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Nursing School > 💊- Neuro, Antiemetic, Opioid Drugs Test > Flashcards

💊- Neuro, Antiemetic, Opioid Drugs Test Flashcards

0
Q

What are the side effects of antihistamines

A

Anticholinergic (drowsiness, dry mouth, constipation) tachycardia, blurred vision and urinary retention

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1
Q

What is the action of antiemetic antihistamines

A

Inhibit vestibular stimulation in the middle ear

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2
Q

Dimenhydrinate

A

Dramamine

Type: antiemetic nonprescription antihistamine

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3
Q

Meclizine hydrochloride

A

Antivert

Type: antiemetic nonprescription antihistamine

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4
Q

How does bismuth subsalicylate work

A

(Pepto bismol)

Acts directly on gastric mucosa to decrease irritation and suppress vomiting

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5
Q

Bismuth subsalicylate

A

Pepto bismol

Type: nonprescription antiemetic

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6
Q

Phosphorated carbohydrate solution

A

Emetrol

Type: nonprescription antiemetic

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7
Q

How does phosphorated carbohydrate solution work

A

(Emetrol)

Decreases n/v by changing the gastric pH and decreases smooth muscle contraction of the stomach

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8
Q

What is important to note about phosphorated carbohydrate solution

A

(Emetrol)

High sugar content - avoid giving to diabetics

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9
Q

List the 3 types of dopamine antagonists

A

Butyrophenones

Phenothiazines

Benzodiazepines

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10
Q

How do dopamine antagonists work

A

Block dopamine2 receptors in the CTZ

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11
Q

Droperidol

A

Inapsine

Type: prescription antiemetica-dopamine antagonists- butyrophenones

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12
Q

Haloperidol

A

Haldol

Type: prescription antiemetic- dopamine antagonists- butyrophenones

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13
Q

What are the side effects of taking butyrophenones (antiemetic dopamine antagonists)

A

EPS syndrome and hypotension

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14
Q

What are butyrophenones used for

A

Postop n/v

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15
Q

Promethazine

A

Phenergan

is also an antihistamine

Type: prescription antihistamine- dopamine antagonist AND antihistamine- phenothiazines

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16
Q

What are some common side effects of taking promethazine

A

(Phenergan)

Antihistamine and anticholinergic effects

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17
Q

Lorazepam

A

Ativan

Type: prescription antihistamine- dopamine antagonists- benzodiazepines

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18
Q

What is lorazepam used for

A

Antianxiety and cancer chemotherapy in combination with others

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19
Q

How do serotonin receptor antagonist work

A

Blocks serotonin receptors in the CTZ

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20
Q

Ondansetron

A

Zofran

Type: antiemetic- serotonin receptor antagonist

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21
Q

What is something important to note about ondansetron

A

(Zofran)

Increased efficacy with steroids and it has potentially fatal cardiac arrhythmias with IV route

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22
Q

Palonosetron

A

(Aloxi)

Type: prescription antiemetic- serotonin receptor inhibitor

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23
Q

What is something important to note about palonosetron

A

(Aloxi)

