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NSG 318 - Pharm > Topic 5 & 6 > Flashcards

Topic 5 & 6 Flashcards

1
Q

what are ways a drug can be called if they stimulate the sympathetic nervous system

A

sympathomimetic
adrenergic agonist
parasympatholytic
anticholinergic (cholinergic-blocking)

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2
Q

what are ways a drug can be called if they stimulate the parasympathetic nervous system

A

parasympathomimetic
cholinergic agonist
sympatholytic
adrenergic blocker (alpha and beta blocker)

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3
Q

sympathetic nervous system

A

fight or flight;
adrenergic

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4
Q

parasympathetic nervous system

A

rest and digest;
cholinergic

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5
Q

sympathetic: eye

A

dilates pupil (mydriasis)

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6
Q

sympathetic: lung

A

bronchodilation

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7
Q

sympathetic: heart

A

increases heart rate

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8
Q

sympathetic: blood vessel

A

constrict- increase BP

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9
Q

sympathetic: GI

A

relaxes (decreases GI secretions and GI motility)

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10
Q

sympathetic: bladder

A

relaxes bladder
constricts bladder sphincter

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11
Q

sympathetic: uterus

A

relax

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12
Q

a1 receptors

A

increase cardiac contractility, vasoconstriction
dilate pupil
decrease salivary secretion
increase bladder and prostate contraction

(think AC = Alpha Constrict; 1’s always constrict)

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13
Q

a2 receptors

A

inhibits norepinephrine (OPPOSITE RESPONSE)
promotes vasodilation and decrease BP (OPPOSITE RESPONSE)
decrease GI motility and tone

(2’s always dilate)

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14
Q

b1 receptors

A

increase cardiac contractility, HR
increase renin secretion and increase BP

(think 1 heart)

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15
Q

b2 receptors

A

decrease GI tone and motility
BRONCHODIALATION
increase blood flow to sk. muscles, relax smooth muscles of uterus
activates liver glycogenolysis (increase blood glucose)

(think 2 lungs)

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16
Q

direct acting adrenergic agonists

A

directly stimulates adrenergic receptor
(epi and norepi)

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17
Q

indirect acting adrenergic agonist

A

stimulates release of norepi from terminal nerve endings
(amphetamine)

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18
Q

mixed acting adrenergic agonist

A

stimulates adrenergic receptor sites AND stimulate release of norepinephrine from terminal nerve endings
(ephedrine)

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19
Q

what are the two types of adrenergic agonists

A

catecholamines and noncatecholamines

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20
Q

endogenous catecholamines

A

(produced naturally in the body)
epi, norepi, dopamine

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21
Q

synthetic catecholamines

A

isoproterenol, dobutamine

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22
Q

noncatecholamines

A

Most have longer duration of action than endogenous and synthetic
Phenylephrine, metaproterenol, albuterol

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23
Q

adrenergic antagonists

A

block effects of adrenergic neurotransmitters
(alpha and beta blockers)

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24
Q

when giving epi IV what is important

A

watch the IV site as it can cause tissue necrosis

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25
Q

epi is most often given which route

A

IV & sub-q

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26
Q

nasal decongestants and epi can…

A

further increase BP

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27
Q

a1 blockers can cause

A

vasodilation, dizziness
orthostatic hypotension, reflex tachycardia
pupil constriction
suppress ejaculation
reduces contraction of sm. muscles in the bladder sphincter and prostate

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28
Q

b1 blockers can cause

A

reduce cardiac contractility
decrease pulse (HR)

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29
Q

b2 blockers can cause

A

bronchoconstriction
contract uterus (given in labor)
inhibit glycogenolysis (could lead to hypoglycemia)

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30
Q

selective alpha adrenergic antagonist

A

selectively blocks a1

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31
Q

nonselective alpha adrenergic antagonist

A

block a1 and a2

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32
Q

what is the action of an alpha adrenergic antagonist

A

promote vasodialation (decrease BP)

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33
Q

what is the action of an alpha adrenergic antagonist

A

promote vasodialation (decrease BP)

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34
Q

what is the use for alpha adrenergic antagonist

A

decrease symptoms of benign prostatic hyperplasia (BPH)

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35
Q

beta blocker drugs end in…

A

“lol”

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36
Q

beta blocker action

A

Decrease BP and pulse

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37
Q

nonselective beta blockers

A

blocks b1- decrease BP and pulse

blocks b2- bronchoconstriction (use w caution in pt w COPD and asthma)

