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Pharmacology Test 1 > Pharma Exam 1 > Flashcards

Pharma Exam 1 Flashcards

1
Q

Nonselective adrenergic agonist

A

Epinephrine

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2
Q

Alpha-1 adrenergic agonists

A

-Phenylephrine
-respond to epinephrine + NE + dopamine.
-Eyes, Blood vessels, Male sex organs, prostatic capsule
-High BP, Mydriasis(pupils dilates), urinary retention

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3
Q

Alpha-2 adrenergic agonist

A

-Clonidine
-respond to epinephrine + NE
-Presynaptic nerve terminals (in the brain) Turn off adrenergic system
-Inhibition of further Norepinephrine release
-Decrease insulin secretion

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4
Q

Beta-1 adrenergic agonist

A
  • Dopamine
  • Primarily the heart, but also the kidneys
    -Keep an eye on urine output when pt is on beta blockers
    -respond to epinephrine + NE + dopamine.
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5
Q

Beta-2 Agonists

A

-Albuterol
- responds to only epi
-Arterioles of heart, lung and skeletal muscle
-Bronchi, uterus, liver and skeletal muscle

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6
Q

Beta- 3 Agonist

A

-Adipose tissue, bladder
-increased breakdown of fat and bladder relaxes preventing output

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7
Q

Dopamine

A

-Fenoldopam

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8
Q

SNS

A
  • Inhibits salivation, stomach & intestines, gallbladder
  • Stimulates :
    -Pupil (dilate)
    -Airways (relax)
    -Heartbeat (increase)
    -Glucose Release
    -Bladder (relax)
  • Promotes ejaculation + vaginal contractions
  • Secretes epi and norepi
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9
Q

Alpha-adrenergic antagonists

A

-Prazosin
- Anything with “-osin”

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10
Q

Bate-adrenergic antagonists

A
  • Metoprolol
  • anything with lol
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11
Q

Adrenergic Receptors

A

-Norepinephrine is the neurotransmitter(Stimulates the adrenergic system)
-Monoamine oxidase is the enzyme (Keeps norepinephrine working longer)

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12
Q

Phenylephrine (Neo-Synephrine)

A
  • Parenteral: Vascular failure in shock (ICU only)
  • Topically: Nasal congestion relief
    (use no more than 3 days > Rebound congestion)
  • Onset: (10-15 minutes)
  • Casues decreased cardiac and renal perfusion due to being a powerful vasoconstrictor
  • SE: Reflex bradycardia(LOW HR due to HIGH BP), Headacehe, restlessness
  • Nursing Considerations: ART Line, Hourly I&O, Peripheral vascular checks(may bc black from vasocontriction)
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13
Q

Prazosin (Minipress)

A
  • CHF(Alphas blocked and BP lower due to lower afterload), Raynaud vasospasm, Prostatic outflow obstruction
  • Only Orally and takes 2 hours
  • First dose syncope
  • Caution for agnia pt since it decreases blood flow
  • SE: Reflex tachycardia(High HR due to low BP)
  • Nursing Considerations: Take at night due to fall risk, Monitor BP before, during, and after admin, monitor weight for fluid(renin release)
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14
Q

2 types of cholinergic receptors

A
  • Nicotinic receptor
    -Activation of it in the adrenal medulla releases epi
    -causes skeletal contraction
  • Muscarinic Receptors
    -causes vasodilation-> decreasing BP
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15
Q

Cholinergic receptors

A
  • Acetylcholine = neurotransmitter.
  • Acetylcholinesterase = enzyme
  • Breaks down acetylcholine and stops it from stimulating the PNS system.
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16
Q

Cholinergic Agonist

A
  • Stimulates the rest and digest actions in the body
  • direct and indirect acting(Bethanechol is direct)
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17
Q

Cholinergic antagonist

A
  • Block any kind of cholinergic receptor
  • ALL TREAT HYPOTENSION + INCREASE HR
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18
Q

Bethanechol (Urecholine)

