Test 1 review Flashcards by tad worku

Controlled Substances are Drugs that…

Have a high potential for addiction or dependence

Physical dependence
Psychological dependence

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Controlled Substance Act of 1970

Restricts use of drugs w/ potential for abuse

Restricted drugs placed into 5 schedules

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School age children and pharmacotherapy

Give Longer, mor detailed explanations, but still basic information

Praise cooperation
Offer choices when appropriate

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Adolescents and pharmacotherapy

Need understanding and respect, teens do not want to look “different than their peers

Educate about hazards of tobacco and substance abuse
Allow time for questions

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Illnesses requiring drug therapy for middle-Aged Adults

Cardiovascular disease
Hypertension
Diabetes
Cancer

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6 Categories of Human-Integration Pyramid

Age
Gender
Genetic predisposition
Community-environment factors
Culture and ethnicity
Psychological-social-spiritual needs

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Community Factors that Affect Pharmacotherapy

Urbanization
Age distribution
Socioeconomic levels
Occupational patterns
Industrial growth

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Physical Dependence Substances…

Opioids
Alcohol
Sedatives
Some Stimulants 
Nicotine

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Psychological Dependence Substances

Marijuana

Anti-Anxiety drugs

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Withdrawal Definition

Withdrawal symptoms and signs are the opposite of what the drug originally causes.

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Opioid Withdrawal Symptoms

Excessive sweating
Restlessness
Dilated Pupils 
Increased HR and BP
N/V

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Barbiturates and Sedative Withdrawal Symptoms

Insomnia
Anxiety
Anorexia
Seizures

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Benzodiazepine Withdrawal

Insomnia
Restlessness
Fatigue
Sensitivity to light and sound

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Alcohol withdrawal symptoms

Withdrawal can be life threatening

-Treat with benzodiazepines or Librium for withdrawal issues

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Substance P

Neurotransmitter responsible for continuing the pain message

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Endogenous Opioids

May modify sensory info, interrupting pain transmission

-Endorphins, dynorphins, ekaphalins

Humor, chocolate, exercise

Mu and Kappa Receptors

Morphine activates mu and kappa receptors

Naloxone (Narcan) inhibits mu and kappa receptors

Opioid Response

Decreased GI motility
Euphoria
Constriction
Physical dependence
Sedation

Morphine

Opioid Agonist (prototype drug)
Binds to mu and kappa receptor sites to produce analgesia

Watch for respiratory depression

Opioid Toxicity

Severe Respiratory depression
Medical emergency
Major change in vital signs

Opioid Antagonists

Reverse effects of opioids
Used for overdose or overly aggressive pain therapy

NARCAN

Treatment of Opioid Dependence

Methadone maintenance

NonOpioid Pain Drugs (Classes)

Acetaminophen
Nonsteroidal Anti Inflammatory NSAIDs
Salicylates
Selective Cox-2 Inhibitors

Tylenol

Prototype drug: Acetaminophen (nonopioid analgesic)
-mildly inhibits prostaglandins

Overdoses are LETHAL

ibuprofen (Motrin)

Prototype NSAID: Ibuprofen (Motrin) - Inhibit COX and prevent formation of prostaglandins - Used for mild or moderate pain and to reduce INFLAMMATION -GI upset, acute renal failure

Aspirin (ASA)

Prototype Salicylate: Aspirin (ASA) - anticoagulant, antipyretic, anti-inflammatory, and analgesic - high doses may cause GI distress and bleeding -May increase action of oral hypoglycemic agents

celecoxib (Celebrex)

Prototype Cox-2 inhibitor - Similar to the NSAIDs - releive pain, fever, inflammation ADVERSE EFFECTS: Mild and related to GI system

Tripans & Ergot alkaloids

Used in antimigraine therapy Act as VASOCONSTRICTORS and constrict certain intracranial vessels

sumatriptan (Imitrex)

Prototype Tripan- Anti-migraine drug Constricts certain intracranial vessels Used to abort migraines ADVERSE EFFECTS; GI upset, INCREASE IN BP

Acute Inflammation (5 basic steps)

1. Vasodilation (REDNESS / HEAT) 2. Vascular permeability (EDEMA) 3. Cellular infiltration (PUS) 4. Thrombosis (CLOTS) 5. Stimulation of nerve endings (PAIN)

Histamine

- Key chemical mediator in INFLAMMATION - stored in MAST CELLS - Initiates Inflammatory Response - Directly stimulate pain receptors Release of histamine produces VASODILATION -CAPILLARIES BECOME LEAKY causing tissue SWELLING

Cyclooxygenase (COX-1)

Inhibition of COX-1 results in: -BLEEDING, GASTRIC UPSET, REDUCED RENAL FUNCTION REMEMBER: ASPIRIN inhibits both COX-1 and COX-2

COX-2

Present at sites of injury -Promotes inflammation, sensitizes pain receptors, mediates fever in brain. INHIBITION of COX-2 results in suppression of inflammation

Anti-Inflammatory Drugs

Prototype drug: ibuprofen (Advil, Motrin...) -inhibit prostaglandin synthesis Used for musculoskeletal disorders such as rheumatoid arthritis, osteoarthritis, mild to moderate pain, fever reduction TYLENOL IS NOT an NSAID

NSAID drugs - Adverse effects - Patient Education

Adverse Effects: -nausea, heartburn, epigastric pain, dizziness Patient Education -Watch for GI bleeding & pain, Kidney damage, Increased BP

Prednisone

Prototype "Systemic Glucocorticoid" Anti-inflammatory -Long term therapy may result in Cushing syndrome

Cushing Syndrome

Result of long term glucocorticoid use. Effects include: - Suppresion of adrenal gland function - Hyperglycemia - Mood changes, cataracts, peptic ulcers Results Short-term treatment - Insomnia - Personality changes - Increased energy - GI upset

Systemic Glucocorticoids | -Contraindication

Creates potential for existing infections to grow rapidly and undetected -Contraindicated in ACTIVE INFECTIONS

Glucocorticoid | -Long term treatment

- Keep dose as low as possible - Use alternate-day dosing - Cushing syndrome may result - DISCONTINUE GRADUALLY