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Pharmacology > Module 6 > Flashcards

Module 6 Flashcards

1
Q

How to recognize benzodiazepines

A

end in -lam and -pam

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2
Q

Indications for benzodiazepines

A

treat GAD, panic disorder,insomnia?,seizure , trauma (can be used to induce sedation.. think surgery)

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3
Q

Side effects/adverse effectsof benzodiazepines

A

hangover effects, REM rebound (vivid dreams and nightmares) , CNS and Respiratory depression (A), anterograde amnesia, paradoxical response, toxicity (A), dependence and withdrawal (A)

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4
Q

What are signs of benzodiazepine toxicity

A

CNS depression, hypotension, catdiac/respiratory arrest, drowsy, confused

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5
Q

Withdrawal symptoms of benzodiazepines

A

MATH IS TIDY; muscle twitch, anxiety, tachycardia, HTN, insomnia, seizues, tremors, irritability, diaphoresis

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6
Q

How to prevent withdrawal on benzodiazepines

A

taper dose

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7
Q

should those on benzodiazepines take opioids?

A

NO ; black box warning with opiodis

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8
Q

What is the antidote for benzodiazepines

A

flumazenil (0.2 mg IV)

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9
Q

Max doses for flumazenil

A

4 doses

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10
Q

Other nursing considerations for benzodiazepines

A

medication reconciliation, monitor VS and LOC, renal function, fall precautions

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11
Q

What are the priority actions, in order, for suspected benzodiazepines

A

bag mask, intubation, start an IV, give flumazenil, cardiac monitor, gastric lavage

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12
Q

patient teaching for benzodiazepines

A

taper dose, take before bed, avoid grapefruit juice and activities requiring alertness, do not use longer than 7-10 dayys

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13
Q

Should those on benzodiazepines have alcohol

A

NO

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14
Q

What drugs are non-benzodiazepines ?

A

zolpidem, zaleplon, eszopiclone

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15
Q

Indications for non-benzodiazepines

A

acute insomnia

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16
Q

What drugs are hydantoins

A

phenytoin, ethotoin, fosphenytoin (-toin)

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17
Q

Indications of hydantoins

A

anticonvulsant; raise seizure threshold

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18
Q

Adverse effects of phenytoin

A

gingival hyperplasia, blood dyscrasias, osteomalacia, stevens- johnson, cardiac collapse , liver damage

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19
Q

Patient teaching for phenytoin

A

get routine dental care, take calcium and vitamin D, avoid herbs and OTC meds, take at same time each day

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20
Q

Indication for carbamazepine

A

anticonvulsants

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21
Q

therapeutic drug level for carbamazepine

A

4-12 mcg/mL

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22
Q

Adverse effects of carbamazepine

A

blood dyscrasias, stevens johnosn, SI, hepatotoxicity

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23
Q

What are examples of blood dyscrasias we may see with carbamazepine

A

aplastic anemia, thrombocytopenia, agranulocytosis

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24
Q

Nursing considerations for carbamazepine

A

CBC, serum drug level, SI. CNS changes, ECG, electrolytes. Lung sound and edema. Seizure precautions. LFT

