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Nursing school pt 3 > Pharm Exam 1-part2 > Flashcards

Pharm Exam 1-part2 Flashcards

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1
Q
  1. What are the 3 main categories for CNS Stimulants
  2. Stimulant medically approved uses x3
A
  1. Amphetamine, Analeptics (Caffeine), Anorexiants)
  2. ADHS, Narcolepsy, Reverse Respiratory distress
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2
Q
  1. What causes ADHD?
  2. What do Amphetamines release?
  3. Side affects of amphetamines?
A
  1. Can’t regulate, serotonin, norepi, dopamine)
  2. norepi, and dopamine
  3. SNS
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3
Q
  1. What is an amphetamine like drug?
  2. Different side effects from ritalin?
A
  1. CNS Stimulant- Ritalin
  2. dizziness, tremors, inc hyperactivity, thrombocytopneia, low platelets
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4
Q
  1. Ritalin interactions x4
  2. Nursing Interventions for ritaline use
A
  1. Caffeine, decongestants, antiHTN, barbiturates, insulin
  2. Before breakfast, lunch, irregular heartbeat, avoid alcohol/caffeine, sugarless gum for dry mouth
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5
Q
  1. Name an appetitie Supressants? x2
  2. What are Analeptics
  3. What do CNS stimulants affect? x3
A
  1. Dextroamphetamine, benzophetamine
  2. CNS stimulants
  3. brainstem, spinal cord, cerebral cortex
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6
Q
  1. What is the primary use for an analeptic?
  2. Types of Respiraotry stimulants?
  3. How do analeptics correspond with newborns?
A
  1. Stimulate respiration
  2. caffeine, theophylline, NoDoz, Dozapram.
  3. caffeine can increase respiration
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7
Q
  1. Name some SE of Analeptics x5
A
  1. tinnitus, twitching, tremors, dependence, nausea, diarrhea
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8
Q
  1. Types of CNS depressants x3
  2. Name 3 Types of Sedative Hypnotics?
A
  1. Sedative Hypnotics, Antihistamine, Anesthetics
  2. Barbiturates, Benzodiazepines, Non benzo, Melatonin Agonists
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9
Q
  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.
A
  1. Diphenhydramine- antihistamine/allergy cough
  2. Ramelton
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10
Q
  1. What is the difference between tolerance and dependence?
  2. SE of Sedative Hypnotics
A
  1. T- need to increase dose, D- withdrawal symptoms
  2. dependence, tolerance, depression, resper depression.
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11
Q
  1. What is a long acting barbiturates used for?
  2. What are short term Barbiturates used for?
  3. What are ultrashort acting used for>?
A
  1. Seizure Control
  2. Induce sleep
  3. Anesthesia
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12
Q
  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?
A
  1. pheno
  2. pento, seco
  3. thiopental
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13
Q
  1. Ways to manage insomnis without pharm? x3
A
  1. no naps,
  2. warm fluids,
  3. avoid heavy meals/exercise before bed.
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14
Q
  1. Nursing Interventions while using barbituates?
  2. How long should you take a barbituate?
A
  1. side rails up, no driving, taper, no alcohol
  2. 2 wks or less, numerous side effects (class II)
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15
Q
  1. How do Benzodiazepines work?
  2. What is an example of a benzo
  3. Potential Nursing Diagnosis for Benzo?
A
  1. interact with GABA to reduce neron excitability, anxiolytic
  2. Valium, Restoril
  3. Insomnia, Risk for falls
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16
Q
  1. How do non benzo’s work?
  2. What is an example of a Nonbenzo?
A
  1. inhibits neurotransmitter bind to GABA receptors
  2. Ambien, Lunesta
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17
Q
  1. Name three ways anticonvulsants work
A
  1. supress abnormal firing of neurons
  2. supress calcium influx
  3. increase action of GABA (inhibits neurotransmitter in brain)
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18
Q
  1. Name an anticonvulsant drugs that supresses sodium?
  2. Name drugs that supresses caclium
  3. Name drugs that enhances GABA
A
  1. Dilantin
  2. Depakane, Depakote
  3. Klonopin, Neurontin
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19
Q
  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.
