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concept 4 > pharm > Flashcards

pharm Flashcards

1
Q

how high should u hold dropper when administrating eye drop medications and where?

A

1-2 cm above the conjunctival sac

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2
Q

how do u prevent systemic absorption of eye dropper meds?

A

apply pressure to nasolacrimal duct for 30-60 seconds with a clean facial tissue

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3
Q

how long should u wait between eye dropper meds if u are instilling more than one?

A

5 mins

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4
Q

how should you apply eye ointment?

A

from edge of lower eyelid from inner to outer canthus

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5
Q

how should u pull ear for adults when instilling ear meds?

A

up and outward

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6
Q

how should u pull ear for children less than 3 yrs old

A

down and back

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7
Q

how far should u hold ear dropper above ear canal?

A

1 cm

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8
Q

where should u gently apply pressure after instilling ear dropper med?

A

the tragus of the ear

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9
Q

what position should pt remain in after instilling ear drops and how long?

A

side lying for 2-3 mins

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10
Q

which technique should be used to prevent contamination when adminestering nose meds?

A

medical aseptic technique

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11
Q

what position should pts be in for nasal med administration?

A

supine

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12
Q

how long should pt wait to blow their nose after nasal med administration?

A

5 mins

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13
Q

where should nasal spray nozzle be pointed?

A

away from center of nose

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14
Q

what should pt do while you spray nasal meds?

A

inhale and breath through mouth

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15
Q

what position should pt be for rectal supposotories?

A

left lateral position (Sims’ position)

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16
Q

where should suppository be inserted in anus?

A

just past internal sphincter

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17
Q

how long should pt remain in left lateral position after receiving suppository?

A

5 mins

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18
Q

what position should pt be in for vaginal meds?

A

dorsal recumbent or modified lithotomy

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19
Q

how far should suppositories be placed in vagina

A

3-4 inches

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20
Q

how far should creams be inserted for vaginal meds?

A

2-3 inches

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21
Q

how long should u breath in MDI inhaler

A

3-5 secs

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22
Q

how long should u hold breath after inhaling MDI

A

10 secs

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23
Q

should u shake a DPI?

A

no

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24
Q

what does a spacer in an MDI do?

A

keeps med in device longer (looks like a water bottle connected to inhaler)

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25
Q

can u mix meds w enteral feedings?

A

no

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26
Q

how to give crushed tablets through NG or gastronomy tubes

A

dissolve in 15-30 ml of sterile water

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27
Q

where is the best parenteral site for infants?

A

vastus lateralis

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28
Q

how many mL of fluid can deltoid muscle handle when giving IM injection

A

1 mL

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29
Q

what site should u use when giving IM injection over 2 mL

A

ventrogluteal site

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30
Q

which syringe should be used for solutions smaller than 0.5 mL

A

tuberculin syringes

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31
Q

what are tuberculin syringes used for

A

tb and allergy testing

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32
Q

what gauge size should u use for tuberculin syringe

A

26-27 gauge

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33
Q

when should u obtain blood sample for trough levels?

A

immediately before next med dose

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34
Q

how should u adjust med dosage for pt with peripheral vascular disease?

A

lower dosage (pvd impairs distribution)

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35
Q

what schedule classification are drugs with no acceptable medical use and high abuse potential?

A

schedule I

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36
Q

what schedule classification are drugs with high abuse potential but have acceptable med use

A

schedule II

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37
Q

what schedule classification are drugs with abuse potential that may lead to moderate/low physical dependence or high psychological dependence

A

schedule III

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38
Q

what schedule classification are drugs with abuse potential less than schedule III but more than schedule V

A

schedule IV

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39
Q

what schedule classification are drugs with the least potential for abuse

A

schedule V

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40
Q

medication pregancy risk category with human studies that show no risk

A

category A

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41
Q

medication pregnancy risk category with either insufficient human studies but safety in animal studies and vice versa

A

category B

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42
Q

medication pregnancy risk category with insufficient animal studies and problems in animals and vice versa

A

category C

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43
Q

medication pregancy risk category with fetal risks but drug benefits outweigh risk

A

category D

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44
Q

medication pregnancy risk category with fetal risks but benefits do not justify use

A

category X

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45
Q

which medications can cause angioedemas?

