Pharm Exam 1-part2 Flashcards
1
Q
- What are the 3 main categories for CNS Stimulants
- Stimulant medically approved uses x3
A
- Amphetamine, Analeptics (Caffeine), Anorexiants)
- ADHS, Narcolepsy, Reverse Respiratory distress
2
Q
- What causes ADHD?
- What do Amphetamines release?
- Side affects of amphetamines?
A
- Can’t regulate, serotonin, norepi, dopamine)
- norepi, and dopamine
- SNS
3
Q
- What is an amphetamine like drug?
- Different side effects from ritalin?
A
- CNS Stimulant- Ritalin
- dizziness, tremors, inc hyperactivity, thrombocytopneia, low platelets
4
Q
- Ritalin interactions x4
- Nursing Interventions for ritaline use
A
- Caffeine, decongestants, antiHTN, barbiturates, insulin
- Before breakfast, lunch, irregular heartbeat, avoid alcohol/caffeine, sugarless gum for dry mouth
5
Q
- Name an appetitie Supressants? x2
- What are Analeptics
- What do CNS stimulants affect? x3
A
- Dextroamphetamine, benzophetamine
- CNS stimulants
- brainstem, spinal cord, cerebral cortex
6
Q
- What is the primary use for an analeptic?
- Types of Respiraotry stimulants?
- How do analeptics correspond with newborns?
A
- Stimulate respiration
- caffeine, theophylline, NoDoz, Dozapram.
- caffeine can increase respiration
7
Q
- Name some SE of Analeptics x5
A
- tinnitus, twitching, tremors, dependence, nausea, diarrhea
8
Q
- Types of CNS depressants x3
- Name 3 Types of Sedative Hypnotics?
A
- Sedative Hypnotics, Antihistamine, Anesthetics
- Barbiturates, Benzodiazepines, Non benzo, Melatonin Agonists
9
Q
- What is an over the counter drug that can be taken for insomnia?
- What drug selectively targets melatonin receptors to regulate circadian rhthms.
A
- Diphenhydramine- antihistamine/allergy cough
- Ramelton
10
Q
- What is the difference between tolerance and dependence?
- SE of Sedative Hypnotics
A
- T- need to increase dose, D- withdrawal symptoms
- dependence, tolerance, depression, resper depression.
11
Q
- What is a long acting barbiturates used for?
- What are short term Barbiturates used for?
- What are ultrashort acting used for>?
A
- Seizure Control
- Induce sleep
- Anesthesia
12
Q
- Name a type of long acting barbiturate
- Name a type of short acting barbiturates x2
- Name a type of ultrashort acting barbiturate?
A
- pheno
- pento, seco
- thiopental
13
Q
- Ways to manage insomnis without pharm? x3
A
- no naps,
- warm fluids,
- avoid heavy meals/exercise before bed.
14
Q
- Nursing Interventions while using barbituates?
- How long should you take a barbituate?
A
- side rails up, no driving, taper, no alcohol
- 2 wks or less, numerous side effects (class II)
15
Q
- How do Benzodiazepines work?
- What is an example of a benzo
- Potential Nursing Diagnosis for Benzo?
A
- interact with GABA to reduce neron excitability, anxiolytic
- Valium, Restoril
- Insomnia, Risk for falls
16
Q
- How do non benzo’s work?
- What is an example of a Nonbenzo?
A
- inhibits neurotransmitter bind to GABA receptors
- Ambien, Lunesta
17
Q
- Name three ways anticonvulsants work
A
- supress abnormal firing of neurons
- supress calcium influx
- increase action of GABA (inhibits neurotransmitter in brain)
18
Q
- Name an anticonvulsant drugs that supresses sodium?
- Name drugs that supresses caclium
- Name drugs that enhances GABA
A
- Dilantin
- Depakane, Depakote
- Klonopin, Neurontin
19
Q
- This is a anticonvulsant that inhibits the degradation of GABA?
- a crystalline compound present in sugar beet and used in the manufacture of some anticonvulsant drugs.
