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Pharmacology > 💊- Neuro, Antiemetic, Opioid Drugs Test > Flashcards

💊- Neuro, Antiemetic, Opioid Drugs Test Flashcards

1
Q

What are the side effects of antihistamines

A

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

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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
Q

Dexamethasone

A

Decadron

Type: glucocorticoid- prescription antiemetic

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25
Q

Methylprednisolone

A

Solu-medrol

Type: prescription antiemetic- glucocorticoid

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26
Q

What is methylprednisolone used for

A

(Soul-medrol)

Cancer chemotherapy, given IV

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27
Q

Dronabinol

A

Marinol

Type: cannabinoid- prescription antiemetic

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28
Q

What is dronabinol used for

A

(Marinol)

Used when cant take other antiemetics

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29
Q

Metoclopramide

A

Reglan

Type: miscellaneous- prescription antiemetic

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30
Q

How does metoclopramide work

A

Blocks dopamine receptors in the CTZ

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31
Q

Hydroxyzine

A

Vistaril

Type: prescription antiemetic antihistamine

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32
Q

Scopolamine

A

Transderm-scop

Type: prescription antiemetic anticholinergic

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33
Q

Patients with glaucoma should NOT use which drugs

A

Antihistamines and anticholinergics

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34
Q

Ipecac OTC

A

Action: stimulates CTZ and acts directly on gastric mucosa

Use: induce vomiting after toxic substance

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35
Q

What is something important to note about ipecac OTC

A

Avoid vomiting if substance is caustic or petroleum

No ipecac fluid extract

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36
Q

How do adsorbent antidiarrheals work

A

Coats wall of gi tract and adsorbs bacteria or toxin that cause diarrhea

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37
Q

Kaolin-pectin

A

Kapectolin

Type: adsorbent antidiarrheal

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38
Q

Colestipol and cholestyramine

A

Questran

Type: adsorbent antidiarrheal

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39
Q

Diphenoxylate hydrochloride and atropine sulfate

A

Lomotil

Type: opioid antidiarrheal

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40
Q

What is something important to note about diphenoxylate hydrochloride and atropine sulfate

A

(Lomotil)

Is a schedule V controlled substance

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41
Q

Loperamide

A

Imodium

Type: opioid antidiarrheal

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42
Q

Octreotide

A

Sandostatin

Use: severe diarrhea from cancer

Type: somatostatin analog

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43
Q

How do somatostatin analog’s work

A

Inhibit gastric acid, gastric secretions and hormones ; decrease smooth muscle contractility

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44
Q

What are some antidiarrhea nursing interventions

A

Monitor

BP
Respirations
Frequency of bowel movements and sounds
Electrolytes

Notify provider if lasts more than 48hrs

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45
Q

What is a purgative

A

A drug that promotes watery stool with cramping HARSH

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46
Q

Psyllium hydrophyllic mucilloid

A

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

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47
Q

The symptoms of MG are caused by

A

Autoimmune destruction of acetylcholine receptor sites and a resultant ⤵️ in neuromuscular transmission

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48
Q

What is myasthenia Gravis (MG)

A

An autoimmune process, progressive muscular weakness of the respiratory system, facial muscles and extremities

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49
Q

How do acetylcholinesterase inhibitors work

A

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

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50
Q

Neostigmine

A

Prostigmin

Short-acting , every 2-4 hrs

Type: cholinesterase inhibitor

Use: to treat myasthenia crisis

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51
Q

Edrophonium

A

Tensilon

Ultrashort-acting for diagnosing myasthenia gravis

Type: cholinesterase inhibitors

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52
Q

Pyridostigmine bromide

A

Mestinon

Intermediate-acting, every 3-6 hours

Type: cholinesterase inhibitors

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53
Q

What are some common side effects of cholinesterase inhibitors

A

Cholinergic side effects

Nausea, vomiting, diarrhea, abdominal cramps, increased salivation and tears, miosis, blurred vision, bradycardia and hypotension

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54
Q

What is any early sign of myasthenia gravis

A

Ptosis - dropping eyelid

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55
Q

An enlarged thymus means what

A

And increase in antibodies

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56
Q

List 4 nursing implications of myasthenia gravis

A

Observe for respiratory distress

Take before meals if possible

Keep to a specific dosing schedule

Observe for over or under dosing

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57
Q

What is myasthenia crisis

A

A type of Myasthenia gravis crisis character by Generalized muscle weakness

Can occur when Not enough medicine is given , administer Neostigmine (prostigmin) to relieve

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58
Q

What is cholinergic crisis

A

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

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59
Q

Which medication is administered to determine between a myasthenia and cholinergic crisis

A

Edrophonium (tensilon)

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60
Q

What medication is given as the antidote for cholinergic crisis

A

Atropine sulfate

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61
Q

What is multiple sclerosis

A

An autoimmune disorder that attacks the myelin sheath of nerve fibers in the brain and spinal cord

