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Pharm 2 > study guide for exam 1 > Flashcards

study guide for exam 1 Flashcards

1
Q
  1. What are the side effects of phenobarbital (sedative/anticonvulsant)?
  2. What do we monitor for w/phenobarbital? What population gets weird?
  3. What is the antidote for Phenobarbital?
  4. What is the onset of phenobarbital?
A
  1. CNS depression, dependence, GI, vertigo, stevens johnson syndrome
  2. respiratory depression, BP (signs of angioedema). Peds get weird.
  3. no antidote. Just activated charcoal to soak up toxins
  4. o PO 30-60 min, IV 5 min
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2
Q
  1. What is GABA, and what do benzodiazepines do with it?
  2. What adverse effects do Benzodiazepines have in kids?
  3. Benefits of Buspirone?
A
  1. GABA is neurotransmitter that block impulses between nerve cells in the brain. Causes relaxation, and calming effect. Benzos increase GABAs effects.
  2. can cause gasping syndrome in neonates, in peds: don’t stop abruptly - rebound syndrome
  3. Anxiolytic w/ fewer side effects, non-addictive. *Still affects libido, and requires 2-4 weeks to work.
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3
Q
  1. What is Zolpidem?
  2. What is the trade name for fluoxetine?
  3. What are the side effects of SSRIs? How long to be effective?
  4. Why are peeps non-compliant?
A
  1. Ambien. Hypnotic. Need 8 hours of sleep. Unpredictable: sleep walking, amnesia
  2. Fluoxetine is Prozac. It is an SSRI
  3. CNS: headache, drowsy, dizzy, insomnia, tremor, agitation, seizures. GI: nausea, vomit, diarrhea. GU: decreased libido, painful menstruation, cystitis, urgency. Weight gain. Suicidal thoughts.

Can cause serious probs like serotonin syndrome and neuroleptic malignant . Takes 2-4 weeks to be effective.

  1. sexual side effects and weight gain
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4
Q
  1. How do tricyclic antidepressants work? TCAs What is the prototype?
  2. Indications?
  3. What are the side effects of tricyclics?
  4. What should we monitor for w/ tricyclics
A
  1. prevents reuptake of serotonin and NE. Imipramine
  2. depression, nocturesis, enuresis
  3. sedation/drowsy, dry mouth, constipation (most common)
  4. suicidal thoughts and development of neuroleptic malignant syndrome
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5
Q 
1. Which food should be avoided with the following meds:
Buspirone: 
MAOIs: 
Trazadone: 
Barbituates: 
SSRIs:
  1. Which antidepressant is used for smoking cessation:
  2. What race has worse response to antidepressants?
A 
1. Buspirone: grape fruit juice
MAOIs: tyramine
Trazadone: alcohol
Barbituates: alcohol
SSRIs: st john's wort
  1. bupropion (Wellbutrin)
  2. black people
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6
Q
  1. Why might family help w/ schizo patients?
A
  1. help give more accurate hx and help patient maintain med compliance.
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7
Q
  1. What are lithium salts used to treat? What is the priority assessment?
  2. What do we tell patients taking lithium?
  3. What is Methylphenidate used to treat?
  4. What are the side effects of methylphenidate?
  5. When should we give methylphenidate?
A
  1. bipolar. monitor levels of lithium and I&O
  2. do not self-adjust dose. Drink plenty of fluids. It is a salt, after all.
  3. ADHD
  4. nervousness, insomnia, changes in HR and BP, changes in appetite
  5. in the morning to avert insomnia
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8
Q
  1. what is chlorpromazine (Thorazine) and what does it treat?
  2. What is the most dangerous side-effect of Thorazine and what are the symptoms?
  3. What are some side effects of antipsychotics and why is there poor compliance?
A
  1. Typical antipsychotic. 2nd line treatment for schizophrenia and intractable hiccups
  2. Neuroleptic Malignant Syndrome: fever, encephalopathy, dysregulation of vitals, enzyme elevation, rigidity and hyperreflexia
3. hypotension
anticholinergic effects
sedation
weight gain
sexual side effects
“fogginess” 
extrapyramidal effects (EPS)