A
- Sabril
- Hydantoin
20
Q
- Name a type of Hydantoin?
- When is pheytoin contraindicated?
- What is the therapeutic range for Dilantin?
A
- Dilantin
- pregnancy (terotagen)
- 10-20 mcg/mL
21
Q
- Name some Side effects of Hydantoin-dilantin
- Pateint Education with Dilantin
- What is a high priority nursing action before administering dilantin?
A
- Steven Johnson, Gingivits, Nystagmus, slurred speech, thrombocytopenia
- oral care, no alcohol, notify if planning prego
- Monitor phenytoin levels (narrow range)
22
Q
- Off label use of Dilantin
- What drugs does dilantin increase effects? x4
A
- Dysrhythmia/DIg tox, neuropathic pain
- INH, Sulfonamides, Cimetidine, Glucose
23
Q
- What drugs does dilantin decrease effects?
- What do you need to monitor with
A
- Anticoags, contraceptives, antihis, dopamine, theophylline
- Serum drug levels
24
Q
- Patient teaching for Dilantin
- This med treats insomnia and seizures?
- How does phenobarb work?
A
- take at the same time each day, need medical alert band, taper, avoid herbs, alcohol, no driving
- Phenobarbitol, long acting
- enhance GABA, partial, grand mal and status epilepsy
25
Q
- What is the drug of choice for a seizure that can’t stop?
- This drug is used for seizures and bipolar disorder?
- What should you monitor with Tegretol?
A
- Ativan (Benzodiazapine)
- Tegretol
- CBC, Bone marrow, anemia, thrombocytopenia, agranulocytosis
26
Q
- This is a seizer med that you need to monitor liver enzymes?
A
- Valproate
27
Q
- Characteristics of Parkinsons
- Name 5 Types of Antiparkinson drugs?
A
- Tremors, pill rolling, rigidity, bradykinesia, shuffling, lack of facial expression
- Anticholinergics, Dopaminergic, Dopamine agonist, MAO-B inhibitor, COMT inhibitor
28
Q
- Common off-label use of antiparkinson
- If a patient has glaucoma what drug is contraindicated?
A
- Restless leg syndrome (Mirapex)
- Benztropin
29
Q
- How does Anticholinergs work for parikinson?
A
- inhibits acetylcholine–decrease tremors and rigidity. (Benzotropine) (Artane)
30
Q
- Nursing interventions for anticholinergic parkinson? x4
A
- monitor vial (HR!),
- U.O. for retention
- fiber, exercise, alcohol for gastric acidity
- ice chips/candy for dry mouth
31
Q
- LevodopaCardiopa/Sinemet does what?
- How does levodopa work alone
- How does Carbidopa work?
A
- Converts to dopamine, increases mobility (agonist)
- 99% converts to dopa in pns, 1% reaches brain
- inhibits enzyme, more levodopa reach brain
32
Q
- Side effects of Sinemet
A
- orthostatic hypotension, insomnia, nausea, vomiting, retention, skin lesions/melanoma, dyskinesia, psychosis, depression, palpitations
33
Q
- Levodopa has a decreased effect with?
A
- anticholinergic, phytoin, antidepressants, benzo, phenothi, B6
34
Q
- Name an MAO inhibitor/Antipark that inactives MAO-B site in the brain & Increase dopaine available in the brain?
- What is the peak and duration of Rasagiline?
A
- Rasagiline/Azilect
- 1 hour, 40 days
35
Q
- This is a dopamine agonist
- When is it used?
- What can you take it with?
A
- Amantadine
- early parkinsonism, improve symptoms
- levodopa anticholinergic
36
Q
- General consideration taking antiparkinsons x6
A
- discoloration of urine and sweat
- on-off phenomenon
- CBC, liver kidney
- taper
- avoid B6 and alcohol
- LOW protein
37
Q
- What does alzheimer’s disease do
- What does cholinesterase inhibitors do?
A
- breaks down acetylcholine
- help stop acetylcholine from breaking down
38
Q
- Name 2 examples of cholinesterase inhibors?
