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Pharmacology N2100 > Unit 6 - CNS > Flashcards

Unit 6 - CNS Flashcards

1
Q

a disorder that responds well to complimentary and alternative medicine ( CAM)

A

Anxiety

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2
Q

a perception of a threat to a person’s well-being or security

A

anxiety

- can be caused by secondary reasons: such as meds (adrenergic agonists)

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3
Q

Type of Anxiety:

  • a healthy response
  • is not disabling or consistent
  • does not require pharmacotherapy
A

situational anxiety (healthy)

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4
Q

Type of Anxiety:

  • panic disorder
  • generalized anxiety disorder (GAD)
  • social anxiety disorder
  • obsessive-compulsive disorder (OCD)
  • post-traumatic stress disorder
A

anxiety disorders (unhealthy)

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5
Q

characterized by them being chronic and interfering with ADL’s

A

anxiety disorders

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6
Q

Type of Anxiety Disorder:

intense and immediate (fight or flight response), history of 1 month of worrying about having a panic attack

A

panic disorder

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7
Q

Type of Anxiety Disorder:

have to have spent 6 months or longer with some sort of excessive fear or worry of something in your life

A

generalized anxiety disorder (GAD)

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8
Q

Type of Anxiety Disorder::

fear of crowds or being ridiculed in public, considered a type of phobia

A

social anxiety disorder

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9
Q

Type of Anxiety Disorder:
spending at least 1 hour every day either thinking or doing the obsession/compulsion
1. regarding thoughts (obsessive)
2. regarding behaviors (compulsive)

A

OCD

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10
Q

Type of Anxiety Disorder:
has to do with a previous life experience/traumatic life event, intense feelings of helplessness, have to have occurred longer than a month (ex. sexual assault, natural disasters, war)

A

PTSD

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11
Q

what determines a sleep disorder

A

it had to have occurred for 30 days or longer and affecting ADL’s

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12
Q

Type of Sleep disorder:

it takes you longer than 30 min. to fall asleep

A

sleep-onset insomnia

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13
Q

Type of Sleep disorder:

where a person wakes up in the middle of the night and can’t fall back to sleep

A

sleep-maintenance insomnia

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14
Q

Type of Sleep disorder:

where a person prematurely wakes up or too early and can’t get back to sleep

A

sleep-offset insomnia

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15
Q

Type of Sleep disorder:

you’re sleeping at night, but you feel really sleepy throughout the day

A

non-restorative sleep

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16
Q

there’s some sort of other problem related to insomnia (ex. pain, medications) = you want to try and treat the underlying cause

A

secondary insomnia

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17
Q

you just fall asleep at the drop of the hat, usually from a stimulus

A

narcolepsy

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18
Q

T/F: anxiety and insomnia are interrelated

A

T

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19
Q

nurse’s first choice to treat anxiety & insomia

A

complimentary alternative method (counseling, yoga, herbal supplements, etc.)

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20
Q

Anxiety/Insomnia Prescription drugs:

drugs that relieve anxiety

A

anxiolytics

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21
Q 
Anxiety/Insomnia Prescription drugs:
the class related to relaxation & calming during daytime activities (ex. going in a procedure during the day and need to be relaxed for it)
A

sedatives

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22
Q

Anxiety/Insomnia Prescription drugs:

they help induce sleep for night time sleeping

A

hypnotics (etc. ethynol)

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23
Q

nonprescription drugs that are used to treat anxiety & insomnia

A

antihistamines (diphenhydramine)

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24
Q

drugs used to treat anxiety

A
  • benzodiazepines
  • non-benzodiazepines
  • antidepressants
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25
Q

prototype for benzodiazapines class

A

lorazepam

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26
Q

what does “pam” usually indicate

A

benzodiazepine

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27
Q

FYI: Lorazepam combines with gaba receptors = calms the CNS down = decrease CNS functioning = calms people down and helps them to sleep

A

:)

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28
Q

What drug:
anti-anxiety, sedation, anesthesia induction and maintenance, seizures (status epilepticus), sedation for mechanical ventilation, alcohol withdrawal symptoms

A

Lorazepam

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29
Q

should a pregnant girl take Lorazepam

A

NO!

