Exam 3 (week 9) Flashcards
(182 cards)
1
Q
What is the brand name for Levodopa/carbidopa?
A
sinemet
2
Q
What is the pharmacological class for Levodopa/carbidopa?
A
Dopaminergic
3
Q
what is the therapeutic class for Levodopa/carbidopa?
A
Drug for parkinson disease
4
Q
MOA for Levodopa/carbidopa:
A
- increases dopamine synthesis in the striatum
2. undergoes uptake in dopaminergic nerve terminals and converted into dopamine.
5
Q
MOA specifically for carbidopa:
A
inhibits decarboxylation of levodopa in the intestine and peripheral tissues
6
Q
Use for Levodopa/carbidopa:
A
parkinson disease
7
Q
Effects of Levodopa/carbidopa are dose what?
A
dose dependent
8
Q
what are 4 adverse effects of Levodopa/carbidopa?
A
- nausea and vomiting
- dyskinesias
- postural hypertension
- psychosis
9
Q
What is a nursing implication of Levodopa/carbidopa?
A
Inform patients that benefits of drug may be delayed for weeks to months
10
Q
Is there a cure with Levodopa/carbidopa for parkinson disease?
A
no cure, but symptomatic relief
11
Q
full therapeutic responses with Levodopa/carbidoda take how long to develop?
A
months
12
Q
What is another important thing to remember with Levodopa/carbidopa?
A
acute loss of effect
13
Q
What is the pharmacological class for donepezil?
A
Reversible cholinesterase inhibitor
14
Q
What is the therapeutic class for donepezil?
A
Drug for Alzheimer’s disease
15
Q
MOA for donepezil:
A
- Reversibly binds to cholinesterase preventing the degradation of acetylcholine by (acetyl) cholinesterase CENTRALLY.
- increased amount of acetylcholine available to activate receptors
- Enhanced transmission in central cholinergic neurons that have not yet been destroyed
16
Q
Uses for donepezil:
A
Alzheimer’s disease
17
Q
5 adverse effects of donepezil:
A
cholinergic effects:
- nausea, vomiting
- dyspepsia
- diarrhea
- dizziness
- headache
18
Q
1 nursing implication for donepezil:
A
medication adherence is crucial
19
Q
What does donepezil slow the loss of?
A
memory and cognition
20
Q
What does donepezil prolong?
A
independent function
21
Q
True or false: donepezil is a cure for alzheimer’s disease
A
false; there is no cure
22
Q
What is the brand name of interferon beta?
A
There is no brand name
23
Q
Pharmacological class of interferon beta:
A
disease-modifying drug: immunomodulator
24
Q
Therapeutic class of interferon beta:
A
Drug for Multiple Sclerosis (MS)
25
MOA of interferon beta:
1. enhances naturally occurring interferon.
2. a glycoprotein that inhibits the migration of proinflammaotry leukocytes across the BBB and suppresses T-helper cell activity
26
How is interferon beta manufactured?
recombinant therapy
27
Use of interferon beta:
relapsing form of multiple sclerosis
28
3 adverse effects of interferon beta:
1. flu-like symptoms
2. hepatotoxicity
3. myelosuppression
29
1 nursing implication of interferon beta:
instruct patient to store drug appropriately
30
define multiple sclerosis
a chronic inflammatory autoimmune disorder that damages the myelin sheath of neurons in the CNS
31
How many types of MS are there?
4
32
Immunomodulators are drugs used to modify what?
Modify disease process, treat acute relapse and manage symptoms
33
Are immunomodulators a cure for MS?
No
34
What is the brand name of mitoxantrone:
Novantrone
35
Pharmacological class of Mitoxantrone:
Disease-modifying drug: immunosuppressant
36
Therapeutic class of Mitoxantrone:
Drug for Multiple Sclerosis (MS)
37
MOA of Mitoxantrone:
1. cytotoxic to all cells proliferating or not
2. inhibits DNA and RNA synthesis
3. promotes cross-linking and breakage of DNA strands
38
Use of Mitoxantrone:
multiple sclerosis
39
3 adverse effects of Mitoxantrone:
1. myelosuppression
2. cardiotoxicity
3. fetal injury
40
1 nursing implication of Mitoxantrone:
educate patient to avoid others who are ill
41
What is unique about Mitoxantrone and the FDA?
only immunosuppressant approved by FDA for use in treatment of MS
42
Mitoxantrone has a high risk of?
toxicity
43
immunosuppressants are also anti what?
anticancer drugs
44
What is the brand name of phenytoin?
