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Pharmacology > CNS > Flashcards

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
Q

What is a special nursing implication for hydantonins?

A

highly protein bound (toxicity issues)

26
Q

What is the mechanism of action of Parkinson’s drugs?

A

MAOIs: inhibit breakdown of dopamine
Dopamine modulator: releases dopamine
COMT inhibitors: block enzymes that breakdown catecholamines

27
Q

What are the 9 side effects of Parkinson’s drugs?

A
  1. headache
  2. dizziness
  3. orthostatic hypotension
  4. nausea
  5. diarrhea
  6. edema
  7. insomnia, fatigue, syncope
  8. cardiac dysrhythmias
  9. urinary retention
28
Q

What are 2 side effects of COMT inhibitors?

A

dark, discolored urine
GI upset

29
Q

How long does it take for Parkinson’s meds to have a therapeutic effect?

A

2-3 weeks

30
Q

What is the mechanism of action of anxiolytic drugs?

A

depress areas in CNS via GABA receptors (inhibitory)

31
Q

What is the mechanism of action of mood-stabilizing drugs?

A

lithium ions alter sodium transport which decreases catecholamines

32
Q

What is the mechanism of action for TCAs (antidepressant)?

A

block presynaptic reuptake of serotonin and norepinephrine

33
Q

What is the mechanism of action of antipsychotic drugs?

A

blocks dopamine receptors; produces a tranquilizing effect

34
Q

What is the indication for anxiolytic drugs?

A

anxiety

35
Q

What is the indication for mood-stabilizing drugs?

A

bipolar

36
Q

What are the 5 indications for antidepressant drugs?

A

neuropathic pain
insomnia
bipolar
OCD
panic attacks

37
Q

What are the 4 nursing implications for anxiolytic drugs?

A

CBC
electrolytes
hepatic/renal function
Orthostatic BP

38
Q

How long does it take for lithium to reach therapeutic levels?

A

7-14 days

39
Q

What is the appropriate range for lithium?

A

0.6-1.2

40
Q

What electrolyte needs to be monitored with lithium admin?

A

sodium

41
Q

What are 3 nursing implications for antipsychotic drugs?

A

Serum drug concentrations
monitor for suicidal ideation
assess cardiac

42
Q

What is the mechanism of action for SSRIs (antidepressant)?

A

inhibit reuptake of serotonin

43
Q

What is the mechanism of action for SNRIs?

A

inhibit reuptake of serotonin and norepinephrine

44
Q

What are the 4 side effects of TCAs (antidepressant)?

A
  1. dry mouth
  2. constipation
  3. urinary retention
  4. sedation
45
Q

What are the 5 side effects of SSRIs & SNRIs?

A
  1. insomnia
  2. weight gain
  3. sexual dysfunction
  4. serotonin syndrome
  5. GI upset
46
Q

What are the 2 interactions of TCAs (antidepressant)?

A

anticholinergics
CNS depressants

47
Q

What are the 3 interactions of SSRIs & SNRIs?

A

highly protein bound
warfarin
phenytoin

48
Q

What is a nursing implication special to TCAs?

A

overdose is lethal

49
Q

What is a nursing implication special to SSRIs?

A

slowly tapered when Dc’d

50
Q

How are antidepressants supposed to be administered?

A

with food and 4-6 oz fluid

Pharmacology (5 decks)

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