2nd generation , more potent and has a longer half life

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24
Dexamethasone
Decadron Type: glucocorticoid- prescription antiemetic
25
Methylprednisolone
Solu-medrol Type: prescription antiemetic- glucocorticoid
26
What is methylprednisolone used for
(Soul-medrol) Cancer chemotherapy, given IV
27
Dronabinol
Marinol Type: cannabinoid- prescription antiemetic
28
What is dronabinol used for
(Marinol) Used when cant take other antiemetics
29
Metoclopramide
Reglan Type: miscellaneous- prescription antiemetic
30
How does metoclopramide work
Blocks dopamine receptors in the CTZ
31
Hydroxyzine
Vistaril Type: prescription antiemetic antihistamine
32
Scopolamine
Transderm-scop Type: prescription antiemetic anticholinergic
33
Patients with glaucoma should NOT use which drugs
Antihistamines and anticholinergics
34
Ipecac OTC
Action: stimulates CTZ and acts directly on gastric mucosa Use: induce vomiting after toxic substance
35
What is something important to note about ipecac OTC
Avoid vomiting if substance is caustic or petroleum No ipecac fluid extract
36
How do adsorbent antidiarrheals work
Coats wall of gi tract and adsorbs bacteria or toxin that cause diarrhea
37
Kaolin-pectin
Kapectolin Type: adsorbent antidiarrheal
38
Colestipol and cholestyramine
Questran Type: adsorbent antidiarrheal
39
Diphenoxylate hydrochloride and atropine sulfate
Lomotil Type: opioid antidiarrheal
40
What is something important to note about diphenoxylate hydrochloride and atropine sulfate
(Lomotil) Is a schedule V controlled substance
41
Loperamide
Imodium Type: opioid antidiarrheal
42
Octreotide
Sandostatin Use: severe diarrhea from cancer Type: somatostatin analog
43
How do somatostatin analog's work
Inhibit gastric acid, gastric secretions and hormones ; decrease smooth muscle contractility
44
What are some antidiarrhea nursing interventions
Monitor BP Respirations Frequency of bowel movements and sounds Electrolytes Notify provider if lasts more than 48hrs
45
What is a purgative
A drug that promotes watery stool with cramping HARSH
46
Psyllium hydrophyllic mucilloid
Metamucil Use: prevention and treatment of chronic constipation Administration: mix in water or juice, drink immediately, follow with 1 glass of water Type: bulk forming anticonstipation
47
The symptoms of MG are caused by
Autoimmune destruction of acetylcholine receptor sites and a resultant ⤵️ in neuromuscular transmission
48
What is myasthenia Gravis (MG)
An autoimmune process, progressive muscular weakness of the respiratory system, facial muscles and extremities
49
How do acetylcholinesterase inhibitors work
They inhibit the action of the enzyme. Resulting in more acetylcholine is available to activate the cholinergic receptors and promote muscle contraction ⤴️ transmission of neuromuscular impulses by preventing the destruction of ach
50
Neostigmine
Prostigmin Short-acting , every 2-4 hrs Type: cholinesterase inhibitor Use: to treat myasthenia crisis
51
Edrophonium
Tensilon Ultrashort-acting for diagnosing myasthenia gravis Type: cholinesterase inhibitors
52
Pyridostigmine bromide
Mestinon Intermediate-acting, every 3-6 hours Type: cholinesterase inhibitors
53
What are some common side effects of cholinesterase inhibitors
Cholinergic side effects Nausea, vomiting, diarrhea, abdominal cramps, increased salivation and tears, miosis, blurred vision, bradycardia and hypotension
54
What is any early sign of myasthenia gravis
Ptosis - dropping eyelid
55
An enlarged thymus means what
And increase in antibodies
56
List 4 nursing implications of myasthenia gravis
Observe for respiratory distress Take before meals if possible Keep to a specific dosing schedule Observe for over or under dosing
57
What is myasthenia crisis
A type of Myasthenia gravis crisis character by Generalized muscle weakness Can occur when Not enough medicine is given , administer Neostigmine (prostigmin) to relieve
58
What is cholinergic crisis
A type of myasthenia gravis crisis characterized by muscle weakness, drooling, increased tearing and sweating, bradycardia and abdominal cramps Can occur when too much medicine is given
59
Which medication is administered to determine between a myasthenia and cholinergic crisis
Edrophonium (tensilon)
60
What medication is given as the antidote for cholinergic crisis
Atropine sulfate
61
What is multiple sclerosis
An autoimmune disorder that attacks the myelin sheath of nerve fibers in the brain and spinal cord
62
List 4 characteristics of multiple sclerosis
Remissions and exacerbations Weakness Spasticity in extremities Diplopia
63
What is diplopia and what condition is it associated with
Double vision Is associated with multiple sclerosis
64
What 3 types of drugs are used to treat multiple sclerosis
Glucocorticoids Biologic response modifiers Immunosuppressants
65
What glucocorticoid is used to treat multiple sclerosis
Prednisone
66
What biologic response modifier is used to treat multiple sclerosis
Interferon B
67
Azathioprine
Imuran Used to treat chronic and progressive multiple sclerosis Type: immunosuppressant
68
Cyclophosphamide
Cytoxan Used to treat chronic and progressive multiple sclerosis Type: immunosuppressant
69
What is a muscle spasm
Occurs when muscles become tightened and develop a fixed pattern of resistance
70
How do muscle relaxants work to relax skeletal muscle
Depressing motor activity originating at the level of the brainstorm and spinal motor neurons Increasing circulating norepinephrine
71
What are some side effects of muscle relaxants
CNS depression , dizziness , headache , diplopia , flatulence , erectile dysfunction and risk for falls Has anti-anxiety and sedative properties with a risk for dependency
72
What are some teaching implications related to muscle relaxants
Avoid other CNS depressants Short term treatment Contraindicated in pregnancy Don't stop abruptly
73
Cyclobenzaprine
Flexeril Type: muscle relaxant
74
Methocarbamol
Robaxin Type: muscle relaxant
75
Carisoprodol
Soma Type: muscle relaxant
76
Diazepam
Valium Used to treat acute muscle spasms
77
Antispasmodic drugs are used to treat what
Spasticity due to spinal cord injury, cerebral palsy
78
Baclofen
Lioresal Is a centrally acting muscle relaxant that acts on the spinal cord Type: antispasmodic
