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Pharmacology Exam 2 > CNS And PNS > Flashcards

CNS And PNS Flashcards

1
Q

Central Nervous System consists of

A

Brain and spinal cord

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2
Q

Respiration’s controlled by

A

Pons and medulla

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3
Q

Neurotransmitters are

A

Norepinephrine, serotonin, and dopamine

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4
Q

CNS stimulants

A

Provoke release of neurotransmitters
Decrease reputable of neurotransmitters
Inhibit postsynaptic enzymes

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5
Q

Anxiety

A

Feeling tension, nervousness, apprehension, or fear involving unpleasant reactions to a stimulus

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6
Q

sedation

A

Loss of awareness and reaction to environmental stimuli

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7
Q

Hypnosis

A

Extreme sedation resulting in further CNS depression and sleep

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8
Q

The downers of CNS

A

Cause various degrees of depression

  • sedative-hypnosis
  • anesthetic
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9
Q

Sedatives

A

Treat sleep disorders

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10
Q

Sedative-hypnotics

A

Barbiturates
Benzodiazepines
Nonbenzodiazepines

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11
Q

General side effects of sedative hypnotics

A 
Residual drowsiness
Drug dependence 
Drug tolerance 
Withdrawal symptoms 
Respiratory depression
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12
Q

Benzodiazepines-AS A CLASS-

A

drug of choice to treat anxiety
Do not cause much sedation
Less likely to cause dependence-schedule 4 drug
Act by potentiating GABA

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13
Q

Benzodiazepines Indications

A

Anxiety disorders, alcohol withdrawal, hyper excitability, agitation, seizures, induction of anesthesia, conscious sedation, preoperative sedation

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14
Q

Benzodiazepines

A

Well absorbed GI tract, lipid soluble, metabolized by liver

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15
Q

Benzodiazepines Actions

A 
Act in limbic system and the RAS
Make GABA more effective 
Cause interference with neurons firing
Lower doses assist with anxiety
Higher doses cause sedation and hypnosis
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16
Q

Pharmacokinetics Benzo

A 
Absorbed from GI tract
Peak level 30 min to 2 hrs
Lipid soluble and distributes well
Cross placenta
Enter breast milk
Metabolize in liver 
Excretion in urine
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17
Q

Contraindications of Benzo

A

Allergy
Psychosis
Acute narrow angle glaucoma
Decrease liver and kidney function

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18
Q

Adverse effects of Benzo

A

CNS and anticholinergic effects
Use with causation in African Americans
Addictive effect with alcohol or narcotics
UNPREDICTABLE REACTION IN ELDERLY

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19
Q

Anxiolytics-used to depress CNS-of Benzo

A 
Diazepam
Chlordiazepoxide
Lorazepam
Aprazolam
Oxazepam
Clonazepam
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20
Q

GABA

A

Gamma-aminobutyric system

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21
Q

RAS

A

Reticular activating system

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22
Q

Benzodiazepines suffix

A

-zopam or -zolam

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23
Q

Benzodiazepine antidote

A

Flumazenil -romazicon

:inhibits effects of the benzodiazepines at the GABA receptors and is used to treat Benzo overdoses

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24
Q

NONbenzodiazepines

A 
Zolpidem-ambien
\:duration of action is 6-8 hrs
Eszopiclone-lunesta
Zaleplon-sonata
Chloral hydrate
Melatonin receptor agonist
\:ramelteon-not a controlled substance
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25
Q

Barbiturates actions

A

CNS depressants
Inhibit neuroral impulse conduction in ascending RAS
Depress cerebral cortex
Depress motor output
Cause—sedation,hypnosis,anesthesia, and coma

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26
Q

Barbiturates Indications

A 
Reliefs of signs and symptoms of anxiety
Sedation 
Insomnia 
Preanesthesia
Seizures
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27
Q

Pharmacokinetics barbiturates

A

Well absorbed, reached peak in 20-60 min, metabolizes in liver, excreted in urine

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28
Q

Adverse effects of Barbiturates

A 
CNS depression 
Physical dependency
Drowsiness 
Somnolence 
Lethargic 
Ataxia
Vertigo
Nausea/Vomiting 
Constipation
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29
Q

