Week 1: Overview, Cognition, Mood, Affect

Question 1

drug interactions: additive effects

Answer 1

-2 drugs with similar actions sum their effects
-can be desireable or undesirable
ie, hydralazine + nitroglycerin= > hypotension
(requires caution and patient knowledge)

beta blocker+ diuretic=

Question 2

drug interactions: synergism or potentiation

Answer 2

• two drugs with different mechanisms of action produce greater effects (1+1=3)
• ie, codeine+ASA= >pain relief

ampicillin + sulbactam= >therapeutic effect

Question 3

drug interactions: drug interference

Answer 3

one drug increases or decreases the metabolism or excretion of another

-ie, warfarin, barbituates and cimetidine affect metabolism of many drugs

probenicid slows renal excretion of penicillin

Question 4

drug interaction: displacement

Answer 4

two drugs compete for binding sites on plasma proteins (i.e., albumin)

ie, anticoagulants & anti- inflamatory = > risk of bleeding

Question 5

drug interaction: antagonism

Answer 5

• effects of two drugs that cancel each other (1+1=0)
• basis for antidotes to toxic effects of another drug or chemical

ie, naloxone (narcan) prevents opiates from binding to CNS receptor sites (caution not to push Narcan all at once)

Question 6

drug interaction: incompatibility

Answer 6

• interaction of 2 drugs interferes with action of at least one drug
• check resource (epocrates, micromedex or pharmacist before mixing IV drugs or in syringe)
• basis for drugs that bind/ inactivate another toxic drug in the GI tract
• ie, magnesium in antacids + tetracycline= may impair absorption of tetracycline
• mixing different types of IV meds in the same tubing can cause crystallized drug and line occlusion

Question 7

Phases of drug action

Answer 7

1. pharmaceutics
2. pharmcokinetics
3. pharmacodynamics

Question 8

pharmaceutics

Answer 8

drug becomes a solution so that it can cross the biologic membrane

SUBCU, IM, IV DRUGS DO NOT GO THROUGH A PHARMACEUTIC PHASE

Question 9

pharmcokinetics

Answer 9

absorption
distribution- protein binding
metabolism or biotransformation
excretion or elimination

Question 10

pharmcokinetics: absorption of oral meds

Answer 10

first pass effect

bioavailability

Question 11

first pass effect is when the drug passes through the ___ before entering ___ ____. ___ and ___ barriers in GI environ

Answer 11

liver
systemic circulation
chemical
biological

Question 12

____ is the ___ of drug that reaches ___ ____. in ____ it is always __ 100%. in ___ drugs it is usually ____

Answer 12

bioavailability 
percent 
systemic circulation
PO 
IV 
100% (no first pass effect)

Question 13

___ ____ ____ affects _____

Answer 13

first pass metabolism

bioavailability

Question 14

distribution is the process by which drug becomes ___ __ ___ ___ & _____

Answer 14

available
to
body fluid
tissues

Question 15

the ___ ___ portion is ___ in ___ ___ ___ drugs

Answer 15

bound drug
inactive
plasma protein bound

Question 16

a drug is high bound when ___ than ___%

Answer 16

greater than 89%

Question 17

a drug is considered low protein bound when less than ___%

Answer 17

30%

Question 18

2 __ protein bound drugs can cause toxicity

Answer 18

high

Question 19

only __ drugs are ___

Answer 19

free

active

Question 20

hypoalbuminemia

Answer 20

excess free drug and can cause toxicity

Question 21

be aware of __ ___% of all drugs taken by the client. Check __ ___& __ levels

Answer 21

protein binding
plasma protein
albumin

Question 22

distribution and blood flow: abscesses, exudates, ___ and tumors all ___ distribution

Answer 22

glands

decrease

Question 23

distribution and body tissue affinity:

some drugs accumulate in ___, bone, ___ muscle, and ___ ____

Answer 23

fat
liver
eye tissue

for example amiodarone can cause lung toxicities

Question 24

psychiatric agents

Answer 24

antipsychotics
anxiolytics
antidepressants
mood stabilizers

Question 25

___ and __ are communicated throughout the ___ by chemical ____. an impulse travels though the ___ neuron across the ___ __ and binds to a receptor on the __ ____ neuron

Answer 25

moods 
emotions 
CNS 
NT 
presynaptic 
synaptic cleft 
post synaptic neuron

Question 26

dopamine

Answer 26

cognition 
emotional responses 
motivation 
movement 
attention

Question 27

serotonin

Answer 27

role in mood, sleep rhythms, arousal

Question 28

norepinephrine

Answer 28

control of arousal, 
vigilance 
mood 
anxiety 
fight or flight response

Question 29

Gamma-aminobutyric acid (GABA)

Answer 29

regulation of anxiety

Question 30

psychosis

Answer 30

• losing contact with reality, manifested in mental or psychiatric discords.
• thought to be d/t imbalance of dopamine in the brain

Question 31

in psychosis there is usually more than 1 sx

Answer 31

difficulty processing information 
difficulty coming to a conclusion 
delusions
hallucinations 
incoherence 
catatonia 
aggressive/violent behavior

Question 32

delusion is a false __ in which one’s own thoughts, feelings, or fears cannot be distinguished from reality.

Answer 32

belief

ie delusions of persecution, grandeur, of control

Question 33

a hallucination is a false ___ having no relation to reality. it may be ___, __, tactile, ___ or olfactory

Answer 33

perception
visual
auditory
gustatory

Question 34

___ is a major category of psychosis. it is ___.

Answer 34

schizophrenia

chronic

Question 35

positive sx of ___ are additive, and an __ of normal function. it includes ___ and ___

Answer 35

schizophrenia
exaggeration
agitation
hallucinations

Question 36

negative sx of ____ are diminished. it involves a ___ or ___ of function. for example, ___ of speech content and ___ ___

Answer 36

schizophrenia
decreased or loss
poverty
social withdrawl

Question 37

antipsychotics block ___ receptors. the 2 major categories are ___ and ___

Answer 37

dopamine
typical
atypical

Question 38

typical antipsychotics are ____ and ____ ____. they include ____ and ____

Answer 38

traditional
first generation
phenothiazines
nonphenothiazines

Question 39

atypical or ___ ___ antipsychotics are effective for treating ____ and other psychotic disorders ___ to typical antipsychotics. it is also used if ___ to typical antipsychotics

Answer 39

second generation
schizophrenia
unresponsive
intolerant

Question 40

all antipsychotics block __ receptors.

Answer 40

d2