
  3. anxiety
  4. insomnia
  5. increased metabolic rate
  6. GI upset
  7. dry mouth
  8. suicidal thoughts
  9. tingling
  10. flushing
  11. congested feeling
22
Q

What are 4 nursing implications for CNS stimulants?

A
  1. need drug holidays
  2. addictive potential
  3. cardiac assessment
  4. take on empty stomach
23
Q

What are 9 nursing implications for antiepileptic medications?

A
  1. assess neuro status
  2. monitor blood levels of barbiturates
  3. gradual weaning period
  4. assess cardiac
  5. Hydantonins & Iminostilbenes (narrow therapeutic index)
  6. liver function labs
  7. avoid grapefruit
  8. avoid carbonated beverages
  9. take with food
24
Q

What are 5 contraindications of antiepileptic medications?

A
  1. respiratory difficulties
  2. pregnancy
  3. severe liver/kidney disease
  4. bradycardia
  5. bone marrow depression
25
What is a special nursing implication for hydantonins?
highly protein bound (toxicity issues)
26
What is the mechanism of action of Parkinson's drugs?
MAOIs: inhibit breakdown of dopamine Dopamine modulator: releases dopamine COMT inhibitors: block enzymes that breakdown catecholamines
27
What are the 9 side effects of Parkinson's drugs?
1. headache 2. dizziness 3. orthostatic hypotension 4. nausea 5. diarrhea 6. edema 7. insomnia, fatigue, syncope 8. cardiac dysrhythmias 9. urinary retention
28
What are 2 side effects of COMT inhibitors?
dark, discolored urine GI upset
29
How long does it take for Parkinson's meds to have a therapeutic effect?
2-3 weeks
30
What is the mechanism of action of anxiolytic drugs?
depress areas in CNS via GABA receptors (inhibitory)
31
What is the mechanism of action of mood-stabilizing drugs?
lithium ions alter sodium transport which decreases catecholamines
32
What is the mechanism of action for TCAs (antidepressant)?
block presynaptic reuptake of serotonin and norepinephrine
33
What is the mechanism of action of antipsychotic drugs?
blocks dopamine receptors; produces a tranquilizing effect
34
What is the indication for anxiolytic drugs?
anxiety
35
What is the indication for mood-stabilizing drugs?
bipolar
36
What are the 5 indications for antidepressant drugs?
neuropathic pain insomnia bipolar OCD panic attacks
37
What are the 4 nursing implications for anxiolytic drugs?
CBC electrolytes hepatic/renal function Orthostatic BP
38
How long does it take for lithium to reach therapeutic levels?
7-14 days
39
What is the appropriate range for lithium?
0.6-1.2
40
What electrolyte needs to be monitored with lithium admin?
sodium
41
What are 3 nursing implications for antipsychotic drugs?
Serum drug concentrations monitor for suicidal ideation assess cardiac
42
What is the mechanism of action for SSRIs (antidepressant)?
inhibit reuptake of serotonin
43
What is the mechanism of action for SNRIs?
inhibit reuptake of serotonin and norepinephrine
44
What are the 4 side effects of TCAs (antidepressant)?
1. dry mouth 2. constipation 3. urinary retention 4. sedation
45
What are the 5 side effects of SSRIs & SNRIs?
1. insomnia 2. weight gain 3. sexual dysfunction 4. serotonin syndrome 5. GI upset
46
What are the 2 interactions of TCAs (antidepressant)?
anticholinergics CNS depressants
47
What are the 3 interactions of SSRIs & SNRIs?
highly protein bound warfarin phenytoin
48
What is a nursing implication special to TCAs?
overdose is lethal
49
What is a nursing implication special to SSRIs?
slowly tapered when Dc'd
50
How are antidepressants supposed to be administered?
with food and 4-6 oz fluid

Pharmacology (5 decks)

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