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Pharmacology In Nursing > Drugs And The Nervous System > Flashcards

Drugs And The Nervous System Flashcards

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1
Q

What is the basic function of the NS?

A

Recognise changes in the internal and external environment
Process and integrate environmental changes that are perceived
Reactive to the environmental changes by producing an action or response

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2
Q

What is the difference between inhibitory and excitatory?

A

Inhibitory: slows down
Excitatory: speeds up

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3
Q

Name the neurotransmitters in the brain.

A

Excitatory: noradrenaline, dopamine, glutamate, 5-HT, AcH

Inhibitory; GABA, Glycine

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4
Q

What are the six drugs that mainly act upon the nervous system?

A 
Anaesthetis
Anxiolytics/hypnotics
Neuromuscular blockers
Anti Parkinson's
Anti convulsants 
Anti depressant
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5
Q

Why use anaesthetics?

A 
Promote:
1 analgesia
2 unconsciousness 
3 amnesia
4 loss of reflexes

To much of it can lead to death

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6
Q

What are general anaesthetics?

A

Act mainly on the CNS
may be given via inhalation or IV
Person unconscious

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7
Q

How does anaesthetics work?

A

1 work in the CNS to promote insentivity
2 usually fat soluble and so can cross blood brain barrier
3 may act on the membrane receptors to reduce excitation of neurones
4 may affect ion channels

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8
Q

What are the typical side effects of anaesthetics?

A 
Nausea/ vomiting
Breathing shallow/rapid
Decrease blood pressure/ CO
Decrease kidney perfusion
Loss of temperature control
Crosses placenta
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9
Q

What are the two phases of anaesthesia?

A

Induction: usually IV

Maintenance: usually inhalation

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10
Q

What are the four stages of anaesthesia?

A

1- analgesia
2- excitement
3- surgical anaesthisia- skeletal muscle relaxation/ loss of reflexes
4- medullary paralysis- loss of respiratory/ VMC

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11
Q

What are the four types of general anaesthesia?

A

Gases
Barbiturates
Non-barbiturates
Volatile liquids

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12
Q

What is n20?

A

Nitric oxide- laughing gas
Used in maintaining anaesthesia with oxygen
Used in combination with other drugs
Potent analgesic
Low level long term exposure may damage foetus

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13
Q

Other inhaled general anaesthetics?

A

Isoflurane
desflurane
sevoflurane

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14
Q

How is anaesthetics controlled?

A

Death of anaesthesia is controlled by varying concentration of vapour

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15
Q

What are the side effects of anaesthesia?

A

CV depression
hypotension
Arrhythmia
Can decrease CSF pressure

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16
Q

What are the commonly used IV anaesthetics drugs?

A

1- Propofol: non-barbiturate, rapid action, rapid recovery without hang over, may cause convulsions/ anaphylaxis

  1. Thiopental (thiopentone): barbiturate, useful for brief procedures, rapid awakening, long lasting, sedation problems
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17
Q

What other drugs are used as general IV anaesthetics?

A
  1. Etomidate: no hangover effect, less hypotension, muscle movements, suppression of adrenocorticol function
  2. Ketamine: shocked patients, increased heart rate and blood pressure, hallucination during recovery
18
Q

Name the 6 drugs used in surgery.

A 
Bezodiapines: anxiolytics, hypnotics
Neuroleptics and anti-emetics
Analgesics usually opioids
Antihistamines 
Anticholinergics (atropine, hyoscine)
19
Q

What help ends when you increase the doses of benzodiapines?

A

Anxiety
Sedation
Hypnosis

20
Q

Explain the use of benzodiapines.

A

Oral, IV, IM or rectal
I.e, midazolam- pre med. 20 mins before surgery, can be used in children
Temazepam, diazepam, prior to dental treatment
Doesn’t cause excessive sedation in low doses
Causes amnesia
No analgesic effect
Hypotension
Constipation

21
Q

What is the mechanism of action for benzodiazepines?