79
Dantrolene
Dantrium Action: acts peripherally at the neuromuscular junction to block calcium release Type: antispasmodic
80
What is something to note about antispasmodic's
- start with a low dose and increase gradually | - watch for hypotension
81
How do neuromuscular blocking agents work
Block the effect of acetylcholine at the receptor Block the release and synthesis of acetylcholine
82
When are neuromuscular blocking agents used
During surgery or for patients who are on ventilators Prevents voluntary muscle contraction
83
Pancuronium bromide
Pavulon Type: neuromuscular blocking agent/ paralytic
84
Succinylcholine
Anectine Type: neuromuscular blocking agents/ paralytic
85
What is something to note about/before taking paralytics
The patient should be sedated before administration
86
What is Parkinson's disease
Chronic neurologic disorder caused by degeneration of dopamine producing cells that effects the extrapyramidal motor tract (controls balance, posture, locomotion)
87
What is bradykinesia
Slow movement
88
What are the 3 key features of Parkinson's disease
Rigidity , bradykinesia and tremors
89
What is the cause of Parkinson's
Caused by an imbalance of the neurotransmitters dopamine (inhibitory) and acetylcholine (excitatory)
90
In reference to Parkinson's dopamine usually does what in relation to acetylcholine
Dopamine usually maintains control and inhibits its excitatory response
91
Drug therapy related to Parkinson's
Focus is restoring the balance between dopamine and acetylcholine - enhancing dopamine production or replacing it - decreasing the influence of acetylcholine Anticholinergic and dopaminergic drugs
92
What do dopaminergic drugs do
Increase dopamine
93
How are Anticholinergics used to treat Parkinson's
Block the action of acetylcholine reducing the rigidity and some of the tremors characteristic of Parkinson's , but have minimal effect on bradykinesia
94
Benzotropine
Cogentin Type: anticholinergic used to treat Parkinson's
95
Trihexyphenidyl
Artane Type: anticholinergic used to treat Parkinson's
96
What are some side effects of anticholinergics used to treat Parkinson's
``` Dry mouth Blurred vision Eye pain Photophobia Constipation Urinary retention Tachycardia Orthostatic hypotension Anhidrosis ```
97
Mydriasis
Dilation of pupils
98
Anhidrosis
Inability to sweat
99
Carbidopa-levodopa
Sinemet Type: dopaminergic Use: to treat Parkinson's
100
Bromcriptine
Parlodel Type: dopaminergic Use: to treat Parkinson's
101
Amantadine
Symmetrel Type: dopaminergic Use: early treatment of Parkinson's as drug tolerance develops
102
What is something important to note about amantadine
(Symmetrel) It is also an antiviral drug for influenza A
103
Selegeline
Eldepryl Type: MAO-B inhibitors Use: to treat Parkinson's Action: inhibits MAO-B thus prolonging the action of levodopa
104
Entacapone
Comtan Type: COMT (catechism-o-methyl trabsferase) inhibitor Use: to treat Parkinson's
105
What is something important to note about entacapone
(Comtan) When taken in conjunction with carbidopa-levodopa it lessens the "wearing off" effects of levadopa
106
What are some common side effects of drugs used to treat Parkinson's
*increased suicidal thoughts 💭 * ``` Fatigue, insomnia Dry mouth Blurred vision Orthostatic hypotension/palpitations/dysrhytmias Urinary retention Nausea, vomiting Dyskinesia/psychosis/severe depression ```
107
What is dyskinesia
Uncontrolled, involuntary muscle | Movement
108
What are some nursing interventions for people taking drugs to treat Parkinson's
- monitor for orthostatic hypotension - avoid excessive vitamin B6 intake (foods like Lima,navy, kidney beans,cereals) - don't stop taking them abruptly - warn of harmless brown discoloration of urine and sweat - assess for dividing tendencies - take on regular schedule - assess symptom status and "on-off" phenomenon - monitor blood cell counts, liver and kidney function - no drivung
109
What are some causes of dementia
``` Alzheimer's Stroke AIDS Atherosclerosis Medications Parkinson's ```
110
What are the symptoms of Alzheimer's caused by
The loss of acetylcholine
111
Name two conditions that cholinesterase inhibitors are used to treat Hint:from chapters 24 and 23
Myasthenia gravis and Alzheimer's
112
What is Alzheimer's disease characterized by
The loss of cholinergic neurons that secrete acetylcholine
113
What is the purpose/action of drugs used to treat Alzheimer's
- increased acetylcholine available at the receptors | - increase cognitive function
114
Monepril
Aricept Type: cholinesterase inhibitor Use: to treat mild to moderate Alzheimer's
115
Rivastigmine
Exelon Slows the disease process Type: cholinesterase inhibitor Use: to treat mild to moderate Alzheimer's
116
Memantine
Namenda Type: N-methyl D-aspartate (NMDA) antagonist Use: to treat later stages of Alzheimer's Action: regulates the activity of glutamate, a chemical messenger involved in learning and memory
117
What are some contraindications of drugs used to treat Alzheimer's
Reduced kidney or liver function
118
What are some side effects of drugs used to treat Alzheimer's
ANVD, dizziness, headache
119
What are some nursing implications for drugs used to treat Alzheimer's
- monitor side effects, especially safety related | - evaluate effectiveness
120
What is a seizure
Abnormal electrical activity in the brain; may result in alteration in consciousness, motor or sensory ability and/or behavior
121
What is a convulsion
Involuntary, spasms of the large skeletal muscles of the face, neck, arms and legs that may accompany seizures
122
What is epilepsy
Chronic disorder with recurrent, unprovoked seizure activity
123
What is status epilepticus
Repeated, unremitting occurrence of a seizure; can cause brain damage and ultimately death Lasts greater than 5 mins
124
What are a few things to note about antiepileptics (AEDS)
- stabilize nerve cell membranes and suppress the abnormal electric impulses in the cerebral cortex - affect concentration and movement of sodium, calcium and chloride ions across the neuronal cell membrane - depress excitability of neurons by enhancing GABA (inhibitory) receptors
125
How do antiepileptics work
Suppress abnormal neuron firing
126
List 8 antiepileptics that's suppress sodium influx
