Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

N112 > The Finny- PHARM > Flashcards

The Finny- PHARM Flashcards

1
Q

What is pharmacology?

A

Study of drugs that alter functions of living organisms
• Includes pharmacotherapy, pharmacokinetics, pharmacodynamics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which health care providers are involved in the management, distribution, and education of pharmacology?

A

Doctors
Dietitians
Pharmacists
PAs
NPs
Nurses
RTs
CNAs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

4 major concepts that assist in understanding pharmacology

A

-Nursing management of drug therapy
-Medication
-Core drug knowledge
-Core patient variables

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is core drug knowledge

A

Pharmacotherapeutics
Pharmacokinetics
Pharmacodynamics

Precautions/contraindications
Drug interactions
adverse/side effects
Patient/family teaching

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the core patient variables

A

Culture
Health status
Inherited traits
Life style
Diet
Life span
Environment
Habits
Gender

CHILD LEHG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is nursing management of drug therapy

A

Education and safety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How do we maximize therapeutic effects

A

Promote absorption
Appropriate time
Lab values

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How do we minimize adverse effects

A

Modify admin
Allergies
Contraindications
Safety checks
Assess pt
Lab values
Adverse effects
DC/withhold

MAC SALAD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Sources/ types of medications

A

Animal
Plant
Minerals
Synthetic
Semi-synthetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the 3 classifications of drug nomenclature

A

therapeutic
physiologic
chemical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What classification is categorized by the disease state it is used to treat

A

Therapeutic classification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which classification is categorized by the drugs MOA

A

Pharmacologic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which drug names are lowercase

A

generic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which drug names are uppercase

A

Brand-Trade names

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the USP-NF

A

The United States Pharmacopeia - National Formulary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the purpose of the USP-NF

A

Sets the standards for drugs / reviews drugs

Not a government agency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What information about drugs should be included during pt teaching?

A

Drug name
Reason drug was prescribed
Intended effects
Adverse/ side effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

7 parts of a med order

A

Pt name
Order date/time
Name of drug
Dosage
Route
Frequency
HCP signature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

7 rights of med administration

A

Right:

Pt
Med
Dose
Route
Time
Reason
Documentation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is Pharmacotherapeutics

A

Achievement of the desired therapeutic goal from drug therapy

The indication for giving the drug- right reason

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is Pharmacokinetics

A

Effects of the BODY on the drug

absorption
distribution
metabolism
excretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is Pharmacodynamics

A

The effects of the DRUG on the body

Variables that affect drug action
Toxicology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is enteral

A

By way of the intestines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is Parenteral

A

By way other than the intestines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is absorption

A

movement of the drug from the site of administration into the bloodstream

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What factors affect absorption

A

Dosage
Route
GI Function
Lipid solubility
Blood flow
Surface area
pH
Food

Dr. GLBS fish food

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What route is absorbed faster than IM and Subcut

A

IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Geri pH is

A

more alkaline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Geri GI motility is

A

Slowed
Reduced blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is distribution

A

Movement of drug into cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What factors affect distribution

A

Tissue availability
Blood flow
Protein binding
Solubility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Does the blood brain barrier have a low or high selectivity

A

Highly selective

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Geris lean body mass is

A

Decreased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Geris fat is

A

Increased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Geris body water content is

A

Reduced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Geris protein binding sites are

A

Reduced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Geris BBB is

A

Less effective

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is metabolism

A

Conversion of the drug into another substance or substances

Metabolites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What effect limits drugs effect due to break down by liver

A

Hepatic first pass effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What INCREASES metabolism

A

Inducers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What DECREASES metabolism

A

Inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Geris liver is

A

Decreased in size/ mass
Decreased blood flow- decreased metabolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is excretion

A

Removal of the drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is clearance

A

Rate of disappearance
Both renal and hepatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Geris renal filtration is

A

Decreased- reduced blood flow/ decrease in nephrons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is half life

A

Time it takes for 50% of drug to be eliminated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Protein binding
60-89%