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38
Q

cholinergic agonists

A

drugs that stimulate the parasympathetic nervous system

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39
Q

muscarinic receptors

A

affect smooth muscle and slow the heart rate

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40
Q

nicotinic receptors

A

affect skeletal muscles

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41
Q

parasympathetic: eye

A

constricts pupil

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42
Q

parasympathetic: lungs

A

bronchoconstriction
increase secretions

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43
Q

parasympathetic: heart

A

decrease HR and BP

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44
Q

parasympathetic: blood vessels

A

vasodialate

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45
Q

parasympathetic: GI

A

increase peristalsis, motility and secretions

46
Q

parasympathetic: bladder

A

contracts bladder
relax bladder sphincter

47
Q

parasympathetic: glands

A

increase salivation
increase perspiration and tears

48
Q

direct acting cholinergic agonist

A

drug reacts directly on receptor sites at target tissue level, mimicking action of ACh

49
Q

indirect acting cholinergic agonists

A

Inhibit the enzyme acetylcholinesterase, which breaks down ACh
Results in more ACh available at the receptors and prolongs the action of naturally occurring ACh

50
Q

anticholinergic toxidrome

A

happens if given too much anticholinergics

Mad as a hatter (Altered mental status)
Blind as a bat (Mydriasis)
Red as a beet (vasodilation, flushed)
Hot as a hare (febrile)
Dry as a bone (no secretions/diaphoresis)

51
Q

what are the medically approved uses for CNS stimulants?

A

ADHD
narcolepsy
reversal of respiratory distress

52
Q

what are the three categories of CNS stimulants?

A

amphetamines and caffeine
analeptics and caffeine
anorexiants

53
Q

amphetamines and caffeine act on…

A

the cerebral cortex

54
Q

analeptics and caffeine act on…

A

the brainstem and medulla

55
Q

anorexiants act on…

A

the satiety center in the hypothalamic and limbic areas

56
Q

what is the patho of ADHD

A

disregulation of transmitters (serotonin, norepi, dopamine)

57
Q

what is the epidemiology of ADHD

A

usually occurs in children before the age of 7
more common in boys

58
Q

what are the characteristics of ADHD

A

Inattentiveness, inability to concentrate, restlessness, hyperactivity, inability to complete tasks, impulsivity, poor coordination

59
Q

EEG findings in an individual with ADHD may be…

A

abnormal

60
Q

______ is usually not affected in individuals with ADHD, but _______ are often present

A

intelligence
learning disabilities

61
Q

what are the actions of amphetamines

A

recurrent attacks of drowsiness and sleep during normal waking activities
sleep paralysis

62
Q

what do amphetamines cause

A

euphoria
increased alertness
cardiovascular problems

63
Q

what are the risks with amphetamines

A

there is a high potential for abuse, tolerance and dependence
excessive use may lead to psychosis

64
Q

what are the two stages of sleep

A

rapid eye movement (REM)
non rapid eye movement (NREM)

65
Q

insomnia

A

recurring problems in falling or staying asleep

66
Q

what patients is insomnia more common in?

A

females

67
Q

what are the treatments for insomnia

A

try nonpharmalogic methods first
sedative hypnotics

68
Q

what are some nonpharmalogic methods for insomnia

A

arise at a specific hour in the morning
limit daytime naps
avoid caffeine, alcohol and nicotine 6 hours before bedtime
avoid heavy meals, large amount of fluid, long noise, strenuous exercise before bed
take warm bath, read , listen to quiet music, drink warm milk before bed
limit screen time before bed

69
Q

benzodiazepines end in

A

-pam or -lam

70
Q

what are the three classifications of sedative hypnotics?

A

barbiturates
benzodiazepines
nonbenzpdiazepines

71
Q

what are the general side effects of sedative hypnotics

A

Residual drowsiness (hangover)
vivid dreams, nightmares
drug dependance
drug tolerance
excessive depression
respiratory depression
hypersensitivity

72
Q

which CAMS should not be taken in combo with CNS depressants?

A

kava kava
valerian
chamomile

73
Q

kava kava combined with CNS depressant can..

A

increase sedative effect

74
Q

Valerian is used for what?

A

insomnia

75
Q

valerian combined with alcohol or CNS depressant can..

A

increase sedative effect of prescribed drug

76
Q

What is chamomile used for?

A

treat sleeplessness, anxiety, and stomach or intestinal ailments

77
Q

what side effects are possible with chamomile and sedative hypnotics?

