Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > Exam 4 > Flashcards

Exam 4 Flashcards

1
Q
  • Is a chronic neurological disorder that is an imbalance of neurotransmitter dopamine and acetylcholine.
  • Is a degeneration of dopaminergic neurons leading to a lack of dopamine.
A

Parkinson’s Disease and Alzheimer’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Frequently occurs as an adverse reaction to various drugs

A

Pseudoparkinsonism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q
  • Has damage to the extrapyramidal motor tract

* Creation of dopamine is damaged so there is an imbalance of dopamine and acetylcholine

A

Parkinson’s Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Is a an inhibitory neuro transmitter.

A

Dopamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Is an excitatory neuro transmitter.

A

Acetylcholine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Characteristics of Parkinson’s Disease

A
  • Involuntary tremors of limbs
  • Rigidity of muscles
  • Bradykinesia (slow movement)
  • Postural changes
    • Head and chest thrown forward
    • Shuffling
  • Lack of facial expression
  • Pill-rolling motion of hands
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What can help prevent someone from getting Parkinson’s Disease?

A

Exercising

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are Non-pharmacological ways to treat Parkinson’s Disease?

A
  • Exercise
  • Fiber Intake
  • Fluid Intake
  • Balanced diet
  • Support Groups
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What drugs can treat Parkinson’s Disease?

A
  • Anticholinergics
  • Dopamine Replacements
  • Dopamine agonists
  • MAO-B Inhibitors
  • COMT Inhibitors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What drug blocks cholinergic receptors?

A

Anticholinergics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What drug blocks cholinergic receptors?

A

Anticholinergics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What drug stimulates dopamine receptors?

A
  • Dopamine replacements

* Dopamine agonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What drug inhibits MAO-B enzyme that interferes with dopamine?

A

MAO-B Inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What drug inhibits COMT enzyme that inactivates dopamine?

A

COMT Inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Benztropine and trihexypenidyl are examples of what kind of drug?

A

Anticholinergics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Anticholinergics Action is what?

A
  • Reduces rigidity and some of the tremors.

* Minimal effect on bradykinesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Anticholinergics have what side effects?

A
  • Blurred vision
  • Ocular hypertension
  • Weakness
  • Dry mouth
  • Constipation
  • Anhidrosis
  • Urinary retention
  • Pupil dilation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the Anticholinergic agent assessment?

A
  • Health History
  • History of glaucoma
  • GI dysfunction history
  • Urinary retention history
  • Angina history
  • Myasthenia gravis history
  • Drug history
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the Anticholinergic agent nursing diagnosis?

A
  • Mobility
  • Impaired physical related to muscle rigidity
  • Tremors
  • Bradykinesia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the Anticholinergic agent planning?

A

Patient will have decreased involuntary symptoms caused by Parkinson’s Disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the Anticholinergic agent nursing interventions?

A
  • Councel patients to get a routine eye exam because they are contraindicated in patients with glaucoma.
  • Encourage patients to relieve a dry mouth with hard candy, ice chips, or sugarless gum.
  • Monitor urine output for urine retention
  • Increase fluid intake, fiber, and exercise to avoid constipation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What drug is a dopaminergic?

A

Carbidopa-levodopa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the carbidopa-levodopa action?

A

Converts to dopamine and increases mobility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the carbidopa-levodopa side effects?

A 
•Fatigue 
•Insomnia
•Dry mouth
•Blurred vision
•Orthostatic hypotension
•Palpitations
•Dysrhythmias
•GI distress
•Urinary retention
•Dyskinesia 
•Psychosis
•Sever depression
•Discolorization of urine (black, brown, red)
Agranulocytosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What should be taught about with Patient Teaching with Carbidopa-levodopa?

A
  • Orthostatic hypotension
  • Take meds with high protein foods even though it may decrease GI upsets it can delay absorption
  • Urine may be discolored and dark perspiration

.•Report side effects & symptoms of dyskinesia

  • Don’t discontinue meds abruptly
  • Can take months to get the full therapeutic effects of the medication
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What does Bromocriptine do and why is it used?