``` Phenytoin (Dilantin) Fosphenytoin Carbamazepine Oxcarbazepine Valporic acid Topiramate Zonisamide Lamotrigine ```
127
List 2 antiepileptics that suppress calcium influx
``` Valporic acid (depakane) Ethosuximide ```
128
List 3 antiepileptics that enhance action of GABA
Barbiturates Benzodiazepines Tiagabine
129
List an antiepileptic that promotes GABA release
Gabapentin
130
How do barbiturates and benzodiazepines work to stop seizures
Increase the action of the neurotransmitter GABA (gamma amino butyric acid)
131
What type of seizures are barbiturates and benzodiazepines used to treat
Petit/grand mall seizures and status epilepticus
132
What are some side effects of barbiturates and benzodiazepines in reference to antiepileptics
Drowsiness/CNS effects Addictive- produce tolerance and withdrawal Barbiturates: respiratory depression
133
Phenobarbital
Type: barbiturates Use: to treat seizures
134
Diazepam
Valium Type: benzodiazepines Used: to treat seizures
135
Clonazepam
Klonopin Type: benzodiazepines Use: to treat seizures
136
Phenytoin
Dilantin Type: hydantoins Action: inhibit sodium influx Use: to treat seizures
137
Valporic acid
Depakote Possible hepatotoxicity, monitor liver enzymes Not given to children under 12 Type: antiepileptics
138
What is something to note about Carbamazine
Tegretol Grapefruit juice can cause toxicity Type: antiepileptic
139
Lamotrigine
Lamictal Type: antiepileptic
140
Topiramate
Topamax Type: antiepileptic
141
What is something important to note about tigabene
Gabitril Only taken with epilepsy- can cause increase in seizures
142
What are some side effects of neurologic and psychiatric antiepileptics
``` Slurred speech Headache Confusion Depression Trouble with attention Hypertrophy of the gums (can cause bleeding) ```
143
What are some common side effects of phenytoin
- thrombocytopenia (low platelet) - leukopenia (low WBC count) - gingival hyperplasia (overgrowth or redness of gums) - hyperglycemia - nausea/vomiting/constipation - drowsiness - pinkish-brown urine
144
What is a warning issued by the FDA in reference to antiepileptics
11 popular antiseizure drugs were found to almost double the risk of suicidal behavior and ideation/violent deaths amount patients Gabapentin, lamotrigine, oxcarbazepine, tiagabine, valproate
145
List some nursing considerations for patients taking antiepileptics
- evaluate most current blood level of medications, if appropriate - be aware of drug-drug and drug-food interaction - maintain therapeutic blood levels for maximal effectiveness - observe children for cognitive changes - assess for suicidal ideation a
146
List some teaching implications for patients taking antiepileptics
- effective seizure management involves strict adherence to drug therapy - be aware of CNS side effects - dont stop the medication abruptly, unless a rash presents - inform doctors that you take anticonvulsants - should receive pre-operatively - do not skip doses - wear medic alert tag - good oral hygiene - some teratogenic effects
147
What are the directions for administering medication during status epilepticus
1. Diazepam (Valium) or lorazepam (Ativan) via IV - benzodiazepine 2. Give phenytoin (Dilantin) via IV - barbiturate * if seizures persist, intubate for airway* 3. Midazolam (versed) or propofol (diprivan)
148
What are adrenergics
Drugs that stimulate the sympathetic nervous system
149
Which neurotransmitter(s) stimulate the sympathetic nervous system (adrenergic system)
Norepinephrine and epinephrine
150
Which neurotransmitter stimulates the parasympathetic nervous system (cholinergic system)
Acetylcholine
151
How does the sympathetic response vs the parasympathetic response affect the eye
Sympathetic- dilates pupils Parasympathetic- constricts pupils
152
How does the sympathetic response vs the parasympathetic response affect the lungs
Sympathetic- dilates bronchioles Parasympathetic- constricts bronchioles, increases secretions
153
How does the sympathetic response vs the parasympathetic response affect the ❤️
Sympathetic- increase heart rate Parasympathetic- decreases heart rate
154
How does the sympathetic response vs the parasympathetic response affect the blood vessels
Sympathetic- constricts blood vessels Parasympathetic- dilates blood vessels
155
How does the sympathetic response vs the parasympathetic response affect the gastrointestinal
Sympathetic- relaxes smooth muscles of gi tract Parasympathetic- increases peristalsis
156
How does the sympathetic response vs the parasympathetic response affect the bladder
Sympathetic- relaxes bladder muscles Parasympathetic- constricts bladder
157
How does the sympathetic response vs the parasympathetic response affect the uterus
Sympathetic- relaxes uterine muscle
158
How does the sympathetic response vs the parasympathetic response affect the salivary glands
Parasympathetic- increases salivation
159
How does the sympathetic response vs the parasympathetic response affect the skeletal muscle
Parasympathetic- increased contraction
160
What are the 3 steps to norepinephrine function
1. NE is released 2. NE binds with its receptor 3. The action of NE is terminated by MAO and COMT *if MAO-I is present, NE is not broken down
161
What two enzymes inactive norepinephrine
MAO (inside the neuron) and COMT (outside the neuron)
162
What are the 3 steps to acetylcholine function
1. Ach is released 2. Ach binds with its receptor 3. The action of Ach is terminated by Ach E *if Ach E-I is present, Ach is not broken down
163
Sympathetic nervous system stimulants are also known as
Sympathomimetics Adrenergic agonists Adrenergics Adrenomimetics
164
Sympathetic nervous system depressants are also known as
Sympatholytics Adrenergic antagonist Adrenergic blockers Adrenolytics
165
Alpha1 adrenergic receptor site
Located primarily in blood vessels Vasoconstriction, increase BP and improved circulation
166
Alpha2 adrenergic receptor site
Located in the CNS Inhibits the release of norepinephrine, vasodilation and decrease BP
167
Beta1 adrenergic receptor site
Located in the ❤️ Increases heart rate and contractility
168
Beta2 adrenergic receptor site
Located in the lungs Bronchodilation
169
Nonselective
Activates more than one receptor SITE Ex: epinephrine acts on alpha 1/2, beta 1/2
170
Adrenergic agonists are frequently used to treat what types of conditions