A
  1. Sabril
  2. Hydantoin
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20
Q
  1. Name a type of Hydantoin?
  2. When is pheytoin contraindicated?
  3. What is the therapeutic range for Dilantin?
A
  1. Dilantin
  2. pregnancy (terotagen)
  3. 10-20 mcg/mL
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21
Q
  1. Name some Side effects of Hydantoin-dilantin
  2. Pateint Education with Dilantin
  3. What is a high priority nursing action before administering dilantin?
A
  1. Steven Johnson, Gingivits, Nystagmus, slurred speech, thrombocytopenia
  2. oral care, no alcohol, notify if planning prego
  3. Monitor phenytoin levels (narrow range)
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22
Q
  1. Off label use of Dilantin
  2. What drugs does dilantin increase effects? x4
A
  1. Dysrhythmia/DIg tox, neuropathic pain
  2. INH, Sulfonamides, Cimetidine, Glucose
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23
Q
  1. What drugs does dilantin decrease effects?
  2. What do you need to monitor with
A
  1. Anticoags, contraceptives, antihis, dopamine, theophylline
  2. Serum drug levels
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24
Q
  1. Patient teaching for Dilantin
  2. This med treats insomnia and seizures?
  3. How does phenobarb work?
A
  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
25
Q
  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?
A
  1. Ativan (Benzodiazapine)
  2. Tegretol
  3. CBC, Bone marrow, anemia, thrombocytopenia, agranulocytosis
26
Q
  1. This is a seizer med that you need to monitor liver enzymes?
A
  1. Valproate
27
Q
  1. Characteristics of Parkinsons
  2. Name 5 Types of Antiparkinson drugs?
A
  1. Tremors, pill rolling, rigidity, bradykinesia, shuffling, lack of facial expression
  2. Anticholinergics, Dopaminergic, Dopamine agonist, MAO-B inhibitor, COMT inhibitor
28
Q
  1. Common off-label use of antiparkinson
  2. If a patient has glaucoma what drug is contraindicated?
A
  1. Restless leg syndrome (Mirapex)
  2. Benztropin
29
Q
  1. How does Anticholinergs work for parikinson?
A
  1. inhibits acetylcholine–decrease tremors and rigidity. (Benzotropine) (Artane)
30
Q
  1. Nursing interventions for anticholinergic parkinson? x4
A
  1. monitor vial (HR!),
  2. U.O. for retention
  3. fiber, exercise, alcohol for gastric acidity
  4. ice chips/candy for dry mouth
31
Q
  1. LevodopaCardiopa/Sinemet does what?
  2. How does levodopa work alone
  3. How does Carbidopa work?
A
  1. Converts to dopamine, increases mobility (agonist)
  2. 99% converts to dopa in pns, 1% reaches brain
  3. inhibits enzyme, more levodopa reach brain
32
Q
  1. Side effects of Sinemet
A
  1. orthostatic hypotension, insomnia, nausea, vomiting, retention, skin lesions/melanoma, dyskinesia, psychosis, depression, palpitations
33
Q
  1. Levodopa has a decreased effect with?
A
  1. anticholinergic, phytoin, antidepressants, benzo, phenothi, B6
34
Q
  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?
A
  1. Rasagiline/Azilect
  2. 1 hour, 40 days
35
Q
  1. This is a dopamine agonist
  2. When is it used?
  3. What can you take it with?
A
  1. Amantadine
  2. early parkinsonism, improve symptoms
  3. levodopa anticholinergic
36
Q
  1. General consideration taking antiparkinsons x6
A
  1. discoloration of urine and sweat
  2. on-off phenomenon
  3. CBC, liver kidney
  4. taper
  5. avoid B6 and alcohol
  6. LOW protein
37
Q
  1. What does alzheimer’s disease do
  2. What does cholinesterase inhibitors do?
A
  1. breaks down acetylcholine
  2. help stop acetylcholine from breaking down
38
Q
  1. Name 2 examples of cholinesterase inhibors?
  2. Action
A
  1. Aricept, Exelon
  2. more ACH, inc cog fxn
39
Q
  1. Side effects of Anticholinesterase inhibiros
A
  1. insomnia, blurred vision, depression, hypo/hypertn., dry mouth, dysrhthmias, hepatotoxicity, gi distress. dizziness
40
Q
  • Nursing interventions for alzheimer patients? x6
A
  • monitor vitals
  • consistency
  • safety when wandering
  • arise slowly
  • GI bleed
  • support groups
41
Q
  • What side effect of simemet is most important to monitor?