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62
Q

List 4 characteristics of multiple sclerosis

A

Remissions and exacerbations

Weakness

Spasticity in extremities

Diplopia

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63
Q

What is diplopia and what condition is it associated with

A

Double vision

Is associated with multiple sclerosis

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64
Q

What 3 types of drugs are used to treat multiple sclerosis

A

Glucocorticoids

Biologic response modifiers

Immunosuppressants

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65
Q

What glucocorticoid is used to treat multiple sclerosis

A

Prednisone

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66
Q

What biologic response modifier is used to treat multiple sclerosis

A

Interferon B

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67
Q

Azathioprine

A

Imuran

Used to treat chronic and progressive multiple sclerosis

Type: immunosuppressant

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68
Q

Cyclophosphamide

A

Cytoxan

Used to treat chronic and progressive multiple sclerosis

Type: immunosuppressant

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69
Q

What is a muscle spasm

A

Occurs when muscles become tightened and develop a fixed pattern of resistance

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70
Q

How do muscle relaxants work to relax skeletal muscle

A

Depressing motor activity originating at the level of the brainstorm and spinal motor neurons

Increasing circulating norepinephrine

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71
Q

What are some side effects of muscle relaxants

A

CNS depression , dizziness , headache , diplopia , flatulence , erectile dysfunction and risk for falls

Has anti-anxiety and sedative properties with a risk for dependency

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72
Q

What are some teaching implications related to muscle relaxants

A

Avoid other CNS depressants

Short term treatment

Contraindicated in pregnancy

Don’t stop abruptly

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73
Q

Cyclobenzaprine

A

Flexeril

Type: muscle relaxant

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74
Q

Methocarbamol

A

Robaxin

Type: muscle relaxant

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75
Q

Carisoprodol

A

Soma

Type: muscle relaxant

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76
Q

Diazepam

A

Valium

Used to treat acute muscle spasms

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77
Q

Antispasmodic drugs are used to treat what

A

Spasticity due to spinal cord injury, cerebral palsy

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78
Q

Baclofen

A

Lioresal

Is a centrally acting muscle relaxant that acts on the spinal cord

Type: antispasmodic

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79
Q

Dantrolene

A

Dantrium

Action: acts peripherally at the neuromuscular junction to block calcium release

Type: antispasmodic

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80
Q

What is something to note about antispasmodic’s

A
  • start with a low dose and increase gradually

- watch for hypotension

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81
Q

How do neuromuscular blocking agents work

A

Block the effect of acetylcholine at the receptor

Block the release and synthesis of acetylcholine

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82
Q

When are neuromuscular blocking agents used

A

During surgery or for patients who are on ventilators

Prevents voluntary muscle contraction

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83
Q

Pancuronium bromide

A

Pavulon

Type: neuromuscular blocking agent/ paralytic

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84
Q

Succinylcholine

A

Anectine

Type: neuromuscular blocking agents/ paralytic

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85
Q

What is something to note about/before taking paralytics

A

The patient should be sedated before administration

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86
Q

What is Parkinson’s disease

A

Chronic neurologic disorder caused by degeneration of dopamine producing cells that effects the extrapyramidal motor tract (controls balance, posture, locomotion)

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87
Q

What is bradykinesia

A

Slow movement

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88
Q

What are the 3 key features of Parkinson’s disease

A

Rigidity , bradykinesia and tremors

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89
Q

What is the cause of Parkinson’s

A

Caused by an imbalance of the neurotransmitters dopamine (inhibitory) and acetylcholine (excitatory)

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90
Q

In reference to Parkinson’s dopamine usually does what in relation to acetylcholine

A

Dopamine usually maintains control and inhibits its excitatory response

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91
Q

Drug therapy related to Parkinson’s

A

Focus is restoring the balance between dopamine and acetylcholine

  • enhancing dopamine production or replacing it
  • decreasing the influence of acetylcholine

Anticholinergic and dopaminergic drugs

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92
Q

What do dopaminergic drugs do

A

Increase dopamine

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93
Q

How are Anticholinergics used to treat Parkinson’s

A

Block the action of acetylcholine reducing the rigidity and some of the tremors characteristic of Parkinson’s , but have minimal effect on bradykinesia

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94
Q

Benzotropine

A

Cogentin

Type: anticholinergic used to treat Parkinson’s

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95
Q

Trihexyphenidyl

A

Artane

Type: anticholinergic used to treat Parkinson’s

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96
Q

What are some side effects of anticholinergics used to treat Parkinson’s

A 
Dry mouth 
Blurred vision 
Eye pain 
Photophobia 
Constipation 
Urinary retention 
Tachycardia 
Orthostatic hypotension 
Anhidrosis
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97
Q

Mydriasis

A

Dilation of pupils

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98
Q

Anhidrosis

A

Inability to sweat

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99
Q

Carbidopa-levodopa

A

Sinemet

Type: dopaminergic

Use: to treat Parkinson’s

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100
Q

Bromcriptine

A

Parlodel

Type: dopaminergic

Use: to treat Parkinson’s

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101
Q

Amantadine

A

Symmetrel

Type: dopaminergic

Use: early treatment of Parkinson’s as drug tolerance develops

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102
Q

What is something important to note about amantadine

A

(Symmetrel)