A
  • Think “wet” + Tiny pupils
  • Direct (Muscarinic) Cholinergic Agonist
  • GI Hyperactivity, GERD, dry mouth, urinary retention (non-obstructive)
  • Stimulates smooth muscles in GI tract to increase peristalsis & bladder to reduce urinary retention
  • Routes = SubQ or oral ONLY
  • DO NOT GIVE WITH BPH, urethral structures, or with known urinary obstruction
  • DO NOT GIVE: asthma, COPD, bradycardia, epilepsy, Parkinsonism
  • Nursing Considerations: Monitor for Hypotension, Monitor RR, UO, BM’s, and increased liver enzymes, and Monitor for cholinergic crisis
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19
Q

Cholinergic crisis

A
  • DUMBELS
    -D: Diaphoresis & diarrhea
    -U: Urinary frequency
    -M: Miosis(small pupils)
    -B: Bronchospasms
    -E: Emesis
    -L: Lacrimation(tears)
    -S: Salivation
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20
Q

Atropine

A
  • Think Dry and Big Pupils
  • Cholinergic Antagonist
  • Cardiac Arrhythmias, pesticide poisoning, nerve gas attacks, Hypotension
  • Pre-op: decrease respiratory/salivary secretions
  • Maximum dose = 3 mg total IV (too much = reverse rest & digest may get bowel ischemia)
  • 0.5 mg Q5min till you get the HR up
  • Dont give to glaucoma, myasthenia gravis or autoimmune pts(cant make acetylcholine)
  • Mad as a hatter (CNS psychotic effect), Dry as a bone (salivary), Red as a beet (peripheral vasodilation), blind as a bat (Mydriasis)
  • Antidote= Neostigmine(also treats myasthias gravis)
  • Nursing Considerations= Monitor HR and BP, Beware of GI ileus due to decreased motility, Monitor for urinary retention, Darken room for mydriasis
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21
Q

SSRI

A
  • SSRIs indirectly increase the amount of the neurotransmitter serotonin available in the synapses.
    -They keep the serotonin from being broken down.
  • They are preferred over the tricyclics and the MAOIs because they can cause less side effects.
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22
Q

Paroxetine (Paxil)talopram (Celexa), fluoxetine (Prozac),
escitalopram (Lexapro)

A
  • Panic disorders, anxiety, OCD, Depression, PTSD
  • Takes 2 to 3 weeks for maxium effect
  • SE: sexual dysfunction, weight gain, serotonin discontionation syndrom if you dont taper
  • St. Jon Wart increases risk of serotonin syndrome
  • Nursing Considerations: Serotonin Syndrome(2-72 hrs after admin), Suicidal tendencies(More energy to complete task such as ODing), Monitor for Hypotension + bleeding, Alcohol makes meds worse, and Teeth grinding (abruxism)
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23
Q

Serotonin Discontinuation Syndrome Mnemonic

A
  • (FINISH)
    -F-Flue like symptoms
    -I- insomnia
    -N- nausea
    -I- Imbalance (dizziness, vertigo)
    -S- sensory disturbances (burning, tingling, shock-like sensations)
    -H- Hyperarousal (anxiety, irritable, aggression)
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24
Q

Serotonin Syndrome

A
  • SHIVERS
    -Shivering (neuromuscular activity)
    -Hyperreflexia
    -Increased temp
    -Vital sign changes( Tachycardia, tachypnea, labile b/p)
    -Encephalopathy(Mental status change, confusion, delirium)
    -Restlessness
    -Sweating
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25
Q

Benzodiazepines

A
  • poteintate the effects An inhibitory neurotransmitter(GABA); causes the cells to relax and go to sleep night night. Inhibits nervous system response causing more CNS depression
  • A high margin of safety. Can still cause respiratory depression.
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26
Q

lorazepam (Ativan)

A
  • Benzodiazepine + GABA effect
  • Alchy widrawal, anticonvulsant, muscle relaxer, Anxiety relief, sleep promotion,
  • Pre-op sedation & conscious sedation(conscious = cardioversion or wisdom teeth removal)
  • Induction of general anesthesia(allows for less general sedation)
  • Dont give to pts with Psychoses (worsens condition)
  • SE= Long-term physical dependence(Can have seizure and/or die from withdrawal)
  • Nursing Considerations: CNS assessments, Avoid abrupt cessation, Antidote = Flumanezil, and Highly abusable
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27
Q