A
  • Acts directly on dopamine receptors in CNS, cardiovascular system, and GI tract
  • Used when patients do not tolerate carbidopa-levodopa
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the action of Selegiline?

A

Inhibit MAO-B enzyme that interferes with dopamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What drug is Selegiline?

A

MAO-B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the interaction of Selegiline?

A
  • Foods high in tyramine can cause hypertensive Crisis

* CNS toxicity with tricyclic antidepressants or SSRIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are foods high in tyramine?

A
  • Aged cheese
  • Red wine
  • Bananas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Large doses of Selegiline may inhibit what enzyme?

A

MAO-A

•and enzyme that promotes metabolism of of tyramine in the GI tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What do COMT Inhibitors do?

A

Inhibit COMT enzyme that inactivates dopamine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What can Tolcapone be?

A

Hepatoxic- monitor for liver function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Entacapone does what?

A
  • No effect on liver function
  • Often combined with Carbidopa-levodopa
  • Orange-brown urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is Alzheimer’s Disease?

A
  • Incurable dementia illness
  • Chronic, progressive neurodegenerative disorder
  • Marked cognitive dysfunction
  • Onset usually between ages 45-65
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the pathophysiology of Alzheimer’s Disease?

A
  • Cholinergic neuron degeneration and acetylcholine deficiency
  • Neuritic plaques form
  • Neurofibrillary tangles are in neurons
  • Not completely understood
  • Occurs more often in women than men
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Alzheimer’s disease had what stages?

A
  • Mild (early stage)
  • Moderate (middle stage)
  • Severe (late stage).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Alzheimer’s disease Mild Stage

A
  • Memory loss
  • Forgetfulness
  • Trouble planning
  • Organizing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Alzheimer’s disease moderate stage

A 
Middle stage
•Personality and behavioral changes 
•Increased memory loss
•Frustration and anger
•Unable to perform routine tasks 
•Loss of bowel or bladder control
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Alzheimer’s disease severe stage

A 
Late Stage
•Does not recognize loved ones
•Increased assistance with ADLs
•Unable to walk or talk
•Loses ability to swallow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Acetylcholinesterase/Cholinesterase Inhibitors do what?

A

•Used to treat mild-moderate Alzheimer’s disease

  • Increase availability of acetylcholine in CNS
    • Improved brain function or delay in loss of functions
  • Also increases acetylcholine in periphery and Increases parasympathetic responses.
    * Nausea, GI upset, diarrhea, bradycardia, hypotension, bronchoconstriction

•Stops acetylcholine from being broke down

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What are examples of Acetylcholinesterase/Cholinesterase Inhibitors?

A
  • Rivastigmine

* Donepezil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is the action of Rivastigmine?

A
  • Allow more acetylcholine in neuron receptors
  • Increase cognitive function, slows disease process
  • Indirect acting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What are the side effects of Rivastigmine?

A
  • Dizziness
  • Headache
  • Confusion
  • Depression
  • Dry mouth
  • GI distress
  • Dehydration
  • Weight loss
  • Bradycardia
  • Orthostatic hypotension
  • Dysrhythmia
  • Hepatotoxicity
  • Suicidal ideation
  • Stevens-Johnspn syndrome

*Has to be taken on an empty stomach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is the Assessment got Rivastigmine?

A
  • Assess patients mental and physical abilities.
  • Obtain a history especially hepatic or renal dysfunction.
  • Assess for memory and judgement losses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is the Nursing Diagnosis for Rivastigmine?

A
  • Self care deficit, toileting related to memory loss

* Confusion, chronic related to memory loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What is the Planning for Rivastigmine?

A
  • Patients memory will be improved

* Patient will maintain self-care with assistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What is the Nursing Interventions for Rivastigmine?

A
  • Maintain consistency in care
  • Record vitals
  • Observe any patient behavioral changes and note any improvements or decline
  • Teach family members about safety measures to avoid injury when the patient wanders
  • Inform family members of availabile support groups
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What is Meantime used for?

