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Pharmacology Exam 2 > CNS And PNS > Flashcards

CNS And PNS Flashcards

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1
Q

Central Nervous System consists of

A

Brain and spinal cord

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2
Q

Respiration’s controlled by

A

Pons and medulla

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3
Q

Neurotransmitters are

A

Norepinephrine, serotonin, and dopamine

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4
Q

CNS stimulants

A

Provoke release of neurotransmitters
Decrease reputable of neurotransmitters
Inhibit postsynaptic enzymes

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5
Q

Anxiety

A

Feeling tension, nervousness, apprehension, or fear involving unpleasant reactions to a stimulus

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6
Q

sedation

A

Loss of awareness and reaction to environmental stimuli

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7
Q

Hypnosis

A

Extreme sedation resulting in further CNS depression and sleep

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8
Q

The downers of CNS

A

Cause various degrees of depression

  • sedative-hypnosis
  • anesthetic
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9
Q

Sedatives

A

Treat sleep disorders

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10
Q

Sedative-hypnotics

A

Barbiturates
Benzodiazepines
Nonbenzodiazepines

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11
Q

General side effects of sedative hypnotics

A 
Residual drowsiness
Drug dependence 
Drug tolerance 
Withdrawal symptoms 
Respiratory depression
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12
Q

Benzodiazepines-AS A CLASS-

A

drug of choice to treat anxiety
Do not cause much sedation
Less likely to cause dependence-schedule 4 drug
Act by potentiating GABA

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13
Q

Benzodiazepines Indications

A

Anxiety disorders, alcohol withdrawal, hyper excitability, agitation, seizures, induction of anesthesia, conscious sedation, preoperative sedation

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14
Q

Benzodiazepines

A

Well absorbed GI tract, lipid soluble, metabolized by liver

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15
Q

Benzodiazepines Actions

A 
Act in limbic system and the RAS
Make GABA more effective 
Cause interference with neurons firing
Lower doses assist with anxiety
Higher doses cause sedation and hypnosis
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16
Q

Pharmacokinetics Benzo

A 
Absorbed from GI tract
Peak level 30 min to 2 hrs
Lipid soluble and distributes well
Cross placenta
Enter breast milk
Metabolize in liver 
Excretion in urine
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17
Q

Contraindications of Benzo

A

Allergy
Psychosis
Acute narrow angle glaucoma
Decrease liver and kidney function

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18
Q

Adverse effects of Benzo

A

CNS and anticholinergic effects
Use with causation in African Americans
Addictive effect with alcohol or narcotics
UNPREDICTABLE REACTION IN ELDERLY

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19
Q

Anxiolytics-used to depress CNS-of Benzo

A 
Diazepam
Chlordiazepoxide
Lorazepam
Aprazolam
Oxazepam
Clonazepam
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20
Q

GABA

A

Gamma-aminobutyric system

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21
Q

RAS

A

Reticular activating system

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22
Q

Benzodiazepines suffix

A

-zopam or -zolam

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23
Q

Benzodiazepine antidote

A

Flumazenil -romazicon

:inhibits effects of the benzodiazepines at the GABA receptors and is used to treat Benzo overdoses