Nonbenzodiazepine/Nonbarbiturate

A
  • Used primarily for sleep/ sleep anxiety
  • Affects the GABA receptors
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28
Q

Zolpidem (Ambien)

A
  • Nonbenzo/Nonbarbituate + GABA effect
  • Short-term insomnia (7-10 days)
  • RAPIDLY induces sleep & should be taken immediately before bed
  • Cautin= Elderly population(Monitor for paradoxical effect)
  • Nursing Considerations: Monitor for unusual sleep behaviors,
    Flumanezil may help with overdose(BC this med affects GABA), and No bueno for long term
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29
Q

Gran Mal(Clonic-Tonic)

A

Cerebral Cortex
shaking

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30
Q

Peti-mal Seizure

A

Hypothalamus
Blank stare

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31
Q

Diazepam(Valium)

A
  • Treats seizures by increasing GABA
  • Benzo
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32
Q

Phenyotin(Dilantin)

A
  • Sodium channel blocker
  • Seizures
  • Monitor pts who are malnourinshed bc the drug is 90-95% protein bound
  • Doesnt allow absorption of Vitamin K in the gut
  • Dont give to pts with bradycardia or heart block
  • If you give it in Hand IV can cause purple glove syndrome(necrose)
  • Nursing Intervetions: Monitor CBC, monitor drug levels(thereputic= 10-20 mcg), push in a deciated line with saline bc its very irritaing, will crystalize if you admin with dextrose, push med slowly(50mcg/min) can cause arrhthmias so push even slower in elderly.
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33
Q

Ethosuximide (Zarontin C)

A
  • Absence (petit-mal) seizures(Works by inhibiting Ca+ flow rate into cell)
  • SE= blood dyscrasias and Known to interact with other antiepileptic drugs
  • Nursing Considerations: Monitor drug levels at initiation + dose changes, taper dose if discontinuing bc if not can cause seizures
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34
Q

Phenobarbital

A
  • CNS depressant through stimulation of GABA receptor.
  • Increases sensitivity to pain.
  • Has street value(ppl love to snort it)
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35
Q

Gabapentin (Neurontin)

A
  • Promotes natural GABA neurotransmitter production, also used for nerve pain
  • Diabetic neuropathy-> relaxes/sedates the nerve
  • Mood Stablizer(anxiety and bipolar
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36
Q

Antileptics

A
  • Monitoring drug levels is essential for valproic acid,
    phenytoin, and phenobarbital
  • Labs: CBC + Electrolyte (CA, Na) bc most of these causes blood dyscrasia(aplastic anemia)
  • Monitor CNS function and for bruising or bleeding
  • Caution with CNS depressants
  • Encourage foods high in: K, D, B, folic acid
37
Q

Physical Causes of Depression

A
  • Vit D Deficiency
  • Early Alzheimer’s
  • Thyroid Disorders
38
Q

What is the first chose for treating depression?

A
  • SSRI such as fluoxetine (Prozac) & *paroxetine (Paxil)
39
Q

Tricyclic Antidepressants

A
  • enhance the activity of norepinephrine and
    serotonin by blocking neuronal reuptake of these
    neurotransmitters.
  • Tricyclics have a very narrow therapeutic index
  • Prototype drug: amitriptyline (Elavil)
40
Q

Amitriptyline (Elavil)

A

*Tricyclic + norepi+ serotonin
* Depression, chronic pain, migraines
* NO for pts with Cardio diseases(increase HR) or seizure disorders(increases risk by increasing norepi)
* SE= weight gain(4lb) , tremors, urinary retention

41
Q

Monoamine Oxidasease Inhibitors

A
  • metabolizing amines such
    as dopamine, epinephrine, norepinephrine, and
    serotonin in the synapse.
  • Prototype drug: phenelzine (Nardil)
42
Q

Phenelzine (Nardil)

