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Pharm > Exam 4 Module 7 Drug Purpose > Flashcards

Exam 4 Module 7 Drug Purpose Flashcards

1
Q

Properties of anxiolytics

A
  • Prevent tension or fear
  • Sedatives
  • Hypnotics (sleep and minor tranquilizing)
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2
Q

Risk for addiction/dependence and sedation higher than benzos

A

Barbiturates

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3
Q

phenobarbital (Luminal) indications

A

relief of s/sx of anxiety, sedation, insomnia, treatment of seizures

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4
Q

phenobarbital (Luminal) adverse effects

A
  • CNS depression
  • bradycardia, hypotension, syncope, hypoventilation
  • hypersensitivity
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5
Q

Flumazenil (Romazecon)

A

Used to treat acute withdrawal syndrome

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6
Q

Benzodiazepines

A
  • Prevent anxiety without causing much sedation

- less likely to cause physical dependence

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7
Q

Acute withdrawal syndrome

A

Caused by abrupt cessation of drug

Causes nausea, headache, malaise, vertigo, and nightmares

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8
Q

Diazepam (Valium) indications

A
  • Anxiety disorders
  • Alcohol withdrawal
  • hyperexcitability
  • Agitation
  • Preop relief of anxiety and tension
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9
Q

Diazepam (Valium) adverse effects

A
  • sedation, drowsiness, depression, lethargy, blurred vision, apathy, mild paradoxical reactions
  • HTN, hypotension, arrhytmias, respiratory difficulty
  • urinary retention, loss of libido
  • withdrawal
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10
Q

Antidote for diazepam

A

flumazenil

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11
Q

action of tricyclic antidepressants

A
  • prevents reuptake of 5HT and NE

- exact mechanism in decreasing depression unknown

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12
Q

uses of Imipramine (Tofranil)

A
  • relief of depression
  • sedative effect for anxiety
  • might be effective in treating anuresis in children >6 years old
  • being investigated for treating chronic pain
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13
Q

side effects of TCAs

A
  • anticholinergic effects

- sleep disturbances and decreased libildo

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14
Q

nursing process for TCAs

A
  • abrupt cessation causes withdrawal syndrome

- administer at bedtime

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15
Q

interactions with TCAs

A
  • oral anticoagulants lead to higher serum levels of the anticoagulant and increase risk of bleeding
  • sympathomimetics or clonidine: risk for HTN and arrhythmias
  • MAOIs- lead to severe hyperpyretic crisis with severe convusions, HTN episodes and eath
  • all drugs should be carefully considered when given with TCAs
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16
Q

MAOIs (monoamine oxidase inhibitors) actions

A

irreversibly inhibit MAOs

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17
Q

side effects of MAOIs

A
  • more fatal than other antidepressants r/t accumulation of NE in the synaptic cleft
  • HTN crisis: occipital headache, palpitations, neck stiffness, N/V, sweating, dilated pupils, photophonia, tachy, angina… may progress to intracranial bleeding and fatal stroke
  • liver toxicity
  • mania, hyperreflexia, tremors, confusion, insomnia, agitation, blurred vision
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18
Q

contraindications for MAOIs

A
  • insuline, oral antidiabetic agents: additive hypoglycemic effects (monitor closely)
  • TCAs: can result in life threatening hypertensive crisis
  • SSRIs: serotonin syndrome… never give at same time
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19
Q

MAOI diet

A

-avoid tyramine-containing foods: chocolate, aged foods like cheese, wine, meats

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20
Q

treatment for hypertensive crisis

A

Phentolamine (Regitine) or another adrenergic blocker

21
Q

actions of SSRIs (selective serotonin reuptake inhibitors)

A

blocks the reuptake of serotonin with little or no effect on NE

22
Q

adverse effects of SSRIs

A
  • not as many adverse effects so its a good first-choice drug
  • effects are related to increase of 5HT levels
  • mild GI and GU
  • Resp: cough, upper resp infections, pharyngitis
  • CNS: headache, drowsiness, insomnia, anxiety, tremor, seizures (rare)
23
Q

nursing priorities with pts starting SSRIs

A

suicide precautions

24
Q

action of typical antipsychotics

A

-block dopamine receptors preventing the stimulation of the post-synaptic neurons by dopamine; also suppress the RAS, limiting the stimuli coming into the brain