A
  • Used to treat moderate to severe Alzheimer’s symptoms
  • NMDA receptor antagonist
  • Blocks effects of glutamate at NMDA receptors
  • Fewer side effects than cholinesterase Inhibitors
    * Most common-dizzieness, HA, confusion, constipation
    * About same incidence as placebo
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What is Memantime used for?

A
  • Used to treat moderate to severe Alzheimer’s symptoms
  • NMDA receptor antagonist
  • Blocks effects of glutamate at NMDA receptors
  • Fewer side effects than cholinesterase Inhibitors
    * Most common-dizzieness, HA, confusion, constipation
    * About same incidence as placebo
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is the pathophysiology of Myasthenia Gravis?

A
  • Autoimmune disorder
  • Antibodies attach to acetylcholine receptor sites, obstruct binding of acetylcholine, and destroy receptor sites
  • Lack of acetylcholine impairs transmission of messages at neuromuscular junction s
  • Leads to ineffective muscle contraction and muscle weakness
  • Leads to weakness of respiratory, facial, and extremity muscles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Where are the nicotinic receptors found?

A

Skeletal muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

The Thymus glad is what for Myasthenia Gravis?

A

Is the source of antibodies that that destroy acetylcholine receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Myasthenia Gravis and the Thymus Gland

A
  • Lymph organ
  • Produces T cells for immune system
  • Enlarged in ~60% Myasthenia Gravis patients
  • Thymectomy (removal of thymus)
    * Early in diseases process
    * Clinic symptoms decreased
    * Remission or reduction in medication
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Myasthenia Gravis Characteristics are what?

A
  • Skeletal muscle weakness
  • Fatigue, ptosis
  • Dysphagia, dysarthria
  • Respiratory muscle weakness, paralysis, and arrest
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What is a Myasthenic crisis?

A

•Severe generalized muscle weakness that involves diaphragm and intercostal muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What are Myasthenic crisis Triggers

A
  • Inadequate dosing
  • Emoyional stress, menses, pregnancy
  • Infection, surgery, trauma
  • Hypokalemia, alcohol intake
  • Temperature extremes
  • Medications: Aminoglyciside antibiotics, CCB, phenytoin, psychotropics
  • Treat with neostigmine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Myasthenia Gravis Cholinergic Crisis is what?

A
  • Usually occurs within 30-60 minutes after taking Cholinesterase Inhibitor
  • Triggered by overdosing
  • Antidote is atropine (anticholinergic)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Myasthenia Gravis Symptoms

A
  • Severe muscle weakness
  • Possibly respiratory paralysis and arrest
  • Abnormal pupil constriction
  • Pallor, sweating, vertigo
  • Excess salivation, GI distress
  • Bradycardia, fasciculations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What is Myasthenic crisis?

A

Caused by underdosing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What is cholinergic crisis?

A

Caused my overdosing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Overdosing and underdosing have what?

A
  • Similar symptoms

* Muscle weakness, dyspnea, bradycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What kinda of drug is Edrophonium (Tension)?

A

•Ultra-short-acting Cholinesterase Inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What is Endrophonium used for?

A

•Used to determine if Myasthenic crisis or cholinergic crisis
•Also used to diagnose myasthenia gravis
Patients symptoms improve - Myasthenic crisis
Patient symptoms worsen - Cholinergic crisis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What is Endrophonium used for?

A

•Used to determine if Myasthenic crisis or cholinergic crisis
•Also used to diagnose myasthenia gravis
Patients symptoms improve - Myasthenic crisis
Patient symptoms worsen - Cholinergic crisis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What are come Acetylcholinesterase Inhibitors?

A
  • Edrophonium
  • Neostigmine
  • Pyridostigmine
  • Ambenonium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

What is Endrophonium?

A
  • Ultrashort-acting for diagnosing

* Differentiates between Myasthenic and cholinergic crisis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

What is Neostigmine?