A

Moderate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Protein binding
Above 89%

A

High

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Protein binding
Below 30%

A

Low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

The relation between the effective dose and lethal dose

A

Therapeutic index

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

In between peak and trough

A

Therapeutic index

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Adverse effect can happen if there is not enough_____
for drugs to attach to

A

Albumin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Po drugs absorb where

A

small intestine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What is an agonist

A

Promote function
Stimulate the cell to act

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What is an antagonist

A

Block function
Block something else from attaching to and causing an effect

Antidotes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What factors contribute to distribution

A

Protein binding
Blood flow
Tissue availability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Drugs ability to leave the body depends on what

A

Protein binding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What factors affect metabolism

A

First pass effect
Inducers
Inhibitors
Liver damage/aging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Name some inhibitors

A

Benadryl/ grapefruit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Name some inducers

A

Tobacco/ St. John’s wort

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

A damaged liver causes what

A

High levels of active drug / toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

The main mechanism drugs use to cause their effect on the body

A

Binding with receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What is the study of biological, chemical, physiologic interactions of a drug in the body

A

Pharmacodynamics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What is receptor theory

A

Drugs exert their effects by binding with receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What is a Physiochemical reaction

A

Binding either stimulates or inhibits normal cell functions
(Agonist vs. antagonist)
Direct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Describe changes in the permeability of cell membrane to one or more ions:

A

Ion channels open or close
(Calcium channel antagonists)
Direct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Drugs that modify the synthesis, release, or inactivation of neurohormones that regulate physiologic processes

A

Acetylcholine
Norepinephrine

(Indirect)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Non receptor drugs

A

Antacids- act chemically

Anticancer Drugs- structurally similar to nutrients required by the body; interfere with normal cell function

Osmotic diuretics- increase osmolarity

Metal chelating agents- combine with toxic metals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Variables that affect drug action

A

Potency
Serum drug level
Therapeutic index
Efficacy
Maintenance vs. loading dose
MEC

P STEMM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Drug-diet admin times

A

30 mins before or after meal
Specific drugs: 1hr before or 2 hrs after

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What are additive effects

A

Combine to create a bigger effect than what was originally desired

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

What is synergism

A

Help each other produce the desired effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What is displacement

A

When drugs that are high protein bound fight compete for protein binding

One drug displaces another

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Pt related variables

A

Preexisting conditions
Ethnicity
Psych factors

Genetics

Weight
Age
Gender

PEP G SWAG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

What occurs with to much therapeutic effect

A

Adverse effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

What are adverse effects

A

Undesired response to a drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

What drugs have adverse effects

A

All drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What is the strongest FDA warning

A

Black box warning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Toxicity results from what

A

Excessive amounts of a drug

May damage body tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Name different types of toxicity

A

cardiotoxicity
ototoxicity
ocular damage
immunotoxicity
hepatotoxicity,
nephrotoxicity,
neurotoxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Subcut landmarks

A

the upper posterior area of the arm
Anterior aspects of the thighs
abdomen 2 inches away from the navel
lateral abdomen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Subcut needle length and gauge

A

25-30 G
3/8” - 1”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

IM landmarks

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

IM needle length and gauge

A

20-25 G
5/8”-1.5”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

3 purposes for intra dermal injections

A

Skin testing (drug/allergy sensitivities)
Determine presence of microorganism
Local anesthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Intradermal landmarks

A

Lightly pigmented, thinly keratinized, hairless skin (thinner skin)
Ventral forearm
Outer aspect of the upper arms
Scapular area of back
Upper chest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Intradermal equipment

A

TB or 1mL syringe
1mL calibrated in 0.01 increments (usually 0.01 to 0.1mL injected)
TB syringe most common

26 -27 G

3/8” - 5/8”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

How do you hold the skin for an intradermal injection

A

Taut

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

What angle do you insert the needle during an intradermal injection

A

5-15 degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

Which way should the bevel face during an intradermal injection

A

Up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

What should be visible during an intradermal injection

A

The needle should be visible under the skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