Dilantin
45
Pharmacological class of phenytoin:
hydantoin: selective inhibition of sodium channel
46
Therapeutic class of phenytoin:
traditional antiepileptics
47
MOA of phenytoin:
1. suppression of sodium influx
2. suppression of calcium influx
3. promotion of potassium efflux
4. potentiation of GABA
48
Uses of phenytoin:
epilepsy; partial-seizures and tonic-clonic seizures
49
What are adverse effects dependent on with phenytoin: ?
dose dependent
50
What are 5 adverse effects of phenytoin:
Dose dependent effects:
1. CNS/neurologic
2. dermatologic
3. gastrointestinal
4. cardia
5. teratogenic
51
1 nursing implication of phenytoin:
educate patients on strict adherence
52
What is the abbreviation for anti epileptic drugs?
AEDs
53
What is the goal of anti epileptics
goal is to reduce seizures to an extent that enables the patient to live a normal or near-normal life
54
what are also used as anti epileptics?
barbiturates
55
What is the brand name for valproic acid?
depakote
56
Pharmacological class for valproic acid:
carboxylic acid: selective inhibition of sodium channels
57
Therapeutic class for valproic acid:
traditional antiepileptics
58
MOA of valproic acid:
1. suppression of sodium influx
2. suppression of calcium influx
3. promotion of potassium efflux
4. potentiation of GABA
59
use of valproic acid:
epilepsy
60
adverse effects of valproic acid:
Dose dependent effects:
1. CNS/neurologic
2. dermatologic
3. gastrointestinal
4. cardia
5. teratogenic
61
1 nursing implication for valproic acid:
educate patients on strict adherence
62
What is the brand name of oxcarbazepine?
trileptal
63
Pharmacological class of oxcarbazepine:
inhibition of voltage-sensitive sodium channels
64
Therapeutic class of oxcarbazepine:
newer antiepileptic
65
MOA of oxcarbazepine:
1. suppression of sodium influx
2. suppression of calcium influx
3. promotion of potassium efflux
66
Use of oxcarbazepine:
epilepsy
67
Adverse effects of oxcarbazepine:
Dose dependent effects:
1. CNS/neurologic
2. dermatologic
3. gastrointestinal
4. cardia
5. teratogenic
68
1 nursing implication of oxcarbazepine:
educate patients on strict adherence
69
What is the brand name of baclofen?
lioresal
70
Pharmacological class of baclofen:
centrally-acting muscle relaxant
71
therapeutic class of baclofen:
drug for spasticity
72
MOA of baclofen:
1. Acts within the spinal cord to suppress hyperactive reflexes involved in the regulation of muscle movement
73
Use of baclofen:
1. Spasticity and/or muscle spasm caused by MS, Cerebral Palsy (CP), spinal cord injury, stroke, and other disorders
2. Malignant hyperthermia
74
Adverse effects of baclofen:
1. CNS depression
| 2. gastrointestinal effects
75
1 nursing implication of baclofen:
education patient not to stop medication abruptly
76
Drugs used to treat spasticity do not relieve what?
do not relieve acute muscle spasm and vice versa
77
What do you want to consider with drugs for muscle spasm:
physical dependence
78
What is the brand name of dantrolene?
dantrium
79
Pharmacological class of dantrolene:
direct-acting muscle relaxant
80
Therapeutic class of dantrolene:
drug for spasticity
81
MOA of dantrolene:
1. Acts directly on skeletal muscle by suppressing release of calcium for the sarcoplasmic reticulum
82
Use of dantrolene:
1. Spasticity and/or muscle spasm caused by MS, Cerebral Palsy (CP), spinal cord injury, stroke, and other disorders
2. Malignant hyperthermia
83
Adverse effects of dantrolene:
1. CNS depression
| 2. gastrointestinal effects
84
1 nursing implication of dantrolene:
educate patient not to stop medication abruptly
85
What is the brand name for haloperidol?
Generic only!
86
Pharmacological class of haloperidol:
butyrophenone: dopamine2 receptor blockade
87
Therapeutic class of haloperidol:
first-generation antipsychotic (FGA)
88
MOA of haloperidol:
1. block several kinds of receptors within and outside of CNS
2. strong blockade of dopamine 2 receptors in the CNS
89
Uses of haloperidol (4):
1. schizophrenia (delusional disorders, bipolar disorder, depressive psychoses, drug-induced psychoses)
2. suppress emesis
3. Tourette's syndrome
4. huntington's chorea
90
Adverse effects of haloperidol:
1. extrapyramidal symptoms (EPS) - serious movement disorders
2. neuroleptic malignant syndrome
91
1 nursing implication of haloperidol:
educate patient on early signs of movement disorders
92
True or false: first-generation antipsychotics are conventional
true
93
what are first-generation antipsychotics also known as:
neuroleptics
94
how are first-generation antipsychotics classified:
by potency: high, medium, low. By chemistry
95
What kind of relief do first-generation antipsychotics provide:
symptomatic relief, no cure
96
What is the brand name of clozapine?