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24
Q

NONbenzodiazepines

A 
Zolpidem-ambien
\:duration of action is 6-8 hrs
Eszopiclone-lunesta
Zaleplon-sonata
Chloral hydrate
Melatonin receptor agonist
\:ramelteon-not a controlled substance
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25
Barbiturates actions
CNS depressants Inhibit neuroral impulse conduction in ascending RAS Depress cerebral cortex Depress motor output Cause—sedation,hypnosis,anesthesia, and coma
26
Barbiturates Indications
``` Reliefs of signs and symptoms of anxiety Sedation Insomnia Preanesthesia Seizures ```
27
Pharmacokinetics barbiturates
Well absorbed, reached peak in 20-60 min, metabolizes in liver, excreted in urine
28
Adverse effects of Barbiturates
``` CNS depression Physical dependency Drowsiness Somnolence Lethargic Ataxia Vertigo Nausea/Vomiting Constipation ```
29
Long acting barbiturates
Phenobarbital and mephobarbital
30
Intermediate acting barbiturates
Amobarbital Aprobarbital Butabarbital
31
Short acting barbiturates
Pentobarbital | Secobarbital
32
Barbiturates
Controlled substance schedule 2 or 3 | Many drug interactions including kava kava and valerian
33
Contraindications barbiturates
``` Allergy History of addiction to sedative Liver or kidney function Respiratory distress or depression Pregnancy ```
34
Adverse effects or barbiturates
Respiratory depression hangover Do NOT withdrawal abruptly or mix with alcohol
35
General anesthetics
CNS depressants used to produce loss of pain sensation and consciousness
36
Local anesthetics
Used to cause loss of pain sensation and feeling is a designated area Does not produce systemic efforts associated with severe CNS depression
37
Goals of General anesthetics
``` Analgesia -loss of pain perception Unconsciousness -loss of awareness of ones surroundings Amnesia -inability to recall what took place ```
38
Risk factors of General
CNS factors Cardiovascular factors Respiratory factors Renal and hepatic function
39
Balanced anesthesia
``` Hypnotic the night before Premedication Short acting barbiturate Inhaled gas Muscle relaxant ```
40
Stages of General
Analgesia Excitement or delirium Surgical Medullary paralysis
41
Adverse affects w/ CNS
Suppression
42
Adverse effects w/local anesthetic
Loss of skin integrity
43
Adverse effects w/respiratory
Suppression
44
Adverse effects/cardio vascular
Hypotension and slow pulse
45
Adverse effects w/ GI
Decreased activity Nausea Vomiting
46
Malignant hyperthermia
Antidote:dantrolene
47
Topical/local anesthetic
``` NOT be absorbed systemically Topical administration Infiltration Field block Nerve block-epidural IV regional anesthesia Pain pump ```
48
Esters
Benzocaine Procaine Tetracaine
49
Amides
Bupivacaine Dibucaine Levobupivacaine LIDOCAINE-xylocaine EMLA MODERATE ACTING
50
Spinal anesthesia
Need to monitor respiration’s and BP | Complication: terrible headache
51
Neuromuscular junction
Point at which motor neuron communicates with skeletal muscle fiber, and results in muscle contraction
52
Neuromuscular junction
Dynamic balance of excitatory and inhibitory impulses results in muscle tone
53
No depolarization
Acts as antagonists to ACh at NMJ and prevents depolarization of muscle cells
54
Depolarization
Acts as ACh agonist causing stimulation of muscle cell and preventing it from repolarizing
55
Nondepolarizing NMJ blockers 1
PANCURONIUM GENERIC
56
Actions and indications of no depolarization blockers
Adjunct to general aesthetic during surgery when reflex muscle movement could interfere w/ procedure or delivery of gas Facilitate mechanical intubation by preventing resistance to passing of endotracheal tube Facilitate endoscopic diagnostic procedures when reflex muscle reaction would interfere Facilitate electroconvolsuive therapy when intense skeletal muscle contraction
57
No depolarization blockers pharmacokinetics
Compete with ACh for a receptor site Metabolize in serum, dependent on liver for plasma Excreted in urine Differing onset/duration
58
Contraindications on NMJ blockers
Allergy Myasthenia graves Renal and haptic disease
59