25
Q

side effects of antipsychotics

A
  • anticholinergic, antihistamine, alpha-adrenergic blocking effects all related to blocking of dopamine receptor sites
  • sedation, tremors, EPS, pseudo-parkinsonism, dystonia, akethesia, tardif dyskonisia, NMS
26
Q

nursing process for typical antipsychotics

A
  • don’t crush or chew sustained-release capsules
  • monitor for glucose intolerance
  • acute withdrawal syndrome
  • ice and hrd candies for dry mouth
  • void before taking if urinary retention is a problem
27
Q

actions of atypical antipsychotics

A

block both dopamine and serotonin receptors, helping to alleviate some of the unpleasant neurological effects found in typical

28
Q

actions of antimanic drugs (lithium)

A

alters Na+ transport in nerve and muscle cells, inhibits release of NE and dopamine, but not serotonin, from from stimulated neurons; increases the interneuronal stores of NE and dopamine slightly and decreases interneuronal content of second messengers (may allow it to selectively modulate the responsiveness of hyperactive neurons that might contribute to the manic state

29
Q

contraindications of lithium

A

hyponatremia

s/s: lethargy, slurred speech, muscle weakness, fine tremor, polyuria (renal toxicity), n/v and diarrhea

30
Q

nursing considerations for lithium

A
  • hold if serum lithium is too high or Na+ is too low
  • narrow therapeutic range
  • lots of CNS effects
31
Q

actions and uses of CNS stimulants

A
  • tricks the brain, gives them stimulation that allows them to think in a rational, calm manner
  • used for ADD and narcolepsy
32
Q

actions of phenytoin (Dilantin)

A

stabilize nerve membranes throughout the CNS directly by influencing ionic channels in the cell membrane thereby decreasing the excitability and hyperexcitability to stimulation

33
Q

dilantin therapeutic level

A

10-20 mcg/ml

34
Q

expected side effects of dilantin

A

teeth staining and hypertrophy of the gums

35
Q

actions of succinamides

A

suppress the normal electrical activity in the brain that is associated with absense seizures

36
Q

actions of GABA modulators

A

stabilize nerve membranes:

  • directly by altering Na+ and Ca+ channels
  • indirectly by increasing activity of GABA (inhibitory transmitter) thereby decreasing excessive activity
37
Q

side effects of valproic acid (Depakene)

A
  • BBW for increased suicidality

- can be directly toxic to bone marrow and liver

38
Q

therapeutic level of carbamazepine (tegretol)

A

4-12 mcg/ml

39
Q

side effects of carbamazepine (Tegretol)

A

suicide, SJS (look for skin issues)

40
Q

actions of levodopa (Dopar)

A

treats movement disorders

-crosses the BBB because dopamine normally can’t, so meds have to be used to stimulate existing dopamine in the brain

41
Q

antidote for EPS from neuroleptics

A

benztropine (Cogentin)

42
Q

actions and uses of baclophen (Lioresol)

A
  • work in the CNS to interfere with the reflexes that care causing spasm (spasmolytics)
  • used for spasms/ tension
43
Q

antidote to morphine overdose

A

naloxone (Narcan)

44
Q

actions of Ergots

A

block adrenergic and serotonin receptor sites in the brain to cause a constriction of cranial vessels and decrease in cranial artery pulsations and decrease in hyperfusion of the basilar artery

45
Q

big side effect of Ergots

A

pulselessness, parasthesias, muscle pain

46
Q

drug interactions of Ergots

A

beta blockers (risk for peripheral ischemia and gangrene

47
Q

succinylcholine (Anectine) actions

A

attaches to the acetylcholine receptor site on the muscle cell causing a prolonged depolarization of the muscle

48
Q

antidote for succinylcholine (Anectine)

A

a cholinesterase inhibitor

Pharm (20 decks)

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