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Pharmacology Exam 3 KS > Study Guide Exam 3 (lacking Diabetes) > Flashcards

Study Guide Exam 3 (lacking Diabetes) Flashcards

1
Q

Symptoms of Parkinsons

A 
	Tremors
	Muscle rigidity
	Bradykinesia
	Postural instability
	Affective flattening
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2
Q

goals of drug therapy for Parkinsons and seizures

A

 Drug Therapy for Parkinsonism
 Restores dopamine function
 Blocks acetylcholine

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3
Q

Difference between simple and complex Partial (focal) seizures

A

Simple
• Olfactory, auditory, and visual hallucinations
• Intense emotions
• Twitching of arms, legs, and face

Complex
• Aura (preceding)
• Brief period of confusion or sleepiness afterward with no memory of seizure (postictal confusion)
• Fumbling with or attempting to remove clothing
• No response to verbal commands

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4
Q

Difference between Absence (petit mal), Atonic (drop attacks), and Tonic-clonic (grand mal) seizures?

A

Absence (petit mal)
• Lasting a few seconds
• Seen most often in children (child stares into space, does not respond to verbal stimulation, may have fluttering eyelids or jerking)
• Misdiagnosed often (especially in child) as ADD or daydreaming

Atonic (drop attacks)
• Falling or stumbling for no reason
• Lasting a few seconds

Tonic-clonic (grand mal)
• Preceeded by aura
• Intense muscle contraction (tonic phase) followed by alternating contraction and relaxation of muscles (clonic phase)
• Crying at beginning as air leaves lungs; loss of bowel/bladder control; shallow breathing with periods of apnea; usually lasting 1–2 minutes
• Disorientation and deep sleep after seizure (postictal state)

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5
Q

Symptoms of Myoclonic Seizures?

A
  • Large jerking movements of a major muscle group, such as an arm
  • Falling from a sitting position or dropping what is held
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6
Q

Neurotranmitters - Norepinephrine (NE)

A 
•	binds with adrenergic receptors
       o	alpha (1 and 2)
       o	beta (1 and 2)

• Sympathetic (energetic, fight or flight)

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7
Q

Neurotransmitters - Acetylcholine (Ach)

A 
•	binds with cholinergic receptors
       o muscarinic (muscle/heart)
       o nicotinic (neuromuscular)

• Parasympathetic (rest and digest)

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8
Q

Drugs that mimic the effect of norepinephrine (other names for them)

A
  • sympathomimetics

* Adrenergic agonists

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9
Q

Drugs that block the effects of norepinephrine (other names for them)

A
  • sympatholytics
  • adrenergic blockers
  • adrenergic antagonists
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10
Q

Drugs that mimic acetylcholine

(other names for them)

A
  • parasympathomimetics
  • cholinergic agonists
  • cholinergic drugs
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11
Q

Drugs that block acetylcholine (other names for them)

A
  • parasympatholytics
  • anticholinergics
  • Cholinergic antagonists/blockers
  • muscarinic blockers
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12
Q

Epinepherine acts on more than one receptor (nonselective)…. so what does it do where? (so, for example, explain to a patient all the effects it might have)

A

– Alpha1, increases the blood pressure
– Beta1, increases heart rate (tachycardia)
– Beta2, promotes bronchodilation

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13
Q

Steroids

A

Glucocorticoids - Used for short-term therapy for severe inflammation… are immunosuppressants. Examples: dexamethasone and prednisone.

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14
Q

How to give Dilantin IV

A

IV is not compatible with other drugs… only with Normal Saline Solution (NS)… give it slowly

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15
Q

Pathology of Cancer

A
  • Characterized by rapid, uncontrolled growth of cells
  • Cells lose normal functions and invade normal tissues
  • Metastasize: travel to another location
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16
Q

Growth Fraction

A
  • Measure of how many cells are undergoing mitosis
    • Ratio of replicating cells to resting cells
  • Solid tumors have low growth fraction; thus less sensitive to chemotherapy
  • Leukemias and lymphomas have high growth fraction; thus chemotherapy more effective
  • Hair follicles, bone marrow, gastrointestinal tissue have high growth factor—this explains many adverse effects
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17
Q

Principles of Chemotherapy

A
  • Transported through blood
  • Has potential to reach each cancer cell
  • Some drugs can cross blood-brain barrier
  • Some drugs distilled directly into body cavities (ex: bladder)
  • Often combined with or done after surgery and radiation to increase chance of cure
    * Called adjuvant therapy
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18
Q

