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Pharmacology ex.1 > Week 6 > Flashcards

Week 6 Flashcards

1
Q

An autoimmune disease that attacks acetylcholine receptors on skeletal muscles

A

Myasthenia gravis

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2
Q

Symptoms of Myasthenia gravis

A

double vision (diplopia), drooping of the eyelids(ptosis), difficulty swallowing, and skeletal muscle weakness

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3
Q

Myasthenia gravis meds

A
  1. Cholinesterase inhibitors
  2. Immunosuppressive drugs
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4
Q

Cholinesterase Inhibitors

A
  1. Neostigimine
  2. Pyridostigmine
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5
Q

Cholinesterase Inhibitors common uses

A

1.Treat symptoms of myasthenia gravis
2.reverse certain nondepolarizing neuromuscular blocking agents

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6
Q

Cholinesterase Inhibitors MOA

A

1.Motor neurons release acetylcholine, causing muscle contraction
2. Cholinesterase breaks down acetylcholine
3. Cholinesterase inhibitors temporarily bind to cholinesterase, slowing it down
4. Acetylcholine levels rise and produce stronger muscle contraction

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7
Q

Anytime you give a PO medication you should assess a person’s ____________

A

swallowing ability

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8
Q

Assess swallowing ability by asking patient to take a few sips of ____________

A

water

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9
Q

The doses of myasthenia gravis meds often need ____________

A

adjusting

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10
Q

Cholinesterase Inhibitors HYC:

  1. Signs of under medication include ______ and _______.
  2. Overmedication is excessive ________
  3. High levels cause _________
A
  1. ptosis and difficulty swallowing
  2. parental (IV)
  3. cholinergic crisis
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11
Q

Cholinergic crisis symptoms (SLUDGE and Killer Bs)

A

Salivation
Lacrimation (excessive tearing)
Urination
Diaphoresis/ Diarrhea
Gastrointestinal cramping
Emesis (vomiting)
Bradycardia, Bronchospasm, and Bronchorrhea (watery sputum)

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12
Q

Neurons that sense pain are called ________

A

nociceptors

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13
Q

Types of pain

A
  1. nociceptive pain
  2. neuropathic pain
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14
Q

Pain that occurs when intact nerves are stimulated by actual or potential tissue damage

A

nociceptive pain

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15
Q

Pain caused by damage to the nerve fibers themselves. Common conditions are shingles and diabetic neuropathy

A

neuropathic pain

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16
Q

Pain that persists for 6 months or longer is __________

A

chronic pain

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17
Q

Vital sign changes include:

A

increased heart rate, increased blood pressure and decreased respiratory rate.

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18
Q

Pain Meds

A
  1. Non-steroidal Anti-inflammatory Drugs (NSAIDS)
  2. Acetaminophen
  3. Opioids
  4. Neuropathic pain medications
  5. Muscle Relaxers & Antispasmodics
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19
Q

NSAIDS meds

A
  1. Aspirin
  2. Ibuprofen
  3. Naproxen
  4. Ketorolac
  5. Celecoxib
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20
Q

NSAIDs are prescribed for _______, ___________, ________, and _______

A

pain, inflammation, fever and arthritis

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21
Q

Aspirin decreases _______ and ______

A

heart attacks and strokes

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22
Q

COX-1 and COX-2 convert arachidonic acid into ________

A

prostaglandins

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23
Q

NSAIDs inhibit the conversion of ________ into _________ (Cox-1 and Cox-2)

A

arachidonic acid, prostaglandins

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24
Q

Inhibiting COX-1 causes ______, _______, _______

A

stomach ulcers, decreased blood clotting and decreased kidney blood flow

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25
Q

Inhibiting COX-2 decreases ______, ______ ,______

A

pain, inflammation, and fever

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26
Q

NSAIDs HYC
NSAIDs cause

A
  1. gastrointestinal problems (bleeding, dark stools, take with food or milk)
  2. Renal impairment - harmful to kidney, monitor BUN and creatinine
  3. Heart attacks & strokes - All except aspirin increase risk. NSAIDs the inhibit COX-2 cause greatest risk
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27
Q

Aspirin overdose ( salicylism) manifestations include:

A

1.ear ringing or buzzing (tinetis)
2. sweating
3. headaches
4. dizziness
5. Blood ph imbalances

