E2 Concepts Flashcards

1
Q

Pathophysiology of Myasthenia Gravis

A

Acetylcholine (ACh) receptor sites destroyed leading to a lack of nerve impulses and muscle responses at the myoneural junction

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2
Q

What special precautions should you take with patients who have myasthenia gravis?

A

Lack of muscle control leads to decreased ability to breathe. Always access breathing and ability to swallow before giving PO medication.

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3
Q

Cholinergic vs Adrenergic

A

Both involved with the autonomic nervous system. Cholinergic (constricted pupils, increased saliva, bronchoconstriction, increased GI mucus, bladder contraction) Adrenergic (dry mouth, dilated pupils, increased contractility, increased HR, bronchodilation, bladder relaxation)

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4
Q

Cholinergic NT

A

Acetylcholine (Ach)

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5
Q

Adrenergic NT

A

Epinephrine, Norepinephrine and dopamine

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6
Q

Parkinson’s Disease Patho

A

Chronic disorder with the imbalance of NT. Dopamine normally control acetylcholine to inhibit (ACh’s) excitability.
Parkinson’s disease is the degeneration of dopamine neurons

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7
Q

Three main Parkinson characteristics

A

Tremors (head, neck and limbs at rest) Rigidity (increased muscle tone) Bradykinesia (slow movements)
Additional: Postural changes (head + chest forward) Shuffling walk, lack of facial expressions

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8
Q

Treatment of parkinson

A

Many of the dopamine neurons are destroyed before signs show.
Non pharmacologic: Exercise, nutrition (weight loss) and supports
Medications to replace dopamine or block acetylcholine

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9
Q

Anticholinergics

A

Blocks cholingergic receptors

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10
Q

Dopaminergics

A

Converts to dopamine

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11
Q

Dopamine agonists

A

Stimulates dopamine receptors

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12
Q

MOA-B inhibitors

A

Inhibits the action of the MOA-B enzyme that interferes with dopamine

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13
Q

Alzheimers Disease

A

Chronic progressive neurodegenerative condition
Beta-amyloid and neuritic plaques form, neurofibrillary tangles and not enough !acetylcholine!`

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14
Q

Acetylcholinsterase (AChE) Inhibitors/Cholinesterase Inhibitor

A

Inhibit the break down of ACh that is done by AChE
Allows more acetylcholine in the neuron receptors, increases cognitive function, used for mild to moderate dementia

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15
Q

NMDA Receptro Antagonist

A

Blocks neuronal receptors for N-methyl- D-aspartate
- Normalzies the Ca++ enhancing the use of glutamate

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16
Q

Cholinergic Crisis

A

Overdosed from cholinesterase inhibitors - see SE within 30-60 minutes
Severe muscle weakness: respiratory paralysis and arrest, abnormal pupil constriction, excess salivation, pallor, sweating, vertigo, Gi distress, bradycardia

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17
Q

Multiple Sclerosis (MS)

A

Autoimmune disorder - attacks myelin sheath of nerve fivers, causes lesions or plaques
Characteristics: Variable but muscle weakness, cognitive impairment, spasticity, diplopia and dysphagia
No specific diagnosis labs can indicate elevated (IgG) or increased IgG/albumin ratio
Lesions are observable in a brain MRI
Drug therapy used to relieve symptoms, maintain QOL, and prevent permanent damage

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18
Q

Disease modifying therapy (DMT) for MS

A

Can decrease the number and severity of the MS attacks, slow progression of disability
Do not use with Echinacea + melatonin
Monitor liver function (hepatotoxicity) and signs of infection

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19
Q

Narcolepsy

A

Falling asleep uncontrollably while driving, talking, eating or standing
Treatment is a stimulant

20
Q

ADHD

A

Dysregulation of serotonin, norepinephrine and dopamine
Inattentive, inability to concentrate, restlessness, impulsivity

21
Q

Herbs nursing considerations

A

No regulation, pts should look for seals (US Pharmacopeia, consumer lab, natural products association and NSF international)
Do not give herbs to infants or young children, do not take large quantities
Assessment: Obtain all therapies a patient uses (OTC drugs, herbs and vitamins)

22
Q

Glaucoma

A

Too much aqueous humor leads to increased intraocular pressure (IOP) which leads to nerve damage
Two classifications: Open angle + Closed/Narrow Angle

23
Q

Diagnostic studies for eyes

A

Locate lesions, foreign bodies, objects, eval dry eye
Forurescein stains, rose bengal, lissamnie green

24
Q

Conjunctivitis

A

inflammation of conjunctiva membrane (pink eye)

25
Q

Blepharitis

A

infection of lids/lashes

26
Q

Chalazion

A

blocked meibomian gland, eyelid cyst

27
Q

Hordelum

A

stye

28
Q

Infectious keratitis

A

cornea infection

29
Q

infectious uveitis

A

vascular infection, red + swollen eyes

30
Q

Eye infections Pt Education

A

Discard and discontinue contact lenses

31
Q

Eye decongestants

A

Vasoconstrictors that narrow blood vessels, reduce eye redness/edema
CAUTION with pt hypertension
Contraindicated in pts with narrow angle glaucoma

32
Q

Macular degeneration

A

Central vision affected
Overgrowth of sub retinal blood vessel, fluid leakage and separation of the macula leads to vision loss/distortion

33
Q

Ear infection (Acute otitis media)

A

Often starts as congestion and eustachian tube inflammation
PAIN relief + antibiotics

34
Q

Acute Otitis Externa

A

Swimmers ear, in the outer ear canal
Anti-infectives can cause burning or stinging and aminoglycosides can cause ototoxicity

35
Q

Acne Vulgaris

A

Characterized by comedones, papules, nodules, cycts
Results from keratin plugs and bacteria
Non-pharm: Gentle cleansing, oil free lotions and makeup, healthy diet

36
Q

iPLEDGE

A

Risk management program for isotretinoin includes sections for patient, provider, pharmacist and wholesaler
Sections need to be done by each group each month

37
Q

Verruca Vulgaris

A

Warts, often benign
Can treat with OTC salicylic acid or cryotherapy

38
Q

Drug-Induced Dermatitis

A

Characteristics; Rash, urticaria, papules, vesicles
Erythema multiforme: Steven-Johnson
Toxic Epidermal Necrolysis: detachment of epidermis from underlying layers

39
Q

Contact dermatitis

A

Causes by cosmetics, perfume, laundry soaps or poison ivy
Treatment: Burows solution (aluminum acetate) Calamine lotion

40
Q

Impetigo

A

Staphylococcus aureus infections
Appears as honey-colored crusts
Contagious - spreads through daycare/school quickly
Treatment: Mupirocin (bactroban) cephalixin (keflex)

41
Q

1st, 2nd, 3rd degree burn classification

A

1st: redness, mild to moderate pain
2nd: deep thickness, blistering, painful
3rd: full thickness, nerve damage no pain

42
Q

miosis

A

construction of pupils

43
Q

mydriasis

A

dilation of pupils

44
Q

IOP

A

increased intra ocular pressure

45
Q

mydriatics

A

drugs that cause dilation of pupils

46
Q

cycloplegics

A

drugs that cause paralysis of ocular muscles

47
Q

diplopia

A

double vision