It is also an antiviral drug for influenza A

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103
Q

Selegeline

A

Eldepryl

Type: MAO-B inhibitors

Use: to treat Parkinson’s

Action: inhibits MAO-B thus prolonging the action of levodopa

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104
Q

Entacapone

A

Comtan

Type: COMT (catechism-o-methyl trabsferase) inhibitor

Use: to treat Parkinson’s

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105
Q

What is something important to note about entacapone

A

(Comtan)

When taken in conjunction with carbidopa-levodopa it lessens the “wearing off” effects of levadopa

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106
Q

What are some common side effects of drugs used to treat Parkinson’s

A

*increased suicidal thoughts 💭 *

Fatigue, insomnia 
Dry mouth 
Blurred vision 
Orthostatic hypotension/palpitations/dysrhytmias 
Urinary retention 
Nausea, vomiting 
Dyskinesia/psychosis/severe depression
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107
Q

What is dyskinesia

A

Uncontrolled, involuntary muscle

Movement

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108
Q

What are some nursing interventions for people taking drugs to treat Parkinson’s

A
  • 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
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109
Q

What are some causes of dementia

A 
Alzheimer's
Stroke
AIDS 
Atherosclerosis 
Medications 
Parkinson's
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110
Q

What are the symptoms of Alzheimer’s caused by

A

The loss of acetylcholine

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111
Q

Name two conditions that cholinesterase inhibitors are used to treat

Hint:from chapters 24 and 23

A

Myasthenia gravis and Alzheimer’s

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112
Q

What is Alzheimer’s disease characterized by

A

The loss of cholinergic neurons that secrete acetylcholine

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113
Q

What is the purpose/action of drugs used to treat Alzheimer’s

A
  • increased acetylcholine available at the receptors

- increase cognitive function

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114
Q

Monepril

A

Aricept

Type: cholinesterase inhibitor

Use: to treat mild to moderate Alzheimer’s

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115
Q

Rivastigmine

A

Exelon

Slows the disease process

Type: cholinesterase inhibitor

Use: to treat mild to moderate Alzheimer’s

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116
Q

Memantine

A

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

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117
Q

What are some contraindications of drugs used to treat Alzheimer’s

A

Reduced kidney or liver function

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118
Q

What are some side effects of drugs used to treat Alzheimer’s

A

ANVD, dizziness, headache

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119
Q

What are some nursing implications for drugs used to treat Alzheimer’s

A
  • monitor side effects, especially safety related

- evaluate effectiveness

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120
Q

What is a seizure

A

Abnormal electrical activity in the brain; may result in alteration in consciousness, motor or sensory ability and/or behavior

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121
Q

What is a convulsion

A

Involuntary, spasms of the large skeletal muscles of the face, neck, arms and legs that may accompany seizures

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122
Q

What is epilepsy

A

Chronic disorder with recurrent, unprovoked seizure activity

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123
Q

What is status epilepticus

A

Repeated, unremitting occurrence of a seizure; can cause brain damage and ultimately death

Lasts greater than 5 mins

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124
Q

What are a few things to note about antiepileptics (AEDS)

A
  • 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
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125
Q

How do antiepileptics work

A

Suppress abnormal neuron firing

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126
Q

List 8 antiepileptics that’s suppress sodium influx

A 
Phenytoin (Dilantin) 
Fosphenytoin 
Carbamazepine 
Oxcarbazepine 
Valporic acid 
Topiramate 
Zonisamide 
Lamotrigine
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127
Q

List 2 antiepileptics that suppress calcium influx

A 
Valporic acid (depakane) 
Ethosuximide
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128
Q

List 3 antiepileptics that enhance action of GABA

A

Barbiturates
Benzodiazepines
Tiagabine

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129
Q

List an antiepileptic that promotes GABA release

A

Gabapentin

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130
Q

How do barbiturates and benzodiazepines work to stop seizures

A

Increase the action of the neurotransmitter GABA (gamma amino butyric acid)

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131
Q

What type of seizures are barbiturates and benzodiazepines used to treat

A

Petit/grand mall seizures and status epilepticus

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132
Q

What are some side effects of barbiturates and benzodiazepines in reference to antiepileptics

A

Drowsiness/CNS effects
Addictive- produce tolerance and withdrawal
Barbiturates: respiratory depression

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133
Q

Phenobarbital

A

Type: barbiturates

Use: to treat seizures

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134
Q

Diazepam

A

Valium

Type: benzodiazepines

Used: to treat seizures

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135
Q

Clonazepam

A

Klonopin

Type: benzodiazepines

Use: to treat seizures

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136
Q

Phenytoin

A

Dilantin

Type: hydantoins

Action: inhibit sodium influx

Use: to treat seizures

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137
Q

Valporic acid

A

Depakote

Possible hepatotoxicity, monitor liver enzymes

Not given to children under 12

Type: antiepileptics

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138
Q

What is something to note about Carbamazine

A

Tegretol

Grapefruit juice can cause toxicity

Type: antiepileptic

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139
Q

Lamotrigine

A

Lamictal

Type: antiepileptic

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140
Q

Topiramate

A

Topamax

Type: antiepileptic

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141
Q

What is something important to note about tigabene

A

Gabitril

Only taken with epilepsy- can cause increase in seizures

142
Q

What are some side effects of neurologic and psychiatric antiepileptics

A 
Slurred speech 
Headache 
Confusion 
Depression 
Trouble with attention 
Hypertrophy of the gums (can cause bleeding)
143
Q