A
  • MAOI, Dopamine, Epi, Norepi, Serotonin
  • No for pts with Decreased liver function & CHF
  • SE= Anticholinergic effects, Agranulocytosis, leukopenia, Thrombocytopenia
  • Drug to Drug Interactions: SSRI, Insulin, Antihypertensive, Tyramine Rich foods(can lead to HTN crisis due to increased norepi), TCA, oral anti-diabetics,
43
Q

HTN Crisis

A
  • May lead to a stroke
  • Severe headache,N/V, Sweating,
  • severe anxiety, nose bleeds, confusion
  • SOB, Vision Changes, Chest pain, Tachycardia
44
Q

Antidepressant Treatment Info Summary

A
  • High risk overdose bc They have more energy to care out their suicidial plans.
  • Start low, with divided doses and taper up
  • Bedtime dosing if possible, for MOST antidepressants (sedative effects) except the SSRI’s: sertraline (Zoloft)
45
Q

Mania

A
  • Excessive excitement
  • Delusions of grandeur
  • Flight of ideas (not ADHD)
  • Elevation of mood
  • Sx: insomnia, constant movement, risk taking behaviors, incessant talking
46
Q

methylphenidate (Ritalin)

A
  • CNS stimulant and schedule 2 drug
  • Tx: ADHD, Obesity, Nacrolepsy
  • Releases norepi and dopamine in the brain
  • NO MAOIs, antileptics, HTN drug
  • Nusing Consideration: Use with family therapy or CBT since its a lifelong drug, Last dose before 4pm, Monitor Height and Weight, Highly abusable(street valu2 20 dollars a pill)
47
Q

Conventional Antipsychotics(Phenothiazines)

A
  • blocks dopamine and serotoning at the receptor sites there by diminishing neurological excitement
  • Sedates the nerves and settles down the hallucinations
48
Q

Chlorpromazine

A
  • Conventional Antipsychotics(Phenothiazines)
  • Tx: schizophrenic delusions and hallucinations
  • First pass effect(T 1/2 30 hrs) great for schizo bc they don’t have to take multiple doses
  • No pts with Demetia(increase risk of death) brain injury
  • SE: EPS, Sedation side effects
  • Nursing Considerdations: EPS(5 hrs to 5 days from first dose; muscle spasms of face, neck, back, and tongue), May take up to 7 weeks to be effective, Monitor WBC, K, ECG, liver function, Orthostatic BP, NMS
49
Q

Neuroleptic Malignant Syndrome

A
  • High life threating temp Unstable fluctuating BP, Changes in LOC, Muscle rigidity, dysrhythmias
  • Tx: cooling blanket, dantrolene, frequent vs, hydration, benzodiazepines for muscle spams
  • Can have temp so high they stroke out and die
50
Q

Typical (nonselective- non-phenothiazine) Antipsychotics

A
  • 1st antipsychotic drugs
  • Ex: Haloperidol (Haldol)
51
Q

Haloperidol (Haldol)

A
  • Typical antipsychotic drugs
  • Blocks dopaminergic receptors -> Effective decrease in movement disorders, relief of hallucinations, delusions, and psychosis-> sleep
  • Dont give to pts with Parkinson’s(lack of dopamine) or dementia
  • SE: EPS(more likely to occur if the patient repeatedly stops and restarts therapy)
  • Nursing Considerations: Same as chlorpromazine but haloperidol has a higher potentcy
52
Q

Atypical (selective) Antipsychotics

A
  • Differ from typical antipsychotics bc they only target specific dopamine receptors.
  • Eliminates most of side effects and only affects D2 receptors
  • Prototype drug: 2nd generation risperidone (Risperdal)
53
Q

Risperidone (Risperdal)

A
  • Tx: psychotic symptoms in schizophrenia and for short-term treatment of acute bipolar disorder
  • Highly protein bound(some clear it quickly and need a higher dose, some dont)
  • SE: Tardive dyskinesa, gynecomastia(increased prolactin), Agitation
  • Nursing Considerations: Liver enzymes increased, May cause blood dyscrasias (thrombocytopenia, agranular anemia, Increased blood glucose and prolactin levels, and NO CNS Depressants, Monitor for orthostatic BP
54
Q