What is a bleb or wheal

A

The bubble that forms during an intradermal injection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

How should you inject & remove the needle during an intradermal injection

A

Slowly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

How long should you massage the area after an intradermal injection

A

NEVER

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

What is pain

A

A sensory and emotional experience associated with actual or potential tissue damage

Whatever the patient says it is

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

Pain is based on what

A

The individuals previous experience and social, environmental, and cultural influences

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

What are noiceptors

A

Afferent neurons
Place where the sensation of peripheral pain begins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

Where are nociceptors found

A

Skin
Muscle
Connective tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

What are the 2 types of nociceptors

A

A-Delta fibers
C-fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

What fibers are small

A

A-Delta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

Which fibers respond to mechanical stimuli

A

A-Delta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

Which fibers sense dull pain

A

C-fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

Which fibers sense sharp pain

A

A-Delta fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

Which fibers sense burning pain

A

C-fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

Which fibers respond quickly to acute pain

A

A-Delta fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

Which fibers are myelinated

A

A-Delta fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

Which fibers sense pinching pain

A

A-Delta fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

Which fibers sense stinging pain

A

A-Delta fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

Which fibers are slow

A

C-fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

Which fibers are unmyelinated

A

C-fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

Which fibers respond to mechanical stimuli

A

A-Delta fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

Which fibers respond to mechanical chemical stimuli

A

C-fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

Which fibers respond to hormonal stimuli

A

C-fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

Which fibers respond to thermal stimuli

A

C-fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

Which fibers sense aching pain

A

C-fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

Which fibers transmit sensations with touch or temp

A

A-Delta fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

What med is used for fever pain and inflammation

A

Ibuprofen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

What med is used for fever, mild pain, and has no anti-inflammatory actions

A

Acetaminophen
Para-aminophenol derivative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

Which med is 99% protein binding
Ibuprofen or acetaminophen

A

Ibuprofen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
120
Q

High doses of acetaminophen can cause what

A

Compromised renal function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
121
Q

What is the antidote for acetaminophen

A

Acetylcysteine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
122
Q

What can increase risk for bleeding in patients taking ibuprofen
(Drug-natural)

A

Ginger
Garlic
Ginko
Chamomile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
123
Q

What pain med is the best choice for those on blood thinners

A

Acetaminophen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
124
Q

What med is the best choice for those with hypersensitivity to aspirin, NSAIDs, and are intolerant to GI

A

Acetaminophen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
125
Q

What legislation:
Designated drugs that must be prescribed by a HCP and separated into prescription and non-prescription classes

A

1952
Durham-Humphrey amendment

126
Q

What legislation:
Was the first law directed towards controlling addiction

A

1914
Harrison Narcotic Law

127
Q

What legislation:
Provided regulation regarding the manufacture and distribution of certain drugs

A

1914
Harrison Narcotic Law

128
Q

What legislation:
Regulated distribution of narcotics and categorized narcotics

A

1970
Comprehensive Drug Abuse Prevention and Control Act

129
Q

What legislation:
Established the DEA

A

1970
Comprehensive Drug Abuse Prevention and Control Act

130
Q

What legislation:
Established 5 categories (schedules)

A

1970
Comprehensive Drug Abuse Prevention and Control Act

131
Q

What is schedule 1

A
132
Q

What is schedule 2

A
133
Q

What is schedule 3

A
134
Q

What is schedule 4

A
135
Q

What is schedule 5

A
136
Q

MEDS:
Schedule 1

A

Heroin
LSD
weed

137
Q

MEDS:
Schedule 2

A

Opioid analgesic
Morphine
Meperidine (Demerol)

138
Q

MEDS:
Schedule 3

A

Tylenol with codine
Ketamine
Anabolic steroids

139
Q

MEDS:
Schedule 4

A

Xanax
valium
Ativan
Ambien
tramadol

pentazocine
anticonvulsants
Muscle relaxers
Sedatives

140
Q

MEDS:
Schedule 5

A

Antidiarrheal
Antitussives with small amounts of narcotics (codeine)