What are some common side effects of phenytoin

A
  • thrombocytopenia (low platelet)
  • leukopenia (low WBC count)
  • gingival hyperplasia (overgrowth or redness of gums)
  • hyperglycemia
  • nausea/vomiting/constipation
  • drowsiness
  • pinkish-brown urine
144
Q

What is a warning issued by the FDA in reference to antiepileptics

A

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
Q

List some nursing considerations for patients taking antiepileptics

A
  • 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
Q

List some teaching implications for patients taking antiepileptics

A
  • 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
Q

What are the directions for administering medication during status epilepticus

A
  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
Q

What are adrenergics

A

Drugs that stimulate the sympathetic nervous system

149
Q

Which neurotransmitter(s) stimulate the sympathetic nervous system (adrenergic system)

A

Norepinephrine and epinephrine

150
Q

Which neurotransmitter stimulates the parasympathetic nervous system (cholinergic system)

A

Acetylcholine

151
Q

How does the sympathetic response vs the parasympathetic response affect the eye

A

Sympathetic- dilates pupils

Parasympathetic- constricts pupils

152
Q

How does the sympathetic response vs the parasympathetic response affect the lungs

A

Sympathetic- dilates bronchioles

Parasympathetic- constricts bronchioles, increases secretions

153
Q

How does the sympathetic response vs the parasympathetic response affect the ❤️

A

Sympathetic- increase heart rate

Parasympathetic- decreases heart rate

154
Q

How does the sympathetic response vs the parasympathetic response affect the blood vessels

A

Sympathetic- constricts blood vessels

Parasympathetic- dilates blood vessels

155
Q

How does the sympathetic response vs the parasympathetic response affect the gastrointestinal

A

Sympathetic- relaxes smooth muscles of gi tract

Parasympathetic- increases peristalsis

156
Q

How does the sympathetic response vs the parasympathetic response affect the bladder

A

Sympathetic- relaxes bladder muscles

Parasympathetic- constricts bladder

157
Q

How does the sympathetic response vs the parasympathetic response affect the uterus

A

Sympathetic- relaxes uterine muscle

158
Q

How does the sympathetic response vs the parasympathetic response affect the salivary glands

A

Parasympathetic- increases salivation

159
Q

How does the sympathetic response vs the parasympathetic response affect the skeletal muscle

A

Parasympathetic- increased contraction

160
Q

What are the 3 steps to norepinephrine function

A
  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
Q

What two enzymes inactive norepinephrine

A

MAO (inside the neuron) and COMT (outside the neuron)

162
Q

What are the 3 steps to acetylcholine function

A
  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
Q

Sympathetic nervous system stimulants are also known as

A

Sympathomimetics
Adrenergic agonists
Adrenergics
Adrenomimetics

164
Q

Sympathetic nervous system depressants are also known as

A

Sympatholytics
Adrenergic antagonist
Adrenergic blockers
Adrenolytics

165
Q

Alpha1 adrenergic receptor site

A

Located primarily in blood vessels

Vasoconstriction, increase BP and improved circulation

166
Q

Alpha2 adrenergic receptor site

A

Located in the CNS

Inhibits the release of norepinephrine, vasodilation and decrease BP

167
Q

Beta1 adrenergic receptor site

A

Located in the ❤️

Increases heart rate and contractility

168
Q

Beta2 adrenergic receptor site

A

Located in the lungs

Bronchodilation

169
Q

Nonselective

A

Activates more than one receptor SITE

Ex: epinephrine acts on alpha 1/2, beta 1/2

170
Q

Adrenergic agonists are frequently used to treat what types of conditions

A 
Hypotension 
Bronchospasm 
Asthma 
COPD
nasal congestion 
Orthostatic hypotension 
Shock
171
Q

Catecholamines

A

Produce an adrenergic RESPONSE

Ex: epinephrine, norepinephrine, dopamine and dobutamine

172
Q

Noncatecholamines

A

Stimulate the adrenergic RECEPTORS

Ex: phenylephrine, albuterol

173
Q

Direct-acting adrenergics (sympathomimetics)

A

Directly stimulate receptor SITE

Ex: epinephrine and albuterol

174
Q

Epinephrine is used to treat anaphylaxis, why?

