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Pharmacology > Study Guide 11 > Flashcards

Study Guide 11 Flashcards

1
Q

A type of drug that increases the levels of certain chemical s in the brain and increase alertness, attention, energy, and physical activity.

A

CNS Stimulants

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2
Q

3 Classes Of CNS Stimulants

A

Amphetamines
Analeptics
Anorexiants

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3
Q

Drugs used to treat children with ADHD

A

Amphetamines

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4
Q

What are the actions of analeptics?

A

Drugs that stimulate the respiratory center of the brain and cardiovascular system, used with narcolepsy and as an adjuvant treatment for obstructive sleep apnea.

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5
Q

What are examples of analeptics

A

Armodafinil (Nuvigil) – Narcolepsy, obstructive sleep apnea, sleepiness cause by shift work
Caffeine (Cafcit, 5 hour, energy, Vivarin)- Fatigue drowsiness, as adjunct in analgesic formulation, premature apnea, respiratory depression
Doxa pram (Dopram)- Respiratory depression: post anesthesia, drug induced, acute respiratory insufficiency super imposed on COPD

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6
Q

How do analeptics affect the cardiac and skeletal muscles

A

May cause cardiac stimulation, dilation of coronary and peripheral blood vessels, constriction of cerebral blood vessels, and skeletal muscle stimulation.

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7
Q

CNS are used for

A

*ADHD
*Drug induced respiratory depression
*Post anesthesia respiratory depression, without reduction of analgesia
*Narcolepsy
*Obstructive sleep apnea
*Exogenous obesity
*Sleep-wake disturbances (caffeine)
*Alzheimer’s apathy

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8
Q

Adverse reactions to CNS Stimulants

A

Neuromuscular System Reactions:
*Excessive CNS stimulation headache, dizziness
*Apprehension, disorientation, hyperactivity

Other reactions:
*Nausea, vomiting, cough, dyspnea
*Urinary retention, tachycardia palpitations

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9
Q

CNS Stimulants Contraindications

A

Contraindicated with known hypersensitivity or convulsive disorders in those with ventilation disorders. Do not administer CNS stimulants to clients with cardiac problems, severe hypertension or hyperthyroidism.

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10
Q

CNS Stimulants pre admission Assessment

A

Objective Data:
*Description of general appearance, resistance to infection
*Vital signs
*Weight and height especially for ADHD and obesity treatment, calculate BMI
*Female clients testing for pregnancy or inquiry regarding lactation if postnatal
*Respiratory depression note the depth of the respirations and any pattern to the raspatory rate

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11
Q

Respiratory Depression

A

Happens when the lungs fail to exchange carbon dioxide and oxygen efficiently

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12
Q

When CNS stimulant therapy causes insomnia, teach the caregiver to administer the drug early in the day (when possible) to diminish sleep disturbances.

A

Disturbed sleep patterns

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13
Q

Give examples of other stimulants:

A

Other stimulants, such as coffee, tea, or cola drinks, are avoided. Be aware that energy drinks such as Red Bull, Rockstar, and Monster all contain caffeine in addition to the herbal products and vitamins marketed

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14
Q

What are some nursing considerations?

A

In some clients, nervousness, restlessness, and palpitations may occur. Check vital signs every 6–8 hours or more often if tachycardia, hypertension, or palpitations occur. The adverse drug reactions that may occur with amphetamine use may be serious enough to require discontinuation of the drug.

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15
Q

What about Doxapram?

A

Urinary retention may result from doxapram administration; be sure to measure intake and output, and notify the primary health care provider if the client cannot void or the bladder appears to be distended on palpation.

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16
Q

What are the nursing considerations for ADHD drugs?

A

drug holidays (not taking over weekends/holiday breaks)
take last dose of meds at least 4-6 hrs prior to bedtime
gradually stop drug use (not abrupt)

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17
Q

How would a client avoid insomnia?