A

It increases GABA in the brain at the post synaptic cell

22
Q

What are disadvantages of benzodiapines?

A

Dependence
Respiratory depression
Interacts with alcohol
Crises the placenta

23
Q

What does neuromuscular blocking drugs do?

A 
They are muscle relaxants 
Block transmission in motor nerves
Reduces the need for very deep anaesthesia
Relaxes vocal cords, tracheal tube 
Requires assisted respiration
Prolonged muscle paralysis/pain
Histamine release--bronchospasm
24
Q

What are AcH antagonists?

A

Non-depolarising blockers
They compete with AcH with nicotine content receptors at neuromuscular junction

I.e. atracurium-rapid, short acting.
Pancuronium- longer acting

25
Q

How do we reverse the effects of AcH antagonist?

A

Increase AcH concentration by inhibiting acetylcholinesterase I.e, Neostigmine

26
Q

What are AcH agonist?

A

Depolarising blockers
Mimic AcH but produce sustained depolarisation of muscle- paralysis
They are short acting unless given via drip I.e. Suxamethonium

Suxamethonium is metabolised by psudocholinesterase enzyme

27
Q

How does narcotics work?

A

Act on the CNS- the opioid receptors- to relieve pain
Euphoric
I.e. Fentanyl, alfentanil, remifentanil, morphine

28
Q

What are the side effects of narcotics?

A

Nausea , vomiting
Addiction
Reduce respiration

29
Q

When is local anaesthesia used?

A

Used for analgesia, paralysis

Act on specific nerve pathways, are short acting

30
Q

What is the mechanism of action for LA?

A

Blocks transmission of nerve impulses carrying pain signals from Nociceptors to the brain

Used in minor surgical procedure

31
Q

What is the cellular mechanism of action?

A

Inhibits sodium entry through the v sensitive sodium channels, blocking transmission of nerve impulses

I.e, blocks signal message

32
Q

What are the common methods of administration?

A

Epidural- injection into the epidural space which affects the nerve roots

Intradermal/ topical- relieves minor irritation or superficial pain.

33
Q

What are the commonly used local anaesthesia?

A

Lidocaine- lignocaine- wider,y used, dental surgery, treat premature ejaculation

Prilocaine- misused with lidocaine in a cream (EMLA), surface anaesthesia

LA- end in ‘Caine’

34
Q

What are the side effects of LA?

A 
Caused by anaesthetics reading brain and heart 
Hypersensitivity
Abnormal heart rate
Restlessness
Convulsions
Cardiac arrest in severe cases
35
Q

What are vasoconstrictor drugs?

A

Enhance potency and prolong duration of action
Increase safety margin (reduce toxicity)
Reduce local blood flow (less blood loss during surgery)

I.e. Adrenaline and felypressin

36
Q

Name other drugs that work in the NS.

A

1- antidepressants: increase levels of excitatory neurotransmitters in the brain

2- antiparkinsons: increase levels if dopamine neurotransmitter

  1. Anticonvulsants: treat epilepsy, reduces the conduction of excitatory nerve impulses and,or increasing GABA activity
37
Q

What are the main types of antidepressants:

A
  1. TCAs
  2. SSRIs
  3. MAOIs
38
Q

Example of TCAs drugs and its side effects.

A

Imipramine
Nortriptline
Doxipin

Dry mouth, blurred vision, constipation, urinary retention, arrhythmias, mental confusion, sedation

39
Q

Example of SSRIs and side effects

A

Fluoxetine
Citalopram
Sertraline
Paroxetine

Headaches, Nausea, diarrhoea, convulsion, dizziness

40
Q

Example of MAOIs and side effects

A

Phenelzine, tranlcypromine

Nausea, dizziness, insomnia

Interacts with tyramine-containing foods
-red wine, cheese, marmite

41
Q

What constitutes the nervous system?

A

The CNS: brain and spinal cord
PNS- all nervous tissue outside the CNS
ANS- sympathetic and parasympathetic

Pharmacology In Nursing (11 decks)

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