Pharm Exam 1-part2

Question 1

1. What are the 3 main categories for CNS Stimulants
2. Stimulant medically approved uses x3

Answer 1

1. Amphetamine, Analeptics (Caffeine), Anorexiants)
2. ADHS, Narcolepsy, Reverse Respiratory distress

Question 2

1. What causes ADHD?
2. What do Amphetamines release?
3. Side affects of amphetamines?

Answer 2

1. Can’t regulate, serotonin, norepi, dopamine)
2. norepi, and dopamine
3. SNS

Question 3

1. What is an amphetamine like drug?
2. Different side effects from ritalin?

Answer 3

1. CNS Stimulant- Ritalin
2. dizziness, tremors, inc hyperactivity, thrombocytopneia, low platelets

Question 4

1. Ritalin interactions x4
2. Nursing Interventions for ritaline use

Answer 4

1. Caffeine, decongestants, antiHTN, barbiturates, insulin
2. Before breakfast, lunch, irregular heartbeat, avoid alcohol/caffeine, sugarless gum for dry mouth

Question 5

1. Name an appetitie Supressants? x2
2. What are Analeptics
3. What do CNS stimulants affect? x3

Answer 5

1. Dextroamphetamine, benzophetamine
2. CNS stimulants
3. brainstem, spinal cord, cerebral cortex

Question 6

1. What is the primary use for an analeptic?
2. Types of Respiraotry stimulants?
3. How do analeptics correspond with newborns?

Answer 6

1. Stimulate respiration
2. caffeine, theophylline, NoDoz, Dozapram.
3. caffeine can increase respiration

Question 7

1. Name some SE of Analeptics x5

Answer 7

1. tinnitus, twitching, tremors, dependence, nausea, diarrhea

Question 8

1. Types of CNS depressants x3
2. Name 3 Types of Sedative Hypnotics?

Answer 8

1. Sedative Hypnotics, Antihistamine, Anesthetics
2. Barbiturates, Benzodiazepines, Non benzo, Melatonin Agonists

Question 9

1. What is an over the counter drug that can be taken for insomnia?
2. What drug selectively targets melatonin receptors to regulate circadian rhthms.

Answer 9

1. Diphenhydramine- antihistamine/allergy cough
2. Ramelton

Question 10

1. What is the difference between tolerance and dependence?
2. SE of Sedative Hypnotics

Answer 10

1. T- need to increase dose, D- withdrawal symptoms
2. dependence, tolerance, depression, resper depression.

Question 11

1. What is a long acting barbiturates used for?
2. What are short term Barbiturates used for?
3. What are ultrashort acting used for>?

Answer 11

1. Seizure Control
2. Induce sleep
3. Anesthesia

Question 12

1. Name a type of long acting barbiturate
2. Name a type of short acting barbiturates x2
3. Name a type of ultrashort acting barbiturate?

Answer 12

1. pheno
2. pento, seco
3. thiopental

Question 13

1. Ways to manage insomnis without pharm? x3

Answer 13

1. no naps,
2. warm fluids,
3. avoid heavy meals/exercise before bed.

Question 14

1. Nursing Interventions while using barbituates?
2. How long should you take a barbituate?

Answer 14

1. side rails up, no driving, taper, no alcohol
2. 2 wks or less, numerous side effects (class II)

Question 15

1. How do Benzodiazepines work?
2. What is an example of a benzo
3. Potential Nursing Diagnosis for Benzo?

Answer 15

1. interact with GABA to reduce neron excitability, anxiolytic
2. Valium, Restoril
3. Insomnia, Risk for falls

Question 16

1. How do non benzo’s work?
2. What is an example of a Nonbenzo?

Answer 16

1. inhibits neurotransmitter bind to GABA receptors
2. Ambien, Lunesta

Question 17

1. Name three ways anticonvulsants work

Answer 17

1. supress abnormal firing of neurons
2. supress calcium influx
3. increase action of GABA (inhibits neurotransmitter in brain)

Question 18

1. Name an anticonvulsant drugs that supresses sodium?
2. Name drugs that supresses caclium
3. Name drugs that enhances GABA

Answer 18

1. Dilantin
2. Depakane, Depakote
3. Klonopin, Neurontin

Question 19

1. This is a anticonvulsant that inhibits the degradation of GABA?
2. a crystalline compound present in sugar beet and used in the manufacture of some anticonvulsant drugs.

Answer 19

1. Sabril
2. Hydantoin

Question 20

1. Name a type of Hydantoin?
2. When is pheytoin contraindicated?
3. What is the therapeutic range for Dilantin?

Answer 20

1. Dilantin
2. pregnancy (terotagen)
3. 10-20 mcg/mL

Question 21

1. Name some Side effects of Hydantoin-dilantin
2. Pateint Education with Dilantin
3. What is a high priority nursing action before administering dilantin?