Side effect for Alkylating Agents

A

can cause significant bone-marrow suppression

immunosuppressant effects, thrombocytopenia
Nausea, vomiting, anorexia, diarrhea
Alopecia (hair loss), hemorrhagic cystitis

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19
Q

Side effects for Antimetabolites

A

fatal bone-marrow toxicity at high doses
• Hemorrhage and bruising, low platelet counts
• Nausea, vomiting, anorexia
• Gastrointestinal ulceration, intestinal bleeding

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20
Q

Side effects for Antitumor Antibiotics

A

cardiotoxicity, dysrhythmias
Irreversible heart failure, lower blood-cell counts
Nausea, vomiting

21
Q

Side effects for Hormones/Hormone Antagonists

A

nausea and vomiting
• Association with increased risk of endometrial cancer and thromboembolic disease
• Hot flashes, fluid retention, vaginal discharges common
Development of cross-gender secondary sexual characteristics
• Common, yet distressing, side effects of sex-hormone therapy

22
Q

Side effects for Natural Products

A

nervous system toxicity, numbness and tingling in limbs
• Muscular weakness, loss of neural reflexes, pain
• Paralytic ileus, constipation, alopecia

23
Q

gastric ulcer

A
  • lesion in stomach
  • Less common than the duodenal
    Loss of appetite, weight loss and vomiting are more common
24
Q

duodenal ulcer

A
  • lesion in small intestine
  • Characteristic symptom is a gnawing or burning, upper abdominal pain that occurs 1 to 3 hours after a meal.
    May lead to bleeding that may be evident as either bright red blood in vomit or black, tarry stools
25
Q

Associated with several risk factors for peptic ulcer disease

A

Family history, type O blood
Tobacco use and caffeine
Glucocorticoids and NSAIDs
Psychological stress

26
Q

GURD

A
  • Gastroesphageal Reflux Disease’
  • Caused by loosening of sphincter between esophagus and stomach
  • Associated with obesity
  • Acidic stomach contents move up into esophagus
  • Causes intense burning (heartburn)
  • May lead to esophageal ulcers, esophagitis, or strictures
  • Lifestyle changes can improve GERD symptoms
27
Q

Categories of drugs for Acid Reflux Disease

A

H2 - Receptor Blockers (ie. Zantac, Pepcid, Tagamet)

      - work by blocking H2-receptors in stomach to decrease acid production
     - administered after meals

Proton Pump Inhibitor (i.e. Priolosec)

     - administered 30 min before meals, on empty stomach, may be administered with other antacids
     - reduces acid secretion in stomach by binding irreversibly to enzyme H1, K1-ATPase
      - more expensive

Antacids (i.e. Amphojel, tums)
- neutralizes stomach acid by raising pH of stomach contents

28
Q

Constipation

A 
Common condition caused by
    -Diminished fluid intake
    -Slow motility of waste material    
     through large intestine
    -Certain foods, medications, diseases
     -Lack of exercise
     -Insufficient dietary fiber
29
Q

Diarrhea

A
  • Increase in frequency and fluidity of bowel movements
  • Occurs when colon fails to reabsorb enough water
  • Is a type of body defense
  • Eliminates toxins and pathogens
  • Eliminates certain medications and infections
  • If prolonged, can lead to fluid, electrolyte, and acid-base imbalance
30
Q

Categories of Laxatives

A
  1. Stimulant Laxatives
    Increase peristalsis by irritating sensory nerve endings in the intestinal mucosa
    Examples : (Correctol,bisacodyl (Dulcolax), Senokot)
  2. Osmotic (saline) laxatives
    Hyperosmolar…pull water into the colon and increase water in the feces to increase bulk that causes peristalsis.
    (Phospho-soda, Milk of magnesia, magnesium citrate, Potassium phosphate)
  3. Bulk Laxatives
    Natural fibrous substances that promote large, soft stools by absorbing water into the intestine, increasing bulk and peristalsis
    Examples: (Fibercon, Citrucel, Metamucil)
  4. Emollients (stool softeners)
    lowers surface tension and promote water accumulation in the intestine and stool
    Examples: Ducusate sodium (colace), Mineral oil
31
Q

Osmotic laxatives are contraindicated in what kind of patients?

A

renal failure and CHF

32
Q

Milk of Magnesium is what kind of Laxative?

A

Osmotic

33
Q

Metamucil is what kind of Laxative

A

Bulk Laxative

34
Q

Nursing Implication for Bulk Laxative:

A

They decrease absorption of multiple other drugs including dig, and anticoagulants. Separate by 2 hours.