A

Amphetamines and anorexiants: These drugs are taken early in the day to avoid insomnia

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18
Q

Doxapram

A

Dopram Respiratory depression: postanesthesia, drug-induced, acute respiratory insufficiency superimposed on COPD

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19
Q

Amphetamine

A

Evekeo Narcolepsy, ADHD, exogenous obesity

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20
Q

Phentermine

A

Adipex-P Obesity

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21
Q

Strattera

A

atoMOXetine ADHD (acts like antidepressant rather than stimulant)

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22
Q

is the primary substance that transmits nerve impulses across the sympathetic branch of the autonomic nervous system.

A

Norepinephrine

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23
Q

drugs that block beta-adrenergic receptors. These drugs produce their greatest effect on the beta receptors of adrenergic nerves, primarily the beta receptors of the heart.

A

Beta Adrenergic

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24
Q

drugs produce the direct opposite effect of an adrenergic drug with alpha activity.

A

Alpha Adrenergic Blockers

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25
Q

Alpha Adrenergic Blockers uses

A

▪ Hypertension caused by pheochromocytoma (a tumor of the adrenal gland that produces excessive amounts of epinephrine and norepinephrine)
▪ Hypertension during preoperative preparation
▪ Reduce ocular pressure during laser surgery
▪ Prevent or treat tissue damage caused by extravasation of the drug—dopamine

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26
Q

Blocking nerve impulses a B-adrenergic nerves does what?

A

By blocking the nerve impulse of beta-adrenergic nerves it decreases the heart rate and dilates the blood vessels

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27
Q

Beta adrenergic receptors found where

A

Mainly in the heart

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28
Q

Beta adrenergic decreases heart rate and

A

Dilates blood vessels

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29
Q

Beta adregernic can also treat

A

glaucoma of the eye

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30
Q

Beta adrenergic adverse reactions

A

▪ Generalized reactions that affect the body include orthostatic hypotension, bradycardia, dizziness, vertigo, and headache.
▪ Gastrointestinal (GI) reactions include hyperglycemia, nausea, vomiting, and diarrhea.
▪ Bronchospasm (especially in those with a history of asthma).

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31
Q

Alpha/Beta-Adrenergic blocking Resulting in

A

resulting in peripheral vasodilation.

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32
Q

Alpha/Beta-Adrenergic blocking drugs examples

A

The two drugs in this category are carvedilol (Coreg) and labetalol.

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33
Q

is used to treat essential hypertension and in HF to reduce progression of the disease.

A

Carvedilol

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34
Q

is used in gestational hypertension, either alone or in combination with another drug, such as a diuretic.

A

Labetalol

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35
Q

Alpha/Beta-Adrenergic blocking adverse reactions

A

General body system adverse reactions include fatigue, dizziness, hypotension, drowsiness, insomnia, weakness, diarrhea, dyspnea, chest pain, bradycardia, and skin rash.

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36
Q

Tenormin Hypertension, angina, acute MI

A

Atenolol

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37
Q

Lopressor, Toprol-XL Hypertension, angina, MI, HF

A

Metoprolol

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38
Q

Inderal Cardiac arrhythmias, MI, angina, hypertension, migraine prophylaxis, hypertrophic subaortic stenosis, pheochromocytoma, essential tremor

A

Propranolol

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39
Q

Timoptic is for treatment of

A

Glaucoma

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40
Q

carvedilol Hypertension, HF, left ventricular dysfunction

A

Coreg

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41
Q

Catapres, Catapres-TTS (transdermal) Hypertension, ADHD, severe pain in clients with cancer, opiate withdrawal (supervised only)

A

Clonidine

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42
Q

Minipress Hypertension

A

Prazosin

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43
Q

Hypertension, BPH, dislodge ureteral stones

A

Terazosin

44
Q

Antiparkinson Drugs

A

Drugs used to treat parkinsonism (or more frequently called Parkinson-like symptoms) are called antiparkinson drugs

45
Q

Achalasia

A

failure to relax; usually referring to the smooth muscle fibers of the gastrointestinal (GI) tract, especially failure of the lower esophagus to relax, causing difficulty swallowing and a feeling of fullness in the sternal region

46
Q

Akathisia

A

extreme restlessness and increased motor activity

47
Q

Choreform movement

A

involuntary twitching of the limbs and facial muscles

48
Q

Extrapyramidal symptoms (EPS)

A

Group of adverse reactions involving parietal portion of the nervous system causing abnormal muscle movements especially the akathisia

49
Q

Dopaminergic

A

affect the Dopamine content of the brain.

