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NURS 472A > Exam 3 (week 9) > Flashcards

Exam 3 (week 9) Flashcards

1
Q

What is the brand name for Levodopa/carbidopa?

A

sinemet

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2
Q

What is the pharmacological class for Levodopa/carbidopa?

A

Dopaminergic

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3
Q

what is the therapeutic class for Levodopa/carbidopa?

A

Drug for parkinson disease

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4
Q

MOA for Levodopa/carbidopa:

A
  1. increases dopamine synthesis in the striatum

2. undergoes uptake in dopaminergic nerve terminals and converted into dopamine.

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5
Q

MOA specifically for carbidopa:

A

inhibits decarboxylation of levodopa in the intestine and peripheral tissues

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6
Q

Use for Levodopa/carbidopa:

A

parkinson disease

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7
Q

Effects of Levodopa/carbidopa are dose what?

A

dose dependent

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8
Q

what are 4 adverse effects of Levodopa/carbidopa?

A
  1. nausea and vomiting
  2. dyskinesias
  3. postural hypertension
  4. psychosis
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9
Q

What is a nursing implication of Levodopa/carbidopa?

A

Inform patients that benefits of drug may be delayed for weeks to months

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10
Q

Is there a cure with Levodopa/carbidopa for parkinson disease?

A

no cure, but symptomatic relief

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11
Q

full therapeutic responses with Levodopa/carbidoda take how long to develop?

A

months

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12
Q

What is another important thing to remember with Levodopa/carbidopa?

A

acute loss of effect

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13
Q

What is the pharmacological class for donepezil?

A

Reversible cholinesterase inhibitor

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14
Q

What is the therapeutic class for donepezil?

A

Drug for Alzheimer’s disease

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15
Q

MOA for donepezil:

A
  1. Reversibly binds to cholinesterase preventing the degradation of acetylcholine by (acetyl) cholinesterase CENTRALLY.
  2. increased amount of acetylcholine available to activate receptors
  3. Enhanced transmission in central cholinergic neurons that have not yet been destroyed
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16
Q

Uses for donepezil:

A

Alzheimer’s disease

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17
Q

5 adverse effects of donepezil:

A

cholinergic effects:

  1. nausea, vomiting
  2. dyspepsia
  3. diarrhea
  4. dizziness
  5. headache
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18
Q

1 nursing implication for donepezil:

A

medication adherence is crucial

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19
Q

What does donepezil slow the loss of?

A

memory and cognition

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20
Q

What does donepezil prolong?

A

independent function

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21
Q

True or false: donepezil is a cure for alzheimer’s disease

A

false; there is no cure

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22
Q

What is the brand name of interferon beta?

A

There is no brand name

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23
Q

Pharmacological class of interferon beta:

A

disease-modifying drug: immunomodulator

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24
Q

Therapeutic class of interferon beta:

A

Drug for Multiple Sclerosis (MS)

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25
Q

MOA of interferon beta:

A
  1. enhances naturally occurring interferon.
  2. a glycoprotein that inhibits the migration of proinflammaotry leukocytes across the BBB and suppresses T-helper cell activity
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26
Q

How is interferon beta manufactured?

A

recombinant therapy

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27
Q

Use of interferon beta:

A

relapsing form of multiple sclerosis

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28
Q

3 adverse effects of interferon beta:

A
  1. flu-like symptoms
  2. hepatotoxicity
  3. myelosuppression
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29
Q

1 nursing implication of interferon beta:

A

instruct patient to store drug appropriately

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30
Q

define multiple sclerosis

A

a chronic inflammatory autoimmune disorder that damages the myelin sheath of neurons in the CNS

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31
Q

How many types of MS are there?

A

4

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32
Q

Immunomodulators are drugs used to modify what?

A

Modify disease process, treat acute relapse and manage symptoms

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33
Q

Are immunomodulators a cure for MS?