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30
Q

can Lorazepam cause orthostatic hypotension?

A

yes

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31
Q

the effect is the opposite of what we intended it to have

A

paradoxical reactions

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32
Q

Important potential interactions for Lorazepam

A

increased effect with other CNS depressants

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33
Q

4 important side effects for Lorazepam

A
  • drowsniness
  • excessive sedations
  • impaired motor coordination
  • confusion
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34
Q

Patient teaching for Lorazepam

A
  • don’t take with other CNS depressants (ex. alcohol, other sleeping pills)
  • don’t take if pregnant/notify doctor
  • keep in a secure place/out of reach of children/med abusers
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35
Q

Nursing considerations for Lorazepam

A
  • aspirate prior to IV injection (cause gangrene if not in vein) , also give very slowly with IV!!
  • if pt. is smoker = they will require larger doses
  • monitor ambulation
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36
Q

Is diazepam (valium) a prototype

A

yes

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37
Q

uses for diazepam

A
  • GAD
  • seizures
  • alcohol withdrawal
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38
Q

What drug:

control anxiety, preoperative sedation, skeletal muscle relaxant, treat status epilepticus

A

diazepam

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39
Q

contraindications of diazepam

A
  • narrow-angle glaucoma
  • pregnancy
  • depressed vitals
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40
Q

does Diazepam have similar pt. teachings & nursing consideration as lorazepam

A

yes

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41
Q

can you take diazepam with food

A

yes

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42
Q

can you abruptly stop taking diazepam

A

no, you should ween off of them

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43
Q

antidote to benzodiazepines

A

flumazenil

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44
Q

does flumazenil have a long or short half-life

A

short

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45
Q

drugs used to treat insomnia

A
  • benzodiazepines
  • non-benzodiazepines
  • antidepressents
  • barbiturates
46
Q

FYI: the meds for insomnia tend to reduce REM sleep = allow us to sleep at night, but not as deep as we could get = often tired throughout the day = nurses need to encourage use of non-pharmacologic measures for sleep

A

:)

47
Q

is zolpidem (ambian) a diazepine

A

no, it’s a non-benzodiazapine

48
Q

is zolpidem a non-diazepine prototype

A

yes

49
Q

what is zolpidem used for

A

sleep/insomnia treatment

50
Q

nursing considerations for zolpidem

A
  • give right before going to sleep
  • avoid giving it with food (food prolongs action)
  • pt’s will always be at fall risk when on this med
51
Q

pt/family teaching for zolpidem

A
  • watch out for sleep behaviors (walking, eating, etc.)
  • never take with alcohol/CNS depressents!
  • non-pharm measures for sleeping
52
Q

what is temazepan (resturil) used for

A

sleep/insomnia

53
Q

does temazepam have similar characteristics as other benzodiazepines

A

yes

54
Q

is phenobarbitol given commonly for sleep

A

no

55
Q

T/F: barbituates tend to commit suicide

A

TRUE!

56
Q

problem with phenobarbitol

A
  • it’s a barbituate = suicide?
  • develops tolerance easily to CNS effects = takes more to help fall asleep (respiratory system doesn’t develop this tolerance = unsafe)
57
Q

what is phenobarbitol used for

A
  • short-term treatment of insomnia

- seizures

58
Q

nursing considerations for a patient taking sedative/hypnotics

A
  • give med immediately prior to sleep
  • teach family to watch for night-time behaviors (sleepwalking, eating, etc.)
  • never take with alcohol
  • non-pharmacologic techniques to improve sleep
59
Q

disease caused by destruction of neurons and there’s anatomical changes within brain and decrease in acetylcholine

A

alzheimer’s disease

60
Q

Degenerative brain disease that usually starts with some forgetfulness progressing to minor memory loss and confusion. Unfortunately, the disease progresses to profound irreversible mental impairment. It is not a normal aspect of aging.