A

NSAIDS and ACE inhibitors

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46
Q

can a pregnant pt get the influenza vaccine

A

yes

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47
Q

what pregnancy risk category is warfarin?

A

category x

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48
Q

can a pregnant pt take warfarin

A

no

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49
Q

factor to think about when giving topical meds to children

A

they have increased absorbtion

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50
Q

factor to consider when giving child under 1 years old a protein binding med

A

they have decreased blood protein binding sites

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51
Q

how does decreased protein binding sites in children younger than 1 years old have an effect on receiving protein binding medications?

A

increase in blood level of protein binding meds

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52
Q

factor to consider when giving meds that affect CNS system to children

A

will have increased effect on CNS system

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53
Q

why do CNS meds have an increased effect on children

A

their blood brain barrier is not fully developed

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54
Q

how does inadequate gastric acid have an effect on medications

A

inhibits absorption of meds that. need to acid to dissolve

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55
Q

how does prolonged gastric emptying time affect medications

A

delays absorption of meds in the intestines

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56
Q

are gastric juices (stomach acid) supposed to be acidic or alkaline

A

acidic

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57
Q

factor to consider about newborn/infant gastric juices (stomach acid)

A

alkaline gastric juices

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58
Q

factor about children’s blood pressure to consider when giving medication

A

they have lower blood pressure

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59
Q

how does children having lower blood pressure affect medication

A

more blood flow to liver and brain but less to the kidneys

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60
Q

how is the gastric pH in older adult pts?

A

alkaline (increased)

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61
Q

how is the gastric emptying time in older adult pts

A

decreased

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62
Q

what is the prototype med for benzodiazepines?

A

alprazolam

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63
Q

what class of drugs is diazepam

A

benzodiazepine

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64
Q

what class of drugs is lorazepam

A

benzodiazepine

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65
Q

what class of drugs is chlordiazepoxide

A

benzodiazepine

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66
Q

what class of drugs is chlorazepate

A

benzodiazepine

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67
Q

what class of drugs is oxazepam

A

benzodiazepine

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68
Q

what class of drugs is clonazepam

A

benzodiazepine

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69
Q

what do benzodiazepine increase the effect of

A

GABA

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70
Q

nursing action for oral benzodiazepine toxicity

A

gastric lavage, then activated charcoal or saline cathartics (i.e milk of magnesia)

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71
Q

what medication should be given for benzodiazepine toxicity

A

flumazenil

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72
Q

why do u give flumazenil for benzodiazepine toxicity

A

counter acts sedation

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73
Q

how does flumazenil counteract sedation effects of benzodiazepines

A

blocks and reverses binding to GABA receptor

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74
Q

benzodiazepine withdrawal effects

A

-muscle twitching
-seizures
-hypertension
-delirium
(left out the obvious ones)

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75
Q

what pregnancy category risk are benzodiazepines?

A

category d

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76
Q

can a pt who is pregnant or breast feeding take benzodiazepines?

A

no

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77
Q

what should u do if benzodiazepine causes GI upset

A

take w meals

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78
Q

is buspirone suitable for PRN usage? why or why not?

A

effects take 2-4 weeks to reach full efficiency

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79
Q

buspirone adverse effects

A

-constipation
-agitation
-dizziness
-suicidal ideation
(left out obvious ones)

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80
Q

can u take buspirone if ur taking erythromycin?

A

no

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81
Q

can u take buspirone if ur taking ketoconazole?

A

no

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82
Q

can you build up a tolerance with buspirone?

A

no

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83
Q

what pregnancy risk category is buspirone?

A

category B

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84
Q

can pt who is pregnant or breast feeding take buspirone?

A

no

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85
Q

can u take buspirone with MAOI?

