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Pharmacology N2100 > Final 6/7 > Flashcards

Final 6/7 Flashcards

1
Q

mechanism of action & classification of lorazepam

A
  • benzodiazepine: combines c GABA receptors = calms CNS down =
    decrease CNS functioning = calms people down & helps them sleep
  • anti-anxiety, sedation, anesthesia induction & maintenance,
    Seizures (status epilepticus), sedation for mechanical ventilation, alcohol
    withdrawal symptoms
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2
Q

how do benzodiazepines work

A

combines c GABA receptors = calms CNS down =

decrease CNS functioning = calms people down & helps them sleep

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3
Q

contraindications of Lorazepam

A
  • pregnancy
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4
Q

interactions of Lorazepam

A
  • CNS depressants (alcohol): increased effect
  • OCs: increase or decrease effectiveness
  • some herbs: excessive sedation
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5
Q

side effects of Lorazepam

A
  • drowsiness
  • excessive sedation
  • impaired motor coordination
  • confusion
  • orthostatic hypotension
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6
Q

nursing considerations for Lorazepam

A
  • aspirate prior to IV injection (because gangrene if not in vein)
  • if IV: give slowly
  • if pt. smokes: they require larger dose
  • monitor ambulation
  • don’t take with other CNS depressants
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7
Q

mechanism of action & classification of Diazepam

A
  • benzodiazepine: combines c GABA receptors = calms CNS down =
    decrease CNS functioning = calms people down & helps them sleep
  • control anxiety, preoperative sedation, skeletal relaxant, treat status epilepticus
  • GAD, seizures, alcohol withdrawel
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8
Q

contraindications of Diazepam

A
  • . narrow-angle glaucoma
  • pregnancy
  • depressed vitals
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9
Q

side effects of Diazepam

A

drowsiness

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10
Q

nursing considerations of Diazepam

A
  • can take with food

- ween off

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11
Q

mechanism of action for flumazenil

A
  • antidote to benzodiazepines

- short half-life

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12
Q

nursing consideration for flumezanil

A
  • does not reverse or affect opioid overdose
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13
Q

mechanism of action of Zolpidem

A

treatment of insomni

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14
Q

nursing considerations for Zolpidem

A
  • give right before going to sleep (watch out for sleep walking/eating - non-pharm measurea for sleep)
  • avoid giving c food (prolongs absorption)
  • pt’s will always be at fall risk
  • NEVER take c alcohol/CNS depressants
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15
Q

mechanism of action of phenobarbitol

A
  • improved memory, function and behavior through elevating acetylcholine concentration in the CNS
  • short-term treatment of insomnia
  • seizures
  • not given commonly for sleep
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16
Q

side effects of Phenobarbitol

A
  • A, N, V, D
  • gi cramping
  • HA
  • insomnia
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17
Q

nursing considerations for Phenobarbitol

A
  • it’s a barbiturate = suicide
  • develops tolerance easily to CNS effects = takes more to help fall asleep (respiratory system doesn’t develop this tolerance = unsafe)
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18
Q

mechanism of action and classification for Donepezil

A
  • indirect acting cholinergic (anticholinesterases)
  • improved memory, function & behavior through elevating acetylcholine
    concentration in the CNS
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19
Q

Side effects of Donepezil

A
  • A, N, V, D (because we’re stimulating PNS & ANS)…most will go away with continued use
  • GI cramping
  • HA
  • insomnia
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20
Q

Nursing Conderations for Donepezl

A
  • monitor 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 pts
  • cholinergic = decrease in bronchoconstriction
  • monitor for safety issues/depression
    *- does not cure/prevent disease, just slows it down
  • encourage to take with food/milk to decrease GI upset
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21
Q

mechanism of action of amphetamine & dextroamphetamine

A
  • stimulant
  • drug of choice for ADHD
  • narcolepsy, weight loss
  • stimulates the CNS to improve alertness, awakeness, mood, & attention
  • causes paradoxical sedation effect in ADHD
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22
Q

interactions for amphetamine & dextroamphetamine

A
  • alkaline drugs = decrease elimination
  • acidic drugs = increase excretion
  • caffeine = increase CNS stimulation = avoid
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23
Q

side effects of amphetamine & dextroamphetamine

A
  • irritability
  • insomnia
  • anorexia
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24
Q