A

Short acting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What is Pyridostigmine?

A

Intermediate-acting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

What is Ambenonium?

A
  • Long-lasting

* Action: increases muscle strength in patients with myasthenia gravis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What are side effects of Acetylcholinesterase Inhibitors?

A
  • Increased salivation and tearing
  • Miosis, blurred vision
  • Bradycardia, hypotension
  • GI distress
    * Nausea, vomiting, diarrhea, abdominal cramps
71
Q

What can be used for patients that are unresponsive to Acetylcholinesterase Inhibitors?

A

•Prednisone: Drug of choice
•Plasma Exchange: Helps get rid of antibodies that are attacking the receptors
•Intravenous immune globulin
•Immunosuppressive drugs
Azathioprine: need to monitor for leukopenia and hepatoxicity

72
Q

What is the concept of Acetylcholinesterase Inhibitors?

A

Sensory Perception

73
Q

What is the assessment of Acetylcholinesterase Inhibitors?

A

Assess for evidence of overdosing/underdosing, such as muscle weakness with difficulty breathing and swallowing

74
Q

What are patient problems with Acetylcholinesterase Inhibitors?

A
  • Decreased gas exchange

* Reduced motor function

75
Q

What are patient problems with Acetylcholinesterase Inhibitors?

A
  • Decreased gas exchange

* Reduced motor function

76
Q

What is the Planning with Acetylcholinesterase Inhibitors?

A

•The patients muscle weakness will improve with timely administration if Pyridostigmine

77
Q

What are nursing interventions with Acetylcholinesterase Inhibitors?

A
  • Administer doses on time
  • Take drug before meals if possible
  • Monitor drug effectiveness
  • Have antidote available for cholinergic crisis
    • Atropine (Anticholinergic)
  • Encourage patient to wear medical identification
78
Q

What is Multiple Sclerosis?

A
  • Autoimmune disorder
  • Attacks myelin sheath of nerve fibers in brain and spinal cord
  • Causes lesions (plaques)
79
Q

What are the characteristics of Multiple Sclerosis?

A
  • Remissions and exacerbations
  • Weakness and paralysis of extremeties, fatigue
  • Muscle spasticity, paresthesia
  • Dysarthria, dysphagia, ataxia
  • Diplopia, blurred vision, vertigo, tinnitus
80
Q

What is the Diagnosis of Multiple Sclerosis?

A
  • No specific diagnostic test
  • Indicators of diagnosis
    • Medical history
    • Neurologic exam
    • Multiple lesions observable through MRI
    • Visual evoked potential: measures electrical activity in the brain
    • Elevated immunoglobulin G in the cerebrospinal fluid
81
Q

What are the classifications of MS?

A
  • Relapsing remitting
  • Primary progressive
  • Secondary progressive
  • Progressice relapsing
82
Q

What is relapsing remitting?

A

Relapse with full recovery and residual deficit

83
Q

What is primary progressive?

A

Slowly worsening neurologic function without relapsed or remissions

84
Q

What is secondary progressive?

A

Initial course is relapsing remitting, then progression with or without occasional relapses, minor remissions, and plateaus

85
Q

What is progressive relapsing?

A

Progressive from onset with acute relapses with or without full recovery

86
Q

What is the MS drug treatment?

A
  • Immunomodulators
  • Beta-interferon
  • Corticosteroids
87
Q

What do immunomodulators do?

A
  • First line treatment

* Slows disease progression and prevents relapses

88
Q

What do Beta-interferon drugs do?

A

Slows the progression of relapsing remitting MS

89
Q

What do corticosteroids do?

A

Reduces edema and acute inflammation

90
Q

Centrally acting muscle relaxants do what?

A
  • Relieves muscle spasms and spasticity
  • Have sedative effect
  • Cause drug dependence (all but cyclobenzaprine)
91
Q

What are side effects of centrally acting muscle relaxants?

A
  • Drowsiness
  • Dizziness
  • Headache
  • Nausea
  • Vomiting
92
Q

What action does Cyclobenzaprine have?