A

no can cause hypertensive crisis

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86
Q

what class of drugs is sertraline

A

SSRI

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87
Q

what class of drugs is Citalopram

A

SSRI

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88
Q

what class of drugs is Escitalopram

A

SSRI

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89
Q

what class of drugs is Fluoxetine

A

SSRI

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90
Q

what class of drugs is Fluvoxamine

A

SSRI

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91
Q

what class of drugs is Paroxetine

A

SSRI

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92
Q

which drug is the prototype antidepressant

A

Paroxetine

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93
Q

how long does it take for SSRIs to reach therapeutic levels

A

4 weeks

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94
Q

is nausea an expected adverse effect of SSRIs?

A

yes

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95
Q

when will pt experience nausea with SSRIs

A

first few days/weeks

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96
Q

is diaphoresis an expected adverse effect of SSRIs?

A

yes

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97
Q

when will pt experience diaphoresis with SSRIs

A

first few days/weeks

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98
Q

when will pt experience tremor with SSRIs

A

first few days/weeks

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99
Q

are tremors an expected adverse effect of SSRI?

A

yes

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100
Q

what should u do if pt reports tremors after recently starting SSRI

A

take meds as prescribed and effects should go away

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101
Q

what GI symptoms should u monitor for w SSRI use

A

GI bleeding

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102
Q

grinding and clenching teeth during sleep is called

A

bruxism

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103
Q

how to treat bruxism in pt who is taking SSRI

A

-switch med class
-low dose of buspirone

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104
Q

what to educate pt to do if they have bruxism w SSRI use

A

use mouth guard

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105
Q

how can SSRIs affect sodium?

A

can cause hyponatremia

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106
Q

what should u monitor if older pt on diuretics is taking SSRI

A

sodium levels

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107
Q

what category risk is Paroxetine

A

category D

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108
Q

can u crush lexapro?

A

yes

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109
Q

what class of drugs is venlafaxine

A

SNRI

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110
Q

what class of drugs is desvenlafaxine

A

SNRI

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111
Q

what class of drugs is duloxetine

A

SNRI

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112
Q

what class of drugs is levomilnacipran

A

SNRI

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113
Q

what medications can be used adjunct to SSRIs for sexual dysfunction

A

-sildenafil
-buspirone

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114
Q

what to do if pt develops rash with SSRI use

A

treat w antihistamine or withdrawal of med

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115
Q

what risk category are SSRIs other than Paroxetine

A

Category C

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116
Q

what should u monitor in a pt taking fluoxetine while on warfarin?

A

INR and PT levels (can increase warfarin lvls in blood (displaces warfarin from bound protein) [cant go to war for rin with a flu, ox and a teen]

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117
Q

can u take fluoxetine and TCAs at the same time

A

no increases levels

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118
Q

can u take fluoxetine and lithium at the same time

A

no increases lvls

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119
Q

what to watch out for in pt taking NSAIDs/anticoagulants w fluoxetine

A

bleeding

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120
Q

what risk category are SNRIs

A

category C

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121
Q

when should u stop SNRI use during pregnancy

A

third trimester (can cause infant withdrawal syndrome)

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122
Q

can u breastfeed while taking SNRI

A

no

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123
Q

can u take Kava while on SNRI

A

no can cause cns depression

124
Q

can u take valerian while on SNRI

A

no can cause cns depression

125
Q

what is valerian supplement used for

A

sedative for sleep aid

126
Q

what class of drugs is buproprion

A

atypical antidepressant

127
Q

what class of drugs is mirtazapine

A

atypical antidepressant

128
Q

what class of drugs is vilazodone

A

atypical antidepressant

129
Q

what class of drugs is trazodone ER

A

atypical antidepressant

130
Q

what class of drugs is nefazodone

A

atypical antidepressant

131
Q

what risk category is bupropion

A

category B

132
Q

can a pt with seizure disorder take atypical antidepressants

A

no

133
Q

what is a potential sexual adverse effect of trazodone ER use

A

priapism

134
Q

what class of drugs is amitriptyline

A

tricyclic antidepressants

135
Q

what class of drugs is imipramine

A

tricyclic antidepressants

136
Q

what class of drugs is doxepin

A

tricyclic antidepressants

137
Q

what class of drugs is nortriptyline

A

tricyclic antidepressants

138
Q

what class of drugs is amoxapine

A

tricyclic antidepressants

139
Q

what class of drugs is trimipramine

A

tricyclic antidepressants

140
Q

what class of drugs is desipramine

A

tricyclic antidepressants

141
Q

what class of drugs is clomipramine

A

tricyclic antidepressants

142
Q

what kind of antidepressants can be used for neuropathic pain

A

tricyclic antidepressants

143
Q

what kind of antidepressants can be used for fibromyalgia

A

tricyclic antidepressants

144
Q

what risk category are TCAs

A

category c

145
Q

can pts with recent MI take TCAs

A

no (affect cardiac contractibility)

