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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
Q

Why should we monitor CBC, lung sounds, and s/s of edema in patients taking carbamazepine ?

A

causes blood dyscrasias (agranulocytosis) and heart failure / fluid overload

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26
Q

patients takign anti-seizure drugs should wear?

A

medic alert bracelet

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27
Q

Can patients on anti-seizure drugs drive ?

A

not until physician clears

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28
Q

What can happen if anti-seizure meds are abruptly stopped?

A

status epilepticus , ALWAYS TAPER

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29
Q

What are general seizure precautions?

A

padded side rails, oxygen at bedside, suctioning at bedside

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30
Q

Antiseizure drugs (and ABX) decrease the effectiveness of this drug? What should patients do?

A

decrease oral contraceptives ; use backup method (most antiseizure drugs are category D)

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31
Q

What should patients avoid on antiseizure drugs

A

CNS depressants, grapefruit juice

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32
Q

patients on antiseizure drugs should monitor for rash because this can indicate

A

stevens johnson syndrome

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33
Q

Indications for donepezil

A

alzheimer’s disease

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34
Q

How to evaluate effectiveness of donepezil?

A

assess orientation: ask about person, place time

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35
Q

What should we have next to clients on donepezil

A

crash cart in case of cholinergic crisis

36
Q

Indications for carbidopa-levodopa

A

parkinson’s disease

37
Q

Patient teaching for carbidopa-levodopa

A

take with food and avoid protein (interferes with drug transport), maintain good oral hygiene, anticholinergic teaching, darkening of urine is harmless, avoid multivitamins

38
Q

Indications for neostigmine

A

myasthenia gravis

39
Q

Side/ adverse effects of neostigmine

A

excessive muscarinic stimulation, cholinergic crisis

40
Q

what is antidote for cholinergic crisis brought on by neostigmine

A

atropine

41
Q

How to distinguish between cholinergic crisis and myasthenic crisis

A

administer edrophonium (cholinergic)

42
Q

If we administer edrophonium and symptoms improve, then we administer?

A

more cholinergic

43
Q

if we administer edrophonium and symptoms worsen, we administer?

A

atropine (antidote)

44
Q

Symptoms of cholinergic crisis

A

increased gi motility, diarrhea, cramping, bradycardia, pupillary constriction (meosis), dyspnea

45
Q

Symptoms of myasthenic crisis

A

muscle weakness, quadriparesis/plagia, SOB, respiratory insufficiency, difficulty swallowing

46
Q

What is the antidote for cholinergic crisis

A

atropine

47
Q

What drugs are central acting muscle relaxants

A

baclofen, dantrolene, cyclobenzaprine

48
Q

Indications for central acting muscle relaxants

A

muscle spasms

49
Q

What drug can be used to treat malignant hyperthermia

A

dantrolene

50
Q

what would indicate a muscle relaxant has been effective

A

decreased pain and increased range of motion

51
Q

What are the neuromuscular blocking drugs

A

succinylcholine, pancuronium, vancuronium

52
Q

Adverse effects of neuromuscular blockign drugs

A

malignant hyperthermia

53
Q

Side effects of malignant hyperthermia

A

high fever, rigid muscles, tachycardia, and sweating

54
Q

What is the antidote for malignant hyperthermia

A

dantrolene

55
Q

What drugs are typical antipsychotics

A

haloperidol, chlorpromazine

56
Q

Indications for typical antipsychotics

A

acute and chronic psychotic disorders (schizophrenia, manic states, drug induced psychosis, management of aggressive patients)

57
Q

Adverse effect of typical antipsychotics

A

neuroleptic malignant syndrome

58
Q

adverse effect of haloperidol causes muscle spasm of face, neck, tongue and back

A

acute dystonia

59
Q

Other adverse effects of typical antipsychotics

A

parkinsonism, akathisia (inability to stay still), tardive dyskinesia (uncontrollable movements)

60
Q

Symptoms of neuroleptic malignant syndrome

A

sudden high-grade fever, blood pressure fluctuations, dysrhythmias, muscle rigidity, diaphoresis, tachycardia, changes in LOC (coma)

61
Q

What drugs are atypical antipsychotics

A

olanzapine, clozapine, risperidone

62
Q

Side/ adverse effects of atypical antipsychotics

A

diabetes mellitus, weight gain, hypercholesterolemia, hypotension, anticholinergic effects, agitation, dizziness, elevated prolactin, sexual dysfunction

63
Q

Potentially serious adverse effect of clozapine

A

agranulocytosis

64
Q

Patient teaching for atypical antipsychotics

A

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
Q

How to recognize benzodiazepines

A

-lam and -pam

66
Q

Adverse effects of benzodiazepines

A

CNS depression, anterograde amnersia, toxicity, paradoxical response, withdrawal effects

67
Q

Patient teaching for benzodiazepines

A

taper off, dependence and withdrawal will occur, avoid CNS depressants and driving, avoid frapefruit juice, take with food, administer at bedtime

68
Q

withdrawal symptoms of benzodiazepines

A

irritability, tachy, insomnia, anxiety, diaphoresis, tremors

69
Q

What drugs are SSRIs

A

fluoxetine, sertaline, citalopram, escitalopram, fluvoxamine, paroxetine

70
Q

Indications for SSRIs

A

treat major depression

71
Q

Adverse effects of SSRIs

A

Sexual dysfunction (causes major nonadherence), serotonin syndrome, hyponatremia, withdrawal syndrome

72
Q

symptoms of serotonin syndrome

A

confusion, agitaion, tachycardia, diaphoresis, fever, tremors, NVD, adominal pain, seizures

73
Q

Symptos of withdrawal syndrome with SSRIs

A

HA, nausea, tremors, anxiety, visual changes

74
Q

Nursing considerations for SSRI’s

A

interact with grapefruit juice, pregnancy category C (paroxetine is pregnancy category D), contraindicated in those taking MAOIs or TCAs

75
Q

How to treat serotonin syndrome

A

treatment is symptomatic

76
Q

What drugs are MAOIs

A

phenelzine, isocarboxazid, selegiline transdermal, tranylcypromine

77
Q

Indications for MAOIs

A

neurotic or atypical depression

78
Q

Interactions for MAOIs

A

anything with tyramine (aged cheese, smoked meat, seafood, wine)

79
Q

What drugs are TCAs

A

amitriptyline and nortriptyline

80
Q

Side and adverse effects of TCAs

A

orthostatic hypotension, anticholinergic effects, sedation, toxicity, decreased seizure threshold, excessive sweating, sexual dysfunction, arrhythmias

81
Q

Indications for lithium

A

reduce fluctuations in mood, bipolar disorder

82
Q

Adverse effects of lithium

A

dry mouth, gi upset, weight gain, polyuria, fine hand tremors

83
Q

What can increase pt risk of lithium toxicity and what should you teahc them

A

dehydration, increase fluids

84
Q

What s/s of advanced lithium toxicity 2-2.5

A

extreme polyuria of dilute urine, tinnitus, ataxia, involuntary extremity movements, blurred vision, severe hypotension that can lead to coma and possibly death, seizures

85
Q
A

Pharmacology (12 decks)

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