Exam 6 Flashcards
1
Q
What are CNS depressants used to treat?
Relax
A
- pain, insomnia, relive anxiety, induce relaxation, preform surgical procedures, treat muscle spams, manage psychoses and control epilepsy
2
Q
What is the mechanism of action of CNS Depressants?
A
- reduce CNS overactivity
3
Q
What are benzodiazepines used to treat?
A
- anxiety, alcohol withdrawal, insomnia, muscle spasms
4
Q
What are the contraindications/ interactions of taking benzodiazepines?
NAG, CNSD, GFJ
A
- narrow angle glaucoma
- dont mix w/ other CNS depressants and alcohol
- don’t drink grapefruit juice
5
Q
What are the four different categories of CNS depressants?
Benzo, H, Bar, MR
A
- benzodiazepines
- hypnotics
- barbiturates
- muscle relaxers
6
Q
What is the FDA BBW for benzodiazepines?
RFA, PD, DCW/BOO
A
- risk for abuse
- physical dependence
- dont combine w/ other benzo’s or opioids
7
Q
What are the adverse effects of taking benzodiazepines?
HYPO, C, SS, A, N/V, DM
A
- Hypotension
- confusion
- slurred speech
- ataxia
- nausea
- vomiting
- dry mouth
8
Q
What should the nurse understand before administering benzodiazepine?
Paradoxical and rebound
A
- Paradoxical excitation causing hyperactivity and aggressive behavior may occur in all all ages
- rebound disinhibition may occur in older adults after tapering
- rebound insomnia may occur if abruptly stopped
9
Q
What should the nurse educate the patient on before taking benzodiazepines?
WO, TWF, CPS, DS/DD
A
- wean off to stop
- take with food to avoid GI upset
- change positions slowly to prevent falls
- do both skip doses or double dose
10
Q
what is the antidote for benzodiazepines?
A
Flumazenil
11
Q
What can flumazenil (antidote) cause?
A
- abruptly withdrawal including seizures in long term user
12
Q
What is hypnotics used to treat?
A
- insomnia
13
Q
What are the contraindications/ interactions of taking hypnotics?
SA, COPD, PCC, D, CNSD, B, AED
A
- sleep apnea
- COPD
- pregnancy category C
- decrease dose for women
- depression
- CNS depressants
- barbiturates
- anti epileptic drugs
14
Q
What is the FDA BBW for hypnotics?
sw/ sd
A
- sleepwalking and sleep driving
15
Q
What should the nurse understand before administering hypnotics?
TPTB, SW
A
- take prior to bedtime
- swallow whole do not destroy pill
16
Q
What should the nurse educate the pt on when taking hypnotics?
DCW/HFF, DTA12, 7-8 HOURS
A
- dont combine w/ high fat foods
- dont take after 12am
- take only if 7-8 hours of sleep was acquired the prior night
17
Q
What are the adverse effects of taking hypnotics?
ANGIO, ANA, WD, T/D
A
- angioedema
- anaphylaxis
- worsening depression
- Tolerance and dependence
18
Q
What is the mechanism of action of taking barbiturates?
A
Raises the seizure threshold in the treat of epilepsy
19
Q
What are the contraindications/ interactions of taking barbiturates?
P, IRFF, DTI, IWSM
A
- pregnancy
- increases risk for falls
- disrupt TI of other drugs
- interacts with several medication
20
Q
What are the adverse effects of taking barbiturates?
LTI, D, VND, HYP, MB, DR
A
- low therapeutic index
- drowsiness
- vivid and nightmarish dreams
- hypotension
- mild bradycardia
- decreased respirations
21
Q
What should the nurse understand before administering barbiturates?
A
- give lowest effective dose unless used for epilepsy
22
Q
What is the therapeutic blood level for phenobarbital?
A
10- 40 mcg/ mL
23
Q
What can be used to treat barbiturates overdose?
AC, FD, IVF
A
- activated charcoal
- forced diuresis
- IV fluids
24
Q
What should the nurse educate the pt on when taking barbiturates?
A
- women of reproductive years should use an additional method of BC
25
What are muscle relaxants used to treat?
PMS, MS, CP
- painful muscle spams after injury or surgery
- multiple sclerosis
- cerebral palsy
26
What are the contraindications/ interactions of taking muscle relaxants?
Increased sedation w/ alcohol and other CNS depressants
27
What are the adverse effects of taking muscle relaxants?