146
Q

can TCAs be taken with epinephrine

A

no (increases effects)

147
Q

can TCAs be used with dopamine and why

A

no (increases effects)

148
Q

can TCAs be used with antihistamines and why

A

no (increases anticholinergic effects)

149
Q

can TCAs be used with ephedrine

A

no decreases effect (blocks from nerve terminal)

150
Q

can TCAs be used with amphetamines

A

no decreases effects (blocks from nerve terminal)

151
Q

what class of drugs is phenelzine

A

monoamine oxidase inhibitors

152
Q

what class of drugs is isocarboxazid

A

MAOI

153
Q

what class of drugs is tranylcypromine

A

MAOI

154
Q

what class of drugs is selegiline

A

MAOI (transdermal)

155
Q

what does monoamine oxidase do? (the enzyme)

A

removes norepinephrine, serotonin, tyramine and dopamine from brain (fun police)

156
Q

what do monoamine oxidase inhibitors (MAOI) do

A

block monoamine oxidase enzymes in the brain (Stops the fun police from ruining fun)

157
Q

what does tyramine do in the body

A

raises blood pressure which causes migraines (narrows blood vessels in the brain which gives u migraine)

158
Q

why are MAOI not used often

A

can cause hypertensive crisis (monoamine oxidase cant get rid of tyramine which leaves too much and raises BP)

159
Q

what to do if pt has hypertensive crisis from MAOI

A

give phentolamine IV or nifedipine SL

160
Q

why is nifedipine given for MAOI hypertensive crisis

A

treats high BP

161
Q

why Is phentolamine given for MAOI hypertensive crisis

A

treats high BP

162
Q

what can cause hypertensive crisis with MAOI use

A

intake of dietary tyramine

163
Q

what to do if pt gets rash from Selegiline (transdermal MAOI)

A

apply topical glucocorticoid

164
Q

what risk category are MAOIs

A

category C

165
Q

why should MAOIs be used cautiously in diabetic pts

A

can cause hypoglycemia and increase insulin effect

166
Q

transdermal selegiline is contraindicated for pts taking what anticonvulsants

A

carbamazepine and oxcarbazepine (can increase blood levels)

167
Q

can pt with heart failure take MAOI

A

no

168
Q

can pts with cerebrovascular disease take MAOI

A

no

169
Q

can pts with severe renal insfficiency take MAOIs?

A

no

170
Q

what should u monitor in pt taking MAOI and antihypertensive meds

A

can increase hypotensive effect

171
Q

what is hyperpyrexia

A

fever greater than 106 degrees fahrenheit

172
Q

why cant u use meperidine with MAOI

A

can cause hyperpyrexia

173
Q

what are catecholamines and what are the main ones

A

adrenal gland hormones released in response to physical and emotional stress (dopamine, norepinephrine, epinephrine)

174
Q

why should pts on MAOIs avoid chocolate

A

can cause hypertension

175
Q

what does phenylthylamine do to the body

A

releases serotonin

176
Q

what does chocolate contain that can cause hypertension with MAOIs

A

phenythylamine

177
Q

what is mydriasis

A

pupil dilation

178
Q

why do SSRIs cause mydriasis (pupil dilation)

A

releases more serotonin which dilates pupil

179
Q

why should should u monitor glaucoma pts eye pressure when taking venlafaxine

A

pupil dilation can block flow of fluid in eye and increase ocular pressure (increased ocular pressure damages optic nerve further)

180
Q

what class of drug is lithium carbonate

A

mood stabilizer

181
Q

what is the therapeutic level of lithium

A

under 1.5 mEq/L

182
Q

is polyuria an expected adverse effect of lithium

A

yes (will improve over time)