Answer 21

1. Steven Johnson, Gingivits, Nystagmus, slurred speech, thrombocytopenia
2. oral care, no alcohol, notify if planning prego
3. Monitor phenytoin levels (narrow range)

Question 22

1. Off label use of Dilantin
2. What drugs does dilantin increase effects? x4

Answer 22

1. Dysrhythmia/DIg tox, neuropathic pain
2. INH, Sulfonamides, Cimetidine, Glucose

Question 23

1. What drugs does dilantin decrease effects?
2. What do you need to monitor with

Answer 23

1. Anticoags, contraceptives, antihis, dopamine, theophylline
2. Serum drug levels

Question 24

1. Patient teaching for Dilantin
2. This med treats insomnia and seizures?
3. How does phenobarb work?

Answer 24

1. take at the same time each day, need medical alert band, taper, avoid herbs, alcohol, no driving
2. Phenobarbitol, long acting
3. enhance GABA, partial, grand mal and status epilepsy

Question 25

1. *What is the drug of choice for a seizure that can't stop?* 2. This drug is used for seizures and bipolar disorder? 3. *What should you monitor with Tegretol?*

Answer 25

1. *Ativan (Benzodiazapine)* 2. Tegretol 3. *CBC, Bone marrow, anemia, thrombocytopenia, agranulocytosis*

Question 26

1. This is a seizer med that you need to monitor liver enzymes?

Answer 26

1. Valproate

Question 27

1. Characteristics of Parkinsons 2. Name 5 Types of Antiparkinson drugs?

Answer 27

1. Tremors, pill rolling, rigidity, bradykinesia, shuffling, lack of facial expression 2. Anticholinergics, Dopaminergic, Dopamine agonist, MAO-B inhibitor, COMT inhibitor

Question 28

1. Common off-label use of antiparkinson 2. If a patient has glaucoma what drug is contraindicated?

Answer 28

1. Restless leg syndrome (Mirapex) 2. Benztropin

Question 29

1. How does Anticholinergs work for parikinson?

Answer 29

1. inhibits acetylcholine--decrease tremors and rigidity. (Benzotropine) (Artane)

Question 30

1. Nursing interventions for anticholinergic parkinson? x4

Answer 30

1. monitor vial (HR!), 2. U.O. for retention 3. fiber, exercise, alcohol for gastric acidity 4. ice chips/candy for dry mouth

Question 31

1. *LevodopaCardiopa/Sinemet does what?* 2. How does levodopa work alone 3. *How does Carbidopa work?*

Answer 31

1. *Converts to dopamine, increases mobility (agonist)* 2. 99% converts to dopa in pns, 1% reaches brain 3. *inhibits enzyme, more levodopa reach brain*

Question 32

1. Side effects of Sinemet

Answer 32

1. orthostatic hypotension, insomnia, nausea, vomiting, retention, skin lesions/melanoma, dyskinesia, psychosis, depression, palpitations

Question 33

1. Levodopa has a decreased effect with?

Answer 33

1. anticholinergic, phytoin, antidepressants, benzo, phenothi, B6

Question 34

1. Name an MAO inhibitor/Antipark that inactives MAO-B site in the brain & Increase dopaine available in the brain? 2. *What is the peak and duration of Rasagiline?*

Answer 34

1. Rasagiline/Azilect 2. *1 hour, 40 days*

Question 35

1. This is a dopamine agonist 2. When is it used? 3. What can you take it with?

Answer 35

1. Amantadine 2. early parkinsonism, improve symptoms 3. levodopa anticholinergic

Question 36

1. General consideration taking antiparkinsons x6

Answer 36

1. discoloration of urine and sweat 2. on-off phenomenon 3. CBC, liver kidney 4. taper 5. avoid B6 and alcohol 6. LOW protein

Question 37

1. What does alzheimer's disease do 2. What does cholinesterase inhibitors do?

Answer 37

1. breaks down acetylcholine 2. help stop acetylcholine from breaking down

Question 38

1. Name 2 examples of cholinesterase inhibors? 2. Action

Answer 38

1. Aricept, Exelon 2. more ACH, inc cog fxn

Question 39

1. Side effects of Anticholinesterase inhibiros

Answer 39

1. insomnia, blurred vision, depression, hypo/hypertn., dry mouth, dysrhthmias, hepatotoxicity, gi distress. dizziness

Question 40

* Nursing interventions for alzheimer patients? x6

Answer 40

* monitor vitals * consistency * safety when wandering * arise slowly * GI bleed * support groups

Question 41

* What side effect of simemet is most important to monitor?

