CNS stimulants Flashcards
If a patient is showing increased activity of the central nervous system what will the nurse assume the patient may have in their system?
a. depressants
b. stimulants
c. H2O
b. stimulants
stimulants typically enhance neuronal excitationwhile a few will suppress neuronal inhibition.
In doses high enough, all stimulants can cause a seizures.
What two diagnoses will the nurse contribute to stimulants?
a. HBP and HTN
b. Hyperipidemia and HTN
c. ADHD and Narcolepsy
d. Shock and CVD
c. ADHD and Narcolpsy
primary clinical applications of stimulants
ADHD is a psychiatric condition that develops during what age?
a. childhood
b. middle age
c. early adulthood
d. elderly
a.childhood
ADHD is characerized by inattention, hyperactivity/impulsivity. True or false.
True.
It could also be a combination of both and is dx by pt history.
The Amphetamine, Adderall is used to treat a patient with what Dz? select all that apply.
a. ADHD
b. Narcolepsy
c. heart attack
d. stroke
a. ADHD
b. Narcolepsy
Increases DA and NE (central & peripheral) by reversing the transporter through inhibiting storage
Amphetamine
Based on the molecular structure of Amphetamine, how does dextroamphetamine effect patients?
a. more potent
b. less potent
c. pro-drug - vyvanse
d. analog of dextroamphetamine
a. more potent
Based on the molecular structure of Amphetamine, how does levoamphetamine effect patients?
a. more potent
b. less potent
c. pro-drug - vyvanse
d. analog of dextroamphetamine
less potent
Based on the molecular structure of Amphetamine, how does listdexamamfetamine troamphetamine effect patients?
a. more potent
b. less potent
c. pro-drug - vyvanse
d. analog of dextroamphetamine
pro-drug - vyvanse
Based on the molecular structure of Amphetamine, how does methampheamfetamine effect patients?
a. more potent
b. less potent
c. pro-drug - vyvanse
d. analog of dextroamphetamine
d. (analog of dextroamphetamined
pharmacological effects of Amphetamine
- Increased focus, wakefulness, mood, and initiative
- Sympathetic effects: dose-dependent increase in heart rate, AV conduction, force of contraction, and blood vessel tone
- Tolerance develops overtime
People who take Amphetamine for years can develop a physical dependence to the drug, but the nurse knows that is the patient was to stop taking it the patient can develop what syndrome?
abstinence syndrome
- Amphetamine, adderall has a high potential for abuse
The nurse should advise a pt who takes Amphetamine and is experiencing insomnia and restlessness to do what?
avoid late dosing and mixing with caffeine
The nurse should advise a pt who takes Amphetamine and is experiencing weight loss to do what?
morning doses should be taken after breakfast, last daily dose should be taken early in the afternoon
The pt who takes was just placed on Amphetamine and has a hx of heart conditions should be told to do what?
educate patients to monitor and notify their HCP if issues develop (dysrhythmias, angina, palpitations, hypertension)
The nurse should advise a pt who takes Amphetamine and is experiencing paranoid psychosis to do what?
D/C the drug
Methylphenidate
first line agent in ADHD
NONSTIMULANT
Atomoxetine
- used when stimulants fail
- increases norephineprine
Atomoxetine interacts with what drugs, causing a hypertensive crisis therefore needs 3 weeks between the agents?
a. Barbituates
b. NSAIDS
c. MAOI
d. LOL
C. MAOI
Monoamine oxiase inhibitors
MAOI’s: Isocarboxazid, Phenelzine, Selegiline patch
Modafinil is the first line agent in what disorder?
a. ADHD
b. Insomnia
c. BPD
d. Narcolepsy
d. Narcolepsy
Neonatal apnea
Caffeine, or methylxanthine can be given to babies whoe are having trouble with their breathing bc it helps promote the natrual breathing response.
dialates bronchial smooth muscle (theophylline) and stimulates the CNS
Abuse
Use of an agent inconsistent with medical need
Addiction
Use of an agent despite physical, psychologic, or social harm
,
,
,
,
,
prevention is always better that treatment. True or false.
true.
common drugs of abuse
- alcohol
- nicotine
- marijuana
- opioids
- bendodiazepines, barbiturates
- psychostimulants
- inhalants
Consuming Alcohol can pose adverse effects such as liver damage, cancer, and alcohol-related behaviors. True or false?
True.
A pt arrived to the ER for alchol intoication but is complain of pain. What medication should the nurse avoid?