A

Because it increases BP, heart rate and airflow through the lungs

175
Q

Albuterol

A

Proventil, ventolin

Beta2 agonist, that cause bronchodialation for asthmatics

176
Q

Indirect-acting adrenergic

A

Stimulate the release of norepinephrine

Ex: amphetamines

177
Q

Mixed-acting adrenergic

A

Act on the receptor site AND stimulate release of norepinephrine

Ex: ephedrine

178
Q

Central-acting adrenergic

A

Depress the release of norepinephrine through stimulating alpha2 RECEPTORS in CNS

Ex: clonidine and methyldopa

179
Q

Clonidine

A

Catapress

Type: central-acting adrenergic

Use: to decrease BP

180
Q

What is something important to note about clonidine

A

Catapres

Don’t touch the patch, will drop your BP

181
Q

Methyldopa

A

Aldomet

Type: central-acting adrenergic

Use: to lower BP

182
Q

What are some common uses of sympathomimetics

A 
Allergic reaction 
Anaphylaxis 
Asthma 
Bronchospasm 
Severe hypotension 
Cardiac arrest
183
Q

List some side effects of patients taking sympathomimetics

A 
Anorexia 
Nausea 
Nervousness 
Tremor
Agitation
Headache
Insomnia 
Syncope
Dizziness
184
Q

What are some adverse effects of taking sympathomimetics

A

Palpitations, tachycardia , hypertension, cardiac arrhythmia

185
Q

List some contraindications for taking sympathomimetics

A

Cardiac disease
Hypertension
Diabetes (in some cases)
Narrow angle glaucoma

186
Q

What are some food/drug interactions to be mindful of while taking sympathomimetics

A

Increased effects with tricyclic antidepressants and MAOI’s

187
Q

List some nursing implications for taking sympathomimetics

A
  • monitor blood glucose and serum potassium levels
  • monitor for urinary retention
  • monitor blood pressure, heart dysrrythmias

Teaching
-OTC med’s

188
Q

What are adrenergic blockers frequently used to treat

A 
Hypertension 
Angina 
Dysrhythmias 
Myocardial infarction (after initial injury) 
Open angle glaucoma 
Migraines
189
Q

How do adrenergic blockers work

A

Block the effects of the sympathetic nervous system neurotransmitters by occupying the alpha or beta receptor sites or inhibiting the release of neurotransmitters

190
Q

What are adrenergic antagonist primarily used to treat

A

Hypertension

191
Q

Prazosin

A

Minipress

Type: alpha 1 blocker

Use: to treat high BP

192
Q

Atenolol

A

Tenormin

Type: beta 1 adrenergic antagonist

Use: treat high BP

193
Q

Metoprolol

A

Lopressor

Type: beta 1 adrenergic antagonist

Use: treat high blood pressure

194
Q

Propranolol

A

Inderal

Type: nonselective (blocks beta 1 and 2) adrenergic antagonist

Use: to treat high BP

195
Q

Carvedilol

A

Coreg

Type: nonselective (blocks beta 1 and 2) adrenergic antagonist

Use: to treat high BP

196
Q

What are some common uses of beta blockers

A

Hypertension
Angina
Myocardial infarction
Heart failure

197
Q

What are some side effects of taking beta blockers

A

Drowsiness, dizziness, fainting, depression, weakness, flushing, cool extremities, leg pain, impotence, decreased libido

198
Q

What are some adverse effects of taking beta blockers

A

Bradycardia, hypotension , heart failure, pulmonary edema, hypoglycemia, bronchospasm , dysrhythmia, respiratory difficulty

199
Q

Contraindications of taking beta blockers

A

Use with caution with diabetes, impaired renal function

Beta2 blockers with asthma/COPD

200
Q

Nursing implications with beta blockers

A
  • 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
Q

Most alpha and beta agonists end in what

A

-ine or ol

Ex: epinephrine , midodrine, pseudophedrine, albuterol

202
Q

Most alpha blockers end in what

A

-zosin

Ex: doxazosin, prazosin, terazosin

203
Q

Most beta blockers end in what

A

-lol

Ex: carvedilol, metoprolol , propranolol, timolol, atenelol

204
Q

Parasympathetic nervous system stimulants are also known as

A

Parasympathomimetics
Cholinergics
Cholinergic agonists
Cholinesterase inhibitors

205
Q

What two groups of drugs affect the parasympathetic nervous system

A

Cholinergic agonist (parasympathomimetics)

Anticholinergics (parasympathytic)

206
Q

The sympathetic nervous system is

A

Fight of flight

207
Q

The parasympathetic nervous system is

A

Rest and digest

208
Q

The sympathetic NS receptor sites are

A 
Alpha 1
Alpha 2
Beta 1
Beta 2
Dopaminergic
209
Q

The parasympathetic NS receptor sites are

A

Nicotinic

Muscarinic

210
Q

Muscarinic receptor SITE

A

Stimulates smooth muscle and slow heart rate

Construct bronchioles, increase salivation, construct pupils, dilate blood vessels

211
Q

Nicotinic receptor SITE

A

(Neuromuscular)

Affect the skeletal muscles

212
Q

Direct acting cholinergic agonist

A

Selective to muscarinic RECEPTORS but nonspecific

Ex: metoclopramide (reglan) for reflux disease it increases gi tone and motility , increases peristalsis