50
Q

Adv rxns with levodopa:

A

nausea, dizziness, headache, and somnolence.

51
Q

Levodopa treat

A

treat parkinson’s disease and restless leg syndrome.

52
Q

levodopa and carbidopa

A

dry mouth and difficulty swallowing anorexia, abdominal pain and constipation and increased hand tremor, headache and dizziness.

53
Q

If a client is taking Levadopa what would they avoid?

A

foods with vitamin B 6

54
Q

Dopamine receptor agonists

A

Signs and symptoms of parkinson’s disease also used for restless leg syndrome

55
Q

Dopamine receptor agonists Adverse reactions

A

nausea , dizziness and vomiting, somnolence , hallucinations, postural hypotension , abnormal involuntary movement and headache.

56
Q

COMT Inhibitors

A

the drugs to prolong the effect of levodopa.

57
Q

blocking the enzyme, comt, which eliminates

A

Dopamine

58
Q

COMT Inhibitors actions

A

prolong the effect of levodopa.

59
Q

Anticholinergics: or cholinergic blocking drugs:

A

Drugs with Cholinergic blocking activity block Anticholinergics and CNS enhancing dopamine transmission.

60
Q

Name a potent COMT inhibitor

A

Tolcapone is associated with liver damage and liver failure.

61
Q

Anticholinergics: or cholinergic blocking drugs:

A

Drugs with Cholinergic blocking activity block Anticholinergics and CNS enhancing dopamine transmission.

62
Q

Anticholinergics: or cholinergic blocking drugs: adverse reactions

A

can’t pee, can’t see, can’t spit, can’t “shpoop”
Dry mouth , blurred vision, dizziness, mild nausea and nervousness.

63
Q

Drugs with Parkinson like reactions

A

Skin rash, urticaria, urinary retention, dysuria , tachycardia, muscle weakness, disorientation and confusion.

64
Q

give trade name Tasmar is associated with liver injury.

A

Tolcapone

65
Q

What would you monitor with tolcapone

A

high fever and severe rigidity

66
Q

What would you see in your assessment if the client had this condition Parkinson’s

A

Drooling , difficulty in chewing and swallowing, changes in thought process, postural deformities.

67
Q

hallucination occurs in older adults than younger adults receiving anti

A

anti parkinson’s drugs.

68
Q

How does Vitamin B6 interfere with Levodopa?

A

it reduces the effect of levodopa

69
Q

Antidiabetic Drugs

A

Insulin is a hormone produced by the Pancreas . It is required for the proper use of Glucose and metabolism.

70
Q

Insulin lowers blood glucose levels how?

A

by inhibiting glucose production by the liver.

71
Q

What causes hyperglycemia?

A

insulin insufficiency results in elevated blood glucose levels.

72
Q

What diseases are diabetics at risk for?

A

Myocardial infarction, cerebrovascular accident ( stroke) blindness, kidney disease, vascular and neurological impairment in the extremities

73
Q

formerly known as insulin dependent diabetes mellitus or IDDM

A

Type I

74
Q

Formerly known as non insulin dependent diabetes mellitus or NIDDM

A

Type II

75
Q

What are symptoms of Type I?

A

DO not produce enough insulin.

76
Q

Risk factors for Type 2 are?

A

Obesity, older age , family hx of diabetes , history of gestational diabetes , impaired glucose intolerance.

77
Q

when insulin first begins to act in the body.

A

Onset

78
Q

when the insulin is exerting maximum action.

A

Peak

79
Q

the length of time the insulin remains in effect.

A

Duration

80
Q

Adverse reactions with anti diabetic

A

Hypoglycemia( low blood glucose or sugar level ) and hyperglycemia ( elevated blood glucose or sugar levels).

81
Q

Hypoglycemia may occur when?

A

● the clients eats to little food or goes too long between meals
● the client has drastically increased demands ( activity or illness)
● the insulin given is incorrectly measured and is greater than that prescribed.