A

alzheimer’s disease

61
Q

symptoms of what disease:

  • increasing and persistent forgetfulness
  • difficulties with abstract thinking
  • difficulty finding the right word
  • disorientation
  • loss of judgement
  • difficulty performing familiar tasks/ADLs
  • personality changes/mood swings
A

alzheimer’s disease

62
Q

drugs for the treatment of alzheimer’s disease

A

indirect acting cholinergics (anticholinesterases)

63
Q

prototype of indirect acting cholinergics (anticholinesterases)

A

donepezil (aricept)

64
Q

T/F: indirect acting cholinergics (anticholinesterases) can stop the progression of alzheimer’s disease

A

FALSE! They can slow it down, but not stop it

65
Q

why do we even give indirect acting cholinergics (anticholinesterases)

A
  • improve ADLS
  • improve behavior
  • improve cognition
66
Q

what drug:

improved memory, function and behavior through elevating acetylcholine concentration in CNS

A

donepezil

67
Q

important adverse effects of donepezil

A
  • GI issues (A, N, V, D, cramping) (because we’re stimulating PNS of ANS)…most will go away with continued use
68
Q

nursing considerations for donepezil

A
  • monitor for cognitive function (can pt. be responsible enough to take their own meds)
  • monitor for GI bleeding, especially if on NSAIDS
  • monitor for respiratory function, especially for asthma or COPD pt’s
  • walk through ANS (cholinergic = decrease in bronchoconstrition)
  • monitor for safety issues/depression
69
Q

pt. teaching for donepezil

A
  • does not cure/prevent disease, just slows it down
  • report GI bleeding
  • encourage to take with food/milk to decrease GI upset
70
Q

a disorder in children ages 4-17, and can last into adulthood. It can lead to difficulties in school, jobs, and interpersonal relationships

A

ADHD

71
Q

why do kids usually get diagnoses with ADHD so early in life

A

because ti’s very noticeable when they start school

72
Q

2 kinds of meds used for ADHD

A

stimulants & non-stimulants

73
Q

are stimulants or non-stimulants more common

A

stimulants

74
Q

T/F: stimulants are sympathomimetic drugs

A

T, so they increase fight or flight = improve alertness & focusing

75
Q

can ADHD last into adulthood

A

yes

76
Q

T/F: non-stimulant drugs are like antidepressents

A

true

77
Q

Classification of non-stimulant to treat ADHD

A

selective norepinephrine re-uptake inhibitor = increase norepinephrine in system

78
Q

is amphetamine a prototype of a stimulant of non-stimulant

A

stimulant

79
Q

uses of amphetamine

A
  • ADHD
  • narcolepsy
  • weight-loss
80
Q

drug of choice for ADHD treatment

A

amphetamine

81
Q

what drug:

stimulates the CNS to improve alertness, awakeness, mood, and attention. Causes a paradoxical sedation effect in ADHD

A

amphetamine (dextroamphetamine)

82
Q

contraindications of ampethamine

A
  • hyperthyroidism = increase HR (drug already increases HR)
  • diabetes = increase BS (drug already increases HR)
  • bipolar = can potentially throw someone into a manic episode
83
Q

interactions for amphetamine

A
  • alkaline drugs decrease elimination
  • acidic drugs increase excretion
  • caffeine increase CNS stimulation
84
Q

nursing considerations for amphetamine

A
  • assess for therapeutic effects (not toxic), side effects (BP, HR)
85
Q

pt. teaching for amphetamine

A
  • monitor for med abuse = out of reach
  • diabetics: monitor BS
  • monitor for adverse effects of insomnia
  • can decrease growth in children = monitor growth
  • chew gum, drink water for dry mouth
  • avoid caffeine
86
Q

prototype for non-stimulant drug for ADHD

A

atomoxatine

87
Q

atomoxatime is only a problem with what other kinds of drugs

A

highly protein bound drugs

88
Q

T/F: atomoxatine takes a while for therapeutic affects, fpeak is 1-2 hours, onset 2-4 weeks