A

Relax skeletal muscles

93
Q

What uses does Cyclobenzaprine have?

A

Relieves muscle spasm

94
Q

What side effects does Cyclobenzaprine have?

A
  • Anticholinergic effects (blurred vision, dry mouth, tachycardia, urine retention, constipation)
  • Drowsiness, dizziness, headache, nervousness
  • GI distress, unpleasant taste.
  • Dysrhythmias
95
Q

What is the only muscle relaxant that does not cause dependence?

A

Cyclobenzaprine (Flexeril)

*Do not take more than 3 weeks

96
Q

What can happen if muscle relaxers are stopped abruptly?

A

They can have rebound muscle spasms

97
Q

What are come Central Acting muscle relaxants? *****

A
  • Baclofen -used to tx muscle spasms R/T MS or CNS injury
  • Carisoprodol (Soma)
  • Chlorzoxazone (Parafon Forte)
  • Methocarbamol (Robaxin)
98
Q

What ways can Baclofen be administered?

A

•Intrathecal via a pump that’s surgically implanted and delivers a consistently low dose for muscle spasms

99
Q

What ways can Baclofen be administered?

A

•Intrathecal via a pump that’s surgically implanted and delivers a consistently low dose for muscle spasms

100
Q

Skeletal muscle relaxants have what assessment?

A
  • Observe patients drug history for possible drug interactions
  • Note whether patient has a history of narrow-angle glaucoma or myasthenia gravis
101
Q

What nursing diagnoses are for skeletal muscle relaxants?

A

Physical mobility, impaired related to dizziness and hyperactive reflexes

102
Q

What is the Planning for skeletal muscle relaxants?

A

The patients muscular pain will be reduced within 1 week

103
Q

What are nursing interventions for skeletal muscle relaxants?

A
  • Observe for CNS side effects.
  • Teach patient not to stop abruptly but taper off over 1 week.
  • Inform usually taken for <3 weeks
  • Teach patient to avoid alcohol and CNS depressants
  • Educate to take with food to decrease GI upset
104
Q

A patient with myasthenia gravis come to the emergency department in respiratory distress. He has been diagnosed with Myasthenic crisis. The nurse anticipates administration of which drug?

A

Neostigmine

105
Q

The patient is admitted to the emergency department with cholinergic crisis. The nurse anticipates administration of what?

A

Atropine

106
Q

A patient with myasthenia gravis comes to the emergency department in respiratory distress. To determine if the patient is in Myasthenic crisis or cholinergic crisis, the nurse anticipates administration of which drug?

A

Edrophonium

107
Q

A patient with myasthenia gravis is prescribed Neostigmine. The nurse identifies that the medication is effective when the patient experiences?

A

Increased .muscle strength

108
Q

A patient with multiple sclerosis is being treated with large doses of corticosteroids. Which nursing diagnosis would be the priority at this time?

A

Risk for infection

109
Q

A child with cerebral palsy is ordered to receive Baclofen. The nurse is aware that this medication is prescribed to

A

Reduce muscle spasticity

110
Q

What do you give during a cholinergic crisis?

A

Atropine

111
Q

What do you give for a Myasthenic crisis?

A

Neostigmine

112
Q

What is the Etiology of Depression?

A
  • Genetic predisposition.

* Social and environmental factors

113
Q

What are the pathophysiology theories of Depression?

A

•Decreased levels of monoamine neurotransmitters which are norepinephrine, serotonin, dopamine

114
Q

What are the signs and Symptoms of depression?

A
  • Depressed mood
  • Despair
  • Weight loss or gain
  • Loss of interest in normal activities
  • Fatigue
  • Insominia
  • Hypersomnia
  • Decreased ability to think or colZncentrate
  • Suicidal thoughts
115
Q

What is Reactive depression?

A
  • Usually sudden onset after a precipitating event

* Usually lasts for months

116
Q

What is major depression?