Nursing considerations for amphetamine & dextroamphetamine

A
  • assess for therapeutic effects (non toxic), side effects (BP, HR)
  • monitor for med abuse = out of reach
  • diabetic = monitor BS
  • monitor adverse effects of insomnia
  • can decrease growth in children = monitor growth
  • chew gum, drink water for dry mouth
  • paradoxical effect
25
Q

mechanism of action of atomoxatine

A
  • non-stimulant
  • ADHD
  • improves attentiveness & decreases distraction & forgetfulness
26
Q

contraindications of atomoxatine

A
  • highly protein bound drugs

- MAOIs

27
Q

side effects of atomoxatine

A
  • HA
  • N, V, A
  • insomnia
28
Q

nursing considerations for atomoxatine

A
  • BLACK BOX: increase suicidal thoughts
  • take 2-4 wks to show therapeutic effect of ADHD
  • monitor LFTs
  • teach what happens when liver gets sick: chronic N, V, jaundice, dark brown urine, light gray stools
  • make position changes slowly
29
Q

mechanism of action & classify Levodopa

A
  • dopamine agonist
  • Sinemet (Carbidopa)
  • drug of choice for Parkinsons
  • treat parkinsonism = relieve tremors & rigidity
  • crosses BBB
30
Q

side effects of Levodopa

A
  • anticholinergics (dry mouth, blurred vision, urinary retention)
  • involuntary choreiform: spazzy dance movements
  • A, V, N
  • psychosis: because of increase dopamine
31
Q

if client is experiencing quick jerking movements while on Levodopa, what maybe should the nurse ask for

A

a lowered dosage

32
Q

nursing considerations for Levodopa

A
  • monitor liver & kidney function (metabolism & excretion probs)
  • assist c ambulation
  • assess for narrow-angle glaucoma
  • ween off
  • don’t crush/chew
  • report s/s toxicity: twitching, winking, mood changes
  • make position changes slowly
  • increase fluid & fiber in diet: avoid high in protein
  • affects may take several months
  • may have darkening of urine/sweat
  • can take c other meds to help c N, V
33
Q

mechanism of action & classification of Pramipexole

A
  • dopamine agonist

- treat early stages of Parkinsonism

34
Q

interactions of Pramipexole

A
  • dopamine antagonists: phenothiazines & metaclopramide
35
Q

nursing considerations for Pramipexole

A
  • monitor VS (BP because of orthostatic hypotension)
  • avoid alcohol & CNS depressants = drowsiness
  • can cause sleep attacks
  • full effects take several months
  • report hallucinations & uncontrolled movement
  • monitor for tarted dyskinesia (repetative purposeless movements)
  • monitor for potential mental status/mood changes
36
Q

mechanism of action and classification of Benztropine

A
  • anticholinergic

- treat tremor & rigidity of Parkinson’s

37
Q

side effects of Benztropine

A
  • dry mouth
  • constipation
  • sedation
38
Q

nursing considerations for Benztropine

A
  • assess mood changes
  • assess response to tremor/rigidity
  • make position changes slowly
  • monitor eyes & nose, urinary retention, bowel status
  • avoid alcohol & CNS depressants = drowsiness
  • be careful when overheating because of inability to sweat from anticholinergic properties
  • chew gum/candy
  • can take with food
  • increase fluid & fiber due to constipation
39
Q

mechanism of action & classification of Cyclobenzaprine

A
  • central acting (CNS)