183
Q

can u take fluoxetine and TCAs at the same time

A

no

184
Q

how to treat early indication of lithium toxicity

A

-alter dosage based on blood lithium lvls
-promote excretion if adverse effects are severe

185
Q

mild lithium toxicity level

A

1.5-2.0 mEq/L

186
Q

moderate lithium toxicity level

A

2.0-2.5 mEq/L

187
Q

can u take fluoxetine and TCAs at the same time

A

no

188
Q

severe lithium toxicity levels

A

greater than 2.5 mEq/L

189
Q

how to treat severe lithium toxicity

A

hemodialysis

190
Q

how to treat moderate lithium toxicity

A
  • give emetic to alert pt
  • perform gastric lavage
    -give urea (increases urine and helps excrete lithium)
    -mannitol (increases urine production to help excrete lithium)
    aminophylline (increases rate of excretion)
191
Q

what risk category is lithium

A

category D

192
Q

what happens if blood sodium is decreased when taking lithium

A

less lithium is excreted and can build up

193
Q

why should u use lithium be used cautiously in pts taking diuretics

A

sodium will be excreted and allow lithium to build up

194
Q

can pts taking lithium use NSAIDs? why or why not?

A

no will increase renal reabsorption of lithium and lead to toxicity

195
Q

what should lithium pts use as a mild analgesic

A

aspirin

196
Q

why should lithium pts avoid anticholinergics?

A

cause urinary retention and polyuria

197
Q

how often should lithium lvls be obtained with each dosage change

A

1-2x a week

198
Q

how often should lithium lvls be obtained after therapeutic lvl is reached

A

monthly

199
Q

how often should lithium lvls be obtained after period of stability

A

every 2-3 months

200
Q

what time of day should lithium blood levels be obtained and how long after the last dose

A

in the morning, 10-12 hrs after the last dose

201
Q

when should higher levels of lithium be required and how much

A

during initial treatment of manic episode (1-1.5 mEq/L)

202
Q

what is the maintenance range of lithium

A

0.6-1.2 mEq/L

203
Q

how often should lithium be given daily

A

2-3 times because of short half life

204
Q

which class of medications is carbamazepine

A

mood stabilizing antiepileptics

205
Q

which class of medications is valproic acid

A

mood stabilizing antiepileptics

206
Q

which class of medications is lamotrigine

A

mood stabilizing antiepileptics

207
Q

which class of medications is oxcarbazepine

A

mood stabilizing antiepileptic

208
Q

which class of medications is topiramate

A

mood stabilizing antiepileptic

209
Q

when should carbamazepine be administered

A

at bedtime

210
Q

how does carbamazepine affect the cns system

A

-nystagmus
-double vision
-vertigo
-staggering gait
-headache

211
Q

how does carbamazepine affect leukocytes?

A

lowers them (leukopenia)

212
Q

how does carbamazepine affect RBCs

A

lowers them (anemia)

213
Q

how does carbamazepine affect platelets

A

lowers them (thrombocytopenia)

214
Q

what risk category is carbamazepine

A

category D

215
Q

what does ADH do in the body

A

tells kidneys to release less water (anti diuretic)

216
Q

how does carbamazepine cause fluid overload

A

promotes ADH secretion (hypo-osmolality)

217
Q

what skin disorders can carbamazepine cause

A

-stevens johnson syndrome
-rash
-dermatitis

218
Q

how to treat skin disorders caused by carbamazepine

A

-anti-inflammatory
-antihistamine

219
Q

what to if pt develops stevens johnson syndrome rash from carbamazepine

A

withhold medication

220
Q

how does carbamazepine affect the liver

A

it can elevate liver enzymes

221
Q

how does carbamazepine affect the pancreas

A

elevates amylase levels

222
Q

how does carbamazepine affect oral contraceptives

A

decreases effect

223
Q

can u take fluoxetine and TCAs at the same time

A

no

224
Q

how does carbamazepine affect warfarin

A

decreases effect

225
Q

how does carbamazepine affect neurotransmitters?