35
Q

phenytoin (Dilantin) (Category, MOA, and Side Effects)

A

Category: Hydantoin

MOA: desensitizes NA+ channels

Side effects: CNS depression, gingival hyperplasia, skin rash, cardiac dysrhythmias, and hypotension

36
Q

Nursing Implications for Dilantin

A

Monitor serum-drug levels
Monitor for signs of toxicity
Monitor for blood dyscrasias and bleeding disorders
Monitor liver and kidney function
Fatal hepatotoxicity can occur
Monitor lab values
Patients with hypersensitivity to hydantoin products should be cautious.
Rash, seizures due to hypoglycemia, sinus bradycardia, and heart block

37
Q

What is Dilantin used for?

A

All types of epilepsy except absence seizures

38
Q

Valproic acid (Depakene, Depakote)

used for?, category?, MOA? side effects?

A

Used for: absence seizures

category: Phenytoin-like drug

MOA: desensitize NA+ channels

Side effects: limited CNS depression, visual disturbances, ataxia, vertigo, headache, gastrointestinal effects, hepatotoxicity, pancreatitis

39
Q

Nursing Implications for Valproic Acid?

A

Monitor serum-drug levels
Monitor for signs of toxicity
Monitor for blood dyscrasias and bleeding disorders
Monitor liver and kidney function
Fatal hepatotoxicity can occur
Patients with hypersensitivity to hydantoin products should be cautious.
Rash, seizures due to hypoglycemia, sinus bradycardia, and heart block

40
Q

levodopa and carbidopa (Sinemet)

A

Dopaminergic drugs - used to treat parkinsen’s

MOA: Increases biosynthesis of dopamine within nerve terminals

Side effects: dizziness, light-headedness, sleep dysfunction, fatigue, nausea, vomiting, constipation, orthostatic hypertension, dystonia, dyskinesia

41
Q

Infliximab (Remicade)

A

Suppresses inflammation in autoimmune disorders…. is an antibody immunosuppresant.

Toxic to bone marrow
Increase risk of infections and lymphoma

42
Q

Nursing Implications for Remicade (aka for immunosuppresants)

A

 Contraindicated in client with leukemia, metastatic cancer, active infection, renal or liver disease or those who are pregnant
 Obtain vital signs and results of lab testing to provide baseline data
 Monitor for indications of infection
 Monitor degree of bone-marrow suppression (thrombocytopenia and leukopenia)
 Monitor clients taking azathioprine (Imuran) for development of secondary malignancies

43
Q

methotrexate (Folex, Mexate, others)

A

Category: Antimetabolites

MOA: blocks synthesis of folic acid (vitamin B9) to inhibit replication

Side effects: **fatal bone-marrow toxicity at high doses
• Hemorrhage and bruising, low platelet counts
• Nausea, vomiting, anorexia
• Gastrointestinal ulceration, intestinal bleeding

44
Q

tamoxifen (Nolvadex)

A

Category: Hormones/Hormone Antagonists

MOA: blocks estrogen receptors on breast cancer cells

Side effects: nausea and vomiting
• Association with increased risk of endometrial cancer and thromboembolic disease
• Hot flashes, fluid retention, vaginal discharges common
Development of cross-gender secondary sexual characteristics
• Common, yet distressing, side effects of sex-hormone therapy

45
Q

ranitidine (Zantac)

A

H2 Receptor blocker - works by blocking H2 receptors in stomack to decrease acid production. Give after you eat.

Adverse effects: possible reduction in number of red and white blood cells and platelets, impotence or loss of libido in men

46
Q

Hydroxyzine (Vistaril)

A

Antihistamine, given post op with narcotics to decrease nausea.

drowsiness and dry mouth are expected.

47
Q

Psyllium muciloid (Metamucil)

A

Bulk-type laxative;

Natural fibrous substances that promote large, soft stools by absorbing water into the intestine, increasing bulk and peristalsis

They decrease absorption of multiple other drugs including dig, and anticoagulants. Separate by 2 hours.

48
Q

Diphenoxylate (Lomotil)

A

Opiate drug used for Diarrhea, that has less potential for dependence than other opioids.

49
Q

Compazine

A

phenothiazine-like antinausea medicine that is given prior to chemotherapy…. causes dry eyes, blurred vision, dry mouth, constipation, drowiness, phtosensitivity, extrapyrradmidla symptoms, neuroleptic malignany dyndrome, agranulocytiosis.

Pharmacology Exam 3 KS (4 decks)

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