- Action
A
- Aricept, Exelon
- more ACH, inc cog fxn
39
Q
- Side effects of Anticholinesterase inhibiros
A
- 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
- What does MGravis cause
- How does it happen?
A
- muscle weakness, ineffective muscle contraction, difficulty chewing, swallowing, double vision, respiratory muscle paralysis, eyes droop
- destroy ACH sites (thymus may contribute)
43
Q
- What do you use to treat MG?
A
- Cholinesterase Inhibitors (same as alzheimers!)/Parasympathomimetics. NEED MORE ACH
44
Q
- MG ACH inhibitor Types
- Short acting
- Ultra-short acting
A
- Prostigmin, Tensilon, Mestinon, Mytelase
- Prostigmin, can relieve a crisis
- Tensilon- Used to diagnose
45
Q
- This is Ache Gravis Intermeidate Acting
- this is an ACHE gravis long acting
A
- mestinon
- 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
- What can a patient do if Ache doesnt work for gravis
- If a MG crisis occurs how long does Mestinon take to work?
A
- prednisone, plasma xchange, IB glovulin, immunosuppressive (imuran)
- 2-3 days
48
Q
- Ache for gravis, overdosing and underdosing
- What define Myasthenia crisis “underdose)
- What defines cholinergic crisis (overdose)
A
- muscle weaknes, dyspnea, dysphagia, ab cramping, droowling, bradycardia
- resper muscle no contract
- depolar, postsynaptic, neuromuscular cascade
49
Q
- What triggers a Myasthenic crisis (underdose)
- What meds can cause a crisis
- What improves this crisis?
A
- infection, stress, menses, prego, surgery, hypokalemia, alcohol
- aminoglycoside, ccblockers, phentoin, psychotropics
- 3-4 hours after taking
- Tensilon (that why used to dx)
50
Q
- How long does an ACHe overdose take to occur for MG?
- Unique signs of overdose>?
- What happens when you give tensilon?
A
- 30-60 min
- excessive salivation
- It gets worse
51
Q
- Mestinon- ACHE inhibitor for MG- Interventions x4
A
- doses on time
- before meals
- wear medical identification
- Atropine- cholinergic crisis
52
Q
- MS is most common in what demographic
- What happens in MS
- What is McDonald Criteria for diagnosins MS
A
- women 20-40
- attack myelin sheat of nerve fibers in the brain/spinal cord
- MRI, Visual evoked Potential, CSF analysis
53
Q
- These lab tests can suggest MS
- MS treatment for an acute attack
- Remission/exaceratbion
A
- Elevated IgG, IgG/albumin ration, Lesions thru MRI
- Glucocorticoids, Adrenocorticotrpic
- Biologic Response Modifiers
54
Q
- Chronic-Progress Tx for MS
- How do Muscle Relaxants help MS
A
- immunosuppressants
- relief of muscle spasticity
55
Q
- What drugs are centrally acting for MS
- What drugs are direct acting for MS
- Depolarizing relaxants for MS
A
-
Depress Neuron activity in spinal cord, tx no longer than 3wks.
- lioresal, zanaflex, soma, parafon, robaxin, skelaxin, norflex
- Dantrium
- Adjunct anasthesia, must have airway
- pavulon, anectine, norcuron, tubocurarine
56
Q
- What is Flexeril?
- How does it work
- SE
A
- Acute skeletal muscle relaxant for MS
- alleviates muscle spasms
- erectily dysfunction, drowzy, dizzy, headach fever, ab pain
57
Q
- Patient Education for Flexaril for MS
- Contraindications
A
- take with food/milk for GI upset, taper or else rebound, monitor liver
- glaucoma, MG, CV, liver, MAOIs
58
Q
- MS patient treated with larg doses of steroids, what should you watch for?
A
- immunosuppressant risk for infection
59
Q
- What is the hangover effect caused by hypnotics
- Benzo Antidote
- What does protein do for parkinson off period?
A
- residual drowsy, intermidiate and long active
- Romazicon
- can improve the absorption of levodopa