clozaril
97
Pharmacological class of clozapine:
Dopamine and serotonin (5-HT) receptor blockade
98
Therapeutic class of clozapine:
second-generation (atypical) antipsychotic (SGA)
99
MOA of clozapine:
1. block several kinds of receptors within and outside of CNS
2. moderate blockade of dopamine receptors
3. strong blockade of serotonin (5-HT) receptors
100
Uses of clozapine:
1. schizophrenia
| 2. bipolar disorder
101
4 adverse effects of clozapine:
1. sedation
2. agranulocytosis
3. metabolic effects
4. low risk of EPS
102
1 nursing implication of clozapine:
monitor hematologic blood plasma levels
103
What type of antipsychotics are second-generation antipsychotics?
atypical antipsychotics
104
What is the brand name of fluoxetine?
prozac
105
What is the pharmacological class of fluoxetine?
selective 5-HIT reuptake inhibitor: SSRI
106
What is the therapeutic class of fluoxetine?
antidepressant
107
MOA of fluoxetine:
Selectively blocks neuronal reuptake of serotonin (5-HT) increasing the concentration of serotonin in the synapse
108
therapeutic uses of fluoxetine:
1. major depression
2. bipolar disorder
3. panic disorder
4. OCD
5. Generalized anxiety disorder
6. bulimia nervosa
7. premenstrual dysphoric disorder
109
Adverse effects of fluoxetine:
1. sexual dysfunction
2. weight gain
3. serotonin syndrome
110
Nursing implication of fluoxetine
Educate patient and family on suicide risk
111
What is the time course of response for SSRIs
slow time; weeks to months
112
What can abrupt discontinuation of SSRIs cause?
it can cause withdrawal syndrome
113
What are used as adjunct to SSRIs?
non-drug therapies
114
What is the brand name for venlafaxine?
effexor
115
What is the pharmacological class of venlafaxine?
5-HT/norepinephrine (NE) reuptake inhibitor: SNRI
116
What is the therapeutic class of venlafaxine?
antidepressant
117
MOA of venlafaxine:
Block neuronal reuptake of serotonin (5-HT) and norepinephrine (NE)
118
Therapeutic uses of venlafaxine:
1. major depression
2. generalized anxiety disorder
3. social anxiety disorder (social phobia)
119
Adverse effects of venlafaxine:
1. Nausea
2. Headache
3. Anorexia
4. Nervousness
5. Sweating
6. Somnolence
7. Insomnia
120
nursing implications of venlafaxine:
educate patient and family on suicide risk
121
What is the brand name of phenelzine:
nardil
122
MOA of phenelzine:
Irreversibly inhibit MAO-A in nerve terminals, increasing the amount of NE serotonin available for release
123
Therapeutic use of phenelzine:
Atypical depression (for patients who have not responded to any other drug treatments)
124
adverse effects of phenelzine:
1. hypertensive crisis triggered by foods high in tyramine
| 2. CNS stimulation
125
1 nursing implication of phenelzineu:
Educate patient and family on suicide risk
126
What is an enzyme found in the liver, the intestinal wall and terminal of monoamine- containing neurons:
MAO
127
Function of MAO:
to convert monoamine neurotransmitters into inactive products
128
What is similar with SSRIs and SNRIs and TCAs and MAOIS and atypical antidepressants:
the additional info:
1. Slow time course of response—weeks to months
2. Abrupt discontinuation can cause withdrawal syndrome
3. Non-drug therapies used as adjunct
129
What is the brand name of lithium:
lithobid
130
Pharmacological class of lithium:
Mood stabilizer
131
Therapeutic class of lithium:
drug for bipolar disorder
132
MOA of lithium:
1. MOA unclear
2. alters glutamate uptake and release
3. blocks the binding of serotonin to its receptors
4. and/or inhibits glycogen synthase kinase-3 beta
133
Use of lithium:
bipolar disorder
134
effects of lithium:
1. effects based on lithium levels
| 2. teratogenic
135
1 nursing implication of lithium:
promote adherence
136
What are two other class of drugs used to treat bipolar disorder:
1. antipsychotics
| 2. antidepressants
137
what is the brand name of diazepam?