A

decreases neuron stimulation (lowers glutamate, sodium, potassium and calcium conduction in the brain)

226
Q

what does glutamate do

A

controls brain function by stimulating nerve cells

227
Q

what happens if u have too much glutamate

A

overstimulates nerve cells which causes brain cell damage or death

228
Q

what happens if your nerve cells are overstimulated

A

kills neurons which cause strokes, seizures

229
Q

which enzyme metabolizes drugs in the liver?

A

cyp450

230
Q

what effect does carbamazepine have on cyp450

A

increases it in the liver

231
Q

why should therapeutic effects of drugs being used while on carbamazepine be monitored

A

carbamazepine decreases drug effects (because it increases cyp450 in liver which metabolizes drugs)

232
Q

how does phenytoin affect drug metabolism in the liver?

A

increases the metabolism of them which decreases the effect of them (increases cyp450 in liver)

233
Q

how does phenobarbital affect drug metabolism in the liver?

A

increases cyp450 in liver (speeds up drug metabolism)

234
Q

how does valproic acid affect drug metabolism in the liver?

A

decreases cyp450 in liver (slows drug metabolism which increases half life)

235
Q

how does grapefruit juice affect drug metabolism in liver and how

A

slows down metabolism by inhibiting cyp450 enzyme

236
Q

estrogen containing contraceptives effect on lamotrigine

A

decreases levels of lamotrigine

237
Q

how does lamotrigine affect progestin

A

decreases it

238
Q

how does valproic acid affect phenytoin?

A

inhibits cyp450 in liver which slows down drug metabolism and increases half life

239
Q

how do nsaids increase lithium levels

A

reduce renal excretion of lithium

240
Q

what should lithium pt do with sodium intake?

A

increase it

241
Q

what should lithium pts do with fluid intake

A

increase it

242
Q

why should u report sore throat with carbamazepine use?

A

sign of infection due to bone marrow suppression

243
Q

how does carbamazepine cause bone marrow suppression

A

lowers platelets (thrombocytopenia)

244
Q

what class of medicine is chlorpromazine

A

1st gen antipsychotic

245
Q

what class of medicine is haloperidol

A

1st gen antipsychotic

246
Q

what class of medicine is fluphenazine

A

1st gen antipsychotic

247
Q

what class of medicine is thiothixene

A

1st gen antipsychotic

248
Q

what class of medicine is perphenazine

A

1st gen antipsychotic

249
Q

what class of medicine is loxapine

A

1st gen antipsychotic

250
Q

what class of medicine is trifluoperazine

A

1st gen antipsychotic

251
Q

what is the potency of chlorpromazine

A

low

252
Q

what do antipsychotics do

A

block dopamine receptors

253
Q

how does dopamine affect nausea and vomiting

A

dopamine stimulates the vagus nerve (CN X) which triggers gag reflex and signals the Chemoreceptor trigger zone (CTZ)

254
Q

what does the chemoreceptor trigger zone (CTZ) do?

A

controls vomiting and nausea

255
Q

what receptors are on the CTZ?

A

-dopamine
-opioids
-epinephrine
-5HT (serotonin)
-acetylcholine
-histamine

256
Q

where is the vomiting center located

A

in the medulla of the brain

257
Q

what 4 areas activate the vomiting center

A
  • vestibular region (CN XIII)
    -GI tract
  • cerebral cortex/thalmus
    -chemoreceptor trigger zone (CTZ)
258
Q

what receptors are in vestibular nerve (CN VIII)

A

Ach (acetylcholine)

259
Q

how does cranial nerve VIII cause nausea and vomiting

A

stimulation by acetylcholine binding to Ach receptors which activates vomiting center

260
Q

how do anticholinergics stop vomiting

A

blocking Ach receptors in vestibular system (CN VIII)

261
Q

how do dopamine antagonist stop vomiting and nausea

A

blocks dopamine in CTZ

262
Q

how do antihistamines stop vomiting and nausea

A

block histamine and Ach receptors in vestibular system

263
Q

how do seratonin agonists stop vomiting

A

blocks serotonin receptors in GI tract, CTZ and VC

264
Q

how do prokinetics stop vomiting

A

blocks dopamine in CTZ and stimulates Ach in GI tract. (stimulating ach promotes gastric emptying which reduces nausea)