- short term use for muscle spasm

40
Q

contraindications of Cyclobenzaprine

A
  • with other sedative hypnotics = can cause excessive CNS depression
  • geriatrics = more risk for hallucinations & cardiac effects
  • similar to TCS = infinity to heart muscle = adversely affect heart muscle
  • breast feeding
41
Q

side effects of Cyclobenzaprine

A
  • drowsiness
  • dry mouth
  • dizziness
42
Q

nursing consideration for Cyclobenzaprine

A
  • fall risk due to drowsiness
  • hold if hypersensitivity occurs: rashes, itching, hives
  • discourage alcohol
  • can give with food or milke
  • report CV adverse effects & excessive sedation
  • report if not showing s/s after 1-2 wks
  • encourage nonpharm: positioning, strength exercise, heat packs
43
Q

mechanism of action for Dantrolene

A
  • direct acting (muscle)
  • muscle spasticity
  • drug of choice for malignant hyperthermia
44
Q

side effects of Dantrolene

A
  • hepatotoxicity = monitor LFTs
  • muscle weakness
  • drowsiness
45
Q

nursing considerations for Dantrolene

A
  • therapeutic effects take 1 wk
  • discourage alcohol = added sedation
  • monitor VS (especially wth IV admin. = EKG)
  • teach s/s liver dysfunction
46
Q

mechanism of action of Hydroxycloroquine

A
  • decrease inflammation in RA
  • treatment of malaria
  • treatment of lupus
47
Q

contraindications of Hydroxychloroquine

A

antacids = affects absorption

48
Q

side effects of Hydroxycholoroquine

A

A, N, V

49
Q

nursing considerations for Hydroxycholoroquine

A
  • monitor vision = more frequent eye exams
  • give with food or milk to decrease GI upset
  • no alcohol
  • discontinue for s/s of extreme weakness, hearing loss, bruising, bleeding
  • don’t participate in hazardous activities
  • need to wear sunglasses: photosensitivity
50
Q

mechanism of action & classify Alendronate

A
  • biphosphonate
  • osteoporosis (bone resorption)
  • slows rate of bone resorption (Ca+ being sucked out of bones to increase blood Ca+)
  • lowers serum alkaline phosphatase
  • used postmenopausal
  • used for steroid induced osteoporosis
51
Q

side effects of Alendronate

A

irritation

52
Q

nursing considerations for Alendronate

A
  • take 30 min before eating, empty stomach
  • encourage Ca+ foods & Vitamin D supplements, but not within 2 hrs. taking med
  • encourage weight bearing exercise
  • pt. needs to stay upright for at least 30 min (esophagus burning)
  • s/s hypocalcemia: muscle spasms/twitching
53
Q

mechanism of action & classify Raloxifene

A
  • hormonal: SERMs
  • osteoporosis; bone resorption
  • binds with estrogen receptors
  • decreases bone resorption increased bone density in postmenopausal women
  • estrogen agonist: encourages bones build up, Ca+ placement in bone = increase bone strength
  • estrogen antagonist: doesn’t act on uterine or breast tissue like estrogen normally would = benefit of med
54
Q

contraindications of Raloxifene

A

lactation

55
Q

side effects of Raloxifene

A
  • hot flashes
  • leg cramps
  • weight gain
56
Q

nursing consideration for Raloxifene

A
  • BLACK BOX: pregnancy category X
  • monitor lipid levels
  • monitor for thrombolytic events
  • report calf pain or dyspnea
  • don’t sit for long periods of time
  • don’t take with other estrogen drugs or herbal meds
  • NO MEN! Only postmenopausal
57
Q

mechanism of action for Calcium Carbonate

A
  • hypocalcemia

- to increase serum calcium because we want more Ca+ in bone & maintain normal neuromuscular function

58
Q

side effects of Calcium Carbonate

A
  • oral: hypercalcemia, kidney stones
59
Q

nursing considerations for calcium carbonate

A
  • monitor IV & EKG
  • administer Ca+ supplements through IV slowly
  • encourage Ca+ foods (milk, dark green veggies, soy beans, tofu, canned fish, sardines)
  • can take c meals with oral admin.
  • hypercalcemia: lethargy, N, V
  • hypocalcemia: muscle twitching/spasms
  • encourage weight bearing exercise
  • avoid Zinc rich foods (nuts, legumes, seeds, sprouts)

Pharmacology N2100 (26 decks)

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