Nervous System Drugs

Question 1

Morphine (Brand Name)

Answer 1

Roxanol, MS Contin

Question 2

Morphine (Class)

Answer 2

Schedule II Opioid Analegesic

Question 3

Morphine (Action)

Answer 3

Aleviates pain through CNS action; depresses respiratory drive; causes vasodilation; decreases venous return, preload, and afterload decreasing myocardial oxygen demand

Question 4

Morphine (Indication)

Answer 4

heart failure; acute cardiogenic pulmonary edema; CP associated with AMI

Question 5

Morphine (Contraindications)

Answer 5

TBI; COPD excaerbation; bradypnea; hypotension; DLOC; suspected hypovolemia; MAOI within 14 days

Question 6

Morphine (Routes)

Answer 6

IV; IO; IM; SQ

Question 7

Morphine (Side Effects)

Answer 7

confusion; sedation; headache; CNS depression; bradypnea; apnea; bronchospasm; hypotension; syncope; N/V

Question 8

Morphine (Interactions)

Answer 8

potentiates sedative effects of phenothiazines; CNS depressants may potentiate effects; MAOIs cause paradoxical excitation

Question 9

Morphine (Adult Dose)

Answer 9

2 - 4 mg over 1 - 5 minutes; 2 - 8 mg at 5 - 15 min (STEMI); 1 - 5 mg IV (NSTEMI)

Question 10

Morphine (Special Considerations)

Answer 10

pregnancy class C; rapidly crosses placenta; vagotonic effects in patients with acute inferior MI; have Narcan antidote on standby

Question 11

Meperidine Hydrochloride (Brand Name)

Answer 11

Demerol

Question 12

Meperidine Hydrochloride (Class)

Answer 12

Opioid analgesic; schedule II

Question 13

Meperidine Hydrochloride (Action)

Answer 13

Synthetic opioid analgesic whose effects on the CNS and smooth muscle are similar to morphine

Question 14

Meperidine Hydrochloride (Indication)

Answer 14

analgesia for moderate to severe pain

Question 15

Meperidine Hydrochloride (Contra)

Answer 15

patients taking MAOIs; during labor or delivery of a premature infant; undiagnosed abdominal pain; TBI

Question 16

Meperidine Hydrochloride (Routes)

Answer 16

IV; IO; IM; SQ

Question 17

Meperidine Hydrochloride (Side Effects)

Answer 17

seizures; confusion; sedation; dysphoria; headache; hallucinations; ICP; hypotension

Question 18

Meperidine Hydrochloride (Interactions)

Answer 18

potentiates effects of CNS depressants; do not use in pt with MAOI within 14 days

Question 19

Meperidine Hydrochloride (Dose)

Answer 19

50 - 100 mg IM/SQ; 25 - 50 mg slow IV/IO

Question 20

Meperidine Hydrochloride (Considerations)

Answer 20

preg. class C; use caution in pt with COPD and asthma; may aggravate seizures; have Naloxone on standby

Question 21

Nalbuphine Hydrochloride (Brand Name)

Answer 21

Nubain

Question 22

Nalbuphine Hydrochloride (Class)

Answer 22

synthetic opioid agonist/antagonist

Question 23

Nalbuphine Hydrochloride (Action)

Answer 23

activates opiate receptors in the CNS; preferred for chest pain as it reduces the myocardial oxygen demand without reducing BP

Question 24

Nalbuphine Hydrochloride (Indication)

Answer 24

CP associated with AMI; moderate to severe acute pain

Question 25

Nalbuphine Hydrochloride (Contra.)

Answer 25

TBI; undiagnosed abdominal pain; diarrhea caused by poison; hypovolemia; hypotension

Question 26

Nalbuphine Hydrochloride (Routes)

Answer 26

IV; IO

Question 27

Nalbuphine Hydrochloride (Side Effects)

Answer 27

headache; dizziness; vertigo; seizure; CNS depression

Question 28

Nalbuphine Hydrochloride (Interactions)

Answer 28

potentiates effects of CNS depressants

Question 29

Nalbuphine Hydrochloride (Dose)

Answer 29

2 - 5 mg slow IV; may repeat 2 mg doses PRN up to 10 mg total

Question 30

Nalbuphine Hydrochloride (Special Considerations)

Answer 30

Preg. Class B; use caution in patients with respiratory dysfunction; have Naloxone readily available