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Beta Blockers, Pain MOI, SSI > Pain, Beta Blockers, SSI, Anticonvulsants MOI > Flashcards

Pain, Beta Blockers, SSI, Anticonvulsants MOI Flashcards

1
Q

What is acute pain?

A

Pain that is sudden onset and lasts for a short period of time-The pain is described as sharp & usually does not last longer than six months-The causes are surgery, broken bones, dental work, burns or cuts, labor & childbirth

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2
Q

What is chronic pain?

A

Pain lasting more than three to six months.

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3
Q

What is nociceptive pain

A

Pain as a result of tissue damage by either physical or chemical agents- (like trauma, surgery or chemical burns)

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4
Q

Describe adjuvant therapy?

A

Is a drug or other substance or a combination of substances that is useful to increase the efficacy or potency of certain drugs’.

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5
Q

True or False- Medications used as adjuvant analgesics have been developed for other purposes but were found to be effective to treat pain.

A

True

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6
Q

What are two common examples of adjuvant medications?

A

Gapapentin (an anticonvulsant) & Amitriptyline (a tricyclic antidepressant)

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7
Q

What is the action of an Alpha Blocker?

A

Drugs which blocks the activity of epinephrine and norepinephrine by antagonizing the alpha receptors (actually causes vasodilation).

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8
Q

What is the therapeutic use for an Alpha Blocker?

A

Hypertension

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9
Q

What are Anticholinergic adverse effects?

A

Think about CNS effects-blurred vision, pupil dilating, photophobia, increased intraocular pressure, weakness, dizziness, The effects to the CV system are tachycardia, palpitation, GI system-dry mouth, nausea , heartburn, altered taste, & constipation

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10
Q

What type of Beta adrenergic blocker is Atenolol?

A

Cardioselective

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11
Q

What is the expected action for Atenolol?

A

To decrease the heart rate, decrease myocardial contractility, decreased the rate of conduction through the AV node, * reduces the release of renin which decreases angiotensin II and causes vasodilation & promotes the excretion of water & sodium

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12
Q

What are the primary uses for a Beta adrenergic blocker?

A

Hypertension, Angina, tachydysrythmias, heart failure & myocardial infarction*** also other uses can include tx of hyperthyroidism, migraine headache, glaucoma

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13
Q

What are adverse effects or complications for a Beta adrenergic blocker?

A

Bradycardia, Orthostatic hypotension, - assess for signs of worsening heart failure-(shortness of breath, edema, wt gain & fatigue)

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14
Q

What are contraindications for a Beta adrenergic blocker?

A

In clients with AV block, Nonselective Beta blockers are contraindicated who have asthma, bronchospasm, & heart failure & pregnancy.

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15
Q

What is the route of administration for Atenolol?

A

Oral & IV

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16
Q

What are nursing administration points to remember about a Calcium channel blockers?

A

Take with food (orally) to increase absorption, avoid sudden changes in position, do not crush or chew extended stay release tablets, self-monitor B/P & heart rate @ home

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17
Q

What are Beta Blocker Interactions?

A

Antihypertensive

medications can have an additive effect when using an ARB, Increase risk for Lithium toxicity

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18
Q

Which condition is an absolute contraindication to taking a beta blocker?

A

Severe bradycardia, pre-existing sick sinus syndrome, second and third degree AV block & severe left ventricular dysfunction

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19
Q

Why is a beta blocker not ordered if a person has asthma?

A

Beta Blockers work on lung tissue, they cause the airways to contract, which could make it difficult to breathe

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20
Q

What are Cholinergic Adverse effects?

A

First it is over stimulation of the Parasympathetic Nervous System Increased salivation, sweating, nausea & vomiting, diarrhea, ABD cramps, increased urinary frequency, low blood pressure & dizziness.

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21
Q

What is Flumazenil used for?

A

For a complete reversal or a partial reversal of the sedative effects of benzodiazepines in conscious sedation & gen. Anesthesia in the adult & pediatric populations

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22
Q

When is Flumazenil contraindicated?

A

In clients with unknown or mixed overdose, & seizure disorders.

