PHARMA SEMIS Flashcards
drug used to treat disorders involving thought processes;
dopamine receptor blocker that helps affected people to organize their
thoughts and respond appropriately to stimuli
antipsychotic:
behavioral syndrome characterized by an
inability to concentrate for longer than a few minutes and excessive
activity
attention deficit disorder
behavioral disorder that involves extremes of
depression alternating with hyperactivity and excitemen
bipolar disorder:
former name of antipsychotic drugs; the name is no
longer used because it implies that the primary effect of these drugs is
sedation, which is no longer thought to be the desired therapeutic
action
major tranquilizer
state of hyperexcitability; one phase of bipolar disorders, which
alternate between periods of severe depression and mania
mania
mental disorder characterized by daytime sleepiness and
periods of sudden loss of wakefulness
narcolepsy:
a drug with many associated neurological adverse effects
that is used to treat disorders that involve thought processes (e.g.,
schizophrenia)
neuroleptic:
the most common type of psychosis; characteristics
include hallucinations, paranoia, delusions, speech abnormalities, and
affective problems
schizophrenia:
are taken orally for the management of manic
episodes and prevention of future episodes.
Lithium salts (Lithobid)
Mental disorders are now thought to be caused by some inherent
dysfunction within the brain that leads to abnormal thought
processes and responses. They include
a. depression.
b. anxiety.
c. seizures.
d. schizophrenia.
D
Antipsychotic drugs are basically
a. serotonin reuptake inhibitors.
b. norepinephrine blockers.
c. dopamine receptor blockers.
d. acetylcholine stimulators
C
Adverse effects associated with antipsychotic drugs are related to the
drugs’ effects on receptor sites and can include
a. insomnia and hypertension.
b. dry mouth, hypotension, and glaucoma.
c. diarrhea and excessive urination.
d. increased sexual drive and improved concentration.
B
Lithium toxicity can be dangerous. Patient assessment to evaluate
for appropriate lithium levels would look for
a. serum lithium levels >3 mEq/L.
b. serum lithium levels >4 mEq/L.
c. serum lithium levels <1.5 mEq/L.
d. undetectable serum lithium levels.
A
Your patient, a 6-year-old boy, is starting a regimen of
methylphenidate (Ritalin) to control an attention deficit disorder.
Family teaching should include which of the following?
a. This drug can be shared with other family members who might
seem to need it.
b. This drug may cause insomnia, weight loss, and GI upset.
c. Do not alert the school nurse to the fact that this drug is being
taken because the child could have problems later.
d. This drug should not be stopped for any reason for several years.
B
Antipsychotic drugs are also known as neuroleptic drugs because
a. they cause numerous neurological effects.
b. they frequently cause epilepsy.
c. they are also minor tranquilizers.
d. they are the only drugs known to directly affect nerves.
A
Attention-deficit/hyperactivity disorder (the inability to concentrate
or focus on an activity) and narcolepsy (sudden episodes of sleep)
are both most effectively treated with the use of
a. neuroinhibitors.
b. dopamine receptor blockers.
c. major tranquilizers.
d. CNS stimulants.
D
Haloperidol (Haldol) is a potent antipsychotic that is associated with
a. severe extrapyramidal effects.
b. severe hyperactivity.
c. severe hypotension.
d. severe anticholinergic effects.
A
type of generalized seizure that is characterized by
sudden, temporary loss of consciousness, sometimes with staring or
blinking for 3 to 5 seconds; formerly known as a petit mal seizure
absence seizure:
drug used to treat the abnormal and excessive energy bursts
in the brain that are characteristic of epilepsy
antiepileptic
tonic–clonic muscular reaction to excessive electrical energy
arising from nerve cells in the brain
convulsion
collection of various syndromes, all of which are characterized
by seizures
epilepsy:
seizure that begins in one area of the brain and
rapidly spreads throughout both hemispheres
generalized seizure:
also called focal seizures; seizures involving one area of
the brain that do not spread throughout the entire organ
partial seizures:
sudden discharge of excessive electrical energy from nerve cells
in the brain
seizure:
state in which seizures rapidly recur; most severe form
of generalized seizure
status epilepticus:
type of generalized seizure that is characterized by
serious involuntary muscle contractions followed by relaxation
appearing as an aggressive spasm in addition to a loss of
consciousness, with exhaustion and little memory of the event on
awakening; formerly known as a grand mal seizure
tonic–clonic seizure:
When teaching a group of students about epilepsy, which
characteristic should the nurse include?
a. Always characterized by grand mal seizures
b. Only a genetic problem
c. The most prevalent neurological disorder
d. The name given to one brain disorder
C
Which type of seizure would the nurse be least likely to include as a
type of generalized seizure?
a. Petit mal seizures
b. Febrile seizures
c. Grand mal seizures
d. Complex seizures
D
Which instruction would the nurse encourage a patient receiving an
antiepileptic drug to do?
a. Give up his or her driver’s license.
b. Wear or carry a MedicAlert identification.
c. Take antihistamines to help dry up secretions.
d. Keep the diagnosis a secret to avoid prejudice
B
Drugs that are commonly used to treat grand mal seizures include
a. barbiturates, benzodiazepines, and hydantoins.
b. barbiturates, antihistamines, and local anesthetics.
c. hydantoins, phenobarbital, and phensuximide.
d. benzodiazepines, phensuximide, and valproic acid.
A
The drug of choice for the treatment of absence seizures is
a. valproic acid.
b. methsuximide.
c. phensuximide.
d. ethosuximide.
D
Focal or partial seizures
a. start at one point and spread quickly throughout the brain.
b. are best treated with benzodiazepines.
c. involve only part of the brain.
d. are easily diagnosed and recognized.
C
One drug that is used alone in the treatment of partial seizures is
a. carbamazepine.
b. topiramate.
c. lamotrigine.
d. gabapentin.
A
Treatment of epilepsy is directed at
a. blocking the transmission of nerve impulses into the brain.
b. stabilizing overexcited nerve membranes.
c. blocking peripheral nerve terminals.
d. thickening the meninges to dampen brain electrical activity.
B
drug that opposes the effects of acetylcholine at
acetylcholine receptor sites
anticholinergic:
difficulty in performing intentional movements and
extreme slowness and sluggishness; characteristic of Parkinson disease
bradykinesia:
part of the brain that reacts with the substantia nigra to
maintain a balance of suppression and stimulation
corpus striatum:
drug that increases the effects of dopamine at receptor
sites
dopaminergic:
debilitating disease characterized by progressive loss
of coordination and function, which results from the degeneration of
dopamine-producing cells in the substantia nigra
Parkinson disease
Parkinson disease–like extrapyramidal symptoms that are
adverse effects associated with particular drugs or brain injuries
parkinsonism:
a part of the brain rich in dopamine and dopamine
receptors; site of degenerating neurons in Parkinson disease
substantia nigra:
Parkinson disease is a progressive, chronic neurological disorder that
is usually
a. associated with severe head injury.
b. associated with chronic diseases.
c. associated with old age.
d. known to affect people of all ages with no known cause.
C
Parkinson disease reflects an imbalance between inhibitory and
stimulating activity of nerves in the
a. reticular activating system.
b. cerebellum.
c. basal ganglia.
d. limbic system.
C
The main underlying problem with Parkinson disease seems to be a
decrease in the neurotransmitter
a. acetylcholine.
b. norepinephrine.
c. dopamine.
d. serotonin.
C
Anticholinergic drugs are effective in early Parkinson disease. They
act to
a. block stimulating effects of acetylcholine in the brain to bring
activity back into balance.
b. block the signs and symptoms of the disease, making it more
acceptable.
c. inhibit dopamine effects in the brain and increase neuron
activity.
d. increase the effectiveness of the inhibitory neurotransmitter
gamma-aminobutyric acid.
A
A patient receiving an anticholinergic drug for Parkinson disease is
planning a winter trip to Tahiti. The temperature in Tahiti is 70
degrees warmer than at home. What precautions should the patient
be urged to take?
a. Take the drug with plenty of water to stay hydrated.
b. Reduce the dose, and take precautions to reduce the risk for heat
stroke.
c. Wear sunglasses and use sunscreen because of photophobia that
will develop.
d. Avoid drinking the water to prevent gastric distress
B
Replacing dopamine in the brain would seem to be the best treatment
for Parkinson disease. This is difficult because dopamine
a. is broken down in gastric acid.
b. is not available in drug form.
c. cannot cross the blood–brain barrier.
d. is used peripherally before reaching the brain
C
A patient taking levodopa and over-the-counter megavitamins might
experience
a. a cure from Parkinson disease.
b. the return of Parkinson symptoms.
c. improved health and well-being.
d. a resistance to viral infections
B
A patient who has been diagnosed with Parkinson disease for many
years and whose symptoms were controlled using Sinemet has
started to exhibit increasing signs of the disease. Possible treatment
might include
a. an increased exercise program.
b. adding iron to the person’s diet.
c. combination therapy with an anticholinergic drug.
d. changes in diet to eliminate vitamin B6.
C
lower area of the brain, associated with coordination of
unconscious muscle movements that involve movement and position
basal ganglia
lower portion of the brain, associated with coordination of
muscle movements, including voluntary motion, as well as
extrapyramidal control of unconscious muscle movement
cerebellum:
cells from the cortex and subcortical areas,
including the basal ganglia and the cerebellum, which coordinate
unconsciously controlled muscle activity; allows the body to make
automatic adjustments in posture or position and balance
extrapyramidal tract:
simple reflex arcs that involve sensory receptors in
the periphery that respond to stretch and spinal motor nerves and cause
muscle fiber contraction: Responsible for maintaining muscle tone and
keeping an upright position against the pull of gravity
gamma loop system:
state of excessive muscle response and activity
hypertonia:
neuron in the CNS that communicates with other neurons,
not with muscles or glands
interneuron:
fibers within the CNS that control precise, intentional
movement
pyramidal tract
sustained muscle contractions
spasticity:
A muscle spasm often results from
a. damage to the basal ganglia.
b. CNS damage.
c. injury to the musculoskeletal system.
d. chemical imbalance within the CNS.
C
Muscle spasticity is the result of
a. direct damage to a muscle cell.
b. overstretching of a muscle.
c. tearing of a ligament.
d. damage to neurons within the CNS
D
Signs and symptoms of tetanus, which include severe muscle spasm,
are best treated with
a. baclofen.
b. diazepam.
c. carisoprodol.
d. methocarbamol.
B
The drug of choice for a patient experiencing severe muscle spasms
and pain precipitated by anxiety is
a. methocarbamol.
b. baclofen.
c. diazepam.
d. carisoprodol.
C
Dantrolene (Dantrium) differs from the other skeletal muscle
relaxants because
a. it acts in the highest levels of the CNS.
b. it is used to treat muscle spasms as well as muscle spasticity.
c. it cannot be used to treat neuromuscular disorders.
d. it acts directly within the skeletal muscle fiber and not within the
CNS.
D
The use of neuromuscular junction blockers may sometimes cause a
condition known as malignant hyperthermia. The drug of choice for
prevention or treatment of this condition is
a. baclofen.
b. diazepam.
c. dantrolene.
d. methocarbamol.
C
Dantrolene is associated with potentially fatal cellular damage. If
your patient’s condition is being managed with dantrolene, the
patient should
a. have repeated complete blood counts during therapy.
b. have renal function tests done monthly.
c. be monitored for signs of liver damage and have liver function
tests done regularly.
d. have a thorough eye examination before and periodically during
therapy
C
large-diameter nerve fibers that carry peripheral impulses
associated with touch and temperature to the spinal cord
A fibers
small-diameter nerve fibers that carry peripheral impulses
associated with pain to the spinal cord
A-delta fibers:
unmyelinated, slow-conducting fibers that carry peripheral
impulses associated with pain to the spinal cord
C fibers:
drug that causes a vascular constriction in the brain and
the periphery; relieves or prevents migraine headaches but is associated
with many adverse effects
ergot derivative
theory that states that the transmission of a nerve
impulse can be modulated at various points along its path by
descending fibers from the brain that close the “gate” and block
transmission of pain information and by A fibers that are able to block
transmission in the dorsal horn by closing the gate for transmission for
the A-delta and C fibers
gate control theory:
headache characterized by severe, unilateral,
pulsating head pain associated with systemic effects, including
gastrointestinal (GI) upset and sensitization to light and sound; related
to a hyperperfusion of the brain from arterial dilation
migraine headache:
drugs originally derived from opium that react with specific
opioid receptors throughout the body
narcotics
: drugs that react at opioid receptor sites to stimulate the
effects of the receptors
narcotic agonists:
drugs that react at some opioid receptor
sites to stimulate their activity and at other opioid receptor sites to
block activity
narcotic agonists–antagonists:
: drugs that block the opioid receptor sites; used to
counteract the effects of narcotics or to treat an overdose of narcotics
narcotic antagonists
receptor sites on nerves that react with endorphins and
enkephalins, which are receptive to narcotic drugs
opioid receptors:
sensory and emotional experience associated with actual or
potential tissue damage
pain:
nerve pathway from the spine to the thalamus along
which pain impulses are carried to the brain
spinothalamic tract:
selective serotonin receptor blocker that causes a vascular
constriction of cranial vessels; used to treat acute migraine attacks
triptan
According to the gate control theory, pain
a. is caused by gates in the CNS.
b. can be blocked or intensified by gates in the CNS.
c. is caused by gates in peripheral nerve sensors.
d. cannot be affected by learned experiences.
B
Opioid receptors are found throughout the body
a. only in people who have become addicted to opiates.
b. in increasing numbers with chronic pain conditions.
c. to incorporate pain perception and blocking.
d. to initiate the release of endorphins.
C
Most narcotics are controlled substances because they
a. are very expensive..
b. can cause respiratory depression.
c. can be addictive.
d. can be used only in a hospital setting
C
Injecting a narcotic into an area of the body that is chilled can be
dangerous because
a. an abscess will form.
b. the injection will be very painful.
c. an excessive amount may be absorbed all at once.
d. narcotics are inactivated in cold temperatures.
C
Proper administration of an ordered narcotic
a. can lead to addiction.
b. should be done promptly to prevent increased pain and the need
for larger doses.
c. would include holding the drug as long as possible until the
patient really needs it.
d. should rely on the patient’s request for medication.
B
Migraine headaches
a. occur during sleep and involve sweating and eye pain.
b. occur with stress and feel like a dull band around the entire head.
c. often occur when drinking coffee.
d. are throbbing headaches on one side of the head
D
The triptans are a class of drugs that bind to selective serotonin
receptor sites and cause
a. cranial vascular dilation.
b. cranial vascular constriction.
c. clinical depression.
d. nausea and vomiting.
B
The only triptan that has been approved for use in treating cluster
headaches as well as migraines is
a. naratriptan.
b. rizatriptan.
c. sumatriptan.
d. zolmitriptan.
C
loss of memory of an event or procedure
amnesia
loss of pain sensation
analgesia:
drug used to cause complete or partial loss of sensation
anesthetic:
use of several different types of drugs to achieve
the quickest, most effective anesthesia with the fewest adverse effects
balanced anesthesia:
use of drugs to induce a loss of consciousness,
amnesia, analgesia, and loss of reflexes to allow performance of
painful surgical procedures
general anesthesia:
time from the beginning of anesthesia until achievement of
surgical anesthesia
induction
use of powerful nerve blockers that prevent
depolarization of nerve membranes, blocking the transmission of pain
stimuli and, in some cases, motor activity
local anesthesia
the period from stage 3 until the surgical procedure is
complete
maintenance:
enzyme found in plasma that immediately breaks down
ester-type local anesthetics
plasma esterase:
the period from discontinuation of the anesthetic until the
patient has regained consciousness, movement, and the ability to
communicate
recovery:
loss of awareness of one’s surroundings
unconsciousness:
liquid that is unstable at room temperature and releases
vapors; used as an inhaled general anesthetic, usually in the form of a
halogenated hydrocarbon
volatile liquid:
The most dangerous period for many patients undergoing general
anesthesia is during which stage?
a. Stage 1, when communication becomes difficult
b. Stage 2, when systemic stimulation occurs
c. Stage 3, when skeletal muscles relax
d. There is no real danger during general anesthesia
B
Recovery after a general anesthetic refers to the period of time
a. from the beginning of anesthesia until the patient is ready for
surgery.
b. during the surgery when anesthesia is maintained at a certain
level.
c. from discontinuation of the anesthetic until the patient has
regained consciousness, movement, and the ability to
communicate.
d. when the patient is in the most danger of CNS depression
C
While a patient is receiving a general anesthetic, he or she must be
continually monitored because
a. the patient has no pain sensation.
b. generalized CNS depression affects all body functions.
c. the patient cannot move.
d. the patient cannot communicate.
B
The nursing instructor determines that teaching about general
anesthetics was successful when the students identify which person
as being most qualified to administer general anesthetics?
a. Nursing supervisor
b. Graduate nurse
c. Trained physician
d. Surgeon
C
Local anesthetics are used to block feeling in specific body areas. If
given in increasing concentrations, local anesthetics can cause loss
in the following order:
a. Temperature sensation, touch sensation, proprioception, and
skeletal muscle tone
b. Touch sensation, skeletal muscle tone, temperature sensation,
and proprioception
c. Proprioception, skeletal muscle tone, touch sensation, and
temperature sensation
d. Skeletal muscle tone, touch sensation, temperature sensation,
and proprioception
A
area on the muscle cell membrane where
acetylcholine (ACh) reacts with a specific receptor site to cause
stimulation of the muscle in response to nerve activity
acetylcholine receptor site:
stimulation of a
muscle cell, causing it to contract with no allowance for repolarization
and restimulation of the muscle; characterized by contraction and then
paralysis
depolarizing neuromuscular junction (NMJ) blocker:
reaction to some NMJ drugs in susceptible
individuals; characterized by extreme muscle rigidity, severe
hyperpyrexia, acidosis, and in some cases death
malignant hyperthermia:
the synapse between a nerve and a
muscle cell
neuromuscular junction (NMJ):
no
stimulation or depolarization of the muscle cell; prevents
depolarization and stimulation by blocking the effects of acetylcholine
nondepolarizing neuromuscular junction (NMJ) blocker:
lack of muscle function
paralysis
functional unit of a muscle cell, composed of actin and
myosin molecules arranged in layers to give the unit a striped or
striated appearance
sarcomere
theory explaining muscle contraction as a
reaction of actin and myosin molecules when they are freed to react by
the inactivation of troponin after calcium is allowed to enter the cell
during depolarization
sliding filament theory:
Nondepolarizing NMJ blockers
a. antagonize ACh to prevent depolarization of muscle cells.
b. act as agonists of ACh, leading to depolarization of muscle cells.
c. prevent the repolarization of muscle cells.
d. are associated with painful muscle contractions on
administration.
A
Curare is used as a poison on arrow tips in some cultures. Curare
a. is a depolarizing NMJ blocker.
b. causes muscle paralysis in the brain.
c. is not affected by cooking.
d. has no clinical use today
C
Succinylcholine has a more rapid onset of action and a shorter
duration of activity than the nondepolarizing NMJ blockers because
it
a. does not bind well to receptor sites.
b. rapidly crosses the blood–brain barrier and is lost.
c. is broken down by acetylcholinesterase that is found in the
plasma.
d. is very unstable.
C