265
Q

what causes acute dystonia

A

low dopamine caused by dopamine blockers

266
Q

what should u monitor for after giving 1st gen antipsychotic

A

few hrs an 5 days after 1st dose

267
Q

how to treat acute dystonia

A

anticholinergic agents (i.e benztropine, diphenhydramine)

268
Q

how do anticholinergics treat acute dystonia

A

block Ach receptors which balances out dopamine by amplifying dopamine signal

269
Q

which route of anticholinergic should u use for mild acute dystonia

A

oral

270
Q

which route of anticholinergic should u use for severe dystonia

A

IM or IV

271
Q

how long do IM anticholinergics take to work for dystonia

A

20 mins

272
Q

how long does IV anticholinergics take to work for dystonia

A

5 mins

273
Q

what class of medications should u treat parkinsonism with

A

anticholinergics and dopamine promotors

274
Q

which class of medications is amantadine

A

dopamine promotor

275
Q

when should u observe for parkinsonism

A

within 1 month of initial treatment

276
Q

when should u observe for akathisia

A

within 2 months of initial treatment

277
Q

what class of meds should u treat akathisia with

A

-beta blockers
-benzodiazepines
-anticholinergics

278
Q

what to prescribe to treat akathisia

A

valbenazine

279
Q

how does valbenazine treat akathisia

A

unblocks (vesicular monoamine transporter 2) VMAT2 release

280
Q

what causes neuroleptic malignant syndrome

A

dopamine blockers

281
Q

how do dopamine blockers cause neuroleptic malignant syndrome

A

low dopamine causes increased muscle rigidity and tremor

282
Q

what class of meds should u treat neuroleptic malignant syndrome with

A

-muscle relaxers
-dopamine promotors

283
Q

how does dopamine blockage affect prolactin production

A

causes prolactin levels to elevate

284
Q

what does prolactin do to breast

A

-causes breast to grow (gynecomastia)
-milk production (galactorrhea)

285
Q

what is gynecomastia

A

breast enlargement

286
Q

how does elevated prolactin affect menstrual cycle

A

interferes w estrogen & progesterone production which causes irregular periods

287
Q

how do antipsychotics affect prolactin levels

A

elevate them

288
Q

how do antipsychotics affect the skin

A

cause photosensitivity

289
Q

how do antipsychotics affect WBC

A

lower them (agranulocytosis)

290
Q

how do antipsychotics affect potassium

A

block potassium channels

291
Q

what will u see on ECG if potassium channels are blocked

A

lengthened QT intervals

292
Q

what does potassium channel blockage cause in the heart

A

longer cardiac repolarization

293
Q

what drug class is levodopa

A

dopamine promotor

294
Q

dosing for antipsychotics in the beginning

A

oral twice a day

295
Q

dosing for antipsychotics after initial dosage

A

daily at bedtime

296
Q

what class of meds are used for alcohol withdrawal treatment

A

benzodiazepines

297
Q

how do benzodiazepines treat alcohol withdrawal

A

stimulate GABA receptors which reduces seizures and delerium

298
Q

how do beta blockers treat alcohol withdrawal

A

decrease alcohol cravings

299
Q

what should pt avoid doing 15 mins before chewing nicotine gum

A

eating or drinking

300
Q

how does primary angle glaucoma affect vision

A

loss of peripheral vision
halos around lights

301
Q

expected range for intraocular pressure

A

10-21 mm hg

302
Q

what medication classes treat primary open angle glaucoma

A

-beta adrenergic agonists (beta blockers)
-alpha adrenergic agonists
-prostaglandin analogs
-cholinergic agonists
-carbonic anhydrase inhibitors

303
Q

how do beta blockers treat glaucoma

A

stop eye fluid production

304
Q

how do alpha antagonists treat glaucoma

A

decreases IOP by decreasing eye fluid production

305
Q

what does norepinephrine do in the body

A

constricts blood vessels to maintain BP when stressed (fight or flight)

306
Q

what releases norepinephrine

A

the adrenal glands

concept 4 (12 decks)

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