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Pharmacology > CNS Drugs > Flashcards

CNS Drugs Flashcards

1
Q

What are three classes of CNS stimulants?

A

Amphetamines
Analeptics
Anorexiants

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2
Q

What is the primary use for amphetamine like drugs?

A

Tx ADHD and narcolepsy

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3
Q

List two drugs that treat narcolepsy

A

Modafinil

Armodafinil

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4
Q

What is the primary use of analeptics

A

Stimulate respiration in newborns and reversal of respiratory distress

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5
Q

What is the primary use of anorexiants

A

Help suppress appetite in obese persons

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6
Q

What class of drug is Doxapram?

A

Analeptic

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7
Q

What are 3 different classes of sedative hypnotics (CNS depressants)?

A

Barbiturates
Benzodiazepines
Non-Benzodiazepines

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8
Q

What are the four types of barbiturates and their primary use?

A 
Ultra short- acting (used as general anesthetic) 
Short acting (induce sleep but may cause person to wake early) 
Intermediate acting (induce and sustain sleep) 
Long acting (used for epileptic seizure control)
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9
Q

Name an ultra short acting barbiturate.

A

Thiopental

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10
Q

Pentobarbital and secobarbital are examples of _____?

A

Short acting barbiturates

They induce sleep but may cause the person to wake early.

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11
Q

Butabarbital is an example of a _____?

A

Intermediate acting barbiturate

Used to induce and sustain sleep

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12
Q

Phenobarbital is an example of a ____?

A

Long acting barbiturate used to control epileptic seizures

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13
Q

what is the primary use of benzodiazepines? Give an example

A

Temazepam

May be used to reduce anxiety and treat insomnia

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14
Q

What may be a use for non-benzodiazepines? Give an example

A

Treat short term insomnia

Zolpidem

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15
Q

What are the four different mechanisms by which anticonvulsants (antiepileptics) act?

A
  1. Suppress sodium influx
  2. Suppress Calcium influx
  3. Enhance action of GABA
  4. Promote the release of GABA
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16
Q

What is the mechanism of action of amphetamine like drugs?

A

Stimulate the release of norepinephrine and dopamine

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17
Q

What is the use of amphetamine like drugs?

A

Inc. wakefulness in narcolepsy
Inc. attention span/ cognition
Dec. hyperactivity, impulsiveness, and restlessness in ADHD

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18
Q

Action and use of Methylphenidate; what class of drug

A

Increase attention span and decrease impulsivity

Amphetamine (CNS stimulant)

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19
Q

A person taking methylphenidate should be advised to avoid taking _____. Why?

A

Caffeine because it may increase the effects of the drug

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20
Q

What are the potential side effects of Methylphenidate?

A

Tachycardia, palpitations, dizziness, HTN, sleeplessness, restlessness, nervousness, tremors, irritability, anorexia, dry mouth, N/V, diarrhea, weight loss.

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21
Q

What nursing interventions should be implemented for a person taking Methylphenidate?

A 
Give before breakfast and lunch 
Report irregular heart beats
Record, ht, wt, & growth in kids
Avoid alcohol and caffeine
Use sugar free gum to relieve dry mouth
Do not stop taking abruptly 
Utilize counseling
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22
Q

What is the primary use of doxapram?

A

Stimulate respiration in newborns/ reverse respiratory distress

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23
Q

SE of Doxapram and other analeptics?

A

Restlessness, tremors, twitching, palpitations, insomnia, tinnitus, nausea, diarrhea, psychological dependence

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24
Q

Give an example of an anorexiant. What is it’s action?

A

Dextroamphetamine

Suppresses appetite

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25
Q

SE of dextroamphetamine

A

Nervousness, restlessness, irritability, palpitations, HTN

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26
Q

SE of sedative hypnotics

A
  • residual drowsiness (hangover effect)
  • drug dependence
  • drug tolerance
  • excessive depression
  • respiratory depression
  • withdrawal symptoms
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27
Q

Drug interactions of sedative hypnotics

A

Alcohol and other CNS depressants

28
Q

Nursing interventions for sedative hypnotics

A
  • advise nonpharmacologic methods first
  • take 15-45 min before bed
  • report hangover effect
  • be attentive to safety
  • avoid alcohol & other CNS depressants
  • monitor BP, P
  • monitor for withdrawal symptoms
29
Q

What is the action of barbiturates

A

Enhance the action of GABA

30
Q

Action and use of benzodiazepines

A

Enhance the action of GABA; used to reduce anxiety & treat insomnia

31
Q

Temazepam

A

CNS depressant
Benzodiazepine
Used to reduce anxiety and treat insomnia

32
Q
  • barbital
A

Barbiturates

33
Q

Anticonvulsants that suppress Na influx

A

Phenytoin, fosphenytoin, Carbamazepine, valproic acid

34
Q

Anticonvulsants that supress Ca2+ influx

A

Valproic acid

35
Q

Anticonvulsants that enhance action of GABA

A

Barbiturates & Benzodiazepines

36
Q

Anticonvulsants that promote GABA release

A

Gabapentin

37
Q

Class of drugs that are a CNS depressant and anticonvulsant

A

Hydantoins

38
Q

For what persons is phenytoin contraindicated? What patient education should be implemented?

A

Contraindicated in pregnancy

Teach patients to use additional contraceptives

39
Q

Side effects of Phenytoin

A

Gingivitis, gingival hyperplasia, nystagmus, HA, diplopia, dizziness, slurred speech, decreased coordination, thrombocytopenia

40
Q

Nursing interventions for persons taking Phenytoin

A

Shake suspension well, monitor serum levels, instruct to use additional contraceptives, do not discontinue abruptly, frequent oral hygiene and checkups, teach to take Rx same time every day, warn of harmless pinkish red or brown urine; teach safety.

41
Q

Gold standard for status epilepticus (continued seizure state)

A

Diazepam

42
Q

What precautions should be implemented when administering diazepam

A

Admin slowly to prevent HTN and respiratory depression

43
Q

What drugs are included in treatment for Parkinsonism

A

Anticholinergics, dopaminergics

Dopamine agonists, MAOB inhibitors, and COMT inhibitors

44
Q

What is the action of anticholinergics for treating parkinsonim

A

Blocks cholinergic receptors to decrease muscle rigidity

45
Q

What is the action of dopaminergics

A

Convert to dopamine

46
Q

Action of dopamine agonists

A

Stimulate dopamine receptors

47
Q

Action of MAOB inhibitors

A

Inhibit MAOB enzyme from breaking down dopamine

48
Q

Action of COMT inhibitors

A

Inhibit the COMT enzyme that inactivates dopamine

49
Q

What class of drug is carbidopalevodopa? What is its action and potential SE?

A
  • carbidopa prevents levodopa from being metabolized before reaching the brain
  • levodopa crosses BBB and is converted to dopamine

Dopaminergic

SE include N/V, dystonic movements, and psychosis

50
Q

What class of drug is Amantadine. What is its action and use?

A

Amantadine is a dopamine agonist so it will stimulate dopamine receptors. It’s used to treat Parkinsonism as drug tolerance develops and improves symptoms.

51
Q

Nursing interventions with antiparkinsonism drugs

A 
Monitor for orthostatic HTN
Avoid alcohol and other depressants 
Don’t abruptly stop taking 
Warn of harmless brown color of sweat/ urine 
Assess for suicidal thought
Monitor blood cell count
Monitor liver & kindney function
52
Q

Characteristics of Alzheimers disease

A 
Progressive and degenerative 
Formation of neuritic plaques
Presence of neurofibrillary tangles 
Cholinergic NT abnormality 
No cure only slow progression
53
Q

List two cholinesterase inhibitors used to treat Alzheimer’s

A

Donepril

Rivastigmine

54
Q

What is the action of Rivastigmine and Donepril

A

Allow more ACh in neuron receptors to improve cognition

55
Q

Use of Donepril and Rivastigmine

A

Used to treat mild to moderate Alzheimer’s

56
Q

Nursing interventions to implement for Alzheimer’s treatment

A 
Monitor v/s 
Maintain consistency in care 
Monitor behavioral changes
Provide safety when wandering 
Rise slowly to avoid dizziness
57
Q

Characteristics of Myasthenia Gravis

A
  • autoimmune disease
  • lack of nerve impulses and muscle responses
  • lack of ACh reaching cholinergic receptors
  • muscular weakness and fatigue
  • respiratory muscle paralysis, ptosis, difficulty chewing and swallowing
58
Q

Cholinesterase inhibitors to treat Myasthenia gravis. What is their duration of action?

A

Neo-stig-mine (short acting)
Ed-ro-pho-nium (ultra short acting for diagnosis)
Py-rid-o-stig-mine (intermediate acting)

59
Q

Use of neostigmine and pyridostigmine

A

Control and treat MG; increase muscle strength

60
Q

Nursing interventions for medications prescribed to treat MG

A

Admin doses on time
Take drugs before meals
Monitor drug effectiveness
Have antidote (atropine) available for cholinergic crisis

61
Q

How can you tell if the patient has been overdosed or under-dosed with a cholinesterase inhibitor?

A

Administer Edrophonium for Dx
If the severe muscle weakness is improved after administration you know you have a Myasthenia crisis and were underdosed . If the muscle weakness gets worse after the edrophonium, you know you have a cholinergic crisis and will need to administer the antidote (atropine)

62
Q

Carisoprodol

A

Skeletal muscle relaxant

63
Q

Cyclobenzaprine

A

Skeletal muscle relaxant

64
Q

Methocarbamol

A

Skeletal muscle relaxant

65
Q

Nursing interventions for patients taking muscle relaxants

A 
Take with food
Monitor v/s 
Don’t drive
Do not take longer than 3 weeks 
Do not stop abruptly 
Avoid alcohol and other CNS depressants
66
Q

When is amantadine better to treat parkinsons vs. when should something like carbidopalevodopa be given.

A

Amantadine is better in the early stages of the disease before drug tolerance builds

Pharmacology (8 decks)

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