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23
Q
  1. What class is Diazepam
A

Antiepileptic, anxiolytic, Benzodiazepine

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24
Q

Why is it ordered or what is the indication?

A

The treatment of anxiety disorders, skeletal muscle spasms, seizure disorders.

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25
What are adverse effects/
Apathy, bradycardia confusion, constipation, CV collapse
26
What are interactions?
ETOH, CIMETIDINE, ORAL CONTRACEPTIVES, OMEPRAZOLE, RANTIDINE, THEOPHYLLINE
27
Is Diazepam safe in pregnancy? Yes or No
No
28
What are the routes of administration?
Oral, , IV, IM supos
29
What does SSRI represent?
Selective Serotonin Reuptake Inhibitors (SSRI antidepressants)
30
Paroxetine is an SSRI, what is the expected pharmacological action?
It inhibits serotonin reuptake, which allows more serotonin to stay
31
What is serotonin?
It is a chemical that carries messages between nerve cells in the brain & throughout the body. Serotonin plays an important role in many body functions: mood, sleep, digestion, nausea, wound healing, bone health, blood clotting & sexual desire
32
Paroxetine is an SSRI, what is a therapeutic use?
Generalized Anxiety Disorder (GAD), Panic Disorder, Obsessive -Compulsive Disorder (OCD) Social Anxiety Disorder, Depressive Disorder, Adjustment Disorder
33
What are early adverse effects or complications for Paroxetine is an SSRI?
For the first few days/weeks nausea, diaphoresis, tremor, fatigue & drowsiness (these effects should soon subside)* Later adverse effects after 5-6 weeks insomnia, headache, decreased sexual desire, impotence) *** weight changes weight loss early in taking the medication can be followed by weight gain- it is important as a nursing action to monitor the weight*** Serotonin syndrome & Bruxism (grinding teeth)
34
What are the contraindications for Paroxetine is an SSRI?
In pregnancy, Paroxetine is contraindicated in patients taking MAOIs ( Monoamine Oxidase inhibitor are drugs for depression, Avoid ETOH, *** Use with caution in patients with renal & liver dysfunction, seizure disorders or a Hx of GI Bleed
35
What are drug interactions as Paroxetine, SSRI?
Antiplatelet & anticoagulants (can increase the risk for bleeding)
36
What is SEROTONIN SYNDROME?
Usually begins 2–72 hrs after starting treatment, the patient presents as agitated, confused, & has trouble concentrating, hallucinations, tachycardia, abdominal pain, coma leading to apnea and *** death in some cases- it usually resolves once the treatment is stopped
37
What are nursing administration actions for an SSRI?
Take with food, remind patients it can take up to 4 weeks to receive effects, take the medication in the morning as this can prevent sleep disturbances.
38
How can a nurse evaluate the therapeutic response of an SSRI effectiveness?
The patient verbalizes " they feel less anxious & more relaxed, improved mood
39
A nurse is working the ER and a client is admitted with benzodiazepine toxicity. What is a nursing priority? 1. Administer flumazenil 2. Identify the patient's level of orientation 3. Infuse IV fluids 4. Prepare the patient for gastric lavage.
B. Asses & Identify the patient's level of orientation
40
You are the nurse providing teaching to a patient or client who has a new prescription for buspirone to treat anxiety. Which of the following information should the nurse include ? 1. Take the medication on an empty stomach. 2. Expect optimal effects within 24 hours. 3. Take the medication when needed for anxiety. 4. The medication has a low risk for dependence.
4. Again review each answer as true or false-Buspirone ( Buspar) has a low risk for dependence
41
20. Atypical anxiolytic /nonbarbiturate anxiolytics (Buspirone) what is the intended use?
First, if you receive the class-you can usually tell the use-anxiolytic - is antianxiety- Buspirone - is given for panic disorder, social anxiety-disorder, OCD * GAD*** Dependency is much less likely
42
20. Risperidone- class Antipsychotic*** black box warning why?
Not intended in elderly with dementia because there is an increased risk of CV death.
43
What is the intended use for Risperidone- class Antipsychotic*?