213
Q

Bethanechol

A

Urecholine

Use: urinary retention

Type: direct acting cholinergic agonist

Action: increases urination

214
Q

Pilocarpine

A

Pilocar

Use: relieve pressure in the eye related to glaucoma

Type: direct acting cholinergic agonist

Action: constructs the pupils

215
Q

What is xerostomia

216
Q

Indirect acting cholinergic agonist

A

Don’t act on receptors; instead they inhibit the enzyme cholinesterase , allowing acetylcholine to accumulate at the receptor sites

217
Q

Donepezil

A

Aricept

Type: indirect acting cholinergic agonist

Use: to improve cognitive function in Alzheimer’s disease

218
Q

Drugs used to treat myesthenia gravis are what type

A

Indirect acting cholinergic agonist

219
Q

What are some contraindications of cholinergic agonist

A
  • Intestinal or urinary obstruction
  • COPD
  • bradycardia
  • hypotension
220
Q

List some side effects of cholinergic agonist

A

Nausea , vomiting, diarrhea, abdominal cramping, salivation, sweating, flushing, frequent urination, blurry vision, miosis

221
Q

What are some adverse effects of cholinergic agonist

A

Orthostatic hypotension, bradycardia, muscle weakness and twitching, bronchoconstriction, heart block, circulatory and respiratory collapse

222
Q

Nursing implications for cholinergic agonist

A
  • 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
223
Q

Dicyclomine hcl

A

Bentyl

Used to treat irritable bowel syndrome

Type: anticholinergic

224
Q

Tolterodine tartrate

A

Detrol

Used for urinary frequency

Type: anticholinergic

225
Q

Cyclopentolate

A

Cyclogyl

Used to induce pupil dilation for eye exams

Type: anticholinergic

226
Q

Ipratropium

A

Atrovent

Used for COPD

Type: anticholinergic

227
Q

What are some contraindications when administering anticholinergics

A

Narrow angle glaucoma, obstructive gi disorders, paralytic ileus, tachycardia, BPH , myasthenia gravis, myocardial ischemia

228
Q

What are some adverse effects of taking anticholinergics

A 
Tachycardia
Hypotension 
Paralytic ileus 
Coma 
Ventricular fibrillation
229
Q

Teaching implications for anticholinergics

A
  • 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
230
Q

How do stool softeners work

A

Cause more water and fat to be absorbed into the stools; emulsifies and lubricates feces

231
Q

Docusate

A

Colace

Use: to decrease straining during defecation

Type: stool softener

232
Q

Lubiprotone

A

Amitiza

Use: to treat idiopathic constipation in adults

Type: chloride channel activator , stool softener

233
Q

How do stimulant laxatives work

A

Promote peristalsis by irritating the bowel

234
Q

Sennosides

A

Ex-lax

Type: stimulant laxative

235
Q

Biscodyl

A

Dulcolax, corrector

Type: stimulant laxative

236
Q

How do osmotic laxatives work

A

Cause water to be retained in the fecal mass to cause a more watery stool

237
Q

What are osmotic laxatives used for

A

Surgical and diagnostic prep

238
Q

What are some side effects of osmotic laxatives

A

Fluid and electrolyte imbalance, hypotension , weakness

239
Q

Magnesium hydroxide

A

Milk of magnesia

Type: osmotic laxative

240
Q

Polyethylene glycol

A

Miralax, goLytely

Type: osmotic laxative

241
Q

Constipation nursing implications

A

Don’t give with undiagnosed abdominal pain, inflammatory disorders of the gi tract (appendicitis, diverticulitis, etc) spastic colon or a bowel obstruction

242
Q

What is reflux

A

Occurs when stomach contents back up through the LES into the esophagus

243
Q

Where are peptic ulcers most commonly found

A

In the proximal duodenum

244
Q

How do histamine 2 receptor antagonist work

A

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

245
Q

Histamine 2 receptor antagonist are used to treat

A

Symptoms of gerd

246
Q

How should histamine 2 receptor antagonist be administered

A

Wait 30 mins-1 hour between taking an antacid and the H2 blocker

247
Q

Ranitidine

A

Zantac

Type: h2 receptor antagonist

Use: treat gerd

248
Q

Famotidine

A

Pepcid

Type: h2 receptor antagonist

Use: to treat gerd

249
Q

Cimetidine

A

Tagamet

Type: h2 receptor antagonist

Use: treat gerd

250
Q

What is something important to note about cimetidine and ranitidine

A

Can be given IV, but should not be taken with antacids

251
Q

How do proton pump inhibitors work

A

Reduce acid secretion by blocking the enzyme responsible for secreting hcl in the stomach

252
Q

What are proton pump inhibitors used to treat

A

Drug of choice for short term control of peptic ulcer disease and gerd

253
Q

Omeprazole

A

Prilosec

Type: proton pump inhibitors

Use: short term control of pud and gerd

254
Q

Iansoprozole

A

Prevacid

Type: proton pump inhibitors

Use: short term control of pud and gerd

255
Q

Esomeprozole

A

Nexium

Type: proton pump inhibitor

Use: short term control of pud and gerd

256
Q

Omeprazole and sodium bicarb

A

Zegrid

Type: proton pump inhibitor

Use: short term control of our and gerd

257
Q

What is zegrid given for

A

(Omeprazole and Na bicarb)