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28
Q

Aspirin overdose treatment include:

A
  1. charcoal
  2. intravenous fluids
  3. sodium bicarbonate
  4. dialysis
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29
Q

Aspirin causes ________

A

Reyes syndrome - swelling of brain and liver

30
Q

Ketorolac should be take for _____ days due to risk of causing gastrointestinal _______

A
  1. 5
  2. bleed
31
Q

Acetaminophen only works in the _______ system

A

central nervous system

32
Q

Acetaminophen decrease ______ and _____

A

pain and fever

33
Q

Daily max dose of acetaminophen is ______ mg

A

3000

34
Q

Risk groups for acetaminophen liver toxicity

A
  1. Malnourished individuals
  2. regular consumers of alcohol
  3. people with liver disease
35
Q

the antidote for acetaminophen toxicity is __________

A

acetylcysteine (most effective within 8-10 hrs of overdose)

36
Q

Opioid meds

A
  1. codeine
  2. fentanyl
  3. hydrocodone
  4. hydromorphone
  5. meperidine
  6. morphine
  7. oxycodone
37
Q

Opioids activate ___ and ______ receptors in the _____

A

mu
kappa
CNS

38
Q

Opioids causes _______, _______, _______

A

neuronal activity decrease
sedation
decrease pain transmission

39
Q

Opioid receptors trigger _______

A

pain relieving effect and CNS depression

40
Q

Frequent opioid doses are given through _______ pump

A

PCA

41
Q

_______ is formulated as a patch

A

fentanyl

42
Q

Fentanyl patch provide relief for ____ hours. Half life is _____ hrs

A

72, 2-4

43
Q

Dispose of fentanyl patches in the ________

A

toilet

44
Q

_______ is an antidote for opioid toxicity

A

naloxone

45
Q

Naloxone is an opioid ________

A

antagonist

46
Q

Naloxone half life is ______ mins

A

45

47
Q

Opioids in the GI tract cause _______

A

constipation (prescribed constipation med and high fiber diet)

48
Q

Clients taking opioids can also experience _______, _____ and _____

A

itching (pruritus)
nausea and vomiting

treatment:
1. diphenhydramine for itching
2. antiemetic for nausea

49
Q

Local anesthetic med

A

Iidocaine

50
Q

Lidocaine is used for _______ pain and _________ procedures in patch formation

A

neuropathic, surgical

51
Q

Lidocaine block ______ channels along the axon

A

sodium (block electrical conduction)

52
Q

Epinephrine is a strong vasoconstrictor added to _______

A

lidocaine

53
Q

Epinephrine with lidocaine decreases _______

A

bleeding

54
Q

Never inject lidocaine with epinephrine into finger, toes, and hose (causes necrosis)

A
55
Q

Topical version of lidocaine and prilocaine is ________

A

EMLA cream

56
Q

EMLA cream is absorbs after _______ hr

A

1

57
Q

Administer EMLA before _______ procedure

A

painful

58
Q

For localized pain relief _______ has a patch formulation

A

lidocaine

59
Q

Lidocaine patch reaches peak effect after ______ hrs

A

4

60
Q

Neuropathic pain meds

A
  1. gabapentin
  2. pregabalin
61
Q

neuropathic pain meds are prescribed for ______ and _______

A

seizure and neuropathic pain

62
Q

Gabapentin and pregabalin help increase ______ activity in the brain

A

GABA

63
Q

Gabapentin and pregabalin cause some ______ and ______

A

sedation and swelling

64
Q

muscle relaxers & antispasmodic meds

A
  1. cyclobenzaprine
  2. baclofen
  3. dantrolene
65
Q

MR&A meds are used for:

A

muscle spasms, spasticity, spinal cord injury or multiple sclerosis

66
Q

MR&As act within the _____ and increase ______ activity

A

CNS, gaba

67
Q

________ works directly on skeletal muscle and suppresses the release of calcium

A

Dantrolene

68
Q

MR&As cause _______ depression

A

CNS

69
Q

Abrupt discontinuation of _______ is associated with visual hallucinations, paranoid ideation and seizures

A

Baclofen

70
Q

Dantrolene most serious risk is _______

A

hepatoxicity (high risk in women greater than 35 years)

71
Q

_________ treat malignant hyperthermia

A

Dantrolene

Pharmacology ex.1 (6 decks)

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