C: DIZZ, DROW, C, F
S: AR, CARDIAC
Common- dizziness, drowsiness, confusion and fatigue
Severe- allergic reaction, arrthymias, bradycardia, hypotension, respiratory depression
28
What should the nurse assess for in pt taking cyclobenzaprine?
CBC
29
What drug causes marked sedation?
Cyclobenzaprine
30
Why shouldnt muscle relaxants be used cautiously in the older adults?
May cause excessive sedation and hallucinations
31
What should the nurse educate the pt on when taking muscle relaxants?
'
- change positions slowly
- take w/food
32
what is the mechanism of action of CNS stimulants?
increases levevls of dopamine and norepi by blocking reuptake
33
what are CNS Stimulants used for?
| A, N, M
ADHD
narcolepsy
migraines
34
what should the nurse understand about CNS Stimulats?
| potential and mental
potential for abuse and can cause severe paranoia, psychosis, depreesion, and sucial thoughts
35
what is dextroamphetamine sulfate used to treat?
| A, N
ADHD and narolepsy
36
what are the C/I of taking dextroamphetamine sulfate?
| aggrevates and do not
- aggrevates anxeity disorder, tourettes, HTN
- DO NOT admin to pt who has received MAOI therapy
37
what are the adverse effects of taking dextroamphetamine sulfate?
| CP, R, M, BV, I, T, GIU
- cardiac problems
( tachycardia, HTN, angina, dysrhytmias)
- restlessness
- mania
- blurred vision
- insomnia
- tremors
- GI upset
( N/V, diarrhea, anorexia, weight loss )
38
what should the nurse understand before administering dextroamphetamine sulfate?
| DH, DNAL
- drug holidays
- do not administer later than noon
39
what should the nurse educate the patient on when taking dextroamphetamine sulfate?
| AC, DNTOTC, AE
- avoid caffeine
- DO NOT take any OTC cough or cold medication w/o first consulting the HCP
- administer early in the day
40
what is the mechanism of action of "triptans" sumatriptan?
stimulate cerebral arteries to produce vasoconstriction
41
what are "triptans" sumatriptan used to treat?
actue migranes
42
what are the C/I of taking "triptans" sumatriptan?
| CD
cardiovascular disease
43
what are the adverse effects of taking "triptans" sumatriptan?
| N/V, CV, P, F
- coronary vasoconstrict ( neck amd chest tightness)
- paresthesia's
- flushing
44
what should the nurse educate the pt on when taking "triptans" sumatriptan?
take at the first sign of migraines
45
what are opiods used to treat?
- moderate to severe pain
- supression of the cough reflex
- treatment of chronic diarrhea
46
what are the C/I of taking opiods?
- asthma/ respiratory insufficiency
- elevated ICP
- sleep apnea
- paralytic ileus
47
what is the FDA BBW for opiods?
| DNCWB
do not combine with benzodiazepines
48
what are the adverse effects of taking opiods?
| DR, S, N/V, C UR, I, PPP
- decreased respiratory
- sedation
- N/V
- constipation
- Urinary retention
- itching
- pinpoint pupils
49
what are the two reasons a nurse should hold a dose of opiods?
- hold dose if:
- RR is less than 10
- pt is sedated and not arousable even w/ stimulation
50
what is the antidote for opiod OD?
naloxone ( narcan)
51
what should the nurse educate a patient on when taking opiods?
| IIO: F F SS
- increase intake of:
- fiber
- fluids
- stool softners
52
what is morphine used to treat?
post op pain
53
what are the C/I of taking morphine sulfate?
| RI
renal impairment
54
what is codeine used to treat?
- moderate pain
- antitussive
55
what are the C/I of taking codeine?
| A, P, PPT
- allergy
- pregnancy
- pediatric pt
56
what is hyromorphone (dilaudid) used to treat?
moderate to severe pain
57
what is fentanyl used to treat?
- moderate to severe pain
- IV w/ anasethics for surgerical procedures
58
what should a nurse understand before administering fentanyl to a patient?
| tolerance, cancer, steady pain control, max use?
- can only be used in opiod tolerate pt's
- it is used for the management of cancer
- it takes 6-12 hours to reach steady pain control
- patch is only good for 72 hours
59
what should the nurse educate a patient on when applying a fentanyl patch?
- do not cut the patch or expose to heat because it increases rate of absorption which can lead to respiratory arrest
- flush used patch down the toilet
60
what is oxycodone used to treat?
- moderate to severe pain
61
what are the adverse effects of naloxone hydrochloride (narcan)?
| BPD
- BP instability
- dysrhythmias
- pulmonary edema
62
what should the nurse educate the patient on when taking antiepiletic drugs?
never stop abruptly
63
what is the FDA BBW for antiepileptic?