A
  • A granulocytosis b/c dec production of blood cells
42
Q
  1. What does MGravis cause
  2. How does it happen?
A
  1. muscle weakness, ineffective muscle contraction, difficulty chewing, swallowing, double vision, respiratory muscle paralysis, eyes droop
  2. destroy ACH sites (thymus may contribute)
43
Q
  1. What do you use to treat MG?
A
  1. Cholinesterase Inhibitors (same as alzheimers!)/Parasympathomimetics. NEED MORE ACH
44
Q
  1. MG ACH inhibitor Types
  2. Short acting
  3. Ultra-short acting
A
  1. Prostigmin, Tensilon, Mestinon, Mytelase
  2. Prostigmin, can relieve a crisis
  3. Tensilon- Used to diagnose
45
Q
  1. This is Ache Gravis Intermeidate Acting
  2. this is an ACHE gravis long acting
A
  1. mestinon
  2. mytelase
46
Q
  • Characteristics of Mestinon
  • What is the antidone for ACHE Mestinon
A
  • Inc muscle strenght for MG,NO for Gi obstruction, PNS SE
  • Atropine
47
Q
  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?
A
  1. prednisone, plasma xchange, IB glovulin, immunosuppressive (imuran)
  2. 2-3 days
48
Q
  1. Ache for gravis, overdosing and underdosing
  2. What define Myasthenia crisis “underdose)
  3. What defines cholinergic crisis (overdose)
A
  1. muscle weaknes, dyspnea, dysphagia, ab cramping, droowling, bradycardia
  2. resper muscle no contract
  3. depolar, postsynaptic, neuromuscular cascade
49
Q
  1. What triggers a Myasthenic crisis (underdose)
  2. What meds can cause a crisis
  3. What improves this crisis?
A
  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)
50
Q
  1. How long does an ACHe overdose take to occur for MG?
  2. Unique signs of overdose>?
  3. What happens when you give tensilon?
A
  1. 30-60 min
  2. excessive salivation
  3. It gets worse
51
Q
  1. Mestinon- ACHE inhibitor for MG- Interventions x4
A
  1. doses on time
  2. before meals
  3. wear medical identification
  4. Atropine- cholinergic crisis
52
Q
  1. MS is most common in what demographic
  2. What happens in MS
  3. What is McDonald Criteria for diagnosins MS
A
  1. women 20-40
  2. attack myelin sheat of nerve fibers in the brain/spinal cord
  3. MRI, Visual evoked Potential, CSF analysis
53
Q
  1. These lab tests can suggest MS
  2. MS treatment for an acute attack
  3. Remission/exaceratbion
A
  1. Elevated IgG, IgG/albumin ration, Lesions thru MRI
  2. Glucocorticoids, Adrenocorticotrpic
  3. Biologic Response Modifiers
54
Q
  1. Chronic-Progress Tx for MS
  2. How do Muscle Relaxants help MS
A
  1. immunosuppressants
  2. relief of muscle spasticity
55
Q
  1. What drugs are centrally acting for MS
  2. What drugs are direct acting for MS
  3. Depolarizing relaxants for MS
A
  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
56
Q
  1. What is Flexeril?
  2. How does it work
  3. SE
A
  1. Acute skeletal muscle relaxant for MS
  2. alleviates muscle spasms
  3. erectily dysfunction, drowzy, dizzy, headach fever, ab pain
57
Q
  1. Patient Education for Flexaril for MS
  2. Contraindications
A
  1. take with food/milk for GI upset, taper or else rebound, monitor liver
  2. glaucoma, MG, CV, liver, MAOIs
58
Q
  1. MS patient treated with larg doses of steroids, what should you watch for?
A
  • immunosuppressant risk for infection
59
Q
  1. What is the hangover effect caused by hypnotics
  2. Benzo Antidote
  3. What does protein do for parkinson off period?
A
  1. residual drowsy, intermidiate and long active
  2. Romazicon
  3. can improve the absorption of levodopa

Nursing school pt 3 (13 decks)

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