Tx of schizophrenia and bipolar disorder and irritability associated with autistic disorder
44
What are adverse effects for Risperidone- class Antipsychotic?
Agitation, arrhythmias, orthostatic hypotension, seizures, tardive dyskinesia
45
What are the routes for Risperidone- class Antipsychotic?
Oral & IM
46
19. What class is Phenytoin ?
Antiepileptics ( AEDs)
47
What is the expected action for Phenytoin ?
AEDs control seizure disorders in three ways: decreases seizure activity by enhancing the effects of gamma butyric acid (GABA)
48
Phenytoin is a blood-level drug
Phenytoin serum blood levels must be drawn- because it has a narrow therapeutic level 10-20 mg/L* patient must be instructed it is important to take the Rx & have their levels drawn
49
What are the adverse effects of Phenytoin?
****Gingival hyperplasia (softening & overgrowth of gum tissue ( bleeding & tenderness)** Also it interferes with vit K dependent clotting factors causing bleeding in newborns, so the mother must receive prophylactic vitamin K 1 month prior to delivery
50
What are the routes of administration for Phenytoin ?
IV, (slowly) and oral
51
What are the contraindications for Phenytoin ?
Avoid giving to clients with sinus bradycardia, SA Block or Stokes -Adams Syndrome-(periodic fainting spell in which there is an intermittent heart block which can result in an inadequate blood flow to the brain-
52
18. What is Parkinson’s disease?
Parkinson’s disease is a chronic neurological disorder which affects the motor system-disorder of the CNS
53
What class of drugs is used for Parkinson’s disease?
Reversible inhibitors, Anticholinergics, Mao-B inhibitors, Dopamine agonists
54
The common medications for Parkinson's disease are?
Levodopa, & Apomorphine which (is a rescue drug for off times)
55
What is the expected action for Levodopa?
First, the Rx do not stop the disease, they do offer relief from tremors & rigidity- L Dopa ** the beneficial effects diminish by the end of year 5.
56
What are the adverse effects of Levodopa?
Nausea & vomiting & drowsiness, dyskinesias ( head bobbing, tics, & tremors orthostatic hypotension, psychosis
57
17. Oxycodone overdose now more than 200,000 cases per year True or False
True
58
What are the symptoms for an Oxycodone overdose ?
Shallow breathing, confusion, LOC
59
What medication is given for Opioid overdose?
Naloxone
60
What is Methadone?
A drug a substitution which replaces the opioid that the person has an a dependence - used for withdrawal
61
15. Morphine is in what drug class?
Opioid Agonists
62
What is the expected action of Morphine?
Act on the mu receptors and the kappa receptors - when the receptors are activated an analgesia, resp depression, euphoria, & sedation
63
What are the complications of morphine?
Resp depression, constipation, orthostatic hypotension, & urinary retention, cough suppression, Billiary colic( GB spasms) nausea & vomiting
64
What are the contraindications of morphine?
Contraindicated after billiary tract surgery(GB), in premature & NB- due to reps depression, Pregnant patients, Use cautiously in persons with asthma due to resp depression, clients who are extremely obese, patient with Inflammatory bowel disease, those with enlarged prostate ( due to urinary retention)
65
What are the drug interactions with MS04 (morphine)?
ETOH, Benzos, Anticholergenic agents, Hypertensive agents ( Antihypertensive Rxs have additive hypotensive effects
66
14. MAOIs are Monoamine oxidase inhibitors are used less frequently than other anti-depressants why?
Because these meds block MAOI enzymes in the brain & as a result increase norepinephrine, dopamine, serotonin & *** trymine- and increase tymine can cause a hypertensive crisis (elevated blood pressure)
67
What is the use for an MAOI?
Depression, Bulimia nervosa, Panic disorder, GAD OCD, PTSD, & Social anxiety disorder
68
What are complications for an MAOI?
CNS stimulation, orthostatic hypotension, Severe Hypertensive crisis
69
What are drug interactions for an MAOI?
Tricyclic antidepressants can lead to a hypertensive crisis, SSRI can lead to serotonin syndrome, Antihypertensives can have an additive hypotensive effect, use of meperidine can lead to hyperpyrexia

Beta Blockers, Pain MOI, SSI (1 decks)

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