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PHARM > PHARM EXAM 4- ch. 13, 18, 19 > Flashcards

PHARM EXAM 4- ch. 13, 18, 19 Flashcards

1
Q

brain and spinal cord

A

CNS

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2
Q

all nervous tissue outside of the CNS, including sensory and motor neurons

A

PNS

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3
Q

basic fxns of the nervous system

A

recognizing changes in internal/external environment

processing and integrating environmental changes

reacting to environmental changes by producing and action or response

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4
Q

voluntary control over skeletal muscles

A

somatic nervous system

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5
Q

involuntary control over smooth and cardiac muscle and glands

A

autonomic nervous sytem

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6
Q

Sympathetic nervous system

A

activated under stress

fight or flight response

ready the body for an immediate response to a potential threat

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7
Q

sympathetic and parasympathetic nervous system

A

branches produce mostly opposite affects
homeostasis
branches do not always produce opposite effects

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8
Q

proper balance of the two branches.

achieved by changing one or both branches

A

homeostasis

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9
Q

juncture of neurons

A

synapse

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10
Q

connection of two neurons outside CNS–

A

ganglionic synapse

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11
Q

2 parts of ganglionic synapse

A

preganglionic neuron

postganglionic neuron

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12
Q

many drugs affect autonomic function by–

A

altering neurotransmitter activity at the second synapse

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13
Q

in all sympathetic target organs except heart

A

Alpha1-adrenergic receptors

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14
Q

response of the Alpha1-adrenergic receptors

A

constriction of blood vessels

dilation of pupils

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15
Q

at presynaptic adrenergic neuron terminals

activation inhibits release of norepinephrine

A

Alpha2-adrenergic receptors

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16
Q

in heart and kidneys

A

Beta1- adrenergic receptors

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17
Q

response of Beta1-adrenergic receptors

A

activation increases heart rate and force of contraction of heart.

increases release of renin

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18
Q

in all sympathetic target organ except the heart

inhibit smooth muscle

A

Beta2-adrenergic receptors

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19
Q

in sympathetic and parasympathetic divisions at the ganglionic synapse

A

nicotinic receptors

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20
Q

response of nicotinic receptors

A

stimulate smooth muscle

stimulate gland secretion

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21
Q

in parasympathetic target organs except the heart

in heart: decreased heart rate and force of contraction

A

muscarinic receptors

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22
Q

response of muscarininc receptors

A

stimulate smooth muscle

stimulate gland secretion

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23
Q

affords several mechanisms by which drugs may act

A

acetylcholine

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24
Q

Synthesized in presynaptic nerve terminal from choline and acetyl coenzyme A

A

acetylcholine

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25
Q

Ach in the synaptic cleft is rapidly destroyed by the enzyme acetylcholinesterase (AchE)

A

acetylcholine

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26
Q

classification and naming of autonomic drugs is based on

A

4 possible actions of sympathetic and parasympathetic nervous system

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27
Q

chapter 18

A

.

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28
Q

subjective experience for clients

numerical scales and surveys assist in assessment

A

pain assessment

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29
Q

effective pharmacotherapy depends on

A

assessment of degree of pain

determining underlying disorders

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30
Q

intense

defined period of time

A

acute pain

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31
Q

over 6 months

interferes with daily activities

A

chronic pain

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32
Q

used alone of in conjunction with pharmacotherapy

may allow for lower doses and possibly fewer drug-related adverse effects

A

nonpharmacologic techniques for pain management

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33
Q

examples of nonpharmacologic therapies

A 
acupuncture
massage; therapeutic or physical touch
heat or cold
meditation or prayer
relaxation
art or music therapy
chiropractic manipulation
hypnosis
TENS
energy therapies such as Reiki and Qi gong
34
Q

tx for intractable cancer pain

A

radiation or chemotherapy
relieving nerve stimulation
surgery
nerve block

35
Q

a natural or synthetic morphine-like substance responsible for reducing moderate to severe pain

A

opioids

36
Q

opiod receptors:

A

mu, kappa, sigma, delta, & epsilon

37
Q

which receptors are most important for pain management?

A

mu and kappa

38
Q

opioid agonist drugs

A

stimulate receptors

39
Q

opioid antagonist drugs

A

block receptors

40
Q

opioid antagonists:

A

block opioid activity (compete for opioid receptor)

reverse symptoms of addiction, toxicity, and overdose.

