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Pharm Fall 2020 > Week 3 - Neuro > Flashcards

Week 3 - Neuro Flashcards

1
Q

SNS receptor - pupils

A

Alpha 1

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2
Q

SNS receptor - Heart rate

A

Beta 1

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3
Q

SNS receptor - Heart contraction

A

Beta 1

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4
Q

SNS receptor - coronary arteries

A

Alpha 1

Beta 2

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5
Q

SNS receptor - peripheral blood vessels

A

Alpha 1

Beta 2

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6
Q

SNS receptor - bronchi

A

Beta 2

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7
Q

SNS receptor - intestinal blood vessels

A

Alpha 1`

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8
Q

SNS receptor - bladder body

A

Alpha 1

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9
Q

SNS receptor - bladder sphincter

A

Alpha 1

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10
Q

SNS receptor - uterus

A

Alpha 1

Beta 2

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11
Q

Neurotransmitter of SNS

A

NE

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12
Q

Epinephrine category class

A

Adrenergic Agonist

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13
Q

What is epinephrine’s expected pharmacological Action?

A
  • antagonize A1, B1 and B2 receptor sites
  • increased vascular resistance
  • decrease mucosal edema
  • decrease mast cell and basophil action
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14
Q

Epinephrine’s therapeutic uses?

A

anaphylaxis treatment
bronchospasm
local vasoconstriction

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15
Q

Epinephrine complications

A
  • tremor
  • palpitations
  • anxiety
  • restlessness
  • tachycardia
  • dysrythmias
  • HTN
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16
Q

Epinephrine medication administration

A

Subcutaneous
IM
IV
Local injection

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17
Q

epinephrine contraindications/precautions

A

no absolute contraindications

precaution - preexisting tachy/dysrhythmia

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18
Q

Nursing interventions - epinephrine

A
  • manage airway (pt should be connected to cardiac monitor, listen to lung sounds)
  • reassessment
  • O2
  • BP
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19
Q

Interactions - epinephrine

A

none

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20
Q

Evaluation of medication effectiveness - epinephrine

A
  • improvement of symptoms

- lack of localized bleeding (localized vasoconstriction and decreased blood flow to area) (with intra-dermal injection)

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21
Q

Client education - epinephrine

A
  • always carry auto-injector
  • how to use auto-injector
  • unpredictability of anaphylaxis
  • use with H1 and H2 blockers
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22
Q

atenolol category class

A

anti hypertensive beta adrenergic blockers (sympatholytics)

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23
Q

Expected pharmacological action - atenolol

A

decreased HR

decreased peripheral resistance

Decreased BP

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24
Q

Therapeutic use - atenolol

A

HTN - esp. with aldosterone-mediated fluid retention

Long term treatment of angina pectoris

may be used to prevent reinfarction following an MI

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25
Q

Complications - atenolol

A

Hypotension (at baseline and orthostatic hypotension)

Bradycardia

26
Q

Medication administration - atenolol

A

PO: give one dose per day

IV: administer slowly

27
Q

Contraindications/precautions - atenolol

A

Contraindicated:

  1. sinus bradycardia
  2. first degree heart block (conduction delay)
  3. cardiac failure shock
  4. orthostatic hypotension

Precaution: history of asthma; obstructive lung disease; DM (both)

28
Q

Interactions - atenolol

A

Ca++ channel blockers

– Esp. Verapamil and Diltiazem

29
Q

Nursing interventions - atenolol

A

Monitor HR before and after administration

Hold medication if HR is below 60 bpm and report

Monitor BP before and after treatment

Monitor for signs of HF

30
Q

Client education - atenolol

A

Do not discontinue without consulting provider

Avoid sudden changes in position

Do not crush or chew extended release tabs

self monitor BP and HR

31
Q

Evaluation of Medication effectiveness - atenolol

A

Absence of chest pain

Absence of dysrhythmias

Normotensive BP

Control of HR s/s

32
Q

Why is a heart block a risk of atenolol?