141
Q

Nursing Implications for scheduled meds

A

The count: inventory must match
The record: narcotic sheet
Co-signing all discarded and wasted meds: another RN
All controlled substances locked
- narcotics double locked

142
Q

Myths associated with pain

A

Pain increases as we age
Pain is a psych issue made up in the pts head
Taking an opioid will lead to addiction
Addiction is the most serious adverse effect

143
Q

Major complication arising from morphine administration

A

Light headedness
Dizziness
Confused
Sedation
Hypotension
N/V
Constipation

Respiratory depression
Fall risk

144
Q

What is PQRST

A

Provoking factor-cause
Quality- feels like
Radiate/relief- does it move? Any relief?
Severity- scale 1-10
Timing- how long? Constant? Intermittent?

145
Q

Best practice for analgesic dosing:
Morphine

A

-Assess pain
-Re-assess frequently
-PRN- best if dosed routinely around the clock to ensure constant blood levels of analgesia (joint decision between pt and RN)

146
Q

Best practice for analgesic dosing:
Codine

A

Assess respiratory function

147
Q

When would you not give codine

A

When a pt needs to cough to clear airway because it depress cough reflex

148
Q

Education for a pt who is fearful that they will become addicted to pain meds

A

Educate pt that their chances of becoming addicted if they take the pain med as prescribed are slim to none

149
Q

How is the nervous system divided

A

Central nervous system (CNS)
Peripheral nervous system (PNS)

150
Q

What system deals with the nerves of the brain and spinal cord

A

CNS

151
Q

What system deals with the nerves OUTSIDE of the brain and spinal cord

A

PNS

152
Q

How is the PNS subdivided

A

Afferent
Efferent

153
Q

What are Afferent neurons

A

Carry impulses from the periphery to the CNS

154
Q

What are efferent neurons

A

Carry impulses from the CNS to the periphery

155
Q

How are efferent neurons divided

A

Somatic
Autonomic

156
Q

Describe somatic

A

Voluntary
Skeletal muscle control

innervates skeletal muscles and controls voluntary movements

157
Q

Describe autonomic (ANS)

A

Involuntary
Automatic

controls involuntary activity in smooth muscle, secretory glands and the visceral organs of the body (heart, stomach, kidneys, fallopian tubes)

158
Q

How is the autonomic (ANS) divided

A

SNS
PSNS

159
Q

What is the main function of the autonomic (ANS)

A

maintain constant internal environment
respond to stress
repair body tissues

Involuntary control of smooth muscle, heart, exocrine
glands (Glands that produce secretions for the surface of
an organ. Ex. Sweat glands, salivary glands)

160
Q

Adrenergic refers to what

A

SNS

161
Q

Cholinergic refers to what

A

PSNS

162
Q

What are neurotransmitters

A

transmitters of nerve impulses

chemicals that transmit signals from a neuron to a target cell (across a synapse)

163
Q

neurotransmitters bind with what

A

receptors on an effector organ/tissue to bring about an action of respective NS

164
Q

What is an effector organ

A

an organ or cell that carries out a response from a nerve impulse

165
Q

Are neurotransmitters exogenous or endogenous

A

Endogenous

chemicals that originate inside the body

166
Q

The primary neurotransmitters in the SNS

A

norepinephrine (NE)
epinephrine (Epi)

167
Q

The primary neurotransmitters in the PSNS

A

acetylcholine (ACh)

168
Q

Most common NT of SNS

A

Norepinephrine

169
Q

Mainly made in adrenal medulla
(made from norepi)

A

Epinephrine

170
Q

Both NT & hormone

A

Epinephrine
Norepinephrine

171
Q

Acts more like a hormone
(although sm. amounts made in nerve)