valium
138
MOA of diazepam:
1. Depress neuronal function at multiple sites in the CNS
2. Weak respiratory depression
3. Benzodiazepine receptor agonist
4. Potentiate actions of gamma-amino-butyric acid (GABA), an inhibitory neurotransmitter
5. Not direct GABA agonist, enhances the effects of GABA
139
Uses of diazepam:
1. Anxiety
2. Insomnia
3. Seizure disorders
4. Induce general
anesthesia
5. Muscle spasms
6. Withdrawal from
alcohol
140
adverse effects of diazepam:
1. CNS depression
2. Paradoxical effects
3. Low risk of
tolerance and physical dependence
141
1 nursing implication of diazepam:
warn patients against abrupt withdrawal
142
what is a drug that is used for relief of anxiety
antianxiety drug or anxiolytic
143
Benzodiazepines also have what type of effects?
anti epileptic
144
what a drug promotes sleep it is called what?
hypnotic
145
Low doses of benzodiazepines relieve what?
anxiety
146
High doses of benzodiazepines induce what?
sleep
147
What suffix are benzodiazepines known by:
-pam and -lam
148
Pharmacological class of diazepam:
benzodiazepine: amplifies action of endogenous GABA
149
Therapeutic class of diazepam:
sedative-hypnotic
150
Effects of benzodiazepine-like drugs are...
dose dependent
151
Pharmacological class of secobarbitol:
barbiturate: direct-GABA agonist
152
Therapeutic class of secobarbitol:
sedative-hypnotic
153
MOA of secobarbitol:
1. Nonselective depression of CNS function
2. Strong respiratory depression
3. Potentiate actions of gamma-amino-butyric acid (GABA)
4. Directly mimics the actions of GABA
154
Uses of secobarbitol:
1. seizure disorders
2. induction of anesthesia '
3. insomnia
155
Adverse effects of secobarbitol:
1. Respiratory depression
2. Suicide
3. Abuse
4. Tolerance versus
physical dependence
156
1 nursing implication of secobarbitol:
warn patients against abrupt withdrawal
157
Barbiturates fall into 3 groups, what are they?
1. ultrashort-acting
2. short-to-intermediate acting
3. long-acting
158
Effects of barbiturate are dose what?
dose dependent
159
barbiturates are known by what suffix:
-ital
160
What is the brand name of Buspirone:
BuSpar
161
Pharmacological class of buspirone:
binds to serotonin and dopamine receptors
162
therapeutic class of buspirone:
anxiolytic
163
MOA of buspirone:
1. Nonbenzodiazepine- nonbarbiturate MOA:
o Not CNS depressant
o Binds to serotonin and dopamine receptors
164
Uses of buspirone:
1. Generalized anxiety disorder (GAD)
2. Panic disorder
3. Obsessive-compulsive
disorder (OCD)
4. Social anxiety disorder
5. Post-traumatic stress
disorder (PTSD)
165
Adverse effects of buspirone:
1. Dizziness
2. Nausea
3. Headache
4. Nervousness
5. Sedation
6. Excitement
7. Low risk of
tolerance and physical dependence
166
What do you want to warn patients about as the nurse if they are taking an anxiolytic:
against abrupt withdrawal
167
What kind of drugs can be used for management of anxiety as well:
SSRIs, SNRIs, benzodiazepines, and barbiturates
168
What is the brand name of methylphenidate:
ritalin
169
Pharmacological class of methylphenidate:
promotion of NE and DA release and inhibition of NE and DA reuptake
170
Therapeutic class of methylphenidate:
CNS stimulant/Drug for ADHD
171
MOA of methylphenidate:
1. Stimulants: Increase activity of CNS neurons
| 2. Promotion of NE and dopamine release and inhibition of NE and dopamine reuptake
172
Uses of methylphenidate:
Attention- deficit/hyperactivity disorder (ADHD)
173
Adverse effects of methylphenidate:
1. Insomnia
2. Reduced appetite
3. Emotional lability
4. Cardiovascular
effects
5. Psychosis
6. Abuse
7. Tolerance versus physical dependence
174
1 nursing implication of methylphenidate:
educate patient to take medication in the morning
175
What are used in combination of CNS stimulants and non-stimulants?
Alpha2 adrenergic agonists and
antidepressants also
used for treatment
176
What is the brand name of atomoxetine?
straterra
177
Pharmacological class of atomoxetine:
selective NE reuptake inhibitor
178
Therapeutic class of atomoxetine:
Non stimulant/Drug for ADHD
179
MOA of atomoxetine:
Nonstimulant: NE reuptake inhibitor
180
Use of atomoxetine:
ADHD
181
Adverse effects of atomoxetine:
1. Insomnia
2. Reduced appetite
3. Emotional lability
4. Cardiovascular
effects
5. Psychosis
6. Abuse
7. Tolerance versus physical dependence
182
1 nursing implication of atomoxetine:
educate patient to take medication in the morning