Only drug given to prevent stress ulcers in critically ill patients

Type: proton pump inhibitors

258
Q

Metronidazole

A

Flagyl

Type: antibiotics for h pylori

259
Q

Tetracycline

A

Achromycin V

Type: antibiotics for h pylori

260
Q

How do antacids work

A

Promote ulcer healing by neutralizing hydrochloric acid and reducing pepsin activity THEY DO NOT COAT THE ULCER

261
Q

Ca carbonate and Mg hydroxide

A

Rolaids,tums

Type: antacids

262
Q

Mg hydroxide and Al hydroxide

A

Maalox

Type: antacid

263
Q

Drugs with Al and Ca products cause

A

Constipation

264
Q

Magnesium products can cause

265
Q

Simethicone

A

An antiflatulent is added to antacids to reduce gas bubbles that cause bloating and discomfort

266
Q

How do pepsin inhibitors work

A

Produces a thick, gel like substance that coats a gastric ulcer protecting it against further erosion and promoting healing

267
Q

How should pepsin inhibitors be administered

A

30 mins before meals

268
Q

Sucralfate

A

Carafate

Type: pepsin inhibitor

269
Q

Prostaglandin analogues are used for what

A

To prevent gastric ulcers in patients taking high doses of NSAIDS

270
Q

Misoprostol

A

Cytotec

Type: prostaglandin analogue

Use: to prevent gastric ulcers in patients taking high doses of NSAIDS

271
Q

What are sulfonamides used to for

A

To treat ulcerative colitis

272
Q

Balsalazide disodium

A

Colazal

Type: sulfonamide

Use: to treat ulcerative colitis

273
Q

Nursing interventions for antacids

A

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

274
Q

Nursing interventions for ppi’s or H2 blockers

A

Give right before meals, avoid smoking, long term use effects b12 absorption

275
Q

Nursing interventions for pepsin inhibitors

A

Take on an empty stomach, allow 1-2 hour time lapse with meds

276
Q

How do amphetamine like drugs work

A

Suppress appetite by depressing the hunger center in the brain

277
Q

Phentermine

A

Adipex

Type: amphetamine , anorexiant

278
Q

How do fat blockers work

A

Block the enzyme lilase in the gi tract which blocks the absorption of fats

279
Q

Orlistat

A

Xenical

Type: fat blocker

280
Q

What is something important to note about fat blockers

A

They may also decrease absorption of other substances- like fat soluble vitamins and Coumadin

281
Q

How do pancreatic enzymes work

A

Contains the necessary enzymes to digest fats, carbs, and proteins

282
Q

Where do pancreatic enzymes come from

A

Obtained from pigs 🐷

283
Q

Pancrelipase

A

Pancrease

Type: pancreatic lipase

284
Q

What are some side effects of taking pancreatic enzymes

A 
Diarrhea 
Constipation 
Abdominal pain and bloating 
Gas 
N/v
285
Q

Teaching implications for pancreatic enzymes

A

Take it with every meal or snack, drink plenty of fluids, may increase blood sugar in diabetics

286
Q

Cox 1

A

Protects stomach lining , decreases fever , promotes platelet aggregation (blood clotting)

287
Q

Cox 2

A

Triggers pain and inflammation

288
Q

How do NSAIDS work

A

Inhibit biosynthesis of prostaglandins

289
Q

What effects do NSAIDS have

A

Analgesic
Antipyretic
Inhibit platelet aggregation
Mimic corticosteroids

290
Q

Salicylic acid

A

Aspirin

Type: NSAIDS

291
Q

Ibuprofen

A

Advil, Motrin

Type: NSAIDS

292
Q

Naproxin sodium

A

Naprosyn

Type: NSAIDS

293
Q

Ketorolac

A

Toradol

Type: NSAIDS

294
Q

Celecoxib

A

Celebrex

Type: cox 2 inhibitor

295
Q

What are NSAIDS used for

A

Mild to moderate pain, inflammation

296
Q

Contraindications of NSAIDS

A

Hypersensitivity, bleeding disorders, Reye’s syndrome (asa only)

297
Q

Side effects with NSAIDS

A

ANVD, tinnitus, stomach pain

298
Q

Adverse effects with NSAIDS

A 
Blood dycrasis
Bleeding 
Anaphylaxis 
Hearing loss 
Metabolic acidosis (asa only)
299
Q

What interactions should the nurse be mindful of with giving NSAIDS

A

Not taken with anticoagulants

300
Q

Nursing implications of NSAIDS

A

Check for allergy , assess gi status , observe for bleeding

301
Q

Teaching implications for NSAIDS

A

Avoid things that increase gastric upset, tell doctors you are taking NSAIDS, taking during period can increase bleeding