A

No

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34
Q

What is the brand name of mitoxantrone:

A

Novantrone

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35
Q

Pharmacological class of Mitoxantrone:

A

Disease-modifying drug: immunosuppressant

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36
Q

Therapeutic class of Mitoxantrone:

A

Drug for Multiple Sclerosis (MS)

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37
Q

MOA of Mitoxantrone:

A
  1. cytotoxic to all cells proliferating or not
  2. inhibits DNA and RNA synthesis
  3. promotes cross-linking and breakage of DNA strands
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38
Q

Use of Mitoxantrone:

A

multiple sclerosis

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39
Q

3 adverse effects of Mitoxantrone:

A
  1. myelosuppression
  2. cardiotoxicity
  3. fetal injury
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40
Q

1 nursing implication of Mitoxantrone:

A

educate patient to avoid others who are ill

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41
Q

What is unique about Mitoxantrone and the FDA?

A

only immunosuppressant approved by FDA for use in treatment of MS

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42
Q

Mitoxantrone has a high risk of?

A

toxicity

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43
Q

immunosuppressants are also anti what?

A

anticancer drugs

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44
Q

What is the brand name of phenytoin?

A

Dilantin

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45
Q

Pharmacological class of phenytoin:

A

hydantoin: selective inhibition of sodium channel

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46
Q

Therapeutic class of phenytoin:

A

traditional antiepileptics

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47
Q

MOA of phenytoin:

A
  1. suppression of sodium influx
  2. suppression of calcium influx
  3. promotion of potassium efflux
  4. potentiation of GABA
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48
Q

Uses of phenytoin:

A

epilepsy; partial-seizures and tonic-clonic seizures

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49
Q

What are adverse effects dependent on with phenytoin: ?

A

dose dependent

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50
Q

What are 5 adverse effects of phenytoin:

A

Dose dependent effects:

  1. CNS/neurologic
  2. dermatologic
  3. gastrointestinal
  4. cardia
  5. teratogenic
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51
Q

1 nursing implication of phenytoin:

A

educate patients on strict adherence

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52
Q

What is the abbreviation for anti epileptic drugs?

A

AEDs

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53
Q

What is the goal of anti epileptics

A

goal is to reduce seizures to an extent that enables the patient to live a normal or near-normal life

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54
Q

what are also used as anti epileptics?

A

barbiturates

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55
Q

What is the brand name for valproic acid?

A

depakote

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56
Q

Pharmacological class for valproic acid:

A

carboxylic acid: selective inhibition of sodium channels

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57
Q

Therapeutic class for valproic acid:

A

traditional antiepileptics

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58
Q

MOA of valproic acid:

A
  1. suppression of sodium influx
  2. suppression of calcium influx
  3. promotion of potassium efflux
  4. potentiation of GABA
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59
Q

use of valproic acid:

A

epilepsy

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60
Q

adverse effects of valproic acid:

A

Dose dependent effects:

  1. CNS/neurologic
  2. dermatologic
  3. gastrointestinal
  4. cardia
  5. teratogenic
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61
Q

1 nursing implication for valproic acid:

A

educate patients on strict adherence

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62
Q

What is the brand name of oxcarbazepine?

A

trileptal

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63
Q

Pharmacological class of oxcarbazepine:

A

inhibition of voltage-sensitive sodium channels

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64
Q

Therapeutic class of oxcarbazepine:

A

newer antiepileptic

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65
Q

MOA of oxcarbazepine:

A
  1. suppression of sodium influx
  2. suppression of calcium influx
  3. promotion of potassium efflux
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66
Q

Use of oxcarbazepine:

A

epilepsy

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67
Q

Adverse effects of oxcarbazepine:

A

Dose dependent effects:

  1. CNS/neurologic
  2. dermatologic
  3. gastrointestinal
  4. cardia
  5. teratogenic
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68
Q

1 nursing implication of oxcarbazepine:

A

educate patients on strict adherence

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69
Q

What is the brand name of baclofen?

A

lioresal

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70
Q

Pharmacological class of baclofen:

A

centrally-acting muscle relaxant

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71
Q

therapeutic class of baclofen:

A

drug for spasticity

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72
Q

MOA of baclofen:

A
  1. Acts within the spinal cord to suppress hyperactive reflexes involved in the regulation of muscle movement
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73
Q

Use of baclofen:

A
  1. Spasticity and/or muscle spasm caused by MS, Cerebral Palsy (CP), spinal cord injury, stroke, and other disorders
  2. Malignant hyperthermia
74
Q

Adverse effects of baclofen:

A
  1. CNS depression

2. gastrointestinal effects

75
Q

1 nursing implication of baclofen:

A

education patient not to stop medication abruptly

76
Q

Drugs used to treat spasticity do not relieve what?