Adverse effects of NMJ blockers
``` Muscle paralysis Hypotension Cardiac arythmias Gi dysfunction Pressure ulcers ```
60
Drug drug interactions
``` Halogenated hydrocarbon anesthetics Aminoglycoside antibiotics Ca channel blockers Xanthines Alkaline solutions ```
61
Drug herb interactions
Valerian Melatonin Kava
62
Depolarization action/indication
Attaches ACh receptor sites on muscle cell causing prolonged depolarization Rapid onset short duration
63
Pharmacokinetics depolarization
Metabolized in serum by liver Produced by plasma chokinesterates Excreted in urine Crosses plasma
64
Contraindications depolarization
``` Same as no depolarization Fractures Narrow angle glaucoma Penetrating eye injuries Paraplegia ```
65
Advertise effects depolarization
Muscle pain | MALIGNANT HYPERTHERMIA-Danrolene
66
CNS stimulants UPPERS
Amphetamines-stimulate cerebral cortex Anorexiants-center in hypothalamic and limbic areas of brain Analeptics and caffeine-respiration’s in brain stem and medulla Medically approved:narcolepsy, respiratory distress, and ADHD
67
Narcolepsy
MODAFINIL-provigil
68
Anorexiante :Obesity
``` Prescriptive anorexiants Part of weight loss plan under care of medical provider - -benzphentamine HCI -diethylpropion HCI -phentermine -phentermine plié topiramate ```
69
Pain
Sensory and emotional experience assoc with actual or potential tissue damage Can be acute or chronic
70
Drugs used to relieve pain
Narcotics:opium derivatives used to treat many types | Anti migraine drugs:reserved for treatment of migraine headaches
71
Gate control theory
Sensory and emotional experience Transmission of these impulses can be modulated or adjusted Interneurons acts as “gates” Factors:learning experiences, cultural expectations, individual tolerance, placebo effect...activate descending inhibitory nerves from upper CNS
72
Opioid receptors
CNS Nerves in the periphery Cells in the GI tract
73
Narcotic Agonist 1
``` drugs that react with opioid receptors Cause analgesia, sedation, or euphoria Potential for physical dependence Controlled substance Rising problem of addiction ```
74
Narcotic agonist actions
Act at specific opioid receptor site sin CNS | Produce analgesia sedation and sense of well being
75
Narcotic agonist indication
Relief of severe acute or chronic pain Analgesia during anesthesia Cross placenta
76
Narcotic agonists pharmacokinetics
IV most reliable way to achieve therapeutic response IM and SubQ to absorb varies between sex Hepatic metabolism and generally excreted in Urine and bile
77
Narcotic agonist contraindications
Known allergy Pregnancy, labor, lactation Diarrhea
78
Opiates
Morphine Opium Codeine
79
Synthetic opioids
``` Oxycodone Hydrocodone Meperidine Hydromorphone Fentanyl Tramadol Methadone ```
80
Narcotic analgesics | Adverse effects
``` Respiratory depression Nausea Orthostatic hypotension Drowsiness and confusion Constipation Urinate retention Naive VS tolerant and dependent ```
81
Narcotic analgesics contraindications
Head injuries and increased intracranial pressure Respiratory disorders Shock or hypotension
82
Adjuvant therapy
Anti seizure meds-gabapentin Antidepressants-tricyclics Corticosteroids Local anesthetics-lidocaine
83
Narcotic agonist-antagonist
Pentazocaine Nalbuphine HCl Butorphanol Buprenorphine
84
Opioid antagonist actions
Drugs that bind strongly to opioid receptors but they do not activate the receptors Reverse effects of opioids
85
Opioid antagonist indication
Reverse of the adverse effects of narcotics | Treat narcotic and or alcoholic dependence
86
Cluster headaches
Begins during sleep, involve sharp steady eye pain, sweating, tearing, nasal congestion
87
Tension headaches
Occur of times of stress, dull band of pain around entire head
88
Prevention treatment for migraine and cluster
Beta adrenergic blockers-propranolol, atenolol | Anticonvulsant-valproic acid,gabapentin,topiramate
89
Chemical impairment of nurses
10-15% have substance abuse problem | 3-6% demonstrate impaired practice b/c of drugs

Pharmacology Exam 2 (2 decks)

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