302
Q

What 4 drugs are used to treat rheumatoid arthritis

A

Glucocorticoids
Immunosuppressants
DMARDS
immunomodulators

303
Q

What glucocorticoid is used to treat rheumatoid arthritis

A

Prednisone

304
Q

Methotrexate

A

Mexate

Type: immunosuppressant

Use: treat rheumatoid arthritis

305
Q

What is the action of DMARDS

A

Slow down progression of rheumatoid arthritis

306
Q

When are DMARDS used

A

Only after other anti-inflammatory drugs are ineffective due to high side effects

307
Q

Gold salts

A

Crysotherapy

Type: DMARD

use: treat rheumatoid arthritis

308
Q

What is something important to note about gold salts

A

(Crysotherapy)

Don’t give to diabetics, those with renal/liver problems or allergic to gold or metal

309
Q

What is the action of immunomodulators

A

STOP rheumatoid arthritis disease profession ; may induce a long lasting remission

310
Q

Adalimumab

A

Humira

Type: immunomodulators

Use: treat rheumatoid arthritis

311
Q

Etanercept

A

Enbrel

Type: immunomodulators

Use: treat rheumatoid arthritis

312
Q

Infliximab

A

Remicade

Type: immunomodulators

Use: treat rheumatoid arthritis

313
Q

Allopurinol

A

Zyloprim

Use: to treat gout

Type: Uric acid inhibitor

Action: decrease production of uric acid

314
Q

Nursing interventions for Uric acid inhibitors

A

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)

315
Q

What are Uric acid inhibitors used for

A

Long term management of gout

316
Q

Acetaminophen

A

Tylenol

Type: non opioid analgesic

Can cause hepatotoxicity. No anti-inflammatory effect. Good as antipyretic in children. Maximum dose 4 g/day

317
Q

How do triptans work

A

Constrict vessels in the brain

Use: treat migraines

318
Q

Sumatriptan

A

Imitrex

Use: to decrease the severity of migraines and to treat acute migraine pain

Type: triptan

319
Q

Rizatriptan benzoate

A

Maxalt

Type: triptan

Use: to treat migraines

320
Q

Eletriptan

A

Relpax

Type: triptan

Use: to treat migraines

321
Q

What are adjuvant analgesics

A

Have been developed for other purposes and later found to be effective for pain relief neuropathy

322
Q

Propranolol

A

Inderal

Type: beta blocker but also an adjuvant analgesic

323
Q

Amitriptyline

A

Elavil

Type: tricyclic antidepressants and an adjuvant analgesic

324
Q

Gabapentin

A

Neurontin

Type: anticonvulsant and adjuvant analgesic

325
Q

Pregabalin

A

Lyrica

Type: anticonvulsant and adjuvant analgesic

326
Q

Hydrocodone

A

Vicodin, lortab

Type: opiate

327
Q

Oxycodone

A

Percocet, OxyContin

Type: opiate

328
Q

Methadone

A

Dolophine

Use: to treat opioid dependence

Type: opioid

329
Q

Codeine sulfate

A

Codeine

Type: opioid

330
Q

Morphine sulfate

A

Morphine

Type: opioid

331
Q

What is something important to note about opioids

A

They can cross the placenta and don’t give them for neuro trauma

332
Q

Meperidine

A

Demerol

Type: opioid

333
Q

Levophanol

A

Dilaudid

Type: opioid

*is stronger via IV than morphine

334
Q

Fentanyl

A

Duragesic

Type: opioid

*is the strongest, is a transdermal for chronic pain

335
Q

Contraindications for opiates

A

Asthma/COPD, increase intracranial pressure, use with caution in children and older adults

336
Q

Side effects of opiates

A 
N/v 
Constipation 
Sedation 
Urinary retention 
Blurred vision 
Hallucinations
337
Q

Adverse effects of opiates

A

Hypersensitivity
Respiratory depression
Increased ICP
Seizures

338
Q

Nursing implications for opiates

A
  • check for allergy
  • assess respiratory status
  • assess drug hx
  • monitor urinary output
  • HAVE NARCAN AVAILABLE
339
Q

Teaching implications for opiates

A

Avoid other CNS depressants (4 respiration), manage constipation, addictive potential

340
Q

Fentanyl

A

Sublimaze

Type: patient controlled analgesic

341
Q

Hydromorphone

A

Dilaudid

Type: patient controlled analgesia

342
Q

What are combination medications made of

A

Opioids and non narcotic analgesics

343
Q

What is Vicodin made of

A

Hydrocodone 5mg + acetaminophen 500mg

344
Q

What is Percocet made of

A

Oxycodone hcl 5mg + acetaminophen 325mg

345
Q

What is Tylenol with codeine made of

A

15-60 Mg of codeine phosphate + 300-1,000 mg acetaminophen

346
Q

How do opioid antagonist work

A

Compete with opioid agonists for access to the opioid receptor site

347
Q

Naloxone

A

Narcan

Type: opioid antagonist

348
Q

Naltrexone hydrochloride

A

Revia

Type: opioid antagonist

349
Q

Nursing implications for opioid antagonist

A
  • monitor vs and bleeding

- watch for reversal of analgesia

350
Q

What is the action of antiemetic antihistamines

A

Inhibit vestibular stimulation in the middle ear

Pharmacology (8 decks)

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