Risk for
risk for suicidal thoughts and behavoirs
64
what are the adverse effects of taking antiepileptic drugs?
| N/V, DIZZ, DROW, L
- N/V
- dizziness
- drowsiness
- lethargy
65
what should the nurse understand about the TI levels of antiepileptics?
| P and Carb
Phenytoin: 10-20 mcg/mL
Carbamazepine: 4- 12 mcg/ mL
66
what should the nurse understand about a seizing pt?
- do not attempt to pry open the mouth during an episode
67
what is phenytoin (dilantin) used to treat?
management and treatment of generalized and partial seizures
68
what are the C/I of taking phenytoin (dilantin)?
| B,HPBD, MDI
- bradycardia
- highly protein bound drug
- many drug interactions
69
what should the nurse understand before administering phenytoin (dilantin)?
| measles
- if the pt has a measles type of rash contact HCP and hold dose
- review baseline eyes, neuromuscular, CBC, and liver function
70
what is the only solution that phenytoin (dilantin) can be infused w?
normal saline
71
what is carbamazepine (Tegretol) used to treat?
management and treatment of generalized and partial seizures
72
what are the C/I of taking carbamazepine (Tegretol)?
do not use for myoclonic ir absence seizures
73
what should the nurse teach the patient about carbamazepine (Tegretol)?
| juice
avoid grapefruit juice and pomegranate juice
74
what are the C/I of taking gabapentin (Neurontin)?
alcohol causes additive CNS depression
75
what are the adverse effects of taking gabapentin?
| DIZZ, DROW, N, VASC, E
- dizziness
- drowsiness
- nausea
- visual and speech changes
- edema
76
what is levetiracetam ( Keppra) to treat?
treatment and prevention of partial seizures w/ and w/o secondary generalization
77
what are the adverse effects of taking levetiracetam ( Keppra)?
| DIZZ, DROW, HYPE, BC
- dizziness
- drowsiness
- hyperactivity
- behavior changes
78
What is the C/I of taking selegiline?
| o.t
- opioids
- tramadol
79
What are the adverse effects of taking selegiline?
-
80
What should the nurse understand about a pt on who is taking selegiline?
| TD, GPTB, NPO
- tabs dissolve
- give prior to breakfast
- NPO 5 minutes prior and after dose
81
what the nurse educate the pt on when taking selegiline?
| cps, avoid tyra
- change positions slowly
- avoid tyramine contaning foods
82
what is lithium salts used to treat?
acute mania
83
what are the C/I of taking lithium salts?
| S, D, PCD, RI, NSAIDS, TH, ACE
- salt
- dehydration
- pregnancy D
- renal impairment
- NSAIDS, thiazide, ACE
84
What are the adverse effects of taking lithium salts?
| GIU, C, SS, S, D, HYPO
- GI Upset
- confusion
- slurred speech
- seizures
- dysrythmia
- hypotension
85
What should the nurse understand about antidepressants?
delayed onset of action (4-8 weeks response time)
86
what is the FDA BBW for all antidepressants?
- suicide
87
what is fluoxetine (prozac) used to treat?
| D, B, O/ED, OCD, PTSD
- depression
- bipolar
- obesity and eating disorders
- OCD
- PTSD
88
what are the C/I of taking SSRI's?
| M, L, METO, B, W, SJW
- highly protien bound
- MAOIs
- lithium
- metoclopramide
- benzo
- warfarin
- st john's wort
89
What are the adverse effects of taking SSRI's?
| 3D, A, SS
- 3 d's
- asthenia
- serotnin syndrome
90
# SNRI
what is duloxentine is used to treat?
| D, A, NPP, FM
- depression
- anxeity
- neuropathic pain
- fibromyalgia
91
what is the FDA BBW for antipyschotics?
| IRFD, SI, PFESP
- increased risk of death in older adults
- suicidal ideation
- potential for ESP
92
What is Haldol used to treat?
long term management of pyschosis
93
what are the C/I of Haldol?
- parkinson's disease
- high dose of other CNS depressants
94
what is abilify used to treat?
| s, bd, mdd, aaw/a
- schizophrenia
- Bipolar disorder
- Major depressive disorder
- agitation associated w/ autism
95
what are the adverse effects of taking abilify?
| OH, WG, MS
orthostatic hypotension
weight gain
metobolic syndrome
96
what is the reversal for benzo OD?
flumzinal
