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Pharmacology > CNS > Flashcards

CNS Flashcards

1
Q

Norep and epinephrine action

A

catecholamines released by nerves in the sympathetic branch of the ANS

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2
Q

Dopamine action

A

involved in coordination of impulses and responses

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3
Q

absence of dopamine leads to ?

A

parkinsons

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4
Q

Gamma aminobutyric acid (GABA)

A

inhibits nerve activity and is important in preventing overexcitability or stimulation such as SEIZURE ACTIVITY

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5
Q

serontonin function

A

important in the arousal and sleep and in preventing depression and promoting motivation

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6
Q

role of nervous system

A

controls functions of human body
analyzes incoming stimuli
integrates internal and external responses

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7
Q

function of nervous system

A

allow movement
allow realization of various sensations
provide response to internal/external stimuli
stimulate learning thinking and emotions

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8
Q

afferent fibers

A

nerve axons that run from peripheral receptors into CNS

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9
Q

efferent fibers

A

nerve axons that carry nerve impulses from CNS to periphery and stimulate muscles or glands

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10
Q

dendrite

A

carries information from one neuron to the next

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11
Q

how is Ach inactivated

A

cholinesterase

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12
Q

how is norep inactivated

A

by reuptake

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13
Q

how is serotonin inactivated

A

reuptake and monoamine oxidase breakdown MAO

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14
Q

dopamine inactivated by?

A

reuptake or MAO breakdown monoamine oxidase

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15
Q

GABA inactivated by?

A

enzymatic breakdown

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16
Q

hindbrain controls

A

breathing
BP
swallowing/vomiting
reticular activating system

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17
Q

Midbrain components

A

thalamus, hypthalamus, limbic system

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18
Q

thalamus function

A

sends direct information into the cerebrum to transfer sensations

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19
Q

hypothalamus functions

A 
major sensor of activity in the body
temp regulation
water balance
appetite
endocrine function
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20
Q

limbic system action

A

controls expression of emotions

contains high levels of NT - epinephrine, norep, serotonin

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21
Q

forebrain actions

A

receives and sends nerve impulses, coordinates speech, communication and facilitates learning.
made up of 2 cerebral hemispheres joined together by corpus callosum

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22
Q

sensory fiber of the spinal nerve is located?

what does it do?

A

dorsal root

brings the information into the CNS from the periphery

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23
Q

motor fiber of spinal nerves is located and does what?

A

ventral root

causes movement or reaction

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24
Q

R brain is for

A

artistic

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25
Q

L brain is

A

analytical

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26
Q

affect of stress on brain

A

facilitates learning

increased stress inhibits learning

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27
Q

limbic system role

A

role in learning

emotions associated with memory and the present have an impact on stimulus response

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28
Q

R sided CVA affects

A 
paralysis on L
spatial perceptual deficits
quick impulsive behaviors
performance memory deficits
unable to name items
L side visual prob
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29
Q

L side CVA affects

A 
R side paralysis
communication language deficits
slow cautious behaviors
language memory deficits
R side visual provs
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30
Q

anxiety definition

A

state of apprehension tension or uneasiness
stems from anticipation of danger
unknown, unrecognized source of danger

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31
Q

generalized anxiety (GAD)

A

most common, difficult to control, lasting more than 6 months

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32
Q

situational anxiety

A

occurs when experiencing daily events in the environment

often does not require pharmacotherapy

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33
Q

panic

A

characterized by intense feeling of immediate apprehension, impending doom

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34
Q

phobias

A

fearful feelings attached to situation or object

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35
Q

obsessive compulsive disorders

A

repetitive behaviors that interfere with normal activities

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36
Q

PTSD

A

developed in response to reexperience

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37
Q

limbic system functions

A

also includes anxiety, fear, anger, aggression, remorse, depression, sex drive, euphoria

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38
Q

hypothalamus functions

A

responsible for unconscious response to extreme stress
connects with reticular formation
associated with fight or flight response

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39
Q

how is insomnia controlled

A

reticular formation - network of neuron, found along the entire length of brain stem.
reticular activating system is responsible for sleeping and wakefullness; performs an alerting function for the cerebral cortex

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40
Q

how does eeg work

A

is dx procedure used to examine brain wave patterns
id’s types of sleep -
1. non REM
2. has 4 stages of sleep
3. linked to repair and restoration of physical body
4. if deprived of nREM sleep, may get depressed, fatigue, apathy