``` Hypotension Bronchospasm Asthma COPD nasal congestion Orthostatic hypotension Shock ```
171
Catecholamines
Produce an adrenergic RESPONSE Ex: epinephrine, norepinephrine, dopamine and dobutamine
172
Noncatecholamines
Stimulate the adrenergic RECEPTORS Ex: phenylephrine, albuterol
173
Direct-acting adrenergics (sympathomimetics)
Directly stimulate receptor SITE Ex: epinephrine and albuterol
174
Epinephrine is used to treat anaphylaxis, why?
Because it increases BP, heart rate and airflow through the lungs
175
Albuterol
Proventil, ventolin Beta2 agonist, that cause bronchodialation for asthmatics
176
Indirect-acting adrenergic
Stimulate the release of norepinephrine Ex: amphetamines
177
Mixed-acting adrenergic
Act on the receptor site AND stimulate release of norepinephrine Ex: ephedrine
178
Central-acting adrenergic
Depress the release of norepinephrine through stimulating alpha2 RECEPTORS in CNS Ex: clonidine and methyldopa
179
Clonidine
Catapress Type: central-acting adrenergic Use: to decrease BP
180
What is something important to note about clonidine
Catapres Don't touch the patch, will drop your BP
181
Methyldopa
Aldomet Type: central-acting adrenergic Use: to lower BP
182
What are some common uses of sympathomimetics
``` Allergic reaction Anaphylaxis Asthma Bronchospasm Severe hypotension Cardiac arrest ```
183
List some side effects of patients taking sympathomimetics
``` Anorexia Nausea Nervousness Tremor Agitation Headache Insomnia Syncope Dizziness ```
184
What are some adverse effects of taking sympathomimetics
Palpitations, tachycardia , hypertension, cardiac arrhythmia
185
List some contraindications for taking sympathomimetics
Cardiac disease Hypertension Diabetes (in some cases) Narrow angle glaucoma
186
What are some food/drug interactions to be mindful of while taking sympathomimetics
Increased effects with tricyclic antidepressants and MAOI's
187
List some nursing implications for taking sympathomimetics
- monitor blood glucose and serum potassium levels - monitor for urinary retention - monitor blood pressure, heart dysrrythmias Teaching -OTC med's
188
What are adrenergic blockers frequently used to treat
``` Hypertension Angina Dysrhythmias Myocardial infarction (after initial injury) Open angle glaucoma Migraines ```
189
How do adrenergic blockers work
Block the effects of the sympathetic nervous system neurotransmitters by occupying the alpha or beta receptor sites or inhibiting the release of neurotransmitters
190
What are adrenergic antagonist primarily used to treat
Hypertension
191
Prazosin
Minipress Type: alpha 1 blocker Use: to treat high BP
192
Atenolol
Tenormin Type: beta 1 adrenergic antagonist Use: treat high BP
193
Metoprolol
Lopressor Type: beta 1 adrenergic antagonist Use: treat high blood pressure
194
Propranolol
Inderal Type: nonselective (blocks beta 1 and 2) adrenergic antagonist Use: to treat high BP
195
Carvedilol
Coreg Type: nonselective (blocks beta 1 and 2) adrenergic antagonist Use: to treat high BP
196
What are some common uses of beta blockers
Hypertension Angina Myocardial infarction Heart failure
197
What are some side effects of taking beta blockers
Drowsiness, dizziness, fainting, depression, weakness, flushing, cool extremities, leg pain, impotence, decreased libido
198
What are some adverse effects of taking beta blockers
Bradycardia, hypotension , heart failure, pulmonary edema, hypoglycemia, bronchospasm , dysrhythmia, respiratory difficulty
199
Contraindications of taking beta blockers
Use with caution with diabetes, impaired renal function Beta2 blockers with asthma/COPD
200
Nursing implications with beta blockers
- observe for and teach about side effects - safety precautions ; CNS type effects - teaching to avoid orthostatic hypotension - may need to take pulse and/or BP before administration
201
Most alpha and beta agonists end in what
-ine or ol Ex: epinephrine , midodrine, pseudophedrine, albuterol
202
Most alpha blockers end in what
-zosin Ex: doxazosin, prazosin, terazosin
203
Most beta blockers end in what
-lol Ex: carvedilol, metoprolol , propranolol, timolol, atenelol
204
Parasympathetic nervous system stimulants are also known as
Parasympathomimetics Cholinergics Cholinergic agonists Cholinesterase inhibitors
205
What two groups of drugs affect the parasympathetic nervous system
Cholinergic agonist (parasympathomimetics) Anticholinergics (parasympathytic)
206
The sympathetic nervous system is
Fight of flight
207
The parasympathetic nervous system is
Rest and digest
208
The sympathetic NS receptor sites are
``` Alpha 1 Alpha 2 Beta 1 Beta 2 Dopaminergic ```
209
The parasympathetic NS receptor sites are
Nicotinic | Muscarinic
210
Muscarinic receptor SITE
Stimulates smooth muscle and slow heart rate Construct bronchioles, increase salivation, construct pupils, dilate blood vessels
211
Nicotinic receptor SITE
(Neuromuscular) Affect the skeletal muscles
212
Direct acting cholinergic agonist
Selective to muscarinic RECEPTORS but nonspecific Ex: metoclopramide (reglan) for reflux disease it increases gi tone and motility , increases peristalsis
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Bethanechol
Urecholine Use: urinary retention Type: direct acting cholinergic agonist Action: increases urination
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Pilocarpine
Pilocar Use: relieve pressure in the eye related to glaucoma Type: direct acting cholinergic agonist Action: constructs the pupils
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What is xerostomia
Dry mouth
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Indirect acting cholinergic agonist
Don't act on receptors; instead they inhibit the enzyme cholinesterase , allowing acetylcholine to accumulate at the receptor sites
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Donepezil
Aricept Type: indirect acting cholinergic agonist Use: to improve cognitive function in Alzheimer's disease
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Drugs used to treat myesthenia gravis are what type
Indirect acting cholinergic agonist
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What are some contraindications of cholinergic agonist
- Intestinal or urinary obstruction - COPD - bradycardia - hypotension
