Pharmacology-Exam 2 Flashcards
1
Q
Drug class ‘Hydantoins’ are indicated for hx (history) of what condition?
A
Generalized Seizures
2
Q
The CNS (Central Nervous System) consists of what?
A
Brain, Spinal Cord & Cranial Nerves
3
Q
Which neurotransmitter is an ‘inhibiting nerve transmitter’?
A
GABA
4
Q
benzocaine and lidocaine are both examples of what?
A
Local Anesthetics
5
Q
Provide four drugs that are Opioid Agonists.
A
-codeine
-fentanyl
-methadone
-hydromorphone (Dilaudid)
6
Q
What is naloxone (Narcan) classified as?
A
Opioid Antagonist
(reverses it’s affects)
7
Q
What is the MOA (mechanism of action) of vecuronium?
A
Paralytic
8
Q
Which neurotransmitter does rocuronium effect?
A
Acetylcholine
9
Q
Name five common Benzodiazepines (benzos).
A
-clonazepam (Klonopin)
-diazepam (Valium)
-lorazepam (Ativan)
-alprazolam (Xanax)
&
-chlordiazepoxide (Librium)
10
Q
What is an indication for IV lorazepam (Ativan)?
A
Active Seizure
11
Q
In general, what neurotransmitters do anti-depressants effect?
A
serotonin and/or norepinephrine
12
Q
carbidopa (Levodopa) is a medication used to treat what disease?
A
Parkinson’s
13
Q
What are the four categories of anti-depressants?
A
-SSRIs
-SNRIs
-Tricyclics
-MAOs
14
Q
Name three rxs that are neuro-muscular junction blockers (NMBAs).
A
-rocuronium
-vecuronium
-succinylcholine
15
Q
Which drug is classified as a ‘direct acting muscle relaxant’?
A
Botox (botulinum toxin A)
16
Q
What is the indication of tizanidine (Zanaflex)?
A
Spasticity or Severe Muscle Spasm
17
Q
Which neurotransmitter does divalproex (Depakote) effect?
A
GABA
18
Q
What is the indication of carisoprodol (Soma)?
A
Spasticity
19
Q
Classify phenytoin (Dilantin).
A
Hydantoin
20
Q
Which general anesthesia drug is administered via inhalation?
A
Nitrous Oxide
21
Q
What is the indication of carbamazepine (Tegretol)?
A
Hx of generalized seizures.
22
Q
Which neurotransmitter acts on the neuro-muscular junction?
A
Acetylcholine
23
Q
Which classification of medication can be used for anxiety (ex: Benadryl)?
A
Antihistamines
24
Q
What is the most common anti-anxiety drug classification?
A
Benzodiazepines
25
What do Anxiolytics do?
Help stop anxiety
26
Abruptly stopping the use of benzodiazepines puts patients at an increased risk of what?
Seizures
27
Combining benzos and opioids have an increased risk of causing what?
Respiratory Distress
28
diphenhydramine (Benadryl) is classified as what?
Hint-two classifications!
-Anxiolytics
-Antihistamine
29
Both Serotonin and Serotonin-Norepinephrine are neurotransmitters responsible for what?
Aspects of mood & related behavior.
30
What symptom is a black box warning for anti-depressants?
Suicidal Ideation
31
What is the term for abnormal electrical impulses from nerve cells within the brain?
Seizures
32
List three reasons a person may suffer secondary seizures.
-head injury
-electrolyte abnormality
-drug OD
33
What is the classification of rx used to treat seizure disorders?
Antiepileptics
34
List four examples of rxs used to treat generalized seizures.
-levetiracetam (Keppra)
-phenytoin (Dilantin)
divalproex (Depakote)
-valproic acid (Depakene)
35
What do Hydantoins do to neurons during a seizure?
Decrease Excitability
36
What are two adverse effects of anti-seizure agents?
-drowsiness
-depression
37
What disease involves damaged basal ganglia and a reduction in dopamine?
Parkinson's
38
What is the name of the enzyme that allows for higher doses of Levodopa to cross the blood brain barrier?
Carbidopa
Note-this crosses the GI barrier!
39
What is the name of the enzyme that crosses the brain barrier and then turns into dopamine?
Levodopa
40
Dopamine crosses the brain barrier.
True OR False
False
41
Which classification of rx should you use caution for hx of seizure disorders?
Muscle Relaxants
Reason: can interfere with reflexes that cause spasms.
42
Opioid Agonists bind to opioid receptors.
True OR False
True
43
Opioid Antagonists block opioid receptors?
True
Example-naloxone (Narcan)
44
What is the main MOA of anti-migraine agents?
To work by vasoconstriction
45
What derivatives constrict cranial blood vessels & decrease pulsation of cranial arteries?
Ergot Derivatives
46
Which agents cause cranial vascular constriction with LESS vascular & GI effects?
Triptans
47
When is general anesthesia used?
-Surgery
-Intubation
48
List five examples of General Anesthetics.
-etomidate
-ketamine
-midazolam
-propofol
-nitrous oxide
Mneumonic:
Elephants Keep Mr Prop Nice! & sleepy ;)
49
How many stages of anesthesia are there?
Four
50
What are the four stages of anesthesia?
Stage 1-Analgesia
Stage 2-Excitement
Stage 3-Surgical
Stage 4-Medullary Paralysis
51
The Autonomic Nervous System consists of what two systems?
Sympathetic & Parasympathetic Systems
52
What are four examples of Adrenergic Agonists?
-Doputamine
-Dopamine
-Epinephrine
-Norepinephrine
53
Provide two examples of BETA Antagonists?
-propanolol
-timolol
54
What term describes the dynamic balance between the two autonomic branches of the nervous system?
Homeostasis
55
The Autonomic Nervous System regulates what 5 functions of the human body?
-blood pressure
-body temp
-water balance
-urinary excretion
-digestive functions
56
Which two cholinergic receptors make up the Parasympathetic System?
-Muscarinic
-Nicotinic
57
The Parasympathetic System is aka (also known as)...
"rest & digest"
58
The Sympathetic System is aka (also known as)...
"fight or flight"
59
The Peripheral Nervous System is made up of what two nerve groups?
-Sensory
-Somatic
60
The ______ integrates parts of the CNS & PNS to automatically react to changes in the internal and external environment.
Autonomic Nervous System (ANS)
61
List four body reactions that result from stimulation of the Sympathetic System.
-pupils dilate
-increased heart rate & contractility
-relaxed airways
-inhibits digestion
62
List four body reactions that result from the Parasympathetic System.
-pupils constrict
-slows heart rate
-constricts airways
-increases motility & GI secretions
63
What is the name of the adrenergic agent used to treat signs and symptoms of allergic rhinitis?
Phenylephrine
(example-Sudafed & other cold meds)
64
What is another term for adrenergic drugs?
Sympathomimetic Agents
65
A client is prescribed an alpha-1 selective adrenergic blocking agent. What are two conditions the client may have?
-Hypertension
&
-BPH (Benign Prostatic Hyperplasia)
66
What type of nerves only use acetylcholine?
Parasympathetic
67
What system consists of Alpha-Receptors & Beta-Receptors?
Sympathetic
68
Which alpha-2 agonist is given to drop BP & decrease anxiety?
Clonidine
69
Which alpha-1 agonist is given for orthostatic hypotension?
Midodrine
(given to raise BP)
70
What is the name of the beta-2 agonist prescribed for bronchial spasms?
Albuterol
(Ventolin HFA)
71
Which type of agonist is given for dx-overactive bladder?
beta-3
72
What is a possible side effect from the use of Albuterol?
Shakiness, due to over simulation of the sympathetic nervous system.
73
What is the main function of Adrenergic Antagonists?
To block the effects of the SNS (Sympathetic Nervous System).
74
Which drug is given by IV route to patients for cardiac arrhythmias?
Amiodarone
75
What condition does Tamsulosin (Flomax) treat?
BPH
(Benign Prostatic Hyperplasia)
76
What is a peripheral IV line?
Standard IV.
Sites-arm, hand ,foot or scalp.
77
What is a central IV line?
An IV inserted into a large vein near the heart.
(Typically to deliver cardiac meds vs regular peripheral ivs).
78
What are three effects of alpha-a antagonists?
*Decreased vascular tone & vasodilation
*Lower BP
*Relaxation of bladder & prostate
79
What is the name of the drug that is used as a reversal agent if an epi IV line fails?
Phentolamine
(classification-Alpha Antagonist)
80
What are some signs/sx (symptoms) of a peripheral IV line malfunction/fail?
Redness, Pain or Swelling around the site.
81
What type of antagonist is the drug Phentolamine?
Alpha-1 and Alpha-2
82
What are three indications for Rx Propranolol?
-hypertension
-migraines
-cardiac arrhythmias
83
What is Propanolol's drug classification?
Nonselective Beta Blocker
84
Propanolol's use should be avoided if a client suffers from what two conditions?
-Acute Asthma
-Bronchospasms
85
Timolol eye drops are prescribed for what condition?
What is their MOA?
-Glaucoma
-Relieves pressure in the eyes.
86
What are three examples of Beta-1 Antagonists?
*hint- end with 'lol'
-atenolol
-esmolol
-metoprolol (Toprol XL or Lopressor)
87
What are three indications of Beta-1 Blockers?
-hypertension
-angina
-cardiac arrythmias
88
What is the Chronotropic response?
Increased Heart Rate
89
What should an RN always do prior to administering a beta-1 selective antagonist (example-metoprolol)?
Take & Document Apical Pulse and BP of the client.
90
What is the formula for Cardiac Output (BP)?
CO=HR x SV
Cardiac Output=Heart Rate times Stroke Volume
91
What system uses acetylcholine as the neurotransmitter?
Parasympathetic Nervous System (PNS)
92
Muscarinic Receptors are responsible for what 5 reactions within the body?
-pupil constriction
-decreased heart rate
-increased GI motility & secretions
-increased bladder contractions
-male erection
93
What do Nicotinic Receptors affect (two examples)?
-muscle contractions
-preganglionic nerves
94
What are the alpha receptors?
-a1
-a2
95
What are the beta receptors?
-b1
-b2
-b3
96
The Parasympathetic System is broken down into which two receptors?
-Muscarinic
-Nicotinic
97
Where are nicotinic receptors found?
Neuromuscular Junctions
(within the Somatic Nervous System or SNS)
98
How do nicotinic receptors affect the heart?
They can increase OR decrease HR and BP.
99
Which receptors respond to acetylcholine and are found on organs & muscles?
Cholinergic Receptors
100
What are direct acting nicotinics used for?
nicotine withdrawal
(example-nicotine patches)
101
What is an example of a direct acting muscarinic drug used to treat urinary retention?
bethanechol (Duvoid)
102
What is another term for Cholinergic Agonists?
Parasympathomimetics
103
A nurse would question an order for a beta-1 selective adrenergic blocker for a patient with what two conditions?
-Bradycardia (better answer)
-Hypotension
104
Myasthenia gravis (muscle weakness) is treated with indirect-acting cholinergic agents that lead to what accumulation?
Acetylcholine in the synaptic cleft.
105
Adverse effects associated with the use of cholinergic drugs include what two symptoms?
-diarrhea
-urinary urgency
106
If a client is stressed and having a sympathetic stress reaction, what would you expect to find (2 sxs)?
-dilated pupils
-elevated systolic pressure
107
Stimulation of the Parasympathetic Nervous System would cause what two sxs?
-slower HR
-increased GI secretions
108
The nurse determines that the beta-2 receptors in the SNS have been stimulated by which finding?
Bronchial Dilation
109
What agonists could reverse the effects of paralytics?
Cholinergic
110
What are three indications of short acting Cholinergic Agonists?
-reversal of neuromuscular junction blocking agents
-myasthenia gravis
-Alzheimer's Disease
111
What is an example of a drug used to treat Myasthenia Gravis?
Pyridostigmine
(cholinergic agonist)
112
Which response do Anticholinergic Agents block?
Parasympathetic
113
What does atropine do to the heart?
Increases HR
114
What is an indication for atropine?
Bradycardia
115
The Anticholinergic Agent called scopolamine is used to treat what symptoms?
-nausea
-vomiting
-motion sickness
116
Which alpha receptor causes vasoconstriction, increased BP, pupil dilation & closure of urinary bladder sphincter?
alpha-1
117
Which beta receptor increases HR, increases lipolysis and increases myocardial contractility?
beta-1
(hint-one heart)
118
Alpha-2 receptors inhibit the release of what three chemicals?
-Norepinephrine
-Acetylcholine
-Insulin
119
Which receptors cause vasodilation & bronchial dilation?
beta-2
(hint-two lungs)
120
Which receptor decreases peripheral resistance but increases glucagon release?
beta-2
121
What is the name of the term for when the hair on your arms and body stand up?
Piloerection
122
What is the goal of alpha-2 receptors?
To prevent overstimulation of effector sites.
123
The human body naturally produces which two alpha-beta agonists?
-Dopamine
-Epinephrine
124
What is the indication of Adrenergic Agonist (alpha & beta) use?
States of Shock
125
What is the goal of Adreneric Agonists?
-Increase BP to appropriate levels.
-Increase blood flow to organs.
126
Beta-1 receptors target what two organs?
-Heart
-Kidneys
127
Beta-2 receptors target what organs/body systems?
-Lungs
-Blood Vessels
-GI Tract
-Bladder
128
Beta-3 receptors target what type of tissue within the body?
Adipose (Fatty)
129
Which receptor increases metabolism and bladder capacity?
beta-3
130
The Autonomic Nervous System is also known as what system?
Involuntary Nervous System
131
What type of agonist is rx clonidine?
Alpha-2
132
What type of antagonist is rx tamsulosin?
Alpha-1
133
Name five Anticholinergic meds.
(hint-most end in 'ine')
-atropine
-dicyclomine
-hyoscyamine
-scopolamine
-ipratroprium
134
Name two Muscarinic Agonists.
-bethanechol
-pilocarpine
135
Name three Adrenergic Antagonists.
-amiodarone
-carvedilol
-labetolol
136
137
138
139
140