Long acting barbiturates

A

Phenobarbital and mephobarbital

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30
Q

Intermediate acting barbiturates

A

Amobarbital
Aprobarbital
Butabarbital

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31
Q

Short acting barbiturates

A

Pentobarbital

Secobarbital

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32
Q

Barbiturates

A

Controlled substance schedule 2 or 3

Many drug interactions including kava kava and valerian

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33
Q

Contraindications barbiturates

A 
Allergy
History of addiction to sedative
Liver or kidney function 
Respiratory distress or depression
Pregnancy
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34
Q

Adverse effects or barbiturates

A

Respiratory depression
hangover
Do NOT withdrawal abruptly or mix with alcohol

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35
Q

General anesthetics

A

CNS depressants used to produce loss of pain sensation and consciousness

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36
Q

Local anesthetics

A

Used to cause loss of pain sensation and feeling is a designated area
Does not produce systemic efforts associated with severe CNS depression

37
Q

Goals of General anesthetics

A 
Analgesia
-loss of pain perception
Unconsciousness
-loss of awareness of ones surroundings
Amnesia
-inability to recall what took place
38
Q

Risk factors of General

A

CNS factors
Cardiovascular factors
Respiratory factors
Renal and hepatic function

39
Q

Balanced anesthesia

A 
Hypnotic the night before
Premedication
Short acting barbiturate
Inhaled gas
Muscle relaxant
40
Q

Stages of General

A

Analgesia
Excitement or delirium
Surgical
Medullary paralysis

41
Q

Adverse affects w/ CNS

A

Suppression

42
Q

Adverse effects w/local anesthetic

A

Loss of skin integrity

43
Q

Adverse effects w/respiratory

A

Suppression

44
Q

Adverse effects/cardio vascular

A

Hypotension and slow pulse

45
Q

Adverse effects w/ GI

A

Decreased activity
Nausea
Vomiting

46
Q

Malignant hyperthermia

A

Antidote:dantrolene

47
Q

Topical/local anesthetic

A 
NOT be absorbed systemically 
Topical administration 
Infiltration 
Field block
Nerve block-epidural
IV regional anesthesia 
Pain pump
48
Q

Esters

A

Benzocaine
Procaine
Tetracaine

49
Q

Amides

A

Bupivacaine
Dibucaine
Levobupivacaine
LIDOCAINE-xylocaine EMLA MODERATE ACTING

50
Q

Spinal anesthesia

A

Need to monitor respiration’s and BP

Complication: terrible headache

51
Q

Neuromuscular junction

A

Point at which motor neuron communicates with skeletal muscle fiber, and results in muscle contraction

52
Q

Neuromuscular junction

A

Dynamic balance of excitatory and inhibitory impulses results in muscle tone

53
Q

No depolarization

A

Acts as antagonists to ACh at NMJ and prevents depolarization of muscle cells

54
Q

Depolarization

A

Acts as ACh agonist causing stimulation of muscle cell and preventing it from repolarizing

55
Q

Nondepolarizing NMJ blockers 1

A

PANCURONIUM GENERIC

56
Q

Actions and indications of no depolarization blockers

A

Adjunct to general aesthetic during surgery when reflex muscle movement could interfere w/ procedure or delivery of gas
Facilitate mechanical intubation by preventing resistance to passing of endotracheal tube
Facilitate endoscopic diagnostic procedures when reflex muscle reaction would interfere
Facilitate electroconvolsuive therapy when intense skeletal muscle contraction

57
Q

No depolarization blockers pharmacokinetics

A

Compete with ACh for a receptor site
Metabolize in serum, dependent on liver for plasma
Excreted in urine
Differing onset/duration

58
Q

Contraindications on NMJ blockers

A

Allergy
Myasthenia graves
Renal and haptic disease

59
Q

Adverse effects of NMJ blockers

A 
Muscle paralysis
Hypotension
Cardiac arythmias
Gi dysfunction 
Pressure ulcers
60
Q

Drug drug interactions

A 
Halogenated hydrocarbon anesthetics 
Aminoglycoside antibiotics 
Ca channel blockers
Xanthines
Alkaline solutions
61
Q

Drug herb interactions

A

Valerian
Melatonin
Kava

62
Q

Depolarization action/indication

A

Attaches ACh receptor sites on muscle cell causing prolonged depolarization
Rapid onset short duration