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List some side effects of cholinergic agonist
Nausea , vomiting, diarrhea, abdominal cramping, salivation, sweating, flushing, frequent urination, blurry vision, miosis
221
What are some adverse effects of cholinergic agonist
Orthostatic hypotension, bradycardia, muscle weakness and twitching, bronchoconstriction, heart block, circulatory and respiratory collapse
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Nursing implications for cholinergic agonist
- monitor vital signs and bowel sounds - check breath sounds (can cause increased secretions) - observe for cholinergic crisis (the antidote is atropine) - teach about side effect management
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Dicyclomine hcl
Bentyl Used to treat irritable bowel syndrome Type: anticholinergic
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Tolterodine tartrate
Detrol Used for urinary frequency Type: anticholinergic
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Cyclopentolate
Cyclogyl Used to induce pupil dilation for eye exams Type: anticholinergic
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Ipratropium
Atrovent Used for COPD Type: anticholinergic
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What are some contraindications when administering anticholinergics
Narrow angle glaucoma, obstructive gi disorders, paralytic ileus, tachycardia, BPH , myasthenia gravis, myocardial ischemia
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What are some adverse effects of taking anticholinergics
``` Tachycardia Hypotension Paralytic ileus Coma Ventricular fibrillation ```
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Teaching implications for anticholinergics
- increase fluid intake, fiber and exercise to avoid constipation - advise client to relieve dry mouth with ice chips, hard candy or sunglasses for photophobia - avoid becoming overheated - watch OTC's with anticholinergic effects
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How do stool softeners work
Cause more water and fat to be absorbed into the stools; emulsifies and lubricates feces
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Docusate
Colace Use: to decrease straining during defecation Type: stool softener
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Lubiprotone
Amitiza Use: to treat idiopathic constipation in adults Type: chloride channel activator , stool softener
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How do stimulant laxatives work
Promote peristalsis by irritating the bowel
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Sennosides
Ex-lax Type: stimulant laxative
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Biscodyl
Dulcolax, corrector Type: stimulant laxative
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How do osmotic laxatives work
Cause water to be retained in the fecal mass to cause a more watery stool
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What are osmotic laxatives used for
Surgical and diagnostic prep
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What are some side effects of osmotic laxatives
Fluid and electrolyte imbalance, hypotension , weakness
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Magnesium hydroxide
Milk of magnesia Type: osmotic laxative
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Polyethylene glycol
Miralax, goLytely Type: osmotic laxative
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Constipation nursing implications
Don't give with undiagnosed abdominal pain, inflammatory disorders of the gi tract (appendicitis, diverticulitis, etc) spastic colon or a bowel obstruction
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What is reflux
Occurs when stomach contents back up through the LES into the esophagus
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Where are peptic ulcers most commonly found
In the proximal duodenum
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How do histamine 2 receptor antagonist work
Prevents histamine from stimulating the H2 RECEPTORS located on the gastric parietal cells, resulting in a reduction in the volume and concentration of gastric acid secretion
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Histamine 2 receptor antagonist are used to treat
Symptoms of gerd
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How should histamine 2 receptor antagonist be administered
Wait 30 mins-1 hour between taking an antacid and the H2 blocker
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Ranitidine
Zantac Type: h2 receptor antagonist Use: treat gerd
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Famotidine
Pepcid Type: h2 receptor antagonist Use: to treat gerd
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Cimetidine
Tagamet Type: h2 receptor antagonist Use: treat gerd
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What is something important to note about cimetidine and ranitidine
Can be given IV, but should not be taken with antacids
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How do proton pump inhibitors work
Reduce acid secretion by blocking the enzyme responsible for secreting hcl in the stomach
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What are proton pump inhibitors used to treat
Drug of choice for short term control of peptic ulcer disease and gerd
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Omeprazole
Prilosec Type: proton pump inhibitors Use: short term control of pud and gerd
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Iansoprozole
Prevacid Type: proton pump inhibitors Use: short term control of pud and gerd
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Esomeprozole
Nexium Type: proton pump inhibitor Use: short term control of pud and gerd
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Omeprazole and sodium bicarb
Zegrid Type: proton pump inhibitor Use: short term control of our and gerd
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What is zegrid given for
(Omeprazole and Na bicarb) Only drug given to prevent stress ulcers in critically ill patients Type: proton pump inhibitors
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Metronidazole
Flagyl Type: antibiotics for h pylori
