Pharm Midterm

Question 0

What is halothane used for?

Answer 0

anesthesia maintenance - it is an inhalant. dose measured by minimum alveolar concentration

Question 1

Describe the idea of balanced anesthesia?

Answer 1

The use of a variety of medication with different routes of administration to achieve desired effects. It includes induction, muscle relaxation, and analgesia

Question 2

What is thiopental?

Answer 2

a barbiturate used as an IV anesthetic that is no longer available in the US because it’s used for lethal injection

Question 3

What is Diazepam? How quickly does it work?

Answer 3

A Benzo used as an IV anesthetic. Pt is unconscious within a minute

Question 4

What is medazolam? How quickly does it act?

Answer 4

It is a benzo used as an IV anesthetic. Pt is out within 80 seconds

Question 5

What are the new NPO guidelines for pre-op?

Answer 5

Adults: solids: 6-8hrs clears: 2-3hrs
Children: solids: 6hrs clears: 2-3hrs
< 6mo: solids (breastmilk) 4-6hrs clears: 2hrs

Question 6

How do local/regional anesthetics work?

Answer 6

By decreasing the amount of sodium that enters a neuron, preventing conduction of pain impulse/action potential

Question 7

What is Novocaine?

Answer 7

An ester type local/regional anesthetic.

Ester types have higher incidence of allergic reactions than amide types

Question 8

What is Lidocaine?

Answer 8

An Amide-type local/regional anesthetic.
Most widely used, not very long lasting
Can be used for CV dysrhythmias

Question 9

What can be added to local/regional anesthetics and why would you do it?

Answer 9

Epinephrine because it’s a strong vasoconstrictor which would keep blood flow from the area allowing the anesthetic to act more quickly and for a longer period of time

Question 10

What can the nurse administer that requires FULL attention and is their ONLY responsibility during administration?

Answer 10

Monitored Anesthesia Care (MAC)

Moderate/ Conscious sedation

Question 11

How does Ritalin work and what are some key factors to it’s use?

Answer 11

It promotes the release and prevents reuptake of norepi and dopa from the neurons.
Doesnt directly suppress - behavior, but allows for + behavior to be learned.
May require drug holiday for growth & reevaluation of need

Question 12

What is the difference in sedative hypnotics used for anxiety vs insomnia

Answer 12

Anxiety is a smaller dose

insomnia is a larger dose

Question 13

What is ativan used for and what are some key nursing considerations?

Answer 13

it is a benzo used for short term use of anxiety/insomnia
Amplifies GABA effects
Some have active metabolites
Seizures are a serious withdrawal reaction!

Question 14

What is the treatment for a Benzo overdose?

Answer 14

PO - emetic w activated charcoal

IV - Flumazenil: works within 30 seconds but can cause seizures!!

Question 15

What is the MOA of barbiturates used for anxiety/insomnia

Answer 15

Stimulate the synthesis of P450: This causes RAPID and incredibly strong tolerance to drug but NOT the adverse effects

Question 16

What is the treatment for a barbiturate overdose?

Answer 16

There is none!

Question 17

Why are barbiturates not used much anymore?

Answer 17

There is no limit to their degree of CNS depression
#1 drug for suicide

Question 18

What is Thorazine?

Answer 18

It is a low potency FGA that can cause SERIOUS movement disorders: EPS (if overdose occurs)

Other s/e include lactation and seizures

Question 19

What is Haldol?

Answer 19

It is a high potency FGA

Question 20

Which type of symptoms are more responsive to FGA treatment?

Answer 20

Positive, as opposed to negative

Question 21

What is Clozapine?

Answer 21

An antipsychotic that is more effective than others but really dangerous.
agranulocytosis occurs so you MUST get WBC count before each administration.

Question 22

Which cholinesterace inhibitor is approved for severe symptoms of dementia?

Answer 22

Aricept

Question 23

What is the issue with dementia pts and how would you treat this?

Answer 23

They have about 90% less ACh than they should. You would treat w a cholinesterace inhibitors that would prevent the break down of ACh.
“Start low go slow”
Can cause bronchoconstriction!

Question 24

What is the non-Cholinesterace inhibitor that is approved for moderate to severe symptoms of dementia?

Answer 24

Memantine

Question 25

What are the s/s of dilantin toxicity?

Answer 25

Seizures! along with nystagmus, sedation, ataxia, diplopia, cog impairment, etc

Question 26

What is dilantin used for and how does it work?

Answer 26

used for seizures and inhibits the Na+ channels

has very narrow therapeutic index!

Question 27

What would you advise someone on tegretol to avoid?

Answer 27

grapefruit juice! it increases the effectiveness

Question 28

A child is often accused of daydreaming by his teachers. The teacher notices before almost every day dreaming occurence the boy breathes in and out rapidly. What could be happening and what would you do

Answer 28

The child is experiencing absence seizures for which he would be prescribed Zarontin

Question 29

A pt presents with a rapid succession of seizures that don’t allow the brain time to recover. The current seizure is lasting almost 20 minutes. What’s going on? What do you do?

Answer 29

The pt is experiencing status epilepticus which is a neuro emergency! Administer a benzo STAT!

Question 30

What is the drug of choice to abort a headache that is accompanied by N/V, severe sensitivity to light, and sweating?

Answer 30

Imitrex to abort migraine HA. Can be intranasal incase of vomiting

Question 31

What would you expect to see in a pt taking imitrex

Answer 31

pt reports of chest and arms feeling heavy

Question 32

If a pt on medication for migraine HAs complains of numbness and tingling in their hands, and you feel that they are cold to touch, what would you expect is going on?

Answer 32

The pt is on Ergotamine and is experiencing an overdose

Question 33

A pt has frequent migraine HAs. Instead of treating once the symptoms arise, you want to prevent them from occurring. What would you expect to see prescribed?

Answer 33

Propanolol - a beta blocker

Question 34

What is the med used for prophylaxis of tension HAs

Answer 34

Elavil to help w stress