A

There are multiple B 1 sites on the heart so different levels of heart block can occur with beta blockers (verify)

33
Q

Why is atenolol not the best drug for those with DM?

A

It can block the signs and symptoms consistent with hypoglycemia - (shaky, nervous, anxious, fast heart rate)

34
Q

Why is atenolol not the best drug for those with DM?

A

It can block the signs and symptoms consistent with hypoglycemia

35
Q

bethanechol category class

A

Cholinergic agonist

36
Q

Expected pharmacological action - bethanechol

A

Increase acetylcholine in circulation

increase urinary bladder muscle tone

stimulates gastric motility

37
Q

Therapeutic use - bethanechol

A

urinary retention

38
Q

Complications - bethanechol

A

wheezing (bronchospasm)

hypotension

Bradycardia

peptic ulcer

dizziness

fainting

39
Q

Medication administration - bethanechol

A

PO

40
Q

Contraindications/precautions - bethanechol

A

Contraindicated -

  1. hyperthyroidism
  2. PUD
  3. asthma
  4. CAD
  5. Parkinson’s

Precaution - UTIs

41
Q

Interactions - bethanechol

A

Acetylcholinesterase inhibitors

betablockers

42
Q

Nursing interventions - bethanechol

A

vital signs (HR and BP)
I’s & O’s
Implementation of fall risk
Interventions

43
Q

Evaluation of medication effectiveness - bethanechol

A

increased UOP/GI

44
Q

Client education - bethanechol

A

Pregnancy category C*

Report difficulty breathing

Check BP and HR

Don’t take if allergic

Report dizziness or passing out

45
Q

oxybutynin - category class

A

anticholinergic

46
Q

Expected pharmacological action - oxybutynin

A

blocks muscarinic receptors in detrusor muscles (relaxes)

causes contraction of the internal sphincter of the bladder

47
Q

Therapeutic use - oxybutynin

A

overactive bladder

neurogenic bladder

48
Q

complications - oxybutynin

A
  1. Xerostomia
  2. constipation
  3. pupil dilation
  4. drowsiness

contraindications - urinary retention, blurry vision, fever

49
Q

methods of administration - oxybutynin

A

PO (extended release - never crushed)

Transdermal patch (rotate site)

50
Q

What should transdermal patch administration education include?

A

rotating the site as it could irritate the epidermis if it’s placed on the same site more than once for an extended time

51
Q

Contraindications - oxybutynin

A

Angle-closure glaucoma

Mysthenia gravis (decreased cholinergic activity at neuromuscular junction)

GI obstruction

GU obstruction

Active cardia dysfunction (dysrhythmia or MI)

Precautions: UTI, Hyperthyroidism, HTN, BPH, Liver or

52
Q

Nursing interventions - oxybutynin

A

Monitor UOP
Monitor bowel elimination patterns
Monitor for urinary pattern (retention)

53
Q

Interactions - oxybutynin

A

grapefruit juice

phenytoin

54
Q

Evaluation of medication effectiveness - oxybutynin

A

prevention of release of urine at undesired times

55
Q

client education - oxybutynin

A

hard candy for dry mouth
increase fluid and fiber intake
report urinary retention/infection
report dizziness or fainting

56
Q

Why shouldn’t oxybutynin be given to someone with narrow angle glaucoma?

A

Anticholinergic medications can cause increase in ocular pressure

57
Q

Why shouldn’t oxybutynin be given to someone previously diagnosed with Mysthenia gravis?

A

It can cause acute exacerbation

58
Q

Why shouldn’t oxybutynin be given to someone with GI obstruction

A

It can worsen obstruction by decreasing GI motility

59
Q

Why shouldn’t oxybutynin be given to someone with GU obstruction?

A

It can cause urinary retention

60
Q

Anticholinergic side effects

A

can’t pee, can’t see, can’t spit, can’t poop

61
Q

What can urinary retention cause?

A

UTI

Pharm Fall 2020 (5 decks)

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