A

Epinephrine

172
Q

Mostly made inside nerve axons

A

Norepinephrine

173
Q

Synthesized from dopamine and released into blood as hormone

A

Norepinephrine

174
Q

Acts mostly on alpha receptors

A

Norepinephrine

175
Q

Acts on both alpha and beta receptors

A

Epinephrine

176
Q

Only released during times of stress

A

Epinephrine

177
Q

continually released into circulation at low levels as hormone

A

Norepinephrine

178
Q

used for treating:
low BP assoc w/ septic shock
ER tx of allergic reactions
eye surgery to maintain dilation

A

Epinephrine

179
Q

Most prevalent NT in body

A

Acetylcholine

180
Q

NT Dominated by the PSNS

A

Acetylcholine

181
Q

NT Crucial for arousal, learning, memory and motor function

A

Acetylcholine

182
Q

Binds to muscarinic receptors
parasymp response

A

Acetylcholine

183
Q

acts as an excitatory NT in skeletal muscle

A

Acetylcholine

184
Q

Names for adrenergic drugs

A

adrenergic neurotransmitter (NE)= Norepinephrine
sympathomimetics
adrenergic agonists
alpha or beta adrenergic agonists
adrenergic

185
Q

Names for Cholinergic drugs

A

Cholinergic neurotransmitters= Acetylcholine
parasympathomimetics
cholinomimetic
cholinergic agonists
cholinergic

186
Q

What receptor does Acetylcholine attach to to bring about a PSNS response

A

muscarinic

187
Q

What receptor does Acetylcholine attach to to bring about excitatory muscle contraction

A

Nicotinic

188
Q

Direct acting drugs do what

A

directly stimulate receptor

189
Q

Indirect acting drugs do what

A

stimulate neurotransmitter to be released and attach to receptor site

190
Q

Adrenergic Receptors: action
Alpha 1 receptors

A

Vasoconstriction

191
Q

Adrenergic Receptors: action
Alpha 2 receptors

A

Stop norepinephrine

192
Q

Adrenergic Receptors: action
Beta 1 receptors

A

Tachycardia

193
Q

Adrenergic Receptors: action
Beta 2 receptors

A

bronchodilation

194
Q

alpha 2 agonist do what

A

lower blood pressure

Because the function of the alpha 2 receptor is
to stop NE (a vasoconstrictor).

So, in alpha 2 receptors, you would want an agonist to
promote the function of vasodilation which in
turn will then lower blood pressure.

195
Q

Adrenergic Agonist Drugs:
Are absorbed how?

A

Rapidly after injection

196
Q

In ER situations Adrenergic Agonist Drugs are given how

A

IV for rapid onset

197
Q

Adrenergic Agonist Drugs can not be given by what route

A

PO

198
Q

Adrenergic Agonist Drugs duration

A

Short

199
Q

Can Adrenergic Agonist Drugs pass the BBB

A

No

200
Q

Adrenergic Agonist Drugs lose effectiveness if given with what type of drug

A

Adrenergic Antagonists

201
Q

Adrenergic Agonist Drugs cause increased risk of HTN if given with what meds

A

meds that increase HTN including OTC and herbal therapies (caffeine)

202
Q

Nursing implications for Adrenergic Agonist Drugs

A

establish baseline status
(pulse, BP, lung sounds, RR, urine output, lab tests)

Monitor pt response closely

203
Q

Nonselective adrenergic agonist

A

Epinephrine

204
Q

Beta 2 agonist

A

Albuterol

205
Q

Alpha 2 adrenergic agonist

A

Clonidine

206
Q

What does it mean if a drug is nonselective

A

All receptors can be activated

207
Q

Epinephrine Pharmacotherapeutics

A

Shock
Cardiac emergencies
Asthma

Used for tx low BP assoc w/ septic shock, ER tx of allergic reactions, & also used during eye surgery to maintain dilation

208
Q

Epinephrine stimulate which adrenergic receptors

A

ALL

209
Q

Epinephrine causes what

A

increased BP
increased HR & force of contraction
hyperglycemia
bronchodilation
vasoconstriction of arterioles in the skin mucosa and most viscera

