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Pharmacology Exam #1 > Neurological Part 3 > Flashcards

Neurological Part 3 Flashcards

1
Q

diazepam (Valium) and Alprazolam (Xanax): class

A

Benzodiazepines

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2
Q

diazepam (Valium) and Alprazolam (Xanax): EPA

A

enhance inhibitory effects of gamma-aminobutyric acid (GABA), GABA can reduce excitability of neuronal activity

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3
Q

diazepam (Valium) and Alprazolam (Xanax): Use

A

generalized anxiety disorder (GAD) & Panic disorder

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4
Q

diazepam (Valium) and Alprazolam (Xanax): ADR

A

CONTROLLED SUBSTANCE, CNS depression, hypotension, tachycardiac, respiratory depression, tolerance and physical dependence, overdose/toxicity: life-threatening sedation, hypotension, respiratory depression, cardiac arrest

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5
Q

diazepam (Valium) and Alprazolam (Xanax): contraindications

A

teratogenic, glaucoma, respiratory and CNS depression, concurrent use of CNS depressant

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6
Q

diazepam (Valium) and Alprazolam (Xanax): RN Intervention

A

monitor for withdrawal symptoms, monitor for phlebitis, assess falls, regular vital signs, do not stop abruptly, assess CNS and respiratory

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7
Q

What is the antidote for benzodiazepines (Diazepam and Alprzolam)?

A

Flumazenil (Anexate, Romazicon)

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8
Q

Buspirone (BuSpar): class

A

Non-benzodiazepines/ misc. anxiolytic

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9
Q

Buspirone (BuSpar): EPA

A

binds to serotonin & dopamine receptors, agonistic action on dopamine

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10
Q

Buspirone (BuSpar): administration

A

PO, can take 2-4 weeks to take effect, taper

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11
Q

Buspirone (BuSpar): Use

A

short term treatment of generalized anxiety

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12
Q

Buspirone (BuSpar): ADRs

A

paradoxical effects, insomnia, anxiety, restlessness, headache, dizziness, generally well tolerated

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13
Q

Buspirone (BuSpar): contraindications

A

MAOI can lead to HTN, grapefruit juice, ketoconazole, erythromycin may increase blood levels

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14
Q

Buspirone (BuSpar): RN Interventions

A

monitor for paradoxical effects, assess/monitor falls, avoid grapefruit juice

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15
Q

Amitriptyline (Elavil): class

A

tricyclic antidepressants (TCA)

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16
Q

Amitriptyline (Elavil): EPA

A

blocks norepinephrine reuptake pump & serotonin reuptake pump in synaptic space which boosts availability of serotonin, norepinephrine, acetylcholine, and dopamine

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17
Q

Amitriptyline (Elavil): administration

A

take at bedtime due to sedative effects, takes several weeks for effects

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18
Q

Amitriptyline (Elavil): use

A

major depression, 2nd line drug

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19
Q

Amitriptyline (Elavil): ADRs

A

MANY, Anticholinergic effects; sedation, inc risk for suicide (child/adolescent); abrupt discontinuation can cause withdrawal (anxiety, headache, muscle pain, nausea); high risk for overdose (life threatening dysrhythmias, confusion, seizure)

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20
Q

Amitriptyline (Elavil): contraindications

A

avoid with MAOIs, avoid with anticholinergics, avoid with CNS depressants, cardiac dysrhythmias, seizure disorders, recent MI, MANY

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21
Q

Amitriptyline (Elavil): RN Intervention

A

at bedtime, monitor vital signs, monitor for increase in depression, suicide precautions, taper drug over 2 weeks, no more than 1 week supply given at a time

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22
Q

tricyclic antidepressants

A

amitriptyline, imapramine, nortriptyline

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23
Q

Fluoxetine (Prozac): Class

A

selective serotonin reuptake inhibitor (SSRI)

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24
Q

selective serotonin reuptake inhibitors (SSRI)