63
Q

Pharmacokinetics depolarization

A

Metabolized in serum by liver
Produced by plasma chokinesterates
Excreted in urine
Crosses plasma

64
Q

Contraindications depolarization

A 
Same as no depolarization 
Fractures
Narrow angle glaucoma
Penetrating eye injuries
Paraplegia
65
Q

Advertise effects depolarization

A

Muscle pain

MALIGNANT HYPERTHERMIA-Danrolene

66
Q

CNS stimulants UPPERS

A

Amphetamines-stimulate cerebral cortex
Anorexiants-center in hypothalamic and limbic areas of brain
Analeptics and caffeine-respiration’s in brain stem and medulla
Medically approved:narcolepsy, respiratory distress, and ADHD

67
Q

Narcolepsy

A

MODAFINIL-provigil

68
Q

Anorexiante :Obesity

A 
Prescriptive anorexiants
Part of weight loss plan under care of medical provider -
-benzphentamine HCI
-diethylpropion HCI
-phentermine
-phentermine plié topiramate
69
Q

Pain

A

Sensory and emotional experience assoc with actual or potential tissue damage
Can be acute or chronic

70
Q

Drugs used to relieve pain

A

Narcotics:opium derivatives used to treat many types

Anti migraine drugs:reserved for treatment of migraine headaches

71
Q

Gate control theory

A

Sensory and emotional experience
Transmission of these impulses can be modulated or adjusted
Interneurons acts as “gates”
Factors:learning experiences, cultural expectations, individual tolerance, placebo effect…activate descending inhibitory nerves from upper CNS

72
Q

Opioid receptors

A

CNS
Nerves in the periphery
Cells in the GI tract

73
Q

Narcotic Agonist 1

A 
drugs that react with opioid receptors
Cause analgesia, sedation, or euphoria 
Potential for physical dependence 
Controlled substance 
Rising problem of addiction
74
Q

Narcotic agonist actions

A

Act at specific opioid receptor site sin CNS

Produce analgesia sedation and sense of well being

75
Q

Narcotic agonist indication

A

Relief of severe acute or chronic pain
Analgesia during anesthesia
Cross placenta

76
Q

Narcotic agonists pharmacokinetics

A

IV most reliable way to achieve therapeutic response
IM and SubQ to absorb varies between sex
Hepatic metabolism and generally excreted in Urine and bile

77
Q

Narcotic agonist contraindications

A

Known allergy
Pregnancy, labor, lactation
Diarrhea

78
Q

Opiates

A

Morphine
Opium
Codeine

79
Q

Synthetic opioids

A 
Oxycodone
Hydrocodone
Meperidine
Hydromorphone
Fentanyl 
Tramadol
Methadone
80
Q

Narcotic analgesics

Adverse effects

A 
Respiratory depression
Nausea 
Orthostatic hypotension
Drowsiness and confusion
Constipation
Urinate retention
Naive VS tolerant and dependent
81
Q

Narcotic analgesics contraindications

A

Head injuries and increased intracranial pressure
Respiratory disorders
Shock or hypotension

82
Q

Adjuvant therapy

A

Anti seizure meds-gabapentin
Antidepressants-tricyclics
Corticosteroids
Local anesthetics-lidocaine

83
Q

Narcotic agonist-antagonist

A

Pentazocaine
Nalbuphine HCl
Butorphanol
Buprenorphine

84
Q

Opioid antagonist actions

A

Drugs that bind strongly to opioid receptors but they do not activate the receptors
Reverse effects of opioids

85
Q

Opioid antagonist indication

A

Reverse of the adverse effects of narcotics

Treat narcotic and or alcoholic dependence

86
Q

Cluster headaches

A

Begins during sleep, involve sharp steady eye pain, sweating, tearing, nasal congestion

87
Q

Tension headaches

A

Occur of times of stress, dull band of pain around entire head

88
Q

Prevention treatment for migraine and cluster

A

Beta adrenergic blockers-propranolol, atenolol

Anticonvulsant-valproic acid,gabapentin,topiramate

89
Q

Chemical impairment of nurses

A

10-15% have substance abuse problem

3-6% demonstrate impaired practice b/c of drugs

Pharmacology Exam 2 (2 decks)

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