A

do not relieve acute muscle spasm and vice versa

77
Q

What do you want to consider with drugs for muscle spasm:

A

physical dependence

78
Q

What is the brand name of dantrolene?

79
Q

Pharmacological class of dantrolene:

A

direct-acting muscle relaxant

80
Q

Therapeutic class of dantrolene:

A

drug for spasticity

81
Q

MOA of dantrolene:

A
  1. Acts directly on skeletal muscle by suppressing release of calcium for the sarcoplasmic reticulum
82
Q

Use of dantrolene:

A
  1. Spasticity and/or muscle spasm caused by MS, Cerebral Palsy (CP), spinal cord injury, stroke, and other disorders
  2. Malignant hyperthermia
83
Q

Adverse effects of dantrolene:

A
  1. CNS depression

2. gastrointestinal effects

84
Q

1 nursing implication of dantrolene:

A

educate patient not to stop medication abruptly

85
Q

What is the brand name for haloperidol?

A

Generic only!

86
Q

Pharmacological class of haloperidol:

A

butyrophenone: dopamine2 receptor blockade

87
Q

Therapeutic class of haloperidol:

A

first-generation antipsychotic (FGA)

88
Q

MOA of haloperidol:

A
  1. block several kinds of receptors within and outside of CNS
  2. strong blockade of dopamine 2 receptors in the CNS
89
Q

Uses of haloperidol (4):

A
  1. schizophrenia (delusional disorders, bipolar disorder, depressive psychoses, drug-induced psychoses)
  2. suppress emesis
  3. Tourette’s syndrome
  4. huntington’s chorea
90
Q

Adverse effects of haloperidol:

A
  1. extrapyramidal symptoms (EPS) - serious movement disorders
  2. neuroleptic malignant syndrome
91
Q

1 nursing implication of haloperidol:

A

educate patient on early signs of movement disorders

92
Q

True or false: first-generation antipsychotics are conventional

93
Q

what are first-generation antipsychotics also known as:

A

neuroleptics

94
Q

how are first-generation antipsychotics classified:

A

by potency: high, medium, low. By chemistry

95
Q

What kind of relief do first-generation antipsychotics provide:

A

symptomatic relief, no cure

96
Q

What is the brand name of clozapine?

97
Q

Pharmacological class of clozapine:

A

Dopamine and serotonin (5-HT) receptor blockade

98
Q

Therapeutic class of clozapine:

A

second-generation (atypical) antipsychotic (SGA)

99
Q

MOA of clozapine:

A
  1. block several kinds of receptors within and outside of CNS
  2. moderate blockade of dopamine receptors
  3. strong blockade of serotonin (5-HT) receptors
100
Q

Uses of clozapine:

A
  1. schizophrenia

2. bipolar disorder

101
Q

4 adverse effects of clozapine:

A
  1. sedation
  2. agranulocytosis
  3. metabolic effects
  4. low risk of EPS
102
Q

1 nursing implication of clozapine:

A

monitor hematologic blood plasma levels

103
Q

What type of antipsychotics are second-generation antipsychotics?

A

atypical antipsychotics

104
Q

What is the brand name of fluoxetine?

105
Q

What is the pharmacological class of fluoxetine?

A

selective 5-HIT reuptake inhibitor: SSRI

106
Q

What is the therapeutic class of fluoxetine?

A

antidepressant

107
Q

MOA of fluoxetine:

A

Selectively blocks neuronal reuptake of serotonin (5-HT) increasing the concentration of serotonin in the synapse

108
Q

therapeutic uses of fluoxetine:

A
  1. major depression
  2. bipolar disorder
  3. panic disorder
  4. OCD
  5. Generalized anxiety disorder
  6. bulimia nervosa
  7. premenstrual dysphoric disorder
109
Q

Adverse effects of fluoxetine:

A
  1. sexual dysfunction
  2. weight gain
  3. serotonin syndrome
110
Q

Nursing implication of fluoxetine

A

Educate patient and family on suicide risk

111
Q

What is the time course of response for SSRIs

A

slow time; weeks to months

112
Q

What can abrupt discontinuation of SSRIs cause?