Acetaminophen
Acute alcohol overdose is charaterized by vomiting, coma, respiratory depression, hypotension therefore the nurse know what about the pt?
they are a high risk for aspiration
Tolerance
Cross-tolerance occurs with other CNS depressants – but not opioids
severe alcohol withdrawl can reresult in death. True or false.
True.
A patient is having a hard time staying sober and maintaining their alcohol abstinence. What can the nurse assume the HCP will order?
a. Naltrexone
b. Acetaminophen
c. Motrin
d. Altepase
a. Naltrexone
Physical dependence
Cross-dependence occurs with other CNS depressants – but not opioids
What is the #1 culprit for preventable illness and premature death?
a. alcohol
b. opioids
c. marijuana
d. nicotine
d. nicotine
Activation of nicotinic receptors
- Cardiovascular stimulation (sympathetic)
- Increases gastric acid secretion and GI motility (parasympathetic)
What drugs pose adverse effects of cancer, CVD, and lung disease?
Nicotine
other adverse effects:
- increases pregnancy complications
- stains teeth and nails, premature aging
The patient ask the nurse about smoking cessation products for nicotine use. The nurse may metion all of the following except:
a. Patch (NicoDerm)
b. Gum or Lozenge (Nicorette)
c. Nasal Spray or Inhaler (Nicotrol)
d. buying bulk and stopping when you run out
d. buying bulk and stoping when you run out
Nicotine toxicity
- SLUDGE
- respiratory paralysis
- rapid/weak/irregular pulse
SLUDGE
cholinergic crisis
S - Salvation
L - Lacrimation
U - Urination
D - Defication
Cholinergic medications are a category of pharmaceutical agents that act upon the neurotransmitter acetylcholine, the primary neurotransmitter within the parasympathetic nervous system (PNS).
A patient has been prescribed nicorette chewing gum and ask how to propely get the best effects from the product. Which statement indicates the nurses teaching was not effective.
a. “The gum should be chewed slowly for about 30 mins”
b. “I should avoid eating or drining 15 minutes prior and during chewing”
c. “I can chew the same amount of cigarettes I would smoke in an hour”
d. “ My mouth and throat may get sore and I may burp and have the hiccups more often, but thats normal”
c. “I can chew the same amount of cigarettes I would smoke in an hour”
The chewing gum:
- Can cause mouth and throat soreness, belching, and hiccups
- Should be chewed slowly and intermittently (about 30 minutes)
- The pt should chew one piece every 2-3 hours, less than or equal to 24 pieces in a day
- Avoid eating or drinking 15 minutes prior and during chewing
A patient has been prescribed nicorette lozenges and ask how to propely get the best effects from the product. Which statement indicates the nurses teaching was not effective.
a. “I should chew the tablet then swallow when ever I get cravings”
b. “I should Take 1 lozenge every 1-2 hours, ≤ 20 lozenges in a day”
c. “Avoid eating or drinking 15 minutes prior”
d. “ My mouth may become irritated, and I may get nauseus and have the hiccups more often, but thats normal”
a. “I should chew the tablet then swallow when ever I get cravings”
Lozenges:
- Can cause mouth irritation, dyspepsia, nausea, and hiccups
- Allow lozenge to dissolve over 20-30 minutes
- Do not chew or swallow
- Take 1 lozenge every 1-2 hours, ≤ 20 lozenges in a day
- Avoid eating or drinking 15 minutes prior
Transdermal Patches
- Can cause some itching and burning under the patch
- Apply once a day to clean, dry, non-hairy skin
- Rotate application sites daily, do not re-use sites for at least 1 week
Nicotine Inhaler
- Can cause dyspepsia, coughing, through irritation, oral burning, and rhinitis
- Puffing should occur over 20 minutes and the cartridge discarded
- Patients usually start with 6-16 cartridges a day
- Should not be used in patients with asthma
contraindicated in ppl w/ asthma
helps with the satisfation of smoking without getting into the lungs, it is geting mouth
Nicotine Nasal Spray
Nicotine levels rise rapidly
Opioids
- if a pt is prescribed an opioid and wants to take it, you do not have the right to decide not to give it to them
- ## Opioid abstinence syndrome is rarely fatal, but have alot of adverse effects
Benzodiazepines and Barbiturates, which has a high risk of death?
Barbiturates
psychostimulants
Mehtamphetamine
Increase NE and DA release for wakefulness, elevated mood, increased physical and mental capacity