210
Q

Adverse effects of epinephrine

A

nervousness
restlessness
tremors
insomnia
angina
arrhythmias
HTN
tachycardia

211
Q

Classification of epinephrine

A

nonselective adrenergic agonist

212
Q

Trade name for norepinephrine

A

Levophed

213
Q

Classification of norepinephrine

A

adrenergic agonist
With predominate alpha agonist effects

214
Q

Pharmacotherapeutics of norepinephrine

A

Severe hypotension

215
Q

Pharmacodynamics of norepinephrine

A

Has predominate alpha agonist effects and results in potent peripheral arterial vasoconstriction.

Results in increased BP (more than it increases HR, contraction or CO) Causes reduced renal blood flow (which limits long term use)

216
Q

Pt teaching for adrenergic agonists

A

If you are receiving IV adrenergic drugs to stimulate
your heart or raise BP:
frequent cardiac monitoring,
HR, BP, urine output are necessary.

217
Q

Pt teaching for diabetic pts taking adrenergic agonists

A

monitor your glucose levels carefully because adrenergic medication may elevate them

218
Q

Adverse effects of adrenergic agonists

A

diminished renal perfusion and decreased
urine output

decreased liver perfusion with subsequent liver damage due to vasopressor action

cardiac dysrhythmias due to beta1 activity

Hyperglycemia, hypokalemia due to beta1 activity

Severe hypertension and reflex bradycardia

Limb ischemia due to profound vasoconstriction

219
Q

Beta-Adrenergic Antagonists do what

A

Prevent stimulation of SNS by inhibiting catecholamines (epi & norepi)

220
Q

How are Beta-Adrenergic Antagonists grouped

A

according to their selectiveness
(selective or nonselective)

221
Q

Nonselective Beta-Adrenergic Antagonists affect what

A

Beta 1 receptor sites (mainly in heart)
Beta 2 receptor sites (bronchi, blood vessels, uterus)
[(blocks) Bronchodilation]

222
Q

Selective Beta-Adrenergic Antagonists affect what

A

Specific receptor site
Primarily affect beta 1
Tachycardia, inotropy (increased force of contraction)

223
Q

Beta-Adrenergic Antagonists end in what

A

-lol

224
Q

Beta-Adrenergic Antagonists Pharmacotherapeutics

A

Angina
MI
HTN
Heart failure
Dysrhythmias

225
Q

Beta adrenergic antagonists action

A

Antagonizes (blocks) beta receptor sites

226
Q

Selective Beta adrenergic antagonists what happens with higher doses

A

cardioselectivity is diminished

May block beta 2 receptors

227
Q

Beta adrenergic antagonists cause what

A

Decreased
HR
Force of contractions
Rate of a-v conduction

Side effects
Lethargy
CHF
Decreased BP
Depression

228
Q

metoprolol is a what

A

Selective beta 1 adrenergic antagonists

229
Q

metoprolol Pharmacotherapeutics

A

Treatment of arrhythmias, HTN, chronic angina, controlled HF.

230
Q

metoprolol does what

A

Decreases HR & contractility, slows conduction, suppresses automaticity, and decreases cardiac output.

May block beta 2 receptors in high doses

231
Q

metoprolol contraindications

A

Abrupt cessation of med will cause an exacerbation of angina. MI may occur

232
Q

Maximizing therapeutic effects of Beta adrenergic antagonists

A

Do not abruptly stop medication

233
Q

Minimizing adverse effects of Beta adrenergic antagonists

A

Prior to dose: check the apical and peripheral
pulses.
– Monitor blood pressure, cardiac rhythm

234
Q

Teaching for diabetic pts taking Beta adrenergic antagonists

A

Check blood sugar because Beta adrenergic antagonists can mask signs of hypoglycemia

235
Q

Indirect acting cholinergic agonists drug

A

Neostigmine

236
Q

Cholinergic antagonist

A

Atropine

237
Q

When Acetylcholine attaches to a receptor, that receptor is always a what

A

A cholinergic receptor
Either muscarinic or nicotinic

238
Q

2 types of cholinergic receptors

A

Muscarinic
Nicotinic

239
Q

What are muscarinic receptors

A

Stimulated by Ach & muscarine (alkaloid substance from mushrooms)
bethanechol chloride
Vasodilation & perfusion of organs.

