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Pharmacology Examination > Module 2A and 2B Neuropharmacology CNS/ANS drugs > Flashcards

Module 2A and 2B Neuropharmacology CNS/ANS drugs Flashcards

1
Q

Aids in withdrawal effects related to autonomic hyperactivity (diarrhea,
nausea, vomiting2B

A

CLONIDINE

CATAPRES

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2
Q

opioid agonist that replaces opioids, prevents abstinence syndrome Part of
the 12 step self-help program

A

METHADONE

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3
Q

Used for detoxification and maintenance, decreases craving,

administered SL, IM, IV, (for opioid)

A

BUPRENORPHINE

SUBUTEX

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4
Q

An opioid antagonist that suppresses craving

and pleasurable effects of alcohol

A

naltrexone

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5
Q

For alcohol aversion therapy

A

disulfiram

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6
Q

Seizure precautions

A

(padded side

rails and suction equipment at bedside)

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7
Q

Detoxification drugs

A

(Benzodiazepines) Chlordiazepoxide (Librium), diazepam

Valium), lorazepam (Ativan

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8
Q

Succinylcholine nursing intervention

A

Test dose before adm, no resp. distress, proceed to adm

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9
Q

When does alcohol withdrawal starts

A

within 4 to 12 hrs of the last intake of alcohol

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10
Q

Withdrawing from a substance that has the potential to cause
addiction can cause abstinence syndrome. Manifestations of abstinence syndrome can be distressing and may lead to coma and death; occurs when clients abruptly withdraw from a substance to which they are physically dependent.

A

ABSTINENCE SYNDROME

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11
Q

DOC for short procedures [less than 3 minutes] and for orthopedic manipulations; acts like acetylcholine but not inactivated by ACHe

A

Succinylcholine

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12
Q

Nursing Intervention for Neuromuscular Blockers

A

Administer sedatives or general anesthetics before NMBs; Should be administered by personnel skilled in airway management; NMBs precipitates if mixed with alkaline solutions

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13
Q

Directly activates DA receptors

First line drugs

A 
DOPAMINE
AGONISTS
Pramipexole
Ropinirole
Bromocriptine
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14
Q

● Competitive/ stabilizing drugs

● Compete with ACh to prevent muscle from contracting

A

( NON DEPOLARIZING BLOCKING DRUGS)

Atracurium, Cisatracurium, Doxacurium, Mivacurium, Pancuronium, Rocuronium, Vecuronium

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15
Q

Relax skeletal muscles during surgery
Reduce intensity of muscle spasms in drug-induced seizures
Manage patients who are fighting the use of ventilator to help
with breathing

A

NEUROMUSCULAR BLOCKING DRUGS

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16
Q

○ DOC for spasticity
○ Indicated for paraplegic/ quadriplegic patients with spinal cord
lesions
○ Most common adverse effect is transient drowsiness

A

Baclofen

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17
Q

○ Most effective for spasticity of cerebral origin [i.e. cerebral palsy,
MS, spinal cord injury, stroke]
○ Used for treatment of malignant hyperthermia [complication of
anesthesia causing muscle rigidity and high fever]

A

Dantrolene Sodium ( DIRECT ACTING AGENTS)

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18
Q

For treatment of acute muscle spasms caused by anxiety, pain and
trauma
Treat spasticity from conditions as MS and Cerebral Palsy

A 
(CENTRALLY ACTING AGENTS) 
Carisoprodol
Chlorphenesin
Metaxalone
Tizanidine
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19
Q

Defined as involuntary contraction of a muscle or muscle

group; Often painful and decreases level of functioning

A

Muscle Spasm

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20
Q

○ Partial seizures in adults
○ Treatment of pain from diabetic neuropathy
○ Tremors associated with MS, bipolar disorder and migraine
prophylaxis
Works to increase GABA in the brain

A

gabapentin

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21
Q

Nursing intervention for carboxylic acid derivatives

A

Dilute the drug with a compatible diluent if injecting IV and give
over 1 hour, don’t exceed 20mg/min