41
Q

may be used to reverse respiratory depression and other acute symptoms

A

Naxalone (narcan)

42
Q

also used to diagnose overdose

A

Narcan

43
Q

opioid dependence

A

potential to cause physical and psychologic dependence

PCA

combinations with nonnarcotic analgesics

44
Q

tx for opioid dependence

A

switch from IV and inhalation forms to methadone, the oral form

45
Q

metadone maintenance

A

does not cure but avoids withdrawal symptoms

tx may continue for many months and years

46
Q

early treatment for opioid dependence

A

buprenorphine (subtex)

47
Q

mixed opioid agonist-antagonist

sublingual route

A

buprenorphine (subtex)

48
Q

later maintenance of opioid dependence

A

suboxone

49
Q

goal for migraine therapy

A

stop migraine in progress

prevent migraines from occurring

50
Q

two major drug classes to stop migraines in progress

A

triptans and ergot alkaloids

51
Q

triptans and ergot alkaloids both

A

stimulate serotonin (5-HT)

52
Q

selective for 5-HT receptor subtypes

act by constricting certain blood vessels in brain.

A

triptans

53
Q

interact with adrenergic, dopaminergic, and serotonin receptors

promote vasoconstriction, stop ongoing migraines

A

ergot alkaloids

54
Q

other drugs for migraine prophylaxis

A

anti seizure drugs
beta-adrenergic blockers
calcium channel blockers
tricyclic antidepressants

55
Q

role of the nurse

A 
careful monitoring of clients condition
providing education
obtaining medical history
obtaining list of allergies
assessing client's pain level
obtaining history of medications and alcohol and CNS-depressant use
56
Q

chapter 19

A

.

57
Q

five techniques for applying local anesthesia

A 
topical
infiltration
nerve block
spinal
epidural
58
Q

direct injection into tissue immediate to surgical site

blocks specific nerves near site

A

infiltration (field block) anesthesia

59
Q

creams, sprays, suppositories

drops and lozenges

applied to mucous membranes

safe, unless absorbed in the systemic system

A

topical (surface) anesthesia

60
Q

direct injection into tissues that may be distant from surgical site

affects nerve bundles supplying surgical area

used to block sensation in a limb or large area of face

A

nerve-block anesthesia

61
Q

how are local anesthetics classified?

A

by their chemical structures

62
Q

2 major classes of aneshetics

A

esters

amides

63
Q

contain ester chemical linkage

incidence of allergic reaction is low

A

esters

64
Q

first widely used anesthetic

A

cocaine natural ester

65
Q

topical OTC agent

A

benzocaine

66
Q

contain amide chemical linkage

longer duration of action and fewer side effects than esters

A

amides

67
Q

work by blocking sodium channels by temporarily suspending nerve conduction and preventing pain signals from reaching the CNS.

A

local anesthetics

68
Q

other agents sometimes added to increase duration of effectiveness

A

epinephrine

sodium hydroxide

69
Q

constricts blood vessels

increases duration of anesthetic

A

epinephrine

70
Q

alkaline agent

increases effectiveness of anesthetic

used in areas of infection that may be acidic (from bacteria)

A

sodium hydroxide

71
Q

block flow of sodium into neurons

delays nerve impulses and reduces neural activity

produces unconsciousness

produces lack of responsiveness to painful stimuli

A

general anesthetics

72
Q

act within a few seconds

used alone or in combination with inhalation agents: balanced anesthesia

A

intravenous anesthetics

73
Q

stages of general anesthesia:

A

loss of pain
excitement and hyperactivity
surgical anesthesia
paralysis of the medulla

74
Q

the patient loses general sensation but may be awake. This stage proceeds until the patient looses consciousness

A

Stage 1: loss of pain

75
Q

the patient may be delirious and try to resist treatment. Heart rate and breathing may become irregular and blood pressure, can increase. IV agents are administered here to calm the patient

A

Stage 2: excitement and hyperactivity

76
Q

skeletal muscles become relaxed and delirium stabilizes. Cardiovascular and breathing activities stabilize. Eye movements slow and the patient becomes still. Surgery begins here and remains until the procedure ends

A

Stage 3: surgical anesthesia

77
Q

paralysis of the part of the brain that controlls respiratory and cardiovascular activity. usually avoided during general anesthesia

A

Stage 4:

78
Q

prototype drug for amides

A

lidocaine (Xylocaine)

79
Q

mechanism of action:

A

to stop axonal conduction by blocking sodium channels

80
Q

primary use for amides

A

for brief medical or dental procedures

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