The weight gain and sexual side effects as well as stigma make for poor compliance

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9
Q
  1. What drug combo can be used to treat extra-pyramidal effects?
  2. What is clozapine (clozaril) and what labs should be monitored?
A
  1. diphenhydramine (benadryl) and/ or benztropine (cogentin)
  2. Atypical antipsychotic to treat unresponsive schizophrenia. Blood glucose and WBC, cholesterol
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10
Q
  1. Name the combo drug for parkinsons
  2. What other drug combo can be used as an anticholinergic for parkinsons (same as combo for extra-pyramidal affects).
  3. What are the goals for parkinson’s patients?
  4. what are the side effects? Which one is most dangerous?
  5. Name a few nursing diagnosis for parkinsons in regard to drug therapy?
A
  1. levodopa-carbidopa (Sinemet)
  2. benedryl and benzotropine (congentin)
  3. reduce symptoms, and allow for more normal movement. Goals should be small, realistic, and attainable.
4. Abnormal thinking
Agitation
Anxiety
Clenching or grinding of teeth
Clumsiness or unsteadiness
Confusion
Dysphagia = dangerous
Watch out for benign prostactic hypertrophy
  1. Disturbed thought processes related to CNS effects
    Risk for urinary retention related to dopaminergic effects
    Constipation related to dopaminergic effects
    Risk for injury related to CNS effects and incidence of orthostatic hypertension
    Deficient knowledge regarding drug therapy.
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11
Q
  1. What are drugs to treat muscle spasm (centrally acting)?
  2. Name the direct acting skeletal muscle relaxant: What is its black box warning for?
  3. Which drugs would need to be on hand for operative safety?
  4. What is a nursing diagnosis for post op?
A
  1. Baclofen and carisoprodol (soma)
  2. Dantrolene. Black box for liver toxicity. Dantrolene treats malignant hyperthermia AND cerebral palsy
  3. dantrolene to control malignant hyperthermia and naloxone for resp. depression
  4. risk of injury
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12
Q
  1. name the MAOIs

2. Talk about kids and antidepressants

A
  1. Mar-Nar-Par (marplan, nardil, parnate)
  2. Antidepressants have unpredictable effects in kids. Long term effects are unknown. No MAOIs for kids. SSRIs have established doses for OCD, and tricyclics can be used in kids > 6 years if closely monitored. Suicidal ideations are a big risk.
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13
Q
  1. What organ does phenytoin have a negative affect on?
  2. what is a generalized seizure? treatment for a generalized seizure? What is used to treat status epilepticus?
  3. what is a partial seizure? treatment?
A
  1. LIVER
  2. Involves both hemispheres. Loss of consciousness. Give high dose ativan for acute generalized seizure. Barbituates can be used for long-term control. Fosphenytoin is the only med for status epilepticus. Hydantoins are used for maintenance when patient can’t support the drowsiness of barbituates or anxiolytics.. Look for gingival hyperplasia.
  3. Partial aka focal seizures involve one hemisphere. May not even realize its happening. Succinimides (Zerontin and Celontin) treat focal seizures. Also, acetazolamide, valproic acid, and zonisamide
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14
Q
  1. What is the onset and duration of succs?
  2. What is succs used for?
  3. what drug is combined w/ succs as a sedative?
A
  1. onset = 1 min, duration = 4-6 min.
  2. short procedures, intubation
  3. etomidate
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15
Q
  1. Name a local anesthesia

2. what are its side effects?

A
  1. lidocaine

2. hypotension, urinary incontinence, pruritus, seizures; local reactions: burning, stinging, swelling, tenderness.

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16
Q
  1. What drugs interact with barbituates?
A
  1. alcohol, benzodiazepines, and contraceptives

Pharm 2 (4 decks)

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