A
  • May be primary or secondary to health problems
  • Loss of interest in work or home
  • Inability to concentrate and complete tasks
  • Difficulty sleeping or excess sleeping
  • Feelings of fatigue and worthlessness
  • Deep depression
117
Q

What is bipolar disorder?

A

Mood swings between manic and depressive

118
Q

St. Johns wort helps depression by

A

•OTC treatment for depression
•Decreases reuptake of serotonin, norepinephrine, and dopamine
•Increased risk serotonin syndrome—-sx: dizziness, HA, sweating, and agitation
Avoid Ginkgo biloba (another OTC meds used to tx depression) with prescription antidepressants also

119
Q

What are the different Antidepressant groups?

A
  • Tricyclic antidepressants (TCAs)
  • Selectove serotonin reuptake Inhibitors (SSRIs)
  • Serotonin norepinephrine reuptake Inhibitors (SNRIs)
  • Atypical antidepressants
  • Monoamine oxidase Inhibitors (MAOIs)
120
Q

What are examples of Tricyclic Antidepressants?

A
  • Amitriptyline (Elavil)
  • Imipramine
  • Trimipramine
  • Desipramine
  • Doxepin (Sinequan)
  • Nortriptyline
  • Protriptyline
121
Q

What action does Tricyclic Antidepressants have?

A
  • Blocks uptake of norepinephrine and serotonin in brain
  • Elevated mood, increases want in ADLs, decreases insomnia
  • Blocks histamine receptors which leads to sedation
  • Blscks cholinergic receptors which leads to anticholinergic effects
122
Q

What is the use of Tricyclic Antidepressants?

A

Major depression

123
Q

How long might it take for Tricyclic Antidepressants to work?

A

2-4 weeks

124
Q

What are side effects/adverse reactions while being on Tricyclic Antidepressants?

A
  • Drowsiness, dizziness, blurred vision
  • Dry mouth and eyes, GI distress
  • Urinary retention, sexual dysfunction
  • Sleep related behaviors, suicidal ideation
  • Orthostatic hypotension, dysrhythmias
  • Blood dyscrasias—Monitor CBC
  • Extrapyramidal syndrome—-amitriptyline
  • Neuroleptic malignant syndrome—-clomipramone (altered mental status, rigid muscles, facial ticks, fever, sympathetic nervous system stimulation)
  • Cardiotoxicity
125
Q

What are interactions associated with Tricyclic Antidepressants?

A
  • Alcohol and other CNS depressants potentiate CNS depression
  • MAOIs may lead to toxic psychosis, cardiotoxicity
  • Antithyroid drugs may Increase dysrhythmias
126
Q

What are some examples of Selective Serotonin Reuptake Inhibitors?

A
  • Fluoxetine (Prozac)
  • Sertraline (Zoloft)
  • Paroxetine (Paxil)
  • Citalopram (Celexa)
  • Escitalopram (Lexapro)
127
Q

Levodopa (Dopar) is what kind of drug and what is it used for?

A

Dopaminergic and it’s used for Parkinson’s Disease

128
Q

Levodopa/carbidopa-levodopa (Sinemet) is what kind of drug and what is it used for?

A

Dopaminergic and it’s used for Parkinson’s

129
Q

Entacapone (Comtan) is what kind of drug and what is it used for?

A

COMT Inhibitor and it’s used for Parkinson’s Disease

130
Q

Donepezil (Aricept) is what kind of drug and what is it used for?

A

Acetylcholinesterase Inhibitors for Alzheimer’s

131
Q

Rivastigmine (Exelon) is what kind of drug and what is it used for?

A

Acetylcholinesterase Inhibitors for Alzheimer’s

131
Q

Rivastigmine (Exelon) is what kind of drug and what is it used for?

A

Cholinesterase Inhibitor used for Alzheimer’s

132
Q

Neostigmine (Prostigmine) is what kind of drug and what is it used for?

A

Acetylcholinesterase Inhibitors for Myasthenia Gravis

133
Q

Pyridostigmine bromide (mestinon) is what kind of drug and what is it used for?

