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USU Pharmacology > Unit 2: Neurological system part 1 > Flashcards

Unit 2: Neurological system part 1 Flashcards

1
Q

What is Myasthenia gravis?

A

An autoimmune disease that attacks acetylcholine

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2
Q

What is the Pharmacologic Action of Benzodiazepines?

A

They are a CNS depressant. They enhance the effect of GABA.

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3
Q

What is the prototype for Benzodiazepines?

A

Temazepam (Restoril)

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4
Q

What are Benzodiazepines prescribed for?

A

Sleep, Anxiety, seizures/muscle spasms, alcohol withdrawal, and induction and maintenance of anesthesia

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5
Q

What are the side/Adverse effects of Benzodiazepines?

A

Drowsiness, dizziness, confusion, anxiety, amnesia, respiratory depression, and tolerance.

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6
Q

What is the antidote for Benzodiazepines?

A

Flumazenil

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7
Q

Are Benzodiazepines highly addictive?

A

YES!
- They are commonly abused and long-term scheduling is not advised.

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8
Q

How can you easily identify a Benzodiazepine drug?

A

-pam or -lam endings

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9
Q

Withdrawal from Benzodiazepines can cause what?

A

Paranoia, panic attacks, muscle twitching, and hallucinations.

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10
Q

If a patient needs to go off Benzodiazepines what should you do?

A

Taper them off slowly to help reduce withdrawal symptoms!

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11
Q

What patient education should the nurse teach about Benzodiazepines?

A
  • Take before bedtime (30 minutes before) to ensure 8 hours of sleep
  • Do not use any other CNS depressants OR drink alcohol while on these medications
  • These are pregnancy and lactation category X drug
  • Smoking decreases the effects of benzodiazepines
  • Alcohol, opioids, and other benzodiazepines increase the risk of severe sedation and respiratory depression.
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12
Q

What is the prototype for Non-benzodiazepines?

A

Zolpidem (Ambien)

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13
Q

What are the contraindications for Non-Benzodiazepines?

A
  • Children younger than 18
  • Suicidal ideation
  • Smaller doses for patients with hepatic or renal disease
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14
Q

What kinds of routes are there for Zolpidem?

A

oral or intranasal administration

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15
Q

What are Non-Benzodiazepines used for?

A

Short-term treatment of insomnia.

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16
Q

What is the number one thing the nurse should educate the patient on when taking Non-Benzodiazepines like Zolpidem?

A

DO NOT drive or operate heavy machinery!

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17
Q

What are the two kinds of Muscle relaxants?

A

Centrally acting (brain) and Peripherally acting (skeletal muscles)

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18
Q

What is the prototype for centrally acting muscle relaxants?

A

Baclofen (Lioresal)

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19
Q

What is the therapeutic action for baclofen?

A

Spasticity related to spinal cord injuries, cerebral palsy, multiple sclerosis, and muscle injury.

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20
Q

What do centrally acting muscle relaxants like baclofen do?

A

Enhance the effect of GABA in the CNS to reduce muscle spasticity.

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21
Q

What are the side effects of baclofen?

A

Drowsiness, dizziness, nausea, and constipation

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22
Q

What is some patient education for baclofen?

A
  • Increase fiber and fluid intake to counteract risk of constipation
  • Taper off to prevent withdrawal symptoms
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23
Q

What is the prototype for peripherally acting muscle relaxants?

A

dantrolene (Dantrium)

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24
Q

What do peripherally acting muscle relaxants like dantrolene do?

A

They act directly on skeletal muscle. They prevent calcium release which inhibits muscle contraction.

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25
Q

What is the therapeutic action of dantrolene?

A

Spasticity related to spinal cord injuries, cerebral palsy, multiple sclerosis, and muscle injury PLUS treats malignant hyperthermia.

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26
Q

While taking dantrolene what should you monitor your patient for?

A
  • Liver failure (yellow eyes and skin)
  • Muscle strength (falls)
  • Prolonged diarrhea
  • Drug interactions
  • Malignant hyperthermia family history
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27
Q

What are the four types of anti-epileptic drugs (AEDs)?

A
  1. hydantoins
  2. Iminostilbenes
  3. Valproic acid
  4. Other new drugs
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28
Q

What is the prototype for Hydantoins?

A

phenytoin (Dilantin)

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29
Q

What do hydantoins like phenytoin do?

A

Prevent tonic-clonic and partial seizures

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30
Q

What are the side effects of phenytoin?

A

Gingival hyperplasia, diplopia, nystagmus, Rash (Stevens-Johnson), hypotension, and decreases the effectiveness of oral contraceptives.

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31
Q

What is the therapeutic range of phenytoin?

A

10-20 micrograms/milliliter (narrow range!)

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32
Q

What is the prototype for Iminostilbenes?

A

carbamazepine (Tegretol)

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33
Q

What are Iminostilbenes like carbamazepine used for?

A

Partial seizures, tonic-clonic seizures, and bipolar disorder

34
Q

What are the adverse effects of carbamazepine?

A

Visual disturbances, fluid retention, rash, daytime effects, and bone marrow suppression (easy bruising, fever, sore throat)

35
Q

What education should the nurse teach the patient about carbamazepine?

A

Avoid grapefruit juice and note the many drug interactions

36
Q

What is the prototype for valproic acid?

A

valproic acid (Depakote, Depakene)

37
Q

What is valproic acid used for?

A

All types of seizures, mania associated with bipolar disorder, and migraine headache prevention.