A

T, this drug is similar to antidepressant mechanisms = takes a couple weeks to show alleviation/therapeutic effect of ADHD symptoms

89
Q

what drug:

improves attentiveness and decrease distraction and forgetfulness

A

atomoxatine

90
Q

use of MAOI’s

A
  • MAOI is a type of depressents

- MAOI breaks down norepinephrine = norepinephrine re-uptake inhibitor - excessive norepinephrine

91
Q

BLACK BOX WARNING for atomoxatine

A

increase suicidal thoughts

92
Q

what drugs should you not take with atomoxatine

A

MAOIs

93
Q

common side effects of atomoxatine

A
  • headache
  • N, V, A
  • insomnia
94
Q

nursing considerations for atomoxatine

A
  • monitor/encourage LFTs
  • monitor therapeutic/adverse effects
  • black box warning: suicidal thoughts
  • monitor CV status, BP, HR
95
Q

pt. teaching for atomoxatine

A
  • teach what happens when liver gets sick: chronic N&V, jaundice, urine gets darker (brown), stools get lighter (grey)
  • make position changes slowly
  • know how med will affect them
96
Q

Q: Which receptors do benzodiazepines work on?

A

GABA

97
Q

Q: What is the most common adverse effect of lorazepam and diazepam?

A

Drowsiness

98
Q 
Q: What should the nurse warn the patient about who has received a new prescription of zolpidem?
A. nightmares
B. sleep walking and sleep eating
C. inability to stay asleep
D. bed-wetting
A

B. sleep walking and sleep eating

99
Q

Q: Which of the following is NOT a nursing consideration for a patient taking donepezil?
A. monitor cognitive function
B. monitor for depression and anxiety
C. monitor for constipation
D. monitor for GI bleeding, especially with use of NSAIDS

A

C. monitor for constipation

100
Q 
Q: What is a common adverse effect of donepezil?
A. sleepiness
B. increased blood sugar
C. urinary retention
D. nausea
A

D. nausea

101
Q 
Q: Which is NOT a common adverse effect of amphetamine/dextroamphetamine?
A. insomnia
B. bleeding gums
C. anorexia
D. irritability
A

B. bleeding gums

102
Q 
Q: Which of the following is an important teaching point for patients taking atomoxatine?
A. report suicidal thoughts
B. report yeast infection of the mouth
C. report ringing in the ears
D. report joint pain
A

A. report suicidal thoughts

103
Q

Q: At what point might a client get diagnosed with an anxiety disorder and be offered treatment with medications?

A

if the symptoms have been chronic and are interfering with the client’s ability to function

104
Q 
Q: Which of the following is NOT currently used in the treatment of anxiety/insomnia?
A. narcotics, such as morphine
B. anxyolitics
C. antihistamines (diphenhydramine)
D. Herbs
A

a. narcotics, such as morphine

105
Q

Q: Which medication is used as the antidote for benzodiazepine overdose?

A

flumazenil

106
Q

name 2 benzodiazapines

name 1 benzodiazapine antidote

A

lorazepam, diazepam

agonist: flumezanil

107
Q

name 4 meds to help with sleep/anxiety

A
  • benzodiazepines (lorazepam, diazepam)
  • zolpidem
  • temazepam
  • phenobrarbitol
108
Q

name 1 med to help with cognition

A

cholinergic agonist: donepezil

109
Q

name 2 meds to help with ADHD

A
  • atomoxatine

- amphetamine (dextramphetamine)

110
Q

can you abruptly stop taking benzos

A

NO! They must be weened!

Pharmacology N2100 (26 decks)

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