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22
Q

Carboxylic Acid Derivatives therapeutic level

A

50-100 mcg/mL

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23
Q

for All partial and generalized seizures; Bipolar disorder; Migraine

A

(CARBOXYLIC ACID DERIVATIVES)

Valproate, Valproic Acid, Divalproex

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24
Q

Diazepam therapeutic limit

A

5mg/min

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25
Q

Treatment for absence, atypical absence seizures

A

Clonazepam

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26
Q

DOC for acute management of status epilepticus

A

IV Lorazepam

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27
Q

○ is restricted to acute treatment of status epilepticus
○ Not recommended for long-term use due to high potential for
addiction

A

Diazepam (. BENZODIAZEPINES)

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28
Q

Adverse effects of this drug includes leukopenia, anemia and thrombocytopenia [fatal aplastic anemia]

A

carbamazepine

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29
Q

Carbamazepine (IMINOSTILBENES) therapeutic level

A

4-12 mcg/mL

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30
Q

Nursing intervention for carbamazepine

A

Do not drink grapefruit juice

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31
Q

Adverse reactions of this drug includes Rashes, hives and Steven-Johnson Syndrome [fatal inflammatory disease]

A

carbamazepine

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32
Q

○ Cornerstone of epilepsy therapy
○ Active against partial seizures and tonic-clonic seizures but not
absence seizures
○ Suppresses neuronal discharge by delaying recovery of sodium
channels
○ Has fewer side effects than phenytoin and phenobarbital

A

Carbamazepine

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33
Q

Phenobarbital therapeutic limit

A

60mg/min

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34
Q

T or F: IV phenobarbital is reserved for emergency treatment

A

T

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35
Q

Effective against partial seizures and generalized tonic-clonic
seizures but not absence seizures
○ Suppresses seizures by potentiating the effects of GABA
○ Can be used as daytime sedative “sleeping pills”
○ Able to suppress seizures without causing generalized CNS
depression

A

Phenobarbital

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36
Q

phenytoin therapeutic level

A

10-20 mcg/mL

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37
Q

Nursing intervention for phenytoin (IV push)

A

Watch out for PURPLE GLOVE SYNDROME; May precipitate with D5W; clear tubing first with PNSS

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38
Q

most commonly prescribed anticonvulsant drug; Stabilize nerve cells to keep them from getting overexcited by increasing efflux or decreasing influx of sodium ions; drug of choice for Control of tonic-clonic seizure and complex partial seizures; Status epilepticus and Prevention and treatment of seizures during neurosurgery

A

Phenytoin

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39
Q

Simple Partial, Complex Partial, Secondary Generalized Seizures
Tonic-clonic

A

valproic acid, phenobarbital, primidone, phenytoin, cabamazepine

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40
Q

for all types of seizzures

A

valproic acid

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41
Q

When px have seizures turn them to

A

Turn them at the side - they can choke at their own saliva

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42
Q

abnormal motor phenomenon

A

convulsions

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43
Q

Excitation spreads widely throughout

both hemispheres of the brain

A

Generalized Seizures

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44
Q

Excitation undergoes limited spread from the

focus to adjacent cortical areas

A

Partial Seizures

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45
Q

general term that applies to all types of epileptic events

A

seizures

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46
Q

Group of disorders characterized by excessive excitability of
neurons in the CNS

A

EPILEPSY

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47
Q

Nursing intervention on dopaminergic drugs

A

Avoid high-protein meals; Administer with food to prevent GI irritation [except
Levodopa]; If the patient receives a single-dose, the drug is better given
at bedtime

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48
Q 
May cause
Orthostatic hypotension
Ventricular tachycardia
Bradycardia
Worsening angina
A

Bromocriptine

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49
Q 
May cause 
N&v
Orthostatic hypotension
Anorexia
Neuroleptic malignant syndrome
Arrhythmias
Confusion
A