240
Q

What are nicotinic receptors

A

Stimulated by nicotine (plant alkaloid) but will
respond to ACh

241
Q

Nicotinic-N (neuronal-type) receptor stimulation results in what

A

the release of Epinephrine

242
Q

Nicotinic-M stimulation results in what

A

muscle contraction

243
Q

What NS dominates, maintains homeostasis/internal environment

A

parasympathetic

244
Q

Which NS dilates pupils

A

SNS

245
Q

Which NS causes tears to flow

A

PSNS

246
Q

Which NS constricts pupils

A

PSNS

247
Q

Which NS thickens saliva

A

SNS

248
Q

Which NS increases HR

A

SNS

249
Q

Which NS increases watery saliva

A

PSNS

250
Q

Which NS constricts bronchioles and increases secretions

A

PSNS

251
Q

Which NS dilates the coronary artery

A

SNS

252
Q

Which NS dilates the trachea and bronchioles

A

SNS

253
Q

Which NS slows HR

A

PSNS

254
Q

Which NS causes the coronary artery to constrict

A

PSNS

255
Q

Which NS causes the GI to produce more secretions

A

PSNS

256
Q

Which NS increases GI motility

A

PSNS

257
Q

Which NS produces sweat

A

SNS

258
Q

Which NS constricts blood vessels in the skin and mucous membranes

A

SNS

259
Q

Which NS decreases GI tone and mobility

A

SNS

260
Q

Which NS causes ejaculation in men

A

SNS

261
Q

Which NF contracts the lower colon

A

PSNS

262
Q

Which NS contracts the bladder and ureters

A

PSNS

263
Q

Which NF stimulates erection in men

A

PSNS

264
Q

Which NS contracts sphincters

A

SNS

265
Q

Which NS relaxes the uterus and bladder

A

SNS

266
Q

Neurotransmitters transmit signals from ___ to ____

A

Neurons to target cells

267
Q

What is the most prevalent NT in the body

A

ACh

268
Q

Which NT is dominated by the PSNS

A

ACh

269
Q

Which NT is crucial for arousal, learning, memory, and motor function

A

ACh

270
Q

Which NT transmits parasympathetic signals to end organs

A

ACh

271
Q

Which NT will act as excitatory NT in skeletal muscle (nicotinic)

A

ACh

272
Q

What are the muscarinic receptors

A

M1-M5

273
Q

What do muscarinic receptors do

A

vasodilation and perfusion of organs
decrease BP

274
Q

Which receptors are stimulated by nicotine but will respond to ACh

A

Nicotinic

275
Q

What are the 2 nicotinic receptors

A

Nicotinic-N (neuronal type)
Nicotinic-M (muscle type)

276
Q

Nicotinic-N stimulation results in what

A

The release of epinephrine

277
Q

Nicotinic-M stimulation results in what

A

Skeletal muscle contraction

278
Q

What do Adrenergic Agonists do

A

Stimulate all adrenergic receptors
Increase:
BP
HR
Inotropy

Hyperglycemia
Bronchodilation
Vasoconstriction of arterioles in skin

To low BP in association with septic shock
Asthma
Cardiac emergencies
ER tx of anaphylactic shock
Eye surgery to maintain dilation

279
Q

What is the sub classification of epinephrine

A

Nonselective adrenergic agonists

280
Q

What is the sub classification of norepinephrine

A

Adrenergic agonist with predominant alpha agonist effects

281
Q

What does norepinephrine do

A

Helps with severe hypotension

Predominant alpha agonist effects result in potent peripheral arteriole vasoconstriction