38
Q

What is patient education the nurse should do for valproic acid?

A

Ensure patients take the lowest effective dose

39
Q

What is the prototype for the “new drugs” category of AEDs?

A

gabapentin (Neurontin)

40
Q

What does gabapentin do?

A

Treats nerve pain and migraines

41
Q

What is the prototype for local anesthesia?

42
Q

What is the mode of action for lidocaine?

A

blocks conduction of pain impulses in a circumscribed area

43
Q

What are the side effects of lidocaine?

A

Hypotension, bradycardia, prolonged labor, spinal headache, and allergic reaction.

44
Q

What is the prototype for general anesthesia barbiturates?

A

thiopental (Pentothal)

45
Q

What is the mode of action for thiopental?

A

Significantly decreases CNS; enhances GABA

46
Q

What are the adverse effects of thiopental?

A

Decrease HR, BP, and respiratory rate

47
Q

What are important things to note about thiopental?

A
  • Monitor respirations and VS
    -Inject only into a vein because it can damage tissue
  • Be careful using other CNS depressants with it INCLUDING herbals
48
Q

What is the prototype for General Anesthesia Opioids?

A

fentanyl (Sublimaze)

49
Q

What is the mode of action for fentanyl?

A

Narcotic agonists, analgesia, and sedation

50
Q

What are the adverse or side effects of fentanyl?

A

Cardiac or respiratory depression and nausea

51
Q

What should you ensure to do/ have when a patient is under the effects of fentanyl?

A

Naloxone (antidote) is readily available, monitor vital signs closely, have resuscitation equipment nearby, and be prepared with an antiemetic

52
Q

What is a safety alert for fentanyl?

A

MAOI antidepressants taken within 2 weeks of fentanyl make the patient subject to hypertensive crisis!

53
Q

What is the prototype for Neuromuscular Blocking Agents?

A

succinylcholine (Anectine)

54
Q

What is succinylcholine used for?

A

It is used adjunct to anesthesia during surgery or intubation procedures.

55
Q

What is the mode of action of succinylcholine?

A

Blocks acetylcholine at the neuro-muscular junction, causing skeletal muscle paralysis.

56
Q

What are the adverse effects of succinylcholine?

A

Respiratory arrest, apnea, muscle pain after surgery

57
Q

What emergent situation can succinylcholine cause?

A

Malignant hyperthermia

58
Q

What is the treatment for malignant hyperthermia?

A

100% oxygen, cooling measures, muscle relaxants such as dantrolene

59
Q

What are the s/s of malignant hyperthermia?

A

muscle rigidity and HIGH fever

60
Q

What are the two types of drugs that treat ADHD and narcolepsy?

A

Amphetamines and Methylphenidate

61
Q

What is the prototype for Amphetamines?

62
Q

What is the prototype for Methylphenidates?

63
Q

What do Amphetamines and Methylphenidates do?

A

Improve alertness, energy, and mood

64
Q

What are some important side effects to monitor while on Amphetamines and Methylphenidates?

A
  • Decreased appetite
  • Weight loss
  • Insomnia
  • Dysrhythmias; hypertension
  • Tolerance and dependence
65
Q

When should you administer Amphetamines and Methylphenidates?

A

I the morning after/right before meals

66
Q

What are the 2 types of drugs to manage Parkinson’s disease?

A

Dopamine-replacement drugs and Indirect-acting dopamine receptor agonists/MAO inhibitors

67
Q

What is the prototype for Dopamine-replacement drugs to manage Parkinson’s disease?

A

levodopa/carbidopa

68
Q

What symptoms do levodopa/carbidopa help manage?

A

Decrease tremors and muscle rigidity

69
Q

What are the side effects of levodopa/carbidopa?

A

n/v, drowsiness, dyskinesia, tics, orthostatic hypotension, dark urine and seat, psychosis

70
Q

What kinds of foods should patients avoid when taking levodopa/carbidopa?

A

high-protein meals (they decrease effectiveness)

71
Q

What is the prototype for Indirect-acting dopamine receptor agonists/MAO inhibitors?

A

selegiline (Eldepryl, Zelapar)

72
Q

What is selegiline used for?

A

Major depression and adjunct to levodopa and carbidopa

73
Q

What are anticholinergic effects?

A

Dry mouth, dry eyes, blurry vision, urinary retention, constipation (can’t see, can’t pee, can’t spit, can’t sh*t)

74
Q

What drugs are given as treatment for Alzheimer’s disease?

A

Cholinesterase inhibitors

75
Q

What is the prototype for cholinesterase inhibitors?

A

donepezil (Aricept)

76
Q

What are the side effects of donepezil?

A

N/V and GI symptoms, CNS effects like insomnia, dizziness, and headache, bradycardia, and syncope.

77
Q

What medications are used as daily meds for the prevention of migraine headaches?

A

Beta-blockers, tricyclic antidepressants, antiepileptics, and estrogens

78
Q

What is the prototype for migraine headaches?

A

sumatriptan (Imitrex)

79
Q

What is a key side effect of sumatriptan?

A

Heavy chest pressure (NOT pain)

80
Q

What are some interactions of sumatriptan?

A

MAOI’s, St. John’s wort, and serotonin

81
Q

What are some s/s of Ethanol Withdrawal?

A
  • Increase BP, pulse, respirations, and temperature
  • N/V
  • Insomnia and restlessness
  • Tremors
  • Agitation, irritability, depression
  • Alcohol withdrawal delirium (medical emergency)

USU Pharmacology (14 decks)

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