Levodopa

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50
Q

When taking dopaminergic drugs, therapeutic level is reduced when taken with

A

pyridoxine [VIT B6], phenytoin,

benzodiazepines, reserpine and papaverine

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51
Q

Use with antipsychotic reduces ____

A

effectiveness of levodopa

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52
Q

Levodopa + Maoi causes

A

Hypertensive crisis

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53
Q

Inhibits breakdown of dopamine; For newly

diagnosed patients

A

MAO-B inhibitors

Selegiline Rasagiline

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54
Q

Anti-viral but promotes release of dopamine; 2nd or 3rd line

drug

A

DOPAMINE
RELEASER
Amantadine

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55
Q

Inhibits breakdown
of levodopa; Adjunct to
levodopa

A

COMT INHIBITORS
Entacapone
Tolcapone

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56
Q

Converted to Dopamine and activates dopamine

receptors; First-line drug/ supplement to dopamine agonis

A

DOPAMINE
REPLACEMENT
Levodopa
Levodopa/Carbidopa

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57
Q

drugs that block receptors for ACh

A

Anticholinergic Agents

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58
Q

directly/indirectly cause activation of dopamine receptors

A

dopaminergic drugs

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59
Q

● Slowly progressive neurodegenerative disorder characterized by
tremor, rigidity, postural instability and slowed movement
● Affects the extrapyramidal system which influences movement

A

PARKINSON’S DISEASE

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60
Q

doxapram nursing intervention

A

Never give more than 3 liters per minute because respiratory

drive will be gone

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61
Q

Treatment of respiratory depression caused by drug overdose

and COPD

A

Doxapram

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62
Q

Stimulate respiration (amphetamine)

A

Xanthine (analeptic)

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63
Q

Treatment of narcolepsy

A

Modafinil

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64
Q

■ Given to increase child’s attention span and cognitive
performance
■ Used to treat narcolepsy

A

Methylphenidate

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65
Q

Stimulate the release of NE and DA from the brain and SNS

A

: AMPHETAMINES

66
Q

Characterized by falling asleep during normal waking activities
[driving/ talking]; Unable to move and may collapse

A

NARCOLEPSY

67
Q

Dysregulation of the transmitters serotonin, norepinephrine,

dopamine

A

ADHD [Attention Deficit/ Hyperactivity Disorder]

68
Q

state in which abrupt discontinuation of

drug use will precipitate a withdrawal syndrome

A

Physical Dependence

69
Q

T or F: CHILDREN are much more sensitive to CNS drugs than adults

A

T

70
Q

Impedes the entry of drugs into the brain

A

BLOOD BRAIN BARRIER

71
Q

How many compounds does CNS has that serve as neurotransmitters

A

21

72
Q

Used for psychiatric disorders, suppression of seizures, relief of
pain, production of anesthesia

A

CNS DRUGS

73
Q

Process by which information is carried across the gap between
neuron and postsynaptic cell

A

Synaptic Transmission

74
Q

Conducting an action potential down the axon of the neuron

A

Axonal Conduction

75
Q

Study of drugs that alter processes controlled by the nervous
system

A

NEUROPHARMACOLOGY

76
Q

Assess the ff in antinicotinic agents

A

Urine retention and bladder distention
Paralytic ileus
Respiratory adequacy

77
Q

Adverse effects of Antinicotinic agents

A

● Prolong apnea
● Hyperkalemia
● Malignant hyperthermia

78
Q

Causes sodium channels to open for prolonged depolarization
For rapid sequence tracheal intubation
A depolarizing agent

A

Succinylcholine

79
Q

Rapid effect in less than 2 mins, will paralyze small muscles; Binds to ACh receptors but do not induce ion channel opening; Facilitates mechanical ventilator and tracheal intubation

A

Non-Depolarizing Agents

Cisatracurium, Pancuronium, Cisatracurium, Pancuronium

80
Q

○ Stimulate and block cholinergic function
○ Increase production of neurotransmitters
○ Increase BP, HR, but may also decrease BP- non-selective effect
○ CNS Stimulation - causes addiction
○ Not useful in clinical practice
a ganglionic blocker

A

NICOTINE

81
Q

Adverse effects of cholinergic agonists

A 
● D - Diarrhea
● U - Urination
● M – Miosis and Muscle Weakness
● B - Bronchorrhea
● B - Bradycardia
● E - Emesis
● L - Lacrimation
● S – Salivation/ Sweating
82
Q

Adverse effects of Cholinergic blockers

A 
A - Agitation
B - Blurred vision
C - Constipation, Confusion
D - Dry mouth
S - Stasis of urine and Sweating
83
Q

For Parkinson’s like disorders

A

Benztropine

84
Q

COPD, rhinorrhea as inhalation to brochodilate and decrease secretion

A

Ipratropium

85
Q

Motion sickness, Post Op Nausea and Vomiting as patches

A

Scopolamine

86
Q

Same as atropine but with less duration of action

A

Cyclopentolate,

Tropicamide

87
Q

For Mydriasis, Psychoplegia prior to an eye surgery or exam
Blocks M3 – reduced GI motility
Blocks M2 – SA and AV node, tachycardia
in high doses

A

Atropine

88
Q

What to do to lessen n & v

A

Take on empty stomach

89
Q

NEOSTIGMINE (Tensilon) Test

A

increased weakness

90
Q

● Famous for milit

● Caused by overdose of cholinergic agonists

A

CHOLINERGIC CRISIS

91
Q

Alzheimer’s disease to improve cognitive function

A

Donepezil,
Rivastigmine,
Galantamine

92
Q

reverse effects of

anesthesia

A

Neostigmine,

Pyridostigmine

93
Q

Overdose of atropine

A

Physostigmine

94
Q

treatment of open glaucoma

A

Echothiophate

95
Q

Famous for military use as nerve gases

A

INDIRECT ACTING REVERSIBLE cholinergic agonist

96
Q

for acute post-operative and postpartum nonobstructive
urine retention, neurogenic atony of urinary bladder with urine
retention.

A

bethanicol

97
Q

Increase muscle tone in bladder and GIT

A

Bethanechol

98
Q

Constricts pupil, decrease IOP for acute glaucoma

A

Pilocarpine

99
Q

Not as susceptible to AChE, used locally to constrict pupil and
decrease IOP

A

Carbachol

100
Q

Non-specific cholinergic effect, decreases CO, HR, BP, increase GI
activity

A

Acetylcholine

101
Q

transmission of cholinergic signals

A

Nn

102
Q

affects muscle contraction 9receptor)

A

Nm

103
Q

affect skeletal muscles (receptor)

A

nicotinic

104
Q

may increase potassium and decrease heart rate (receptor)

A

M2 (heart)

105
Q

M1 (GU) and M3 (lungs, glands)

A

– may increase calcium activity

106
Q

stimulate smooth muscle and slows HR

A

muscarinic

107
Q

Check apical pulse (<60 bpm alert!); for : mild to moderate hypertension

A

prazosin

108
Q

Hypertension – with vasodilation

A

Carvedilol, Labetalol

109
Q

Glaucoma, decrease

intraocular pressure

A

Timolol (1st gen

110
Q

Propranolol (1st gen)

A

Hypertension, Angina,

Migraine

111
Q

(-olol)

A

beta Blockers

112
Q

Decrease heart rate
Decreases blood pressure
Useful for treating mild to moderate hypertension, angina pectoris
and myocardial infarction

A

BETA BLOCKERS

113
Q

A decrease of 20 mm Hg or more in SBP, a decrease of 10 mm Hg
or more in DBP, and/or
An increase in the HR of 20 beats/minute or more from supine to
standing indicates orthostatic hypotension

A

ORTHOSTATIC HYPOTENSION

114
Q

Alpha blockers examples

A

(zosin)
Terazosin
Doxazosin
Prazosin

115
Q

Blocks alpha and beta receptor blocker

A

ADRENERGIC BLOCKERS

116
Q

non catecholamines aerosol use

A

15 min before exercise

117
Q

cathecolamines iM adm area

A

lateral deltiod area

118
Q

non cathecolamines inhalation adm

A

wait 2 minutes between doses

119
Q

Normal mean arterial pressure

A

> 65

120
Q

Don’t adm in the same IV line as other drugs

A

catecholamines

121
Q

give cardiac glycosides if ordered first

A

cathecolamines

122
Q

for Asthma/ COPD; B2

A

albuterol

123
Q

For Increases heart rate, force of contraction in heart failure, shock; b1

A

Dobutamine

124
Q

antidote for epinephrine

A

phentolamine Mesylate (Regitine)

125
Q

For anaphylaxis, asthma, cardiac stimulation, induction

and maintenance of mydriasis during intraocular surgery; a vasopressor; adrenergic

A

epinephrine

126
Q

receptor for treatment of Asthma, premature labors of contraction

A

Beta 2

127
Q

Receptor for treating Heart failure, cardiac arrest, shock

A

beta 1

128
Q

Receptor for treating Hypertension

A

alpha 2

129
Q

receptor for treating Hypotension, nasal congestion, dilation of pupils

A

alpha 1

130
Q

Has a catechol ring and amines

A

Catecholamines

131
Q

stimulates the release of norepinephrine from terminal nerve

endings.

A

Indirect-Acting Sympathomimetic

132
Q

directly stimulates the adrenergic receptor.

A

Direct-Acting Sympathomimetic

133
Q

stimulate adrenergic receptors

A

sympathomimetic

134
Q

drugs that produces a response

A

agonists

135
Q

Increases salivation

A

parasympa NS

136
Q

Relaxes smooth muscles of the

GI

A

Sympa NS

137
Q

Dilates blood vessels

A

parasympa NS

138
Q

Increases heart rate

A

sympa NS

139
Q

Constricts bronchioles, increase

secretions

A

parasympa NS

140
Q

Dilates pupils

A

SNS

141
Q

inactivates acetylcholine before reaching

organ cells

A

Acetylcholinesterase:

142
Q

Receptor organ cells of PNS

A

nicotinic, muscarinic

143
Q

terminal Neurotransmitter of PNS

A

Acetylcholine

144
Q

Location of PNS

A

cranio sacral

145
Q

Rest and digest response (NS)

A

Parasympathetic system

146
Q

location of SNS

A

thoracolumbar (thoracic and lumbar area)

147
Q

receptor Organs of SNS

A

alpha and beta receptors

148
Q

Terminal Neurotransmitter of SNS

A

Norepoinephrine

149
Q

Fight or flight response (NS)

A

SYMPATHETIC NERVOUS SYSTEM

150
Q

3 types of Termination of the synaptic transmission

A

(a) Reuptake of into nerve terminal - absorbed back to the
nervous terminal
(b) Enzymatic degradation
(c) Diffusion away from the gap

151
Q

Synaptic Transmission

5 processes

A

(1) Synthesis of your neurotransmitter
○ (2) Storage of transmitter in the vesicles
○ (3) Release neurotransmitter because of the response of the
action potential
○ (4) Action at the receptor
○ (5) Termination of the synaptic transmission

152
Q

Voluntary; Innervates the skeletal muscles

A

SOMATIC NS

153
Q

Involuntary; Controls and regulates the heart, GI, respiratory system, bladder,
eyes and glands

A

AUTONOMIC NS/ VISCERAL SYSTEM

154
Q

2 branches of ANS

A

sympathetic/adrenergic and parasympathetic/cholinergic

155
Q

2 branches of efferent/motor PNS

A

ANS and SMS

156
Q

2 branches of PNS

A

afferent/sensory and efferent/motor

157
Q

2 parts of CNS

A

brain and spinal cord

158
Q

2 Types of Nervous System

A

CNS and PNS

159
Q

A decrease of 20 mm Hg or more in SBP, a decrease of 10 mm Hg
or more in DBP, and/or
An increase in the HR of 20 beats/minute or more from supine to
standing indicates orthostatic hypotension

A
160
Q

Conducting an action potential down the axon of the neuron

A

Axonal Conduction

Pharmacology Examination (3 decks)

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