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Pharmacology Final Exam > CNS Depressants, Stimulants, & Anticonvulsants > Flashcards

CNS Depressants, Stimulants, & Anticonvulsants Flashcards

1
Q

Nonpharmacologic Management of insomnia

A
  • Arise @ specific hr every morning
  • Avoid daytime naps
  • Warm fluids
  • Avoid caffeine 6hrs before bed
  • Avoid heavy meals & exercise before bed
  • Avoid loud sounds
  • Warm bath, reading, & listening to music
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2
Q

Benzodiazepines (“lams & Pams”)

Describe:
- Mechanism of Action
- Indication
- Contraindication
- Side effects
- OD Management

A
  • Depresses CNS Activity in CNS by stimulating GABA receptors in brain
    (Indications): Insomnia, Anxiety, Seizures, Muscle spasms, Anesthesia, Status Epileptics

(Contraindictions): Allergy, Pregnancy, Narrow angle-glaucoma, CNS Depressants (Alcohol, Opioids), Kava-kava, Valerian, Grapefruit

(Side effects): Cognitive impairment, amnesia, confusion, drowsiness, dizziness, hangover effect

(OD Management): Antidote (Flumazenil), Provide airway, Vasopressor

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3
Q

Zolpidem

Describe:
- Mechanism of Action
- Indication
- Contraindication
- Side effects
- Pharmacokinetics

A

Non-Benzodiazepine

(MOA): CNS depression, binds to GABA receptors in brain

(Indication): Insomnia

(Pharmacokinetics): 6-8hr duration (2-3hr short life)

(Side effect): Agitation, Tolerance, dependence, Binge-eating, Cognitive impairment (Cognitive sleep behavior), Drowsiness, Dizziness

Interaction: Alcohol, opioids, cns depressants, Kava-kava, Valerian

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4
Q

Nursing process for Benzodiazepines & Non-Benzodiazepines

Describe
- Assessment
- Implementation
- Teaching
- Evaluation

A

(Assessment): Drug history, Medical history, Vital signs, Renal function

(Implementation): Use bed alarm, Monitor VS & renal function, Administer at bed time, For sleep (Benzo drugs: no longer than 3-4weeks)

(Teaching): Avoid CNS depressant, alcohol, kava-kava, valerian, opioids, Do not drive, don’t stop abruptly

(Evaluation): less anxious or better rest

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5
Q

Secobarbital
Butobarbital

Describe
- Drug Class
- Indication

A

CNS Depressant (Barbiturates)
-Treats Insomnia (Short-acting intermediate)

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6
Q

Phenobarbital

Describe
- Drug Class
- Indication

A

CNS Depressant (Barbiturates)
- Treats Seizures (Long-acting)

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7
Q

Barbiturates (“barbital”)

Describe:
- Mechanism of Action
- Indication
- Contraindication
- Side effects
- OD Management

A

(MOA): Reduces nerve impulses traveling to cerebral cortex

(Indication): Insomnia, seizures, anesthesia

(Interaction): Alcohol, opioids, kava-kava, CNS depressants

(Side effects): REM sleep deprivation, Hypotension, Respiratory depression, “hang-over” effect, drowsiness, dizziness

(OD management): Maintain airway, assisting ventilation & administer O2, Fluid replacement, Vasopressor

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8
Q

Nursing process for Barbiturates

Describe
- Assessment
- Implementation
- Teaching
- Evaluation

A

(Assessments): Vital signs, Drug history, renal function/renal impairment

(Implementation): Monitor VS & Renal function, For sleep (Barbs drug: No longer than 2 weeks), Use bed alarm, Administer at bedtime

(Teaching): Avoid Alcohol, opioids, Kava-kava, valerian, CNS depressants, Do not drive

(Evaluation): Better sleep, or stops seizures

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9
Q

Cyclobenzaprine

Describe
- Drug Class
- Mechanism of action
- Indications
- Contraindication
- Side Effects
- Interactions

A

CNS Depressants (Centrally-acting muscle relaxant)

(MOA): Relaxes skeletal muscles through CNS depression

(Indication): muscle spams associated with Acute painful musculoskeletal condition (Within CNS)

(Contraindication): Severe cardiovascular disease, Hyperthyroidism

(Side effects): Hallucinations, Anticholinergic effects, orthostatic hypotension, confusion, fatigue, dizziness, & drowsiness, Serotonin syndrome

(Interactions): Alcohol, Opioids, CNS Depressants, Kava-Kava, MOAI, SSRI, SNRI

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10
Q

Dantrolene

Describe
- Drug Class
- Mechanism of Action
- Indication

A

CNS Depressant (Direct-acting muscle relaxants)

(MOA): Works directly on muscles (Contracts muscles)

(Indication): Malignant hyperthermia & Neuroleptic Malignant syndrome

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11
Q

Nursing process for Cyclobenzaprine & Dantrolene

Describe
- Assessment
- Implementation
- Teaching
- Evaluation

A

(Assessment): Vital signs, causes of muscle spasms, past medical history

(Implementation): Monitor Renal function & VS

(Teaching): Take with food, Rise slowly in stages, disregard drug after (3 weeks) Don’t stop abruptly, avoid (alcohol, opioids, kava kava, valerian, Stop drug (14 days) prior to taking MAOI, do not drive

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12
Q

Amphetamine

Describe
- Drug Class
- Mechanism of action
- Indications
- Contraindication
- Side Effects
- Interactions

A

CNS Stimulant

(MOA): Stimulates release of norepinephrine & dopamine

(Indication): Treats ADHD & Narcolepsy

(Contraindication): Cardiac abnormalities, Glaucoma, Hyperthyroidism, Parkinsonism, Anxiety, Hypertension (Hypertensive crisis)

(Side effects): Tachycardia, Palpations, Sleeplessness, Diarrhea

(Interactions): Other stimulants & MAOI

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13
Q

Methylphenidate

Describe
- Drug Class
- Mechanism of action
- Indications
- Contraindication
- Side Effects
- Interactions

A

CNS Stimulant

(MOA): Affects dopamine transport (Modulating serotangeric pathway)

(Indications): Treats ADHD

(Interaction): CNS depressants, CNS stimulants, MAOI

(Side Effects): Thrombocytopenia, Growth suppression, Tachycardia, Palpations, Hypertension, Dry mouth, Tremors, Anorexia, Weight loss, Vomiting, Sleeplessness

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14
Q

Nursing process for CNS Stimulants

Describe:
- Assessment
- Implementation
- Teaching
- Evaluation

A

(Assessments): Medical history, VS, Mental status

(Implementation): Monitor for S/s (Tachycardia, Palpations, Elevated BP, Nervousness, Restlessness), Measure child’s growth, stop drug (2 weeks) prior to MOAI)

(Teaching): Take before meals (Last dose 6 hours before bed), (Transdermal patch on for 9 hours), Avoid alcohol & caffeine, Tx for dry Mouth, Monitor weight 2x, don’t stop abruptly, eat nutritious breakfast

(Evaluation): Increased focused & longer attention span

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15
Q

Sumatriptan

Describe
- Drug Class
- Mechanism of action
- Indication
- Contraindication
- Side effects
- Interactions

A

CNS Stimulant

(MOA): Causes vasoconstriction of cranial nerves

(Indications): Treats Migraines & clustered headaches

(Contraindication): Ischemic heart attack, Previous MI, Stroke, Uncontrolled hypertension

(Side effects): Heart attack, stroke, seizures, thrombocytopenia, dysrhythmias, muscle cramps, tingling, V,D, warm sensation

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16
Q

Phenytoin

Describe
- Drug Class
- Mechanism of action
- Dosage
- Indication
- Contraindication
- Side effects
- Interactions
- Implementation
- Teaching

A

Anticonvulsant

(MOA): Suppresses abnormal neuron firing

(Dosage): 10 to 20mcg/mL

(Indication): Diminishes seizures & Treats Ventricular arrhythmias

(Contraindications) Pregnancy (Teratogenic) Newborn (Hemorrhage)

(Side effects): Gingival Hyperplasia, Hypotension, Nystagmus, Diplopia, Rash, Hypertrichosis, Ataxia, Dizziness, Seizures (>20mcg/mL)

(Interactions): CNS depressants, Warfarin, Oral contraceptives, Folic acid

(Implementation): Administered only (IV), IV push (slowly infused with NS, no faster than 50mg/min), Pad on side rails (Low position & ensure O2 flow-meter in room)

(Teaching): Brush & floss teeth 2x daily, visit dentist every 6 months, Take drug close to same time everyday, oral contraceptive are less effective (Use condoms)

17
Q

Carbamazepine

Describe
- Drug Class
- Indication
- Side effects
- Dosage
- Implementation
- Teaching

A

Anticonvulsant

(Indication): Seizures, Trigeminal neuralgia, & Bi-polar disorder

(Side effects): Ataxia, Drowsiness, Blood dyscrasias

(Dosage): 4 to 12 mcg/mL

(Implementation): Monitor CBS

(Teaching) Avoid Grapefruit

18
Q

Topiramate

Describe
- Drug Class
- Indication
- Side effects
- Dosage
- Implementation
- Teaching

A

Anticonvulsant

(Indication): Seizures, Migraine headaches, & Bi-polar disorder

(Side effects): Cognitive disorder, impaired concentration/memory, psychomotor slowing, paraesthesia, nystagmus, ataxia, sedation, fatigue, nervousness, speech problems, dizziness & drowsiness

(Dosage): 5 to 20mcg/mL

(Teaching): Do not take within 6 hrs of alcohol intake

19
Q

Valproic Acid

Describe
- Drug Class
- Indication
- Side effects
- Dosage
- Implementation
- Teaching

A

Anticonvulsant

(Indication): Treats seizures, bi-polar disorder, migraine headaches

(Side Effects): Agitation, Hepatotoxicity, Pancreatitis, sedation, insomnia, indigestion, N,V,D, Visual disturbance, tremor, headache, thrombocytopenia

(Dosage): 50 to 100mcg/mL

(Implementation): Monitor liver enzyme, Don’t administer to children under 2 yrs old (Hepatotoxicity)

20
Q

What does all anticonvulsant drugs cause?

A
  • Teratogenic properties
  • Inhibits vitamin K
  • Hypoxia during seizures
  • Loss of folic acid (Pregnancy)
  • Fever + Seizures (children 3months - 5 yrs old)
21
Q

Status Epilepticus

Describe
- Treatment

A

Continued seizure state

Tx
1. Diazepam & Lorazepam (IV)
2. Phentoin (IV)
3. Midazolam or Propofol
4. Long lasting barbiturates

Pharmacology Final Exam (3 decks)

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