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Tetracycline
Achromycin V Type: antibiotics for h pylori
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How do antacids work
Promote ulcer healing by neutralizing hydrochloric acid and reducing pepsin activity THEY DO NOT COAT THE ULCER
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Ca carbonate and Mg hydroxide
Rolaids,tums Type: antacids
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Mg hydroxide and Al hydroxide
Maalox Type: antacid
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Drugs with Al and Ca products cause
Constipation
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Magnesium products can cause
Diarrhea
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Simethicone
An antiflatulent is added to antacids to reduce gas bubbles that cause bloating and discomfort
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How do pepsin inhibitors work
Produces a thick, gel like substance that coats a gastric ulcer protecting it against further erosion and promoting healing
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How should pepsin inhibitors be administered
30 mins before meals
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Sucralfate
Carafate Type: pepsin inhibitor
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Prostaglandin analogues are used for what
To prevent gastric ulcers in patients taking high doses of NSAIDS
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Misoprostol
Cytotec Type: prostaglandin analogue Use: to prevent gastric ulcers in patients taking high doses of NSAIDS
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What are sulfonamides used to for
To treat ulcerative colitis
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Balsalazide disodium
Colazal Type: sulfonamide Use: to treat ulcerative colitis
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Nursing interventions for antacids
May delay absorption of other meds, take 1-3 hours after meals and before bedtime, small amount of water, avoid with milk or foods high in vitamin d, report constipation/diarrhea
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Nursing interventions for ppi's or H2 blockers
Give right before meals, avoid smoking, long term use effects b12 absorption
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Nursing interventions for pepsin inhibitors
Take on an empty stomach, allow 1-2 hour time lapse with meds
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How do amphetamine like drugs work
Suppress appetite by depressing the hunger center in the brain
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Phentermine
Adipex Type: amphetamine , anorexiant
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How do fat blockers work
Block the enzyme lilase in the gi tract which blocks the absorption of fats
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Orlistat
Xenical Type: fat blocker
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What is something important to note about fat blockers
They may also decrease absorption of other substances- like fat soluble vitamins and Coumadin
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How do pancreatic enzymes work
Contains the necessary enzymes to digest fats, carbs, and proteins
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Where do pancreatic enzymes come from
Obtained from pigs 🐷
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Pancrelipase
Pancrease Type: pancreatic lipase
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What are some side effects of taking pancreatic enzymes
``` Diarrhea Constipation Abdominal pain and bloating Gas N/v ```
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Teaching implications for pancreatic enzymes
Take it with every meal or snack, drink plenty of fluids, may increase blood sugar in diabetics
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Cox 1
Protects stomach lining , decreases fever , promotes platelet aggregation (blood clotting)
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Cox 2
Triggers pain and inflammation
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How do NSAIDS work
Inhibit biosynthesis of prostaglandins
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What effects do NSAIDS have
Analgesic Antipyretic Inhibit platelet aggregation Mimic corticosteroids
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Salicylic acid
Aspirin Type: NSAIDS
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Ibuprofen
Advil, Motrin Type: NSAIDS
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Naproxin sodium
Naprosyn Type: NSAIDS
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Ketorolac
Toradol Type: NSAIDS
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Celecoxib
Celebrex Type: cox 2 inhibitor
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What are NSAIDS used for
Mild to moderate pain, inflammation
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Contraindications of NSAIDS
Hypersensitivity, bleeding disorders, Reye's syndrome (asa only)
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Side effects with NSAIDS
ANVD, tinnitus, stomach pain
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Adverse effects with NSAIDS
``` Blood dycrasis Bleeding Anaphylaxis Hearing loss Metabolic acidosis (asa only) ```
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What interactions should the nurse be mindful of with giving NSAIDS
Not taken with anticoagulants
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Nursing implications of NSAIDS
Check for allergy , assess gi status , observe for bleeding
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Teaching implications for NSAIDS
Avoid things that increase gastric upset, tell doctors you are taking NSAIDS, taking during period can increase bleeding
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What 4 drugs are used to treat rheumatoid arthritis
Glucocorticoids Immunosuppressants DMARDS immunomodulators
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What glucocorticoid is used to treat rheumatoid arthritis
Prednisone
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Methotrexate
Mexate Type: immunosuppressant Use: treat rheumatoid arthritis
