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Pharm Final > Meds affecting the NERVOUS SYSTEM > Flashcards

Meds affecting the NERVOUS SYSTEM Flashcards

1
Q

haloperidol

A

first generation antipsychotic meds

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2
Q

chlorpromazine

A

first generation antipsychotic meds

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3
Q

side effects of the older, first generation antipsychotics?

A
  • EPSs (acute dystonia, parkinsonism, akathisia, tardive dyskinesia)
  • neuroleptic malignant syndrome (FEVER- fever, elevated WBCs and CPK, vital signs unstable, encephalopathy, rigidity)
  • neuroendoctine effects (gynecomastia, galactorrhea, amenorrhea)
  • anticholinergic effects
  • orthostatic hypotension
  • sedation
  • photosensitivity
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4
Q

clozapine

A

2nd gen antipsychotics

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5
Q

olanzapine

A

2nd gen antipsychotics

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6
Q

risperidone

A

2nd gen antipsychotics

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7
Q

aripiprazole

A

2nd gen antipsychotics

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8
Q

clozapine is one of the most effective antipsychotic meds. why is it not a first-line medication?

A
  • can cause agranulocytes, destroying WBCs
  • lowers the immune system
  • increase risk of infection
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9
Q

what symptoms should a client report if taking clozapine?

A
  • report any signs of infection
  • also report increased thirst, urination, and appetite (signs of diabetes); weight gain
  • signs of neuroleptic malignant syndrome (FEVER)
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10
Q

what lab test is most important to check on a routine basis if a client is taking clozapine?

A

WBC count

4-11,000/uL

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11
Q

describe neuroleptic malignant syndrome; and what meds can cause NMS?

A
  • potential adverse effect of first and second (mainly first) generation antipsychotics
  • most commonly occurs w/in the first 2 weeks of treatment

FEVER

  • sudden high fever
  • elevated WBCs and CPK
  • vital signs unstable (dysrrhythmias, BP fluctuations, diaphoresis)
  • encephalopathy (changes in LOC, altered mental status, coma)
  • muscle rigidity
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12
Q

is cocaine a CNS stimulant, depressant, or hallucinogen?

A

stimulant

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13
Q

what are signs and symptoms of acute cocaine toxicity?

A
  • arrhythmias (irregular heart rhythm)
  • severe tachycardia
  • very high BP
  • dangerously high body temp
  • severe anxiety
  • severe agitation (combative)
  • psychosis, confusion
  • sweating
  • nausea
  • tremors
  • seizures
  • stroke
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14
Q

what meds can help reduce anxiety and seizures during acute cocaine toxicity?

A

benzos

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15
Q

what is the therapeutic plasma range of phenytoin?

A

10-20

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16
Q

why should clients taking phenytoin avoid alcohol and other CNS depressants?

A

bc phenytoin also enhances the inhibitory effects of GABA (like alcohol and other CNS depressants)

17
Q

what are some steps a client taking phenytoin can take to prevent gingival hyperplasia?

A

advise clients to maintain a good oral hygeine

  • dental flossing, massaging gums, soft-bristle toothbrush
  • folic acid supplements can decrease the occurence
18
Q

what should clients taking phenytoin know regarding pregnancy?

A

-phenytoin can decrease the effectiveness of oral contraceptives

pregnancy risk category D
TERATOGENIC: cleft palate, heart defects, developmental deficiencies

19
Q

what effects can phenytoin have on warfarin and glucocorticoids? what lab tests should be monitored?

A
  • phenytoin decrease effects of warfarin and glucocorticoids
  • lab tests: INR, blood glucose levels
  • adjust dose as needed
20
Q

should a person abruptly stop taking phenytoin? why or why not?

A

no- can cause seizures (even though phenytoin is an antiseizure drug)

21
Q

what is malignant hyperthermia?

A

muscle rigidity accompanied by increased temperature, as high as 43° C (109.4° F).

-antidote = dantrolene

22
Q

what meds can cause malignant hyperthermia?

A

muscle relaxants: succinylcholine

-and other anesthetics

23
Q

if a client has a family history of malignant hyperthermia, is it OK for them to receive succinylcholine?

A

no- succinylcholine causes malignant hyperthermia

24
Q

what are 5 important interventions for malignant hyperthermia?

A
  1. monitor vital signs
  2. stop succinylcholine and other anesthetics
  3. administer oxygen at 100%
  4. initiate cooling measures including administration of iced 0.9% NaCl, applying a cooling blanket, and placing ice bags in groin and other areas
  5. administer dantrolene (to decrease metabolic activity of skeletal muscle)
25
Q

what is the opposite of an anticholinergic medication?

A

muscarinic agonist

acetylcholine

26
Q

what are the signs/symptoms of muscarinic poisoning?

A
  • increased gastric secretion
  • abdominal cramps
  • diarrhea
  • sweating
  • tearing
  • urinary urgency
  • bradycardia
  • hypotension
  • bronchoconstriction
27
Q

what is the antidote for muscarinic poisoning?

A

anticholinergic agents such as atropine

28
Q

atropine effect on the heart:

A

increases heart rate (tachycardia)

29
Q

atropine effect on the exocrine glands:

A

decreases sweating and salivation (causes dry mouth)

30
Q

atropine effect on the smooth muscles:

A

decreases GI motility (causes constipation)

31
Q

atropine effect on the eyes;

A

can cause:
blurred vision,
dry eyes

32
Q

atropine effect on the CNS:

A

allows the enzyme cholinesterase to activate ACh in the brain;
decreasing the amount of ACh available at receptor sites = decrease nerve impulses

33
Q

why might we give atropine in a cardiac code?

A

reverses bradycardia instantly, increases the heart rate

Pharm Final (5 decks)

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