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25
Why should we monitor CBC, lung sounds, and s/s of edema in patients taking carbamazepine ?
causes blood dyscrasias (agranulocytosis) and heart failure / fluid overload
26
patients takign anti-seizure drugs should wear?
medic alert bracelet
27
Can patients on anti-seizure drugs drive ?
not until physician clears
28
What can happen if anti-seizure meds are abruptly stopped?
status epilepticus , ALWAYS TAPER
29
What are general seizure precautions?
padded side rails, oxygen at bedside, suctioning at bedside
30
Antiseizure drugs (and ABX) decrease the effectiveness of this drug? What should patients do?
decrease oral contraceptives ; use backup method (most antiseizure drugs are category D)
31
What should patients avoid on antiseizure drugs
CNS depressants, grapefruit juice
32
patients on antiseizure drugs should monitor for rash because this can indicate
stevens johnson syndrome
33
Indications for donepezil
alzheimer's disease
34
How to evaluate effectiveness of donepezil?
assess orientation: ask about person, place time
35
What should we have next to clients on donepezil
crash cart in case of cholinergic crisis
36
Indications for carbidopa-levodopa
parkinson's disease
37
Patient teaching for carbidopa-levodopa
take with food and avoid protein (interferes with drug transport), maintain good oral hygiene, anticholinergic teaching, darkening of urine is harmless, avoid multivitamins
38
Indications for neostigmine
myasthenia gravis
39
Side/ adverse effects of neostigmine
excessive muscarinic stimulation, cholinergic crisis
40
what is antidote for cholinergic crisis brought on by neostigmine
atropine
41
How to distinguish between cholinergic crisis and myasthenic crisis
administer edrophonium (cholinergic)
42
If we administer edrophonium and symptoms improve, then we administer?
more cholinergic
43
if we administer edrophonium and symptoms worsen, we administer?
atropine (antidote)
44
Symptoms of cholinergic crisis
increased gi motility, diarrhea, cramping, bradycardia, pupillary constriction (meosis), dyspnea
45
Symptoms of myasthenic crisis
muscle weakness, quadriparesis/plagia, SOB, respiratory insufficiency, difficulty swallowing
46
What is the antidote for cholinergic crisis
atropine
47
What drugs are central acting muscle relaxants
baclofen, dantrolene, cyclobenzaprine
48
Indications for central acting muscle relaxants
muscle spasms
49
What drug can be used to treat malignant hyperthermia
dantrolene
50
what would indicate a muscle relaxant has been effective
decreased pain and increased range of motion
51
What are the neuromuscular blocking drugs
succinylcholine, pancuronium, vancuronium
52
Adverse effects of neuromuscular blockign drugs
malignant hyperthermia
53
Side effects of malignant hyperthermia
high fever, rigid muscles, tachycardia, and sweating
54
What is the antidote for malignant hyperthermia
dantrolene
55
What drugs are typical antipsychotics
haloperidol, chlorpromazine
56
Indications for typical antipsychotics
acute and chronic psychotic disorders (schizophrenia, manic states, drug induced psychosis, management of aggressive patients)
57
Adverse effect of typical antipsychotics
neuroleptic malignant syndrome
58
adverse effect of haloperidol causes muscle spasm of face, neck, tongue and back
acute dystonia
59
Other adverse effects of typical antipsychotics
parkinsonism, akathisia (inability to stay still), tardive dyskinesia (uncontrollable movements)
60
Symptoms of neuroleptic malignant syndrome
sudden high-grade fever, blood pressure fluctuations, dysrhythmias, muscle rigidity, diaphoresis, tachycardia, changes in LOC (coma)
61
What drugs are atypical antipsychotics
olanzapine, clozapine, risperidone
62
Side/ adverse effects of atypical antipsychotics
diabetes mellitus, weight gain, hypercholesterolemia, hypotension, anticholinergic effects, agitation, dizziness, elevated prolactin, sexual dysfunction
63
Potentially serious adverse effect of clozapine
agranulocytosis
64
Patient teaching for atypical antipsychotics
report abnormal movements, may cause drowsiness, avoid CNS depressants, report s/s of diabetes mellitus, diet and exercise, change positions slowly, teach ways to manage anticholinergic effects
65
How to recognize benzodiazepines
-lam and -pam
66
Adverse effects of benzodiazepines
CNS depression, anterograde amnersia, toxicity, paradoxical response, withdrawal effects
67
Patient teaching for benzodiazepines
taper off, dependence and withdrawal will occur, avoid CNS depressants and driving, avoid frapefruit juice, take with food, administer at bedtime
68
withdrawal symptoms of benzodiazepines
irritability, tachy, insomnia, anxiety, diaphoresis, tremors
69
What drugs are SSRIs
fluoxetine, sertaline, citalopram, escitalopram, fluvoxamine, paroxetine
70
Indications for SSRIs
treat major depression
71
Adverse effects of SSRIs
Sexual dysfunction (causes major nonadherence), serotonin syndrome, hyponatremia, withdrawal syndrome
72
symptoms of serotonin syndrome
confusion, agitaion, tachycardia, diaphoresis, fever, tremors, NVD, adominal pain, seizures
73
Symptos of withdrawal syndrome with SSRIs
HA, nausea, tremors, anxiety, visual changes
74
Nursing considerations for SSRI's
interact with grapefruit juice, pregnancy category C (paroxetine is pregnancy category D), contraindicated in those taking MAOIs or TCAs
75
How to treat serotonin syndrome
treatment is symptomatic
76
What drugs are MAOIs
phenelzine, isocarboxazid, selegiline transdermal, tranylcypromine
77
Indications for MAOIs
neurotic or atypical depression
78
Interactions for MAOIs
anything with tyramine (aged cheese, smoked meat, seafood, wine)
79
What drugs are TCAs
amitriptyline and nortriptyline
80
Side and adverse effects of TCAs
orthostatic hypotension, anticholinergic effects, sedation, toxicity, decreased seizure threshold, excessive sweating, sexual dysfunction, arrhythmias
81
Indications for lithium
reduce fluctuations in mood, bipolar disorder
82
Adverse effects of lithium
dry mouth, gi upset, weight gain, polyuria, fine hand tremors
83
What can increase pt risk of lithium toxicity and what should you teahc them
dehydration, increase fluids
84
What s/s of advanced lithium toxicity 2-2.5
extreme polyuria of dilute urine, tinnitus, ataxia, involuntary extremity movements, blurred vision, severe hypotension that can lead to coma and possibly death, seizures
85

Pharmacology (12 decks)

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