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What is the action of DMARDS
Slow down progression of rheumatoid arthritis
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When are DMARDS used
Only after other anti-inflammatory drugs are ineffective due to high side effects
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Gold salts
Crysotherapy Type: DMARD use: treat rheumatoid arthritis
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What is something important to note about gold salts
(Crysotherapy) Don't give to diabetics, those with renal/liver problems or allergic to gold or metal
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What is the action of immunomodulators
STOP rheumatoid arthritis disease profession ; may induce a long lasting remission
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Adalimumab
Humira Type: immunomodulators Use: treat rheumatoid arthritis
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Etanercept
Enbrel Type: immunomodulators Use: treat rheumatoid arthritis
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Infliximab
Remicade Type: immunomodulators Use: treat rheumatoid arthritis
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Allopurinol
Zyloprim Use: to treat gout Type: Uric acid inhibitor Action: decrease production of uric acid
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Nursing interventions for Uric acid inhibitors
Monitor CBC, liver enzymes, renal function, yearly eye exams, increase fluid intake to excrete more Uric acid; limit alcohol and caffeine, no high purine foods (organ meats, salmon, sardines, legumes)
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What are Uric acid inhibitors used for
Long term management of gout
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Acetaminophen
Tylenol Type: non opioid analgesic Can cause hepatotoxicity. No anti-inflammatory effect. Good as antipyretic in children. Maximum dose 4 g/day
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How do triptans work
Constrict vessels in the brain Use: treat migraines
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Sumatriptan
Imitrex Use: to decrease the severity of migraines and to treat acute migraine pain Type: triptan
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Rizatriptan benzoate
Maxalt Type: triptan Use: to treat migraines
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Eletriptan
Relpax Type: triptan Use: to treat migraines
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What are adjuvant analgesics
Have been developed for other purposes and later found to be effective for pain relief neuropathy
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Propranolol
Inderal Type: beta blocker but also an adjuvant analgesic
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Amitriptyline
Elavil Type: tricyclic antidepressants and an adjuvant analgesic
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Gabapentin
Neurontin Type: anticonvulsant and adjuvant analgesic
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Pregabalin
Lyrica Type: anticonvulsant and adjuvant analgesic
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Hydrocodone
Vicodin, lortab Type: opiate
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Oxycodone
Percocet, OxyContin Type: opiate
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Methadone
Dolophine Use: to treat opioid dependence Type: opioid
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Codeine sulfate
Codeine Type: opioid
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Morphine sulfate
Morphine Type: opioid
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What is something important to note about opioids
They can cross the placenta and don't give them for neuro trauma
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Meperidine
Demerol Type: opioid
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Levophanol
Dilaudid Type: opioid *is stronger via IV than morphine
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Fentanyl
Duragesic Type: opioid *is the strongest, is a transdermal for chronic pain
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Contraindications for opiates
Asthma/COPD, increase intracranial pressure, use with caution in children and older adults
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Side effects of opiates
``` N/v Constipation Sedation Urinary retention Blurred vision Hallucinations ```
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Adverse effects of opiates
Hypersensitivity Respiratory depression Increased ICP Seizures
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Nursing implications for opiates
- check for allergy - assess respiratory status - assess drug hx - monitor urinary output - HAVE NARCAN AVAILABLE
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Teaching implications for opiates
Avoid other CNS depressants (4 respiration), manage constipation, addictive potential
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Fentanyl
Sublimaze Type: patient controlled analgesic
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Hydromorphone
Dilaudid Type: patient controlled analgesia
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What are combination medications made of
Opioids and non narcotic analgesics
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What is Vicodin made of
Hydrocodone 5mg + acetaminophen 500mg
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What is Percocet made of
Oxycodone hcl 5mg + acetaminophen 325mg
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What is Tylenol with codeine made of
15-60 Mg of codeine phosphate + 300-1,000 mg acetaminophen
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How do opioid antagonist work
Compete with opioid agonists for access to the opioid receptor site
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Naloxone
Narcan Type: opioid antagonist
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Naltrexone hydrochloride
Revia Type: opioid antagonist
349
Nursing implications for opioid antagonist
- monitor vs and bleeding | - watch for reversal of analgesia

Nursing School (36 decks)

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