A

Acetylcholinesterase Inhibitors for Myasthenia Gravis

134
Q

Glatiramer (Copaxone) is what kind of drug and what is it used for?

A

Immunomodulator for MS

135
Q

Mitoxantrone is what kind of drug and what is it used for?

A

Immunosuppressant for MS

136
Q

Diazepam (Valium) is what kind of drug and what is it used for?

A

Muscle relaxant is used to relieve muscle spasms for MS

137
Q

Baclofen (Lioresal) is what kind of drug and what is it used for?

A

Muscle relaxant for muscle spasms caused by MS

138
Q

Dantrolene (Dantrium) is what kind of drug and what is it used for?

A

Peripherally acting muscle relaxer used for chronic neurological disorders that cause spasms

139
Q

Carisoprodol (Soma) is what kind of drug and what is it used for?

A

Centrally acting muscle relaxant used for acute, painful musculoskeletal conditions

140
Q

Chlorzoxazone (Parafon Forte DCS) is what kind of drug and what is it used for?

A

A centrally acting muscle depressant used for skeletal muscle relaxing with sedative properties

141
Q

Methocarbamol (Robaxin) is what kind of drug and what is it used for?

A

Centrally acting muscle relaxer used for musculoskeletal pain

142
Q

Metaxalone (Skelaxin) is what kind of drug and what is it used for?

A

Centrally acting muscle relaxant used for musculoskeletal pain associated with MS

143
Q

Cyclobenzaprine (Flexeril) is what kind of drug and what is it used for?

A

Anxiolytic/Centrally acting Muscle relaxant used for short term treatment of muscle spasms

144
Q

Fluoxetine (Prozac) is what kind of drug and what is it used for?

A

Antidepressant: selective serotonin reuptake Inhibitor to treat depression, bipolar disorder, bulimia disorder, etc.

145
Q

What is the action of selective serotonin reuptake Inhibitors?

A

Block uptake of neurotransmitter serotonin

146
Q

What are the uses of serotonin reuptake Inhibitors?

A
  • Major depression
  • Anxiety disorders
    • obsessive-compulsive disorder
    • Panic disorders
    • Phobias
    • Posttraumatic stress disorder.
  • Prevention of migraines headaches
  • Decrease premenstrual tension syndrome
147
Q

What are Selective serotonin reuptake Inhibitors interactions?

A
  • Increased sedation with alcohol and other CNS depressants

* Grapefruit juice with SSRIs can lead to toxicity

148
Q

What are the side effects/adverse reactions of selective serotonin reuptake Inhibitors?

A
  • Headache, nervousness
  • Blurred vision, insomnia
  • Dry mouth, GI distress
  • Sexual dysfunction, suicidal ideation
  • Side effects often decrease over 1 to 4 weeks
  • Decrease or Increases in appetite
  • Can cause Bruxism: grinding teeth
149
Q

Selective Serotonin Reuptake Inhibitors should not be taken at the same time as what?

A

MAOI’s

150
Q

What are some examples of Serotonin Norepinephrine Reuptake Inhibitors?

A
  • Venlafaxine (Effexor)- First one approved
  • Duloxetine (Cymbalta)
  • Desvenlafaxine (Prestiq)
151
Q

What is the action of Serotonin Norepinephrine Reuptake Inhibitors?

A

Inhibit the reuptake of serotonin and norepinephrine

152
Q

What are the uses for Serotonin Norepinephrine Reuptake Inhibitors?

A
  • Major depression
  • Generalized anxiety disorder
  • Social anxiety disorder
153
Q

What are the uses for Serotonin Norepinephrine Reuptake Inhibitors?

A
  • Major depression
  • Generalized anxiety disorder
  • Social anxiety disorder
154
Q

What is the interaction with Serotonin Norepinephrine Reuptake Inhibitors?

A

•Venlafaxibe & St. John’s wort–increased risk of serotonin syndrome and NMS (Neuroleptic Malignant Syndrome)

155
Q

What is the interaction with Serotonin Norepinephrine Reuptake Inhibitors?