Answer 41

* A granulocytosis b/c dec production of blood cells

Question 42

1. What does MGravis cause 2. How does it happen?

Answer 42

1. muscle weakness, ineffective muscle contraction, difficulty chewing, swallowing, double vision, respiratory muscle paralysis, eyes droop 2. destroy ACH sites (thymus may contribute)

Question 43

1. What do you use to treat MG?

Answer 43

1. Cholinesterase Inhibitors (same as alzheimers!)/Parasympathomimetics. NEED MORE ACH

Question 44

1. *MG ACH inhibitor Types* 2. Short acting 3. *Ultra-short acting*

Answer 44

1. *Prostigmin, Tensilon, Mestinon, Mytelase* 2. Prostigmin, _can relieve a crisis_ 3. ***Tensilon- Used to diagnose***

Question 45

1. This is Ache Gravis Intermeidate Acting 2. this is an ACHE gravis long acting

Answer 45

1. mestinon 2. mytelase

Question 46

* Characteristics of Mestinon * *What is the antidone for ACHE Mestinon*

Answer 46

* Inc muscle strenght for MG,NO for Gi obstruction, PNS SE * *Atropine*

Question 47

1. What can a patient do if Ache doesnt work for gravis 2. *If a MG crisis occurs how long does Mestinon take to work*?

Answer 47

1. prednisone, plasma xchange, IB glovulin, immunosuppressive (imuran) 2. *2-3 days*

Question 48

1. *Ache for gravis, overdosing and underdosing* 2. What define Myasthenia crisis "underdose) 3. *What defines cholinergic crisis (overdose)*

Answer 48

1. *muscle weaknes, dyspnea, dysphagia, ab cramping, droowling, bradycardia* 2. resper muscle no contract 3. *depolar, postsynaptic, neuromuscular cascade*

Question 49

1. *What triggers a Myasthenic crisis (underdose)* 2. What meds can cause a crisis 3. *What improves this crisis?*

Answer 49

1. *infection, stress, menses, prego, surgery, hypokalemia, alcohol* 2. aminoglycoside, ccblockers, phentoin, psychotropics 1. 3-4 hours after taking 3. *Tensilon (that why used to dx)*

Question 50

1. *How long does an ACHe overdose take to occur for MG?* 2. Unique signs of overdose\>? 3. *What happens when you give tensilon?*

Answer 50

1. *30-60 min* 2. excessive salivation 3. *It gets worse*

Question 51

1. Mestinon- ACHE inhibitor for MG- Interventions x4

Answer 51

1. doses on time 2. before meals 3. wear medical identification 4. Atropine- cholinergic crisis

Question 52

1. *MS is most common in what demographic* 2. What happens in MS 3. *What is McDonald Criteria for diagnosins MS*

Answer 52

1. *women 20-40* 2. attack myelin sheat of nerve fibers in the brain/spinal cord 3. *MRI, Visual evoked Potential, CSF analysis*

Question 53

1. These lab tests can suggest MS 2. MS treatment for an acute attack 3. Remission/exaceratbion

Answer 53

1. Elevated IgG, IgG/albumin ration, Lesions thru MRI 2. Glucocorticoids, Adrenocorticotrpic 3. Biologic Response Modifiers

Question 54

1. Chronic-Progress Tx for MS 2. How do Muscle Relaxants help MS

Answer 54

1. immunosuppressants 2. relief of muscle spasticity

Question 55

1. *What drugs are centrally acting for MS* 2. What drugs are direct acting for MS 3. *Depolarizing relaxants for MS*

Answer 55

1. *Depress Neuron activity in spinal cord, tx no longer than 3wks.* 1. lioresal, zanaflex, soma, parafon, robaxin, skelaxin, norflex 2. Dantrium 3. Adjunct anasthesia, must have airway 1. pavulon, anectine, norcuron, tubocurarine

Question 56

1. *What is Flexeril?* 2. How does it work 3. *SE*

Answer 56

1. *Acute skeletal muscle relaxant for MS* 2. alleviates muscle spasms 3. *erectily dysfunction, drowzy, dizzy, headach fever, ab pain*

Question 57

1. Patient Education for Flexaril for MS 2. Contraindications

Answer 57

1. take with food/milk for GI upset, taper or else rebound, monitor liver 2. glaucoma, MG, CV, liver, MAOIs

Question 58

1. MS patient treated with larg doses of steroids, what should you watch for?

Answer 58

* immunosuppressant **risk for infection**

Question 59

1. *What is the hangover effect caused by hypnotics* 2. Benzo Antidote 3. *What does protein do for parkinson off period?*

Answer 59

1. *residual drowsy, intermidiate and long active* 2. Romazicon 3. *can improve the absorption of levodopa*