A

fluoxetine, citalopram, escitalopram, paroxetine, sertraline

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25
Fluoxetine (Prozac): EPA
block reuptake of serotonin -> strengthen transmission of serotonin at serotonergic synapses
26
Fluoxetine (Prozac): Use
depression, anxiety, OCD, bulimia nervosa, premenstrual dysphoric disorder
27
Fluoxetine (Prozac): ADRs
- Insomnia, nervousness, Sexual dysfunction, Weight gain, inc risk for GI bleeding; Hyponatremia (especially in older adults and those taking diuretics), Increased risk for suicidal ideation (especially children, young adults) - Serotonin syndrome Serotonin syndrome: Hypertensive crisis; hyperpyrexia, agitation -> coma, muscle rigidity, seizure
28
Fluoxetine (Prozac): contraindications
MAOIs, St. Johns wort, ibuprofen, many decrease glucose control in diabetics
29
Fluoxetine (Prozac): RN Interventions
monitor for adverse effects, do not stop abruptly, notify provider if you develop persistent headaches
30
Vanlafaxine (Effexor XR): class
selective norepinephrine reuptake inhibitor (SNRI)
31
Vanlafaxine (Effexor XR): EPA
block neuronal reuptake of serotonin and norepinephrine -> increase amount of serotonin/norepinephrine available
32
Vanlafaxine (Effexor XR): use
major depression, social anxiety disorder, generalized anxiety
33
Vanlafaxine (Effexor XR): ARDs
very similar to SSRI, sexual dysfunction less common, hypertension, many
34
Vanlafaxine (Effexor XR): contraindications
MAOIs, First generation antipsychotics/typicals, ibuprofen
35
Vanlafaxine (Effexor XR): RN Interventions
give in the morning with food, monitor for adverse effects, do not stop abruptly, monitor BP periodically
36
Phenelzine (Nardil): class
Monoamine Oxidase Inhibitor (MAOI)
37
Monoamine Oxidase Inhibitors (MAOI)
phenelzine, isocarboxazid
38
Phenelzine (Nardil): EPA
blocks monoamine oxidase - A and monoamine oxidase - B
39
Phenelzine (Nardil): use
depression that hasn't responded to other medications, depression in bipolar
40
Phenelzine (Nardil): ADRs
CNS stimulation, constipation, dry mouth, nausea, weight gain, sexual dysfunction, orthostatic hypotension, hypertensive crisis when eating foods with tyramine
41
Phenelzine (Nardil): contraindications
renal failure, liver disease, cardiac disease, clients over 60, SSRIs, Glaucoma
42
Phenelzine (Nardil): RN Interventions
monitor vitals, list of foods to avoid, report severe anxiety, insomnia, and agitation
43
Bupropion (Wellbutrin): class
atypical antidepressant
44
Bupropion (Wellbutrin): EPA
inhibits dopamine reuptake thereby increase dopamine availability
45
Bupropion (Wellbutrin): Use
depression, seasonal affective disorder, adjunctive to smoking cessation
46
Bupropion (Wellbutrin): ADR
N/V, weight loss, appetite suppression, increase seizure risk, CNS stimulation, increase risk psychosis
47
Bupropion (Wellbutrin): contraindications
history of eating disorder, seizure disorder, MAOI, head trauma, interacts with many medications
48
Bupropion (Wellbutrin): RN Interventions
give with food, in the am, weekly weights, asses for increase depression
49
lithium carbonate (Lithobid): class
mood stabilizer
50
lithium carbonate (Lithobid): EPA
not well understood, changes sodium transport
51
lithium carbonate (Lithobid): use
controls acute mania, bipolar, prophylactically to prevent recurrence of mania or depression
52
lithium carbonate (Lithobid): ADR
GI distress, fatigue, confusion, muscle weakness, memory impairment, polyuria, decrease secretion of thyroid hormone: goiter, toxicity!
53
lithium carbonate (Lithobid): toxicity
due to narrow therapeutic window, muscle weakness, fine tremor to course tremor, ataxia, confusion, seizures, coma, death
54
lithium carbonate (Lithobid): contraindications
teratogenic, cardiac disorders, dehydration, hyponatremia, renal insufficiency, Many drug interactions, Avoid NSAIDS
55
lithium carbonate (Lithobid): RN Interventions
narrow therapeutic range, monitor lithium levels (.6-.8), regular blood work, monitor for toxicity, drink 2-3L fluid, avoid caffeine, consume foods with sodium
56
chlorpromazine: class
1st generation antipsychotics/ traditional
57
chlorpromazine: EPA
blocks several receptors: norepinephrine, acetylcholine, dopamine, histamine
58
chlorpromazine: Use
suppresses symptoms of schizophrenia, acute manic phase of bipolar
59
chlorpromazine: ADR
- Extrapyramidal symptoms (EPS): Abnormal muscle contraction/posturing and Acute dystonia - Neuroleptic malignant syndrome: Fever, stiffness of muscles, altered mental status, change in BP resp. failure - Akathisia (inability to sit still) - Anticholinergic Symptoms (dry mouth, dizziness, urinary retention, etc) - Parkinsonism - Orthostatic hypotension - Cardiac arrhythmias: prolonged QT interval Liver failure
60
chlorpromazine: contraindications
- CNS depressants - Caution with meds that activate dopamine receptors (levodopa) - SSRIs: increase levels of serotonin ->serotonin syndrome - Hyponatremia - Antihypertensives - Pregnancy/Lactation - Parkinsons disease, bone marrow depression
61
chlorpromazine: RN Interventions
wear gloves when handling, have client report adverse reactions
62
Risperidone (Risperdal): class
second generation antipsychotics/ Atypicals
63
Risperidone (Risperdal): EPA
Block receptors for dopamine and serotonin.
64
Risperidone (Risperdal): use
treat symptoms of schizophrenia and bipolar disorder
65
Risperidone (Risperdal): ADRs
Dizziness; sedation; hypotension (blockade of alpha-adrenergic receptors); Metabolic syndrome: wt gain, diabetes, dyslipidemia; Arrhythmias; Agranulocytosis (Clozapine); liver and kidney dysfunction; severe constipation. Extrapyramidal symptoms when given high doses
66
Risperidone (Risperdal): contraindications
- Prolonged QT - Severe CNS depression - Psychosis related to dementia in older adults - Pregnancy/Lactation - Drugs to treat parkinsons disease - MANY drug interactions
67
Risperidone (Risperdal): RN Interventions
weekly blood tests, periodic blood glucose levels, report symptoms, wear gloves, BLACK BOX WARNING
68
Risperidone (Risperdal): BLACK BOX WARNING
risk of death increases in elderly patients with dementia

Pharmacology Exam #1 (4 decks)

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