A

allergic reactions

78
Q

zolpidem is often used for ________ ______ treatment

A

short term, 10 days

79
Q

what is the duration of action for zolpidem

A

6-8 hours

80
Q

what is the onset of zolpidem

A

30 mins

81
Q

sedative hypnotics in older adults

A

TRY NONPARMACOLOGIC METHODS FIRST
short to intermediate acting benzodiazepines are considered safer for older adults
AVOID long acting benzodiazepines

82
Q

to avoid side effects, what should an older adult taking a sedative hypnotic do?

A

use 4x/week or less

83
Q

what are two types of anesthetics and what do they do?

A

general: depress the CNS, alleviate pain, cause LOC
local: pain relief in limited areas

84
Q

what are the common routes of anesthetics?

A

inhalation
IV
topical
local
spinal
epidural

85
Q

topical anesthetics use is limited to…

A

mucous membranes, broken or unbroken skin surfaces, and burns

86
Q

what forms do topical anesthetics come in?

A

solution, liquid spray, ointment, cream, gel, powder

87
Q

what is the action of topical anesthetics

A

decreases sensitivity to nerve endings of affected areas where drug s given
consciousness is maintained

88
Q

what are the common uses for local anesthetics

A

dental procedures, suiting skin laceration
short term minor surgery at localized area
blocking nerve impulses (nerve block) below insertion of spinal anesthetic
diagnostic procedures such as lumbar puncture and thoracentesis
regional blocks

89
Q

anesthetics: assessment

A

obtain drug &health history, noting drugs that affect cardiopulmonary system

90
Q

anesthetics: nursing diagnosis

A

Acute pain related to injury
Ineffective breathing pattern related to central nervous system depression

91
Q

anesthetics: planning

A

patient will participate in preoperative preparation and will understand post op care

92
Q

anesthetics: nursing interventions

A

Monitor patient’s level of consciousness postop
Monitor vital signs (HR, BP, RR).
Monitor urine output (pre and post op)
Administer analgesics cautiously until patient fully recovers.

93
Q

what is epilepsy

A

seizure disorder
abnormal electric discharges from cerebral neurons

94
Q

what are the characteristics of epilepsy

A

LOC
involuntary, uncontrolled movements

95
Q

what are the causes of epilepsy

A

unknown
secondary to brain trauma or anoxia, infection, stroke
isolates seizures due to fever, electrolyte or acid-base imbalance, alcohol or drugs

96
Q

what do anti seizure drugs do?

A

stabilize nerve cell membranes
suppress abnormal electric impulses in cerebral cortex

97
Q

what are the specific actions an anti seizure drug can take?

A

suppress sodium influx
suppress calcium influx
enhance action if GABA

98
Q

anti seizure drugs and pregnancy

A

seizure episodes increase by 25% in pregnant women
antiseizure drugs are teratogenic (refers to potential to cause birth defects), inhibit vitamin K, and increase the loss of folate (folic acid) in pregnant patient

99
Q

anti seizure medication that inhibits vitamin K in pregnant women…

A

contribute to infant hemorrhage soon after birth
vit K can be given during last few days of pregnancy or given infant soon after birth

100
Q

anti seizure medication that increase loss of folate in pregnant women…

A

need daily folate supplements

101
Q

muscle relaxants are used for muscle spasms to…

A

reduce pain and increase range of motion

102
Q

muscle relaxants have a _____ effect

A

sedative

103
Q

what should muscle relaxants NOT be taken with

A

barbiturates
narcotics
alcohol

104
Q

primary anxiety

A

not caused by medical condition or drug use
managed with short-term anxiolytics

105
Q

secondary anxiety

A

It is related to selected drug use, medical or psychiatric conditions.
Medications are not usually given for secondary anxiety.

106
Q

what is the etiology of depression

A

genetic predisposition
social and environmental factors

107
Q

what are the patho theories of depression

A

decrease levels of monoamine neurotransmitters

108
Q

what are the s/s of depression

A

depressed mood, dispair, weight loss or gain
loss of interest in normal activites
fatigue, insomnia, hypersomnia
inability to think or concentrate
suicidal thoughts

109
Q

which CAMS should be discontinued with depression and depression medications

A

ginkgo biloba and St. johns wort

110
Q

what are the antidepressant groups

A

tricyclic antidepressants (TCAs)
Selective Serotonin Reuptake Inhibitors (SSRIs)
Serotonin Norepi Reuptake Inhibitors (SNRIs)
atypical antidepressants
Monoamine oxidase inhibitors (MAOIs)

NSG 318 - Pharm (11 decks)

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