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41
Q

REM sleep

A

rapid eye movement
stage where dreaming occurs
called paradoxical sleep
when deprived, may experience a sleep debt

42
Q

what happens when one experiences a sleep debt

A

becomes -

  1. frightened
  2. irritable
  3. paranoid
  4. emotionally disturbed
43
Q

insomnia and causes

A

sleep disorder may be caused by anxiety, stress, cffeine, nicotine, room temp, light, snoring, sleep apnea.
long term may be psychological and physiological

44
Q

meds used for anxiety and insomnia

A

anxiolytics
cns depressants
sedatives
hypnotics

45
Q

benzodiazepines action

A

bindins with gaba receptor Cl channel molecule, instensify the effects of gaba

46
Q

barbiturates action

A

sedative/hypnotic

general CNS depressant

47
Q

anxiolytic/hypnotic drugs

A

include choral hydrate, ambien, lunesta, antihistamines (benedryl, phenergan)

48
Q

benzodiazepine characters

A

librium, valium
drug of choice for general anxiety and insomnia - onset 30 min
binds with gaba receptor Cl channel molecule
natural receptor, found throughout entire brain
classified as schedule IV drug
some affect REM
may develop tolerance that prolongs use
is CNS depressant

49
Q

what is valium reversed by

A

flumazenil (romazicon)

50
Q

CNS depressant character

A

sedative hypnotic drug with ability to produce calming effect at low dose, and have sleep inducing effect at high doses
similar to hypnosis - deep sleep
can cause physical, psychological dependence
dose adjustment for children, elderly and african americans.
avoid ETOH, antidepressants, narcotics

51
Q

Ach action

A

neurotransmitter that communicates between nerves and muscles

52
Q

consideration for choral hydrate

A

taper dose

53
Q

consideration for paraldehyde

A

avoid plastic

54
Q

consideration for rozerem

A

stay in bed 8 hrs. monitor for depression

55
Q

nursing considerations for anxiety/insomnia drugs

A 
assess need
drug hx
hypersensitivity
use of ETOH and other CNS depressants
ID coping mechanisms
client teaching re: drug therapy
56
Q

MAO inhibitors action

A

inhibit MAOs

increase biogenic amines at synaptic cleft

57
Q

TAD action (tricyclic antidepressants)

A

reduces reuptake of serotonin and norep at synaptic cleft

58
Q

selective serotonin reuptake inhibitors action

A

blocks the reuptake of serotonin at synaptic cleft

59
Q

depression

A

an emotional disorder/state that is characterized by changes in mood that cause subjective distress and inability to function in age appropriate roles

60
Q

s/s of depression

A

low energy
sleep disturbance
lack of appetite
limited libido
inability to perform activities of daily living
overwhelming feelings of sadness, despair, hopelessness, disorganization

61
Q

types of depression

A 
major
dysthymia
bipolar
as a component of physical illness
as a s/e of some drugs - ETOH, antianxiety, non selective anti HTN
62
Q

neurotransmitters involved in depression

A

serotonin 5 HT
dopamine DA
norep NE
epinephrine E

63
Q

which NT’s are biogenic amines

A

serotonin 5HT and E

64
Q

etiology of depression and mania

A

alteration in neuronal and synaptic catecholamine concentrations of norep, DA, and E + serotonin

65
Q

phenelzine (nardil)

A

monoamine oxidase inhibitor

used for resistant depression

66
Q

MAO inhibitor action

A

inhibits MAO, inhibits breakdown of NE, DA 5HT
allows them to accumulate at synaptic cleft
results in increased stimulation of post synaptic receptor
helps relieve depression

67
Q

MAOI s/s

A 
tachycardia
circulatory collapse
seizure
coma
cerebral hemorrhage
68
Q

sign of toxicity of MAOI

A

h/a is 1st sign of OD

69
Q

what can cause MAOI hypertensive crisis

A

tyramine (food product) - releases norep. is metabolized in LV and intestinal tract

70
Q

how does tyramine create hypertensive crisis

A

by releasing norep - norep is not biotransformed so it BUILDS UP at synaptic cleft.