Morphine

A
  • Schedule 2 drug
  • Blocks release of substance ”P” and receptors Mu & Kappa
  • CNS depressant on respiration and cough reflex center
  • SE: respiratory depression, Drops BP
  • Nursing Considerations: Monitor RR, B/P, HR, Fall risk, GI Motility is slowed down
55
Q

Naloxone

A
  • IV preferred for reversal of opioid effects (onset w/n 2 minutes)
  • May need repeated doses if action of narcotic longer than naloxone ½ life of 1-1 ½ hrs.
  • Will cause return of pain and withdrawal symptoms
  • Caution with liver disease
56
Q

1st generation NSAID

A
  • Inhibits both COX-1 and COX-2
  • Enzymes COX-1 and COX-2-> produce prostaglandins-> promote inflammation, pain, and fever.
  • COX-1increases blood flow to kidneys, and mucus/bicarb production in stomach.(Keeps the stomach acid from eating the stomach leading to ulcers )
  • COX-2 produces prostaglandins at injury site activated by injury (Promotes vasconstriction at the point of injury)
  • Ibuprofen, naproxen, indomethacin, ketorolac, meloxicam, diclofenac, and Aspirin
57
Q

Aspirin(acetylsalicylic acid)

A
  • 1st generation NSAID
  • If they have GI issues-> enteric coated aspirin and its digest in the small intestine
  • Tx: Inflammation(inhibit prostagladin), antiplatelet(Pts have to be off aspirin for 5-7 days so their platelets can clot properly), Fever( Dont use unless its a high fever)
  • SE: Abnormal bleeding, GI upset, Reye’s syndrome in kids(life threatning and No baby aspirin to babies or peds patients)
  • Give with milk or food to coat the stomach anddecrease GI upset and Taking with a empty stomach does not cause stomach ulcers.
  • Nursing Considerations: Monitor platelets and renal function, Must be off NSAID’s for 1 week for surgery, ASA is only for cardiac conditions, ASA should not be taken with ibuprofen
58
Q

ASA toxicity

A
  • hemodialysis, IV bicarb admin., activated
    charcoal
  • Bicarb= bc aspirin is an acidic and bicarbonate helps to alkaline the urine.
59
Q

Ketorolac (Toradol)

A
  • Should only be used short term(5 days at the most)
  • Only given IV; Very Potent
  • Can cause GI ulcers and perforation(can kill patients)
60
Q

Migrane Headache

A
  • migraine begins when intracranial
    blood vessels dilate-> dilation stimulates trigeminovascular system-> abnormal excitable neurons that send pain impulses to brain pain receptors
61
Q

Serotonin-Selective Agonist Drug

A
  • First-line drugs for the treatment of acute migraine headache.
  • They are not useful for other types of headache or inflammation that occur elsewhere in the body.
  • Prototype drug: sumatriptan (Imitrex) or any “triptans”
62
Q

Sumatriptan

A
  • acts on receptors of dilated cranial blood vessels to cause vasoconstriction
  • Effects on trigeminal nerve-> blocks inflammatory peptides and decreases pain nerve transmission
  • No pts with CAD or ischemic diseases
  • SE: Dysrhythmias, MI, HTN
  • Nursing Considerations: Monitor pain before and after, Monitor B/P and HR, Monitor for LOC changes,and Pt with circulatory impairment (CVA, CVD, PVD) should not use or use with caution and monitoring
63
Q

Local Anesthetic Agents

A
  • produce local or regional anesthesia by blocking nerve conduction and abolishing sensations in a limited and well-defined area of the body without loss of consciousness.
  • Ex: Cocaine, Lidocaine or any caine
64
Q

Lidocaine(Xylocaine)

A
  • Local anesthetic by diminishing nerve membrane’s permeability to sodium.(Na+ blocker)
  • IV use control ventricular tachycardia(Numbs the excessive electrical activity in the heart)
  • Causes Fetal bradycardia bc blocks the sodium channels in the babys heart.
  • SE: IV use can cause neurotoxicity, dysesthesia (unpleasant sensations, pains, tingling burning of the skin)
  • Nursing Considerations: Monitor for safety of the affected area to prevent injury, Monitor LOC, HR, and the site
65
Q

Parenteral anesthetic agents

A
  • Induction agents as (good to give prior to deep anesthesia to get the body ready for deep anesthesia)
  • Non-barbiturate hypnotic prototype drug:
    propofol (Diprivan)
  • Benzodiazepines, ketamine, fentanyl, opioids
66
Q

Propofol (Diprivan)

A
  • Used for induction and maintenance of anesthesia and maintenance of sedation in ICU.
  • Onset 40 secs if given IV and Duration 3-5 min
  • Dont give to prego/lactation and allergy to soy bean or eggs
  • No with benzo, CNS depressant(additive effect)
  • Nursing Conisderation: LOC, short half life, dont use if no advanced airway or ampu bag, Safety for falls and position injuries. If pt is position wrong in the OR they can get nerve damage), BM and UO(sedates gut)
67
Q

Inhaled Anesthetic Agents

A
  • The prototype drug is isoflurane (Forane) C.
  • “ane” (halothane, desflurane)
68
Q

Isoflurane (Forane)

A
  • Used to induce and maintain anesthesia.
  • Excreted in lungs unchanged(hangs out in dead spaces in lungs.. This is why we ask patients to deep breathe right after surgery…. To get rid of that dead space and help them wake up better)
  • Dont give with pts that have predisposition to NMS(very genetic, watch for sudden spike in temp right after surgery bc it takes 72 hrs after surgery to get an infection)
  • SE: NMS, resp. depression
  • Nursing Considerations: History of NMS in family, Breathing/Airway, Cardiac monitoring, Encourage deep breathing in postop period to excrete drug
69
Q

Depolarizing Neuromuscular Junction
Blockers

A
  • work by causing the muscle
    cell membrane to depolarize or become excited, which causes muscle contraction ->leads to paralysis
    of the muscle after repeated excitation.
  • This mechanism
    differs from that of nondepolarizing NMJ blockers, which
    prevent excitation.
  • Not an anesthetic ! Only paralyzes.
  • succinylcholine (Anectine)
70
Q

Succinylcholine (Anectine)

A
  • Parlzytic/NMJ
  • Used primarily for rapid endotracheal intubation and endoscopic procedures.
  • NO patient/family history of malignant hyperthermia
  • SE: NMS and muscle paralysis
  • Nursing Considerations: Continuous ECG and respiratory monitoring, Monitor K(Damaged muscles release potassium which could cause a spike), Fall risk, Give pain meds, Watch for NMS
71
Q

Parkinson Disease

A
  • Low Dopamine
  • Dopamine is a neurotransmitter that sends information to the parts of the brain that control movement and coordination.
  • As the disease progresses, messages from the brain telling the body how and when to move are delivered more slowly.
72
Q

Antiparkinson Drugs

A
  • Lack of Dopamine and excess acetylcholine causes symp
  • Goal is to restore the balance between
    dopamine and acetylcholine.
  • Parkinson drugs increase dopamine levels, stimulate dopamine receptors, extend the action of dopamine in the brain, or prevent the activation of cholinergic receptors.
  • Dopamine cant cross BBB
73
Q

Carbidopa-levodopa
(Sinemet)

A
  • Parkinsons
  • levodopa is coverted into dopamine and carbidopa prevents levopdopa from being broken down in periperhal circulation so it can cross BBB
  • Reduces Levodopa dose by 25%
  • Protein can interfere with absorption(Monitor diet for high protein)
  • Drug “Holiday” will reach a point where the drug does not work so taper off for a week then back on
  • Nusring Considerations: Must taper off for discontinuation, Monitor for skin cancers bc it causes photosensivity, Eat carbs before med
74
Q

Anticholinergics for Parkinson’s

A
  • Movement disorders are due to the excessive stimulation
    of acetylcholine in the brain.
    Use of anticholinergics decreases ACh activity in the nerve synapses.
  • Prototype: bentropine (Cogentin)
75
Q

Bentropine (Cogentin)

A
  • Anticholinergic
  • Centrally acting in the brain
  • Drives heart rate up
  • Cant see, cant pee, cant spit
76
Q

Dementia

A
  • Language skills (Communication)
  • Higher-level skills, such as judgment, comprehension, and problem solving (ADLs)
  • Ability to recognize or identify objects despite intact sensory function (Cognition)
  • Ability to perform motor skills
  • Mood and behavior may also be affected in dementia.
  • Agitation or withdrawal, hallucinations, delusions, insomnia, emotional apathy, and loss of inhibitions are also common.
77
Q

Alzheimer Disease

A
  • Most common cause of dementia among people 65 years of age and older.
  • Causes a gross, diffuse atrophy of the cerebral cortex.
  • Extracellular plaques with beta-amyloid protein deposits and neurofibrillary tangles in the cortical neurons.
78
Q

What can also cause dementia?

A
  • AIDS, Parkinson disease, Huntington chorea
79
Q

Acetylcholinesterase Enzyme Inhibitors
(Cholinesterase inhibitors)

A
  • By inhibiting the action of AChE, acetylcholinesterase inhibitors (AChEIs) prolong the activity of acetylcholine on the brain
  • Increase concentrations of the memory-regulating and cognition-regulating neurotransmitter acetylcholineby reversibly inhibiting the enzyme cholinesterase.
  • Prototype drug: donepezil (Aricept)
80
Q

Donepezil (Aricept)

A
  • Treating mild-to-moderate dementia.
  • SE: GI(N/V, anorexia, weight loss), joint pain,
  • Atropine is antidote
  • Nursing Considerations: temp prevents decline of cognitive function, Takes 1-6 months to see effect
81
Q

MS

A

*Myelin sheath around nerve fibers is damaged-> Causes muscle weakness and spasms.
* Meds: Immune modulating drugs

82
Q

Immune modulating drugs

A
  • Interferon beta (Avonex, Betaseron)
  • Glatiramer (Copaxone)
  • These drugs are Synthetic protein that simulates myelin basic protein
    to repair itself
83
Q

mitoxantrone (Novantrone)

A
  • Immunosupressant
  • MS patients who have not responded
    to immune-modulating therapy
  • SE: blue-green tint to urine, hair loss, toxicity
  • Nursing Considerations: CBC, Liver enzymes
84
Q

Causes of Muscle Spasms

A

*Excessive use or local injury to skeletal muscle
* Overmedication with antipsychotics
* Epilepsy
* Hypocalcemia
* Dehydration
* Neurologic disorders

85
Q

Treatments for Muscle Spasms

A
  • Benzos such as Diazepam (Valium), lorazepam (Ativan), clonazepam
    (Klonopin)
  • cyclobenzaprine (Flexeril) and Dantrolene
86
Q

Centrally Acting Muscle Relaxants

A

Depress the CNS in the brainstem, basal ganglia, and neurons of the spinal cord

87
Q

Cyclobenzaprine (Flexeril)

A
  • Muscle spasms, cerebral palsy, strains
  • No pts with hyperthyrodism and increaed risk of (arrhythmias) within 14 days of using MAOIs
  • SE: CNS depression and anticholinergic activity
88
Q

Dantrolene Sodium(Dantrium)

A

*Pheripheral Acting
* Blocks CA release from skeletal muscles-> less responsive.
* Used to prevent/manage spasticity from Malignant Hyperthermia, MS, Cerebral Palsy, Spinal cord injuries, CVA
* SE: fatal hepatitis, Ataxia
* Dont give to pts with Cerebral palsy if advanced bc it will worsen condition
* NC: High Fall Risk, NO liver disease/pulmonary/cardiac dysfunctions , NO alchy or CNS depressants, Abrupt DC can lead to seizures, Liver labs, Baclofen lower seizure threashold

89
Q

Testing: Caffeine Halothane Contracture Test

A

A painful muscle biopys before surgery to see if a patient has a predisoption to Dantrolene

Pharmacology Test 1 (4 decks)

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