82
Q

Hyperglycemia may occur when

A
  • The client eats too much food
  • Too little or no insulin is given
  • The client experiences emotional stress, infection, surgery, pregnancy, or an acute illness
83
Q

How does a person become insulin resistant?

A

An individual can become insulin resistant because antibodies develop against insulin. These clients have impaired receptor function and become so unresponsive to insulin that the dose requirement may be in excess of 500 units/day, rather than the usual 40 to 60 units/day.

84
Q

Oral antidiabetics

A

(also called hypoglycemics) are used to reduce glucose blood levels in clients with type 2 diabetes. These drugs are not effective for treating type 1 diabetes.

85
Q

Actions of Sulfonylureas

A

Sulfonylureas appear to lower blood glucose by stimulating the beta cells of the pancreas to release insulin Give 2 Examples: glipizide, and glyburide

86
Q

Actions of Non sulfonylureas

A

sensitizes the liver to circulating insulin levels, reduces intestinal glucose absorption, and reduces hepatic glucose production.

Give 1 example: Biguanides

87
Q

Explain Metformin and glucocorticoids

A

There is an increased risk of lactic acidosis when metformin is administered with the glucocorticoids.

88
Q

Discuss glycosylated hemoglobin (HbA 1C)

A

The glycosylated hemoglobin (HbA1c) test is a blood test used to monitor the client’s average blood glucose level throughout a 3- to 4-month period. When blood glucose levels are high, glucose molecules attach to hemoglobin in the red blood cell.

89
Q

stress and insulin changes

A

Exposure to stress, such as infection, fever, surgery, or trauma, may cause a loss of control of blood glucose levels in clients who have been stabilized with oral antidiabetic drugs. Should this occur, the primary health care provider may discontinue use of the oral drug and administer insulin product.

90
Q

Why is insulin not given orally?

A

Insulin cannot be administered orally, because it is a protein and readily destroyed in the GI tract. Insulin must be administered by the parenteral route, usually the subcutaneous (subcut) route.

91
Q

Glargine=________is given how and when?

A

is given subcut once daily at bedtime.

92
Q

Drawing up 2 types of insulin

A

If the two insulins are to be given in the same syringe, the short-acting insulin (regular or lispro) is drawn into the syringe first.

93
Q

a sign of Hypoglycemia

A

Acute confusion

94
Q

Methods of terminating a hypoglycemic reaction:

A

● 4 ounces of orange juice or other fruit juice
● hard candy or one tablespoon of honey
● glucose gel or glucose tabs
● glucagon by the subcut or iv route
● glucose 10% or 50% iv

95
Q

Glucagon

A

is a hormone produced by the alpha cells of the pancreas. It acts to increase blood glucose by stimulating the conversion of glycogen to glucose in the liver.

96
Q

Deficient Fluid Volume

A

state or condition where the fluid output exceeds the fluid intake.

97
Q

Ineffective Breathing Pattern

A

When taking metformin the client is at risk for lactic acidosis.

98
Q

What about a teaching plan for diabetics:

A

● identification
● diet
● blood glucose or urine testing
● Hypoglycemia/ hyperglycemia
● personal hygiene
● exercise
● traveling

99
Q

Regular Insulin:

A

Is human

100
Q

NPH

A

is an insulin medication to treat and manage diabetes which is a significant risk factor for coronary artery disease.

101
Q

Glargine

A

is given subcut once daily at bedtime, this type of insulin product maintains a steady blood level and is used in treating adults and children with type 1 diabetes and in adults with type 2 diabetes who need long acting insulin for the control if hyperglycemia

102
Q

Glipizide

A

stimulates the release of the insulin from the pancreas and directs the blood sugars.

103
Q

Glyburide

A

treats the high blood sugar levels caused by diabetes mellitus type 2 diabetes metformin.

104
Q

Actos

A

is an oral diabetes medication that helps control blood sugar levels and is used together with diet and exercise.

105
Q

Avandia

A

is an oral antidiabetic agents which acts primarily by increasing insulin sensitivity.

Pharmacology (15 decks)

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