71
Q

what other drugs can result in increased norep

A

OTC cold and flu meds, ie psuedoephedrine

8% of MAOI experience

72
Q

MAOI food and drink to avoid

A 
aged mature cheese
smoked pickled meat fish or poultry
aged fermented meats fish or poultry
yeast extract
red wine
italian broad beans
73
Q

nursing for MAOIs

A

avoid if cardiac disease due to accum of norep
avoid other sympathetics
monitor LV enzymes
Gi disturbance
combined with insulin or others -> hypoglycemia

74
Q

tricyclic antidepressant actions

A 
decrease s/s of major depression esp if characterized by anxiety and sleep disturbance
childhood enuresis
OCD
adjunctive analgesics
trigeminal neuralgia
prophylaxis of migraines
75
Q

s/e of tricyclics

based on receptors

A

muscarinic (block) - dry mouth, constip, urin hesistancy, blurred vision, tachycard
histaminergic (block)- sedation, weight gain, hypotension
alpha adrenergic (block)- orthostatic hypotension, smooth musc dilation
serotonergic (effect) - erectile and ejaculatory dysfx, anorgasmia in female

76
Q

s/s of tricyclic toxicity

A

seizures
arrhythmia
70-80% die before reaching hospital

77
Q

tricyclics and elderly

A

poor choice due to anticholinergic and cardiac effects

78
Q

time for maoi and tricyclics to kick in

A

2-4 weeks

79
Q

tricyclics and SSRI combo effect

A

dangerous cardiac complications

80
Q

time takes to clear MAOIs from system

A

2 weeks

81
Q

maoi consideration

A

has many interactions with drugs. need to washout before starting another drug.
strong anticholinergic effect - not for elderly

82
Q

2nd generation antidepressant

A

considered superior in terms of s/e but not in terms of efficacy
aka selective serotonin reuptake inhibitors - SSRI

83
Q

fluoxetine - prozac

special action

A

preferred for kids with OCD

not fatal in OD

84
Q

uses of prozac

A 
depression
obesity
oCD
panic attacks
social phobia
premenstrual dysphoria
menopausal sx
85
Q

where is serotonin found

A

90% in intestines

86
Q

what time to take serotonin

A

in morning - may cause insomnia

87
Q

other SSRIs

A 
citaloprma - celexa
paroxetine - paxil
fluvoxamine - luvox
sertraline - zoloft
escitalopram - lexapro
88
Q

SSRI s/e

A

h/a, dizzy, tremor, insomnia, risk for suicide increase
N, diarr, constip, dry mouth
decrease sex fx (paxil) - usually reason for non compliance

89
Q

interactions of SSRI

A

increase serotonin with St john’s wort - severe sx include HTN, tachycardia, leading to shock and death

90
Q

SSRI benefits

A

better tolerated in elderly
fewer anticholinergic s/e
approved for anxiety and depression
less lethal

91
Q

bupropion - wellbutrin actions

A

monocyclic norep, DA reuptake inhibitor (NDRI)

92
Q

trazodone - desyrel action

A

serotonin antagonist/reuptake inhibitor (SARI)
has alpha adrenergic effects
chemically unrelated to other groups

93
Q

venlafaxine - effexor and effexor XR

A

bicyclic agent

selective 5HT and norep reuptake inhibitor (SNRI)

94
Q

mirtazapine - remeron action

A

tetracyclic

noreadrenergic/specific serotonergic antidepressant

95
Q

antimanic drugs actions

A

inhibits the release of norep and da
doesn’t inhibit serotonin
LITHIUM

96
Q

CNS stimulants action

A

may increase release of cathecholamines from presynaptic neurons
RITALIN

97
Q

antipsychotics action

A

DA receptor blockers

THORAZINE

98
Q

atypical antipsychotics action

A

block dopamine and serotonin receptors

CLOZAPINE - clozaril

99
Q

bipolar/mania characteristics

A

mania - period of extreme over activity and excitement
bipolar - extreme of depression follow by hyperactivity and excitement
may be due to biochem imbalance followed by overcompensation by neurons to re establish stability

100
Q

narcolepsy definition

A

daytime sleepiness and sudden periods of loss of wakefullness
due to probs with stim of brain by RAS - reticular activating system
and probs with response to that stim

101
Q

ADD characteristics

A

inability to concentrate on one activity for longer than a few minutes
state of hyperkinesia
usually dx in school age children but can also occur in adults

Pharmacology (8 decks)

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