A

it can cause withdrawal syndrome

113
Q

What are used as adjunct to SSRIs?

A

non-drug therapies

114
Q

What is the brand name for venlafaxine?

115
Q

What is the pharmacological class of venlafaxine?

A

5-HT/norepinephrine (NE) reuptake inhibitor: SNRI

116
Q

What is the therapeutic class of venlafaxine?

A

antidepressant

117
Q

MOA of venlafaxine:

A

Block neuronal reuptake of serotonin (5-HT) and norepinephrine (NE)

118
Q

Therapeutic uses of venlafaxine:

A
  1. major depression
  2. generalized anxiety disorder
  3. social anxiety disorder (social phobia)
119
Q

Adverse effects of venlafaxine:

A
  1. Nausea
  2. Headache
  3. Anorexia
  4. Nervousness
  5. Sweating
  6. Somnolence
  7. Insomnia
120
Q

nursing implications of venlafaxine:

A

educate patient and family on suicide risk

121
Q

What is the brand name of phenelzine:

122
Q

MOA of phenelzine:

A

Irreversibly inhibit MAO-A in nerve terminals, increasing the amount of NE serotonin available for release

123
Q

Therapeutic use of phenelzine:

A

Atypical depression (for patients who have not responded to any other drug treatments)

124
Q

adverse effects of phenelzine:

A
  1. hypertensive crisis triggered by foods high in tyramine

2. CNS stimulation

125
Q

1 nursing implication of phenelzineu:

A

Educate patient and family on suicide risk

126
Q

What is an enzyme found in the liver, the intestinal wall and terminal of monoamine- containing neurons:

127
Q

Function of MAO:

A

to convert monoamine neurotransmitters into inactive products

128
Q

What is similar with SSRIs and SNRIs and TCAs and MAOIS and atypical antidepressants:

A

the additional info:

  1. Slow time course of response—weeks to months
  2. Abrupt discontinuation can cause withdrawal syndrome
  3. Non-drug therapies used as adjunct
129
Q

What is the brand name of lithium:

130
Q

Pharmacological class of lithium:

A

Mood stabilizer

131
Q

Therapeutic class of lithium:

A

drug for bipolar disorder

132
Q

MOA of lithium:

A
  1. MOA unclear
  2. alters glutamate uptake and release
  3. blocks the binding of serotonin to its receptors
  4. and/or inhibits glycogen synthase kinase-3 beta
133
Q

Use of lithium:

A

bipolar disorder

134
Q

effects of lithium:

A
  1. effects based on lithium levels

2. teratogenic

135
Q

1 nursing implication of lithium:

A

promote adherence

136
Q

What are two other class of drugs used to treat bipolar disorder:

A
  1. antipsychotics

2. antidepressants

137
Q

what is the brand name of diazepam?

138
Q

MOA of diazepam:

A
  1. Depress neuronal function at multiple sites in the CNS
  2. Weak respiratory depression
  3. Benzodiazepine receptor agonist
  4. Potentiate actions of gamma-amino-butyric acid (GABA), an inhibitory neurotransmitter
  5. Not direct GABA agonist, enhances the effects of GABA
139
Q

Uses of diazepam:

A
  1. Anxiety
  2. Insomnia
  3. Seizure disorders
  4. Induce general
    anesthesia
  5. Muscle spasms
  6. Withdrawal from
    alcohol
140
Q

adverse effects of diazepam:

A
  1. CNS depression
  2. Paradoxical effects
  3. Low risk of
    tolerance and physical dependence
141
Q

1 nursing implication of diazepam:

A

warn patients against abrupt withdrawal

142
Q

what is a drug that is used for relief of anxiety

A

antianxiety drug or anxiolytic

143
Q

Benzodiazepines also have what type of effects?

A

anti epileptic

144
Q

what a drug promotes sleep it is called what?

145
Q

Low doses of benzodiazepines relieve what?

146
Q

High doses of benzodiazepines induce what?