A

•Venlafaxibe & St. John’s wort–increased risk of serotonin syndrome and NMS (Neuroleptic Malignant Syndrome)

156
Q

What are the side effects of Serotonin Norepinephrine Reuptake Inhibitors?

A
  • Drowsiness
  • Dizzieness
  • Insomnia
  • Headache
  • Euphoria
  • Amnesia
  • Blurred vision
  • Photosensitivity
  • Ejaculation dysfunction
  • Can cause an increase in liver enzymes
157
Q

What are the adverse effects of Serotonin Norepinephrine Reuptake Inhibitors?

A
  • Tachycardia
  • Hypertension
  • Angioedema
  • Seizures
  • Suicidal ideation
157
Q

What are the adverse effects of Serotonin Norepinephrine Reuptake Inhibitors?

A
  • Tachycardia
  • Hypertension
  • Angioedema
  • Seizures
  • Suicidal ideation
158
Q

What are examples of Atypical Antidepressants?

A
  • Amoxapine
  • Maprotiline
  • Trazadone
159
Q

What is the action of Atypical Antidepressants?

A

•Affect one or two of the three neurotransmitters: serotonin, norepinephrine, and dopamine

160
Q

What is the use of Atypical Antidepressants?

A
  • Major depression
  • Reactive depression
  • Anxiety
  • Sometimes a sleep aid
161
Q

What are the Interactions of Atypical Antidepressants?

A

Do not take with MAOIs & do not use within 14 days after discontinuing MAOIs

162
Q

What are examples of Monoamine Oxidase Inhibitors ?

A

Tranylcypromine sulfate, isocarboxazid, Selegiline, and phenylzine sulfate

163
Q

What is the action of Monoamine Oxidase Inhibitors?

A

Monoamine Oxidase enzyme inactivates norepinephrine, dopamine, epinephrine, and serotonin

164
Q

What is the use of Monoamine Oxidase Inhibitors?

A

Depression not controlled by TCAs and second-generation antidepressants

165
Q

What drug interactions do Monoamine Oxidase Inhibitors have?

A

•CNS stimulants such as vasoconstrictors & cold medicine containing phenylephrine & pseudoephedrine–hypertensive crisis

166
Q

What food Interactions does Monoamine Oxidase Inhibitors have?

A
  • Foods that contain tyramine— Hypertensive Crisis
  • Some cheeses, cream, yogurt, coffee, chocolate, bananas, raisins, italian green beans, liver, picked foods, sausage, soy sauce, yeast, beer & red wines
167
Q

What side effects/adverse effects do Monoamine Oxidase Inhibitors have?

A
  • Agitation
  • Restlessness
  • Insomnia
  • Anticholinergic effects
  • Orthostatic hypotension
  • Hypertensive crisis from tyramine interaction
168
Q

What is kind of drug is Lithium?

A

Mood stabilizer

169
Q

What therapeutic serum range does lithium have?

A
  • 1.0 to 1.5 mEq/L

* Serum lithium levels greater than 1.5 mEq/L may lead to toxicity

170
Q

What action does Lithium have?

A
  • Alteration of ion transport in muscle and nerve cells

* Increased receptor sensitivity to serotonin

171
Q

What use does Lithium have?

A

Bipolar disorder manic episodes

172
Q

What side effects/adverse reactions

A
  • Headaches, drowsiness, dizziness, blurred vision
  • Restlessness, tremors, memory impairment
  • Dry mouth, metallic taste
  • Can deplete sodium levels
  • Hypotension, dysrhythmias
  • Edema of hands and ankles, dehydration
  • Increased urination, blood dyscrasias, NMS
  • Serotonin syndrome nephrotoxicity
173
Q

What are Interactions with Lithium?

A

•Increased lithium level with
•Thiazides, methyldopa, haloperidol, NSAIDs, Antidepressants, theophylline, phenothiazines
•Decreased lithium level with
Caffeine, loop Diuretics

Pharmacology (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions