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Pharmacology Final Exam > PNS modifying drugs & Anti-Parkinson's Drug > Flashcards

PNS modifying drugs & Anti-Parkinson's Drug Flashcards

1
Q

Cholinergic agonist (Parasympathomimetic)

Describe Actions
- Eyes
- Lungs
- Heart
- GI
- GU
- Glands

A

(Eyes): Pupil Constricts (Miosis)

(Lungs): Bronchoconstriction

(Heart): Vasodilation (decreased BP & HR)

(GI): Increased (gastric acid & Mobility)

(GU): Bladder contraction (Increased bladder emptying)

(Glands): Increased secretion

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2
Q

Bethanechol

Describe
- Drug Class
- Indication
- Contraindication
- Side Effects

A

Direct-Acting Cholinergic Drugs

(Indication): Post-op or Post-part urinary retention

(Contraindication): Bradycardia, COPD/Asthma, Peptic ulcers, Hypotension, Parkinsonism

(Side effects): Blurred vision, hypotension, bradycardia, sweating, bronchoconstriction, increased (Gastric acid & saliva), N,V,D, abdominal cramps

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3
Q

Methoclopramide

Describe
- Drug Class
- Mechanism of Action

A

Direct-acting cholinergic drugs

(MOA): Increases gastric emptying

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4
Q

Pilocarpine

Describe
- Drug class
- Mechanism of Action

A

Direct-acting cholinergic drug

(MOA): Constricts pupils

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5
Q

Donepezil & Rivastigmine

Describe
- Drug Class
- Mechanism of Action
- Indication

A

Direct-Acting Cholinergic drug

(MOA): Allows more acetylcholine in CNS (Increases memory recall)

(Indication): Treats Alzheimer’s

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6
Q

Pyridostigmine

Describe
- Drug class
- Indication
- Treatment

A

Direct-Acting Cholinergic Drug

(MOA): Stimulates skeletal muscles & increase tone

(Indication): Weakness in myasthenia gravis patients (Dropping eyes)

(Tx): Edrophonium (Eyes better = positive MG)

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7
Q

Indirect-Acting Cholinergic Drugs

Describe
- Mechanism of Action
- Contraindication
- Side Effects

A

(MOA): Inhibits Cholinesterase = more available acetylcholine

(Contraindication): Intestinal & Urinary obstruction, Patients w/ (Bradycardia, COPD/Asthma, Peptic ulcers)

(Side effects): Increased GI motility, Bradycardia, Bronchoconstriction, Hypotension, Miosis, Increased urination

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8
Q

Nursing process for Cholinergic drugs

Describe
- Assessment
- Implementation
- Teaching
- Evaluation

A

(Assessment): Baseline VS, Urine output, & Medical History

(Implementation): Monitor Vs & Cholinergic crisis (OD), muscle weakness , record I&O, Observe for (Orthostatic hypotension, Gastric pain, Cramping, D, Bradycardia, Increased salivation), Assess lung sounds, Have (Atropine IV) Available for OD

(Teaching): Rise slowly in stages, Report (Difficulty breathing, GI bleeding, Epigastric pain, Coffee grounds emesis, Dark tarry stools)

(Evaluation): Ability to empty bladder, Deep breath, walk, chew, swallow

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9
Q

Cholinergic Crisis (OD)

Describe
- Early S/s
- Late S/s
- DUMBELLS
- Treatment for OD

A

(Early S/s): Abdominal cramps, salivation, flushing of skin, N, V

(Late S/s): Slow HR (Complete Heart Block), Compromised airway, Low BP

(Tx): Atropine, Antihistamine, Epinephrine

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10
Q

Cholinergic Antagonist (Anticholinergic)

Describe Actions
- Eyes
- Lungs
- Heart
- GI
- GU
- Glands
- CNS`

A

(Eyes): Pupil dilation (Mydriasis)

(Lungs): Bronchodilation (Tx: COPD/Asthma), Decreased secretions

(Heart): Increase pulse

(GI): Reduces smooth muscle, Decreases (Motility, Peristalsis, secretion) = Constipation, (Tx: Gastric Ulcer)

(GU): Increases sphincter constriction (Urinary retention)

(Glands): Decreases (Perspiration & Salivation) = Heat intolerance & Dry mouth

(CNS): Decreases (Tremors & Rigidity) = Tx: Parkinson’s Dz

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11
Q

Atropine

Describe
- Drug Class
- Indication
- Overdose S/s
- Tx for OD

A

(Indication): Systematic bradycardia, Pre-op, Decrease risk of aspiration during surgery, cholinergic crisis

(OD S/s): Confusion, Flushing of skin, Mildly elevated temperatures, dry mouth, pupil dilation, full as a flask

(Tx for OD): Hydration, (Physostigmine) Cholinergic drug (only for severe side effects)

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12
Q

Ipratropium

Describe
- Drug Class
- Indiction

A

Anticholinergic Drug

(Indication): Treats COPD/Asthma (Bronchodilator); slow onset of action & prolonged duration

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13
Q

Diphenhydramine

Describe
- Drug Class
- Indiction

A

Anticholinergic Drug

(Indication): Treats EPS

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14
Q

Benztropine

Describe
- Drug Class
- Indiction

A

Anticholinergic Drug

(Indication): Treats Parkinson’s Disease & EPS

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15
Q

Tolterodine

Describe
- Drug Class
- Indiction

A

Anticholinergic Drug

(Indication): Treats Overactive Bladder

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16
Q

Scopolamine

Describe
- Drug Class
- Indiction

A

Anticholinergic Drug

(Indication): Motion Sickness (Patch) & Pre-op, Decreases death rattle

17
Q

Anticholinergic Drugs

Describe
- Mechanism of Action
- Indication
- Contraindications
- Side effects
- Interactions

A

(MOA): Blocks Acetylcholine at muscarinic receptors

(Indications): Drug-induced EPS, Overactive bladder, motion sickness, systematic bradycardia, Asthma/COPD, Parkinson’s Disease, Peptic ulcers

(Contraindications): Glaucoma, Narrow-angle Glaucoma, Myasthenia Graves

(Side Effects): Tachycardia, Palpations, Constipations, Blurred vision, dry mouth, abdominal distention, Anticholinergic effects, photophobia, flushing, nasal congestion, impotence

(Interaction): Anticholinergic drugs, Digoxin

18
Q

Nursing Process for Anticholinergic drugs

Describe
- Assessment
- Implementation
- Teaching

A

(Assessment) Vital signs, Urine output, Medical history, bowel function

(Implementation): Monitor (VS, I&O) Encourage to void prior to taking meds, provide frequent oral care (Dry mouth), Observe or (Anticholinergic effects)

18
Q

Nursing Process for Anticholinergic drugs

Describe
- Assessment
- Implementation
- Teaching

A

(Assessment) Vital signs, Urine output, Medical history, bowel function

(Implementation): Monitor (VS, I&O) Encourage to void prior to taking meds, provide frequent oral care (Dry mouth), Observe or (Anticholinergic effects)

(Teaching): Avoid heat & physical exertion, Pt w/ (MG & glaucoma) avoid atropine, Wear sunglasses, Tx for (Dry Mouth), Increase (Fluid, Fiber, Ambulation)

19
Q

Selegiline

Describe b
- Drug Class
- Mechanism of Action
- Indication
- Side Effects
- Interactions
- Implementation

A

Antiparkinson drug: Monoamine Oxidase Type B Inhibitor (MAOI-B)

(MOA): Inhibits breakdown of dopamine = More dopamine into CNS

(Indication): Parkinson Dz, Depression, Conjunction w/ (Levodopa)

(Side Effects): Headache, Insomnia, Orthostatic Hypotension, Weight Loss, N,D, Serotonin Syndrome, Hypertensive crisis

(Interaction): (Meperidine, Tramadol, Dextramethorphan), Saint John Wart, other MAOIs (Carbamazepine, oral contraceptives, Buspirone), Food w/ Tyramine

(Implementation):
- Clean area & dry
- Apply patch & hold pressure (30 secs)
- Keep on for 24 hrs
- One patch at a time
- Rotate sites

20
Q

Ropinirole

Describe
- Drug Class
- Mechanism of Action
- Indication
- Side Effects

A

Antiparkinsons: Dopamine receptor Agonist

(MOA): Direct stimulation of pre/post synaptic receptors in brain = More dopamine

(Indications): Various Stages of Parkinsons & Restless leg syndrome

(Side Effects): Ataxia, Dizziness, Orthostatic hypotension, Upset GI

21
Q

Carbidopa/Levodopa

Describe
- Drug Class
- Mechanism of Action
- Indication
- Side Effects
- Interactions
- Contraindications
- Teaching

A

Antiparkinson Drug: Dopamine Replacement Drug

(MOA): Prevents breakdown of Levodopa & Convert to Dopamine

(Indication): Cornerstone therapy for Parkinson’s, becomes ineffective & debilitatied (5-10yrs after Levodopa Tx)

(Side Effect): Cardiac dysrhythmias, Orthostatic hypotension, Involuntary movements, Constipation, Dyskinesia, Depression, N,V

(Contraindications): Angle (Closed or Opened) Glaucoma, High protein meals

(Teaching): Split protein across meals

22
Q

Nursing Process for Anti-Parkinson’s Drug

Describe
- Assessment
- Implementation
- Teaching
- Evaluation

A

(Assessment): VS, Depression & Suicidal ideation, Past medical history

(Implementation): Monitor BP throughout therapy & Administer (Seleilgine: Oral or Transdermal)

(Teaching): Rise slowly in stages, Don’t take (Carbidopa/levodopa) with high protein meals, spilt proteins across meals, drink 3L of fluid, increase fiber, Limit Tyramine food

(Evaluation): Ability to participate in ADLs

Pharmacology Final Exam (3 decks)

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