147
Q

What suffix are benzodiazepines known by:

A

-pam and -lam

148
Q

Pharmacological class of diazepam:

A

benzodiazepine: amplifies action of endogenous GABA

149
Q

Therapeutic class of diazepam:

A

sedative-hypnotic

150
Q

Effects of benzodiazepine-like drugs are…

A

dose dependent

151
Q

Pharmacological class of secobarbitol:

A

barbiturate: direct-GABA agonist

152
Q

Therapeutic class of secobarbitol:

A

sedative-hypnotic

153
Q

MOA of secobarbitol:

A
  1. Nonselective depression of CNS function
  2. Strong respiratory depression
  3. Potentiate actions of gamma-amino-butyric acid (GABA)
  4. Directly mimics the actions of GABA
154
Q

Uses of secobarbitol:

A
  1. seizure disorders
  2. induction of anesthesia ‘
  3. insomnia
155
Q

Adverse effects of secobarbitol:

A
  1. Respiratory depression
  2. Suicide
  3. Abuse
  4. Tolerance versus
    physical dependence
156
Q

1 nursing implication of secobarbitol:

A

warn patients against abrupt withdrawal

157
Q

Barbiturates fall into 3 groups, what are they?

A
  1. ultrashort-acting
  2. short-to-intermediate acting
  3. long-acting
158
Q

Effects of barbiturate are dose what?

A

dose dependent

159
Q

barbiturates are known by what suffix:

160
Q

What is the brand name of Buspirone:

161
Q

Pharmacological class of buspirone:

A

binds to serotonin and dopamine receptors

162
Q

therapeutic class of buspirone:

A

anxiolytic

163
Q

MOA of buspirone:

A
  1. Nonbenzodiazepine- nonbarbiturate MOA:
    o Not CNS depressant
    o Binds to serotonin and dopamine receptors
164
Q

Uses of buspirone:

A
  1. Generalized anxiety disorder (GAD)
  2. Panic disorder
  3. Obsessive-compulsive
    disorder (OCD)
  4. Social anxiety disorder
  5. Post-traumatic stress
    disorder (PTSD)
165
Q

Adverse effects of buspirone:

A
  1. Dizziness
  2. Nausea
  3. Headache
  4. Nervousness
  5. Sedation
  6. Excitement
  7. Low risk of
    tolerance and physical dependence
166
Q

What do you want to warn patients about as the nurse if they are taking an anxiolytic:

A

against abrupt withdrawal

167
Q

What kind of drugs can be used for management of anxiety as well:

A

SSRIs, SNRIs, benzodiazepines, and barbiturates

168
Q

What is the brand name of methylphenidate:

169
Q

Pharmacological class of methylphenidate:

A

promotion of NE and DA release and inhibition of NE and DA reuptake

170
Q

Therapeutic class of methylphenidate:

A

CNS stimulant/Drug for ADHD

171
Q

MOA of methylphenidate:

A
  1. Stimulants: Increase activity of CNS neurons

2. Promotion of NE and dopamine release and inhibition of NE and dopamine reuptake

172
Q

Uses of methylphenidate:

A

Attention- deficit/hyperactivity disorder (ADHD)

173
Q

Adverse effects of methylphenidate:

A
  1. Insomnia
  2. Reduced appetite
  3. Emotional lability
  4. Cardiovascular
    effects
  5. Psychosis
  6. Abuse
  7. Tolerance versus physical dependence
174
Q

1 nursing implication of methylphenidate:

A

educate patient to take medication in the morning

175
Q

What are used in combination of CNS stimulants and non-stimulants?

A

Alpha2 adrenergic agonists and
antidepressants also
used for treatment

176
Q

What is the brand name of atomoxetine?

177
Q

Pharmacological class of atomoxetine:

A

selective NE reuptake inhibitor

178
Q

Therapeutic class of atomoxetine:

A

Non stimulant/Drug for ADHD

179
Q

MOA of atomoxetine:

A

Nonstimulant: NE reuptake inhibitor

180
Q

Use of atomoxetine:

181
Q

Adverse effects of atomoxetine:

A
  1. Insomnia
  2. Reduced appetite
  3. Emotional lability
  4. Cardiovascular
    effects
  5. Psychosis
  6. Abuse
  7. Tolerance versus physical dependence
182
Q

1 nursing implication of atomoxetine:

A

educate patient to take medication in the morning

NURS 472A (9 decks)

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