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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
Q

What are adverse effects/

A

Apathy, bradycardia confusion, constipation, CV collapse

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26
Q

What are interactions?

A

ETOH, CIMETIDINE, ORAL CONTRACEPTIVES, OMEPRAZOLE, RANTIDINE, THEOPHYLLINE

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27
Q

Is Diazepam safe in pregnancy? Yes or No

A

No

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28
Q

What are the routes of administration?

A

Oral, , IV, IM supos

29
Q

What does SSRI represent?

A

Selective Serotonin Reuptake Inhibitors (SSRI antidepressants)

30
Q

Paroxetine is an SSRI, what is the expected pharmacological action?

A

It inhibits serotonin reuptake, which allows more serotonin to stay

31
Q

What is serotonin?

A

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
Q

Paroxetine is an SSRI, what is a therapeutic use?

A

Generalized Anxiety Disorder (GAD), Panic Disorder, Obsessive -Compulsive Disorder (OCD) Social Anxiety Disorder, Depressive Disorder, Adjustment Disorder

33
Q

What are early adverse effects or complications for Paroxetine is an SSRI?

A

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
Q

What are the contraindications for Paroxetine is an SSRI?

A

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
Q

What are drug interactions as Paroxetine, SSRI?

A

Antiplatelet & anticoagulants (can increase the risk for bleeding)

36
Q

What is SEROTONIN SYNDROME?

A

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
Q

What are nursing administration actions for an SSRI?

A

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
Q

How can a nurse evaluate the therapeutic response of an SSRI effectiveness?

A

The patient verbalizes “ they feel less anxious & more relaxed, improved mood

39
Q

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.

A

B. Asses & Identify the patient’s level of orientation

40
Q

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.

A
  1. Again review each answer as true or false-Buspirone ( Buspar) has a low risk for dependence
41
Q
  1. Atypical anxiolytic /nonbarbiturate anxiolytics (Buspirone) what is the intended use?
A

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
Q
  1. Risperidone- class Antipsychotic*** black box warning why?
A

Not intended in elderly with dementia because there is an increased risk of CV death.

43
Q

What is the intended use for Risperidone- class Antipsychotic*?

A

Tx of schizophrenia and bipolar disorder and irritability associated with autistic disorder

44
Q

What are adverse effects for Risperidone- class Antipsychotic?

A

Agitation, arrhythmias, orthostatic hypotension, seizures, tardive dyskinesia

45
Q

What are the routes for Risperidone- class Antipsychotic?

A

Oral & IM

46
Q
  1. What class is Phenytoin ?
A

Antiepileptics ( AEDs)

47
Q

What is the expected action for Phenytoin ?

A

AEDs control seizure disorders in three ways: decreases seizure activity by enhancing the effects of gamma butyric acid (GABA)

48
Q

Phenytoin is a blood-level drug

A

Phenytoin serum blood levels must be drawn- because it has a narrow therapeutic level 10-20mg/L* patient must be instructed it is important to take the Rx & have their levels drawn

49
Q

What are the adverse effects of Phenytoin?

A

**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
Q

What are the routes of administration for Phenytoin ?

A

IV, (slowly) and oral

51
Q

What are the contraindications for Phenytoin ?

A

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
Q
  1. What is Parkinson’s disease?
A

Parkinson’s disease is a chronic neurological disorder which affects the motor system-disorder of the CNS

53
Q

What class of drugs is used for Parkinson’s disease?

A

Reversible inhibitors, Anticholinergics, Mao-B inhibitors, Dopamine agonists

54
Q

The common medications for Parkinson’s disease are?

A

Levodopa, & Apomorphine which (is a rescue drug for off times)

55
Q

What is the expected action for Levodopa?

A

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
Q

What are the adverse effects of Levodopa?

A

Nausea & vomiting & drowsiness, dyskinesias ( head bobbing, tics, & tremors orthostatic hypotension, psychosis

57
Q
  1. Oxycodone overdose now more than 200,000 cases per year True or False
A

True

58
Q

What are the symptoms for an Oxycodone overdose ?

A

Shallow breathing, confusion, LOC

59
Q

What medication is given for Opioid overdose?

A

Naloxone

60
Q

What is Methadone?

A

A drug a substitution which replaces the opioid that the person has an a dependence - used for withdrawal

61
Q
  1. Morphine is in what drug class?
A

Opioid Agonists

62
Q

What is the expected action of Morphine?

A

Act on the mu receptors and the kappa receptors - when the receptors are activated an analgesia, resp depression, euphoria, & sedation

63
Q

What are the complications of morphine?

A

Resp depression, constipation, orthostatic hypotension, & urinary retention, cough suppression, Billiary colic( GB spasms) nausea & vomiting

64
Q

What are the contraindications of morphine?

A

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
Q

What are the drug interactions with MS04 (morphine)?

A

ETOH, Benzos, Anticholergenic agents, Hypertensive agents ( Antihypertensive Rxs have additive hypotensive effects

66
Q
  1. MAOIs are Monoamine oxidase inhibitors are used less frequently than other anti-depressants why?
A

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
Q

What is the use for an MAOI?

A

Depression, Bulimia nervosa, Panic disorder, GAD OCD, PTSD, & Social anxiety disorder

68
Q

What are complications for an MAOI?

A

CNS stimulation, orthostatic hypotension, Severe Hypertensive crisis

69
Q

What are drug interactions for an MAOI?

A

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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