Results in:
Increase BP

Can cause reduced renal blood flow

282
Q

What is metoprolol sub classification

A

Beta adrenergic antagonist (Beta Blocker)
Selective to Beta 1

283
Q

What does metoprolol do

A

Antagonizes beta receptor sites

Cardioselectivity is diminished with higher doses and will cause activity at Beta 2 receptors
- causing lung constriction

Tx:
Arrhythmias
HTN
Chronic angina
Controlled HF

Decreases HR and contractility
Slows conduction
Suppresses
Automaticity
Decreases cardiac output

284
Q

What is propranolol

A

Adrenergic antagonist

285
Q

Is propranolol selective or nonselective

A

Nonselective

286
Q

What does propranolol do

A

Antagonizes beta receptor sites

287
Q

What is neostigmine

A

indirect acting Cholinergic agonist

288
Q

What is the sub classification of neostigmine

A

Indirect acting cholinergic agonist

289
Q

What is bethanechol chloride

A

Direct acting cholinergic agonist

290
Q

What does bethanecol chloride do

A

TX:
Urinary retention- increase muscle tone in bladder to allow for bladder emptying

Helps you pee

291
Q

What is atropine

A

Cholinergic antagonist

292
Q

What does atropine do

A

Helps clear secretions
specifically targets muscarinic cholinergic receptors

Antidote for overdose of cholinergic agonist:
Strong inhibitor of cholinergic receptors
-Brings pt back to baseline

Increases HR
Decrease secretions
Enlarged pupils
Contracts bladder and GI
Decrease GI motility
Drowsiness

293
Q

What happens when you stimulate cholinergic receptors in the eye

A

Pupils constrict

294
Q

What happens when you stimulate cholinergic receptors in the GI

A

Increase secretions
Increase motility
Lower colon contracts

295
Q

What happens when you stimulate cholinergic receptors in the GU

A

Ureters and bladder contract
Increased urine output
Erection in men

296
Q

What causes cholinergic crisis

A

Too much cholinergic stimulation (agonists)

297
Q

What is an issue in cholinergic crisis

A

Respiratory compromise

298
Q

S/S of cholinergic crisis

A

Muscle weakness - prolonged contraction
Slows breathing
Other parasympathetic effects

299
Q

What is the antidote for cholinergic agonists

A

Atropine

300
Q

What are excessive effects of atropine

A

Mad as a hatter- confusion/ delirium
Blind as a bat- pupils constrict
Red as a beet- flushed face, tachycardia
Dry as a bone- decreased secretions, thirsty

301
Q

How do small doses of atropine effect the body

A

Bradycardia
Decreased secretions

  • gets rid of death rattle, but can cause mucus plug
302
Q

How do high doses of atropine effect the body

A

Tachycardia

303
Q

Beta adrenergic antagonist inhibit what

A

Catecholamines

304
Q

How are beta adrenergic antagonists grouped

A

By their selectiveness

305
Q

Adverse side effects of metoprolol

A

Common:
bradycardia
Hypotension
Depression

Serious:
Bronchoconstriction
Bronchospasm

306
Q

Common side effects of any cholinergic antagonist

A

Dry mouth
Constipation
Urinary retention
Blurred vision

307
Q

Cholinergic antagonist prototype

A

Atropine

308
Q

What herbal/ OTC medications increase the effectiveness of atropine

A

Senna (herbal laxative)
Aloe

309
Q

What do you assess for in Geri’s taking atropine
Cholinergic antagonists

A

Increased temp - Due to suppression of perspiration and heat loss

Nervousness
Weakness
Confusion
Excitement

310
Q

What do you assess for in kids taking cholinergic antagonists

A

Increased temp
Hyperpyrexia

Due to suppression of perspiration and heat loss

311
Q

Atropine teaching

A

Avoid high temps
Drink water frequently
Rinse mouth frequently
Hard candy- dry mouth
Void before taking medication
Visit ophthalmologist regularly
Notify HCP- for fever or severe weakness

N112 (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions