πŸ’Š- Neuro, Antiemetic, Opioid Drugs Test Flashcards Preview

Nursing School > πŸ’Š- Neuro, Antiemetic, Opioid Drugs Test > Flashcards

Flashcards in πŸ’Š- Neuro, Antiemetic, Opioid Drugs Test Deck (350)
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0
Q

What are the side effects of antihistamines

A

Anticholinergic (drowsiness, dry mouth, constipation) tachycardia, blurred vision and urinary retention

1
Q

What is the action of antiemetic antihistamines

A

Inhibit vestibular stimulation in the middle ear

2
Q

Dimenhydrinate

A

Dramamine

Type: antiemetic nonprescription antihistamine

3
Q

Meclizine hydrochloride

A

Antivert

Type: antiemetic nonprescription antihistamine

4
Q

How does bismuth subsalicylate work

A

(Pepto bismol)

Acts directly on gastric mucosa to decrease irritation and suppress vomiting

5
Q

Bismuth subsalicylate

A

Pepto bismol

Type: nonprescription antiemetic

6
Q

Phosphorated carbohydrate solution

A

Emetrol

Type: nonprescription antiemetic

7
Q

How does phosphorated carbohydrate solution work

A

(Emetrol)

Decreases n/v by changing the gastric pH and decreases smooth muscle contraction of the stomach

8
Q

What is important to note about phosphorated carbohydrate solution

A

(Emetrol)

High sugar content - avoid giving to diabetics

9
Q

List the 3 types of dopamine antagonists

A

Butyrophenones

Phenothiazines

Benzodiazepines

10
Q

How do dopamine antagonists work

A

Block dopamine2 receptors in the CTZ

11
Q

Droperidol

A

Inapsine

Type: prescription antiemetica-dopamine antagonists- butyrophenones

12
Q

Haloperidol

A

Haldol

Type: prescription antiemetic- dopamine antagonists- butyrophenones

13
Q

What are the side effects of taking butyrophenones (antiemetic dopamine antagonists)

A

EPS syndrome and hypotension

14
Q

What are butyrophenones used for

A

Postop n/v

15
Q

Promethazine

A

Phenergan

is also an antihistamine

Type: prescription antihistamine- dopamine antagonist AND antihistamine- phenothiazines

16
Q

What are some common side effects of taking promethazine

A

(Phenergan)

Antihistamine and anticholinergic effects

17
Q

Lorazepam

A

Ativan

Type: prescription antihistamine- dopamine antagonists- benzodiazepines

18
Q

What is lorazepam used for

A

Antianxiety and cancer chemotherapy in combination with others

19
Q

How do serotonin receptor antagonist work

A

Blocks serotonin receptors in the CTZ

20
Q

Ondansetron

A

Zofran

Type: antiemetic- serotonin receptor antagonist

21
Q

What is something important to note about ondansetron

A

(Zofran)

Increased efficacy with steroids and it has potentially fatal cardiac arrhythmias with IV route

22
Q

Palonosetron

A

(Aloxi)

Type: prescription antiemetic- serotonin receptor inhibitor

23
Q

What is something important to note about palonosetron

A

(Aloxi)

2nd generation , more potent and has a longer half life

24
Q

Dexamethasone

A

Decadron

Type: glucocorticoid- prescription antiemetic

25
Q

Methylprednisolone

A

Solu-medrol

Type: prescription antiemetic- glucocorticoid

26
Q

What is methylprednisolone used for

A

(Soul-medrol)

Cancer chemotherapy, given IV

27
Q

Dronabinol

A

Marinol

Type: cannabinoid- prescription antiemetic

28
Q

What is dronabinol used for

A

(Marinol)

Used when cant take other antiemetics

29
Q

Metoclopramide

A

Reglan

Type: miscellaneous- prescription antiemetic

30
Q

How does metoclopramide work

A

Blocks dopamine receptors in the CTZ

31
Q

Hydroxyzine

A

Vistaril

Type: prescription antiemetic antihistamine

32
Q

Scopolamine

A

Transderm-scop

Type: prescription antiemetic anticholinergic

33
Q

Patients with glaucoma should NOT use which drugs

A

Antihistamines and anticholinergics

34
Q

Ipecac OTC

A

Action: stimulates CTZ and acts directly on gastric mucosa

Use: induce vomiting after toxic substance

35
Q

What is something important to note about ipecac OTC

A

Avoid vomiting if substance is caustic or petroleum

No ipecac fluid extract

36
Q

How do adsorbent antidiarrheals work

A

Coats wall of gi tract and adsorbs bacteria or toxin that cause diarrhea

37
Q

Kaolin-pectin

A

Kapectolin

Type: adsorbent antidiarrheal

38
Q

Colestipol and cholestyramine

A

Questran

Type: adsorbent antidiarrheal

39
Q

Diphenoxylate hydrochloride and atropine sulfate

A

Lomotil

Type: opioid antidiarrheal

40
Q

What is something important to note about diphenoxylate hydrochloride and atropine sulfate

A

(Lomotil)

Is a schedule V controlled substance

41
Q

Loperamide

A

Imodium

Type: opioid antidiarrheal

42
Q

Octreotide

A

Sandostatin

Use: severe diarrhea from cancer

Type: somatostatin analog

43
Q

How do somatostatin analog’s work

A

Inhibit gastric acid, gastric secretions and hormones ; decrease smooth muscle contractility

44
Q

What are some antidiarrhea nursing interventions

A

Monitor

BP
Respirations
Frequency of bowel movements and sounds
Electrolytes

Notify provider if lasts more than 48hrs

45
Q

What is a purgative

A

A drug that promotes watery stool with cramping HARSH

46
Q

Psyllium hydrophyllic mucilloid

A

Metamucil

Use: prevention and treatment of chronic constipation

Administration: mix in water or juice, drink immediately, follow with 1 glass of water

Type: bulk forming anticonstipation

47
Q

The symptoms of MG are caused by

A

Autoimmune destruction of acetylcholine receptor sites and a resultant ‡️ in neuromuscular transmission

48
Q

What is myasthenia Gravis (MG)

A

An autoimmune process, progressive muscular weakness of the respiratory system, facial muscles and extremities

49
Q

How do acetylcholinesterase inhibitors work

A

They inhibit the action of the enzyme. Resulting in more acetylcholine is available to activate the cholinergic receptors and promote muscle contraction

‴️ transmission of neuromuscular impulses by preventing the destruction of ach

50
Q

Neostigmine

A

Prostigmin

Short-acting , every 2-4 hrs

Type: cholinesterase inhibitor

Use: to treat myasthenia crisis

51
Q

Edrophonium

A

Tensilon

Ultrashort-acting for diagnosing myasthenia gravis

Type: cholinesterase inhibitors

52
Q

Pyridostigmine bromide

A

Mestinon

Intermediate-acting, every 3-6 hours

Type: cholinesterase inhibitors

53
Q

What are some common side effects of cholinesterase inhibitors

A

Cholinergic side effects

Nausea, vomiting, diarrhea, abdominal cramps, increased salivation and tears, miosis, blurred vision, bradycardia and hypotension

54
Q

What is any early sign of myasthenia gravis

A

Ptosis - dropping eyelid

55
Q

An enlarged thymus means what

A

And increase in antibodies

56
Q

List 4 nursing implications of myasthenia gravis

A

Observe for respiratory distress

Take before meals if possible

Keep to a specific dosing schedule

Observe for over or under dosing

57
Q

What is myasthenia crisis

A

A type of Myasthenia gravis crisis character by Generalized muscle weakness

Can occur when Not enough medicine is given , administer Neostigmine (prostigmin) to relieve

58
Q

What is cholinergic crisis

A

A type of myasthenia gravis crisis characterized by muscle weakness, drooling, increased tearing and sweating, bradycardia and abdominal cramps

Can occur when too much medicine is given

59
Q

Which medication is administered to determine between a myasthenia and cholinergic crisis

A

Edrophonium (tensilon)

60
Q

What medication is given as the antidote for cholinergic crisis

A

Atropine sulfate

61
Q

What is multiple sclerosis

A

An autoimmune disorder that attacks the myelin sheath of nerve fibers in the brain and spinal cord

62
Q

List 4 characteristics of multiple sclerosis

A

Remissions and exacerbations

Weakness

Spasticity in extremities

Diplopia

63
Q

What is diplopia and what condition is it associated with

A

Double vision

Is associated with multiple sclerosis

64
Q

What 3 types of drugs are used to treat multiple sclerosis

A

Glucocorticoids

Biologic response modifiers

Immunosuppressants

65
Q

What glucocorticoid is used to treat multiple sclerosis

A

Prednisone

66
Q

What biologic response modifier is used to treat multiple sclerosis

A

Interferon B

67
Q

Azathioprine

A

Imuran

Used to treat chronic and progressive multiple sclerosis

Type: immunosuppressant

68
Q

Cyclophosphamide

A

Cytoxan

Used to treat chronic and progressive multiple sclerosis

Type: immunosuppressant

69
Q

What is a muscle spasm

A

Occurs when muscles become tightened and develop a fixed pattern of resistance

70
Q

How do muscle relaxants work to relax skeletal muscle

A

Depressing motor activity originating at the level of the brainstorm and spinal motor neurons

Increasing circulating norepinephrine

71
Q

What are some side effects of muscle relaxants

A

CNS depression , dizziness , headache , diplopia , flatulence , erectile dysfunction and risk for falls

Has anti-anxiety and sedative properties with a risk for dependency

72
Q

What are some teaching implications related to muscle relaxants

A

Avoid other CNS depressants

Short term treatment

Contraindicated in pregnancy

Don’t stop abruptly

73
Q

Cyclobenzaprine

A

Flexeril

Type: muscle relaxant

74
Q

Methocarbamol

A

Robaxin

Type: muscle relaxant

75
Q

Carisoprodol

A

Soma

Type: muscle relaxant

76
Q

Diazepam

A

Valium

Used to treat acute muscle spasms

77
Q

Antispasmodic drugs are used to treat what

A

Spasticity due to spinal cord injury, cerebral palsy

78
Q

Baclofen

A

Lioresal

Is a centrally acting muscle relaxant that acts on the spinal cord

Type: antispasmodic

79
Q

Dantrolene

A

Dantrium

Action: acts peripherally at the neuromuscular junction to block calcium release

Type: antispasmodic

80
Q

What is something to note about antispasmodic’s

A
  • start with a low dose and increase gradually

- watch for hypotension

81
Q

How do neuromuscular blocking agents work

A

Block the effect of acetylcholine at the receptor

Block the release and synthesis of acetylcholine

82
Q

When are neuromuscular blocking agents used

A

During surgery or for patients who are on ventilators

Prevents voluntary muscle contraction

83
Q

Pancuronium bromide

A

Pavulon

Type: neuromuscular blocking agent/ paralytic

84
Q

Succinylcholine

A

Anectine

Type: neuromuscular blocking agents/ paralytic

85
Q

What is something to note about/before taking paralytics

A

The patient should be sedated before administration

86
Q

What is Parkinson’s disease

A

Chronic neurologic disorder caused by degeneration of dopamine producing cells that effects the extrapyramidal motor tract (controls balance, posture, locomotion)

87
Q

What is bradykinesia

A

Slow movement

88
Q

What are the 3 key features of Parkinson’s disease

A

Rigidity , bradykinesia and tremors

89
Q

What is the cause of Parkinson’s

A

Caused by an imbalance of the neurotransmitters dopamine (inhibitory) and acetylcholine (excitatory)

90
Q

In reference to Parkinson’s dopamine usually does what in relation to acetylcholine

A

Dopamine usually maintains control and inhibits its excitatory response

91
Q

Drug therapy related to Parkinson’s

A

Focus is restoring the balance between dopamine and acetylcholine

  • enhancing dopamine production or replacing it
  • decreasing the influence of acetylcholine

Anticholinergic and dopaminergic drugs

92
Q

What do dopaminergic drugs do

A

Increase dopamine

93
Q

How are Anticholinergics used to treat Parkinson’s

A

Block the action of acetylcholine reducing the rigidity and some of the tremors characteristic of Parkinson’s , but have minimal effect on bradykinesia

94
Q

Benzotropine

A

Cogentin

Type: anticholinergic used to treat Parkinson’s

95
Q

Trihexyphenidyl

A

Artane

Type: anticholinergic used to treat Parkinson’s

96
Q

What are some side effects of anticholinergics used to treat Parkinson’s

A
Dry mouth 
Blurred vision 
Eye pain 
Photophobia 
Constipation 
Urinary retention 
Tachycardia 
Orthostatic hypotension 
Anhidrosis
97
Q

Mydriasis

A

Dilation of pupils

98
Q

Anhidrosis

A

Inability to sweat

99
Q

Carbidopa-levodopa

A

Sinemet

Type: dopaminergic

Use: to treat Parkinson’s

100
Q

Bromcriptine

A

Parlodel

Type: dopaminergic

Use: to treat Parkinson’s

101
Q

Amantadine

A

Symmetrel

Type: dopaminergic

Use: early treatment of Parkinson’s as drug tolerance develops

102
Q

What is something important to note about amantadine

A

(Symmetrel)

It is also an antiviral drug for influenza A

103
Q

Selegeline

A

Eldepryl

Type: MAO-B inhibitors

Use: to treat Parkinson’s

Action: inhibits MAO-B thus prolonging the action of levodopa

104
Q

Entacapone

A

Comtan

Type: COMT (catechism-o-methyl trabsferase) inhibitor

Use: to treat Parkinson’s

105
Q

What is something important to note about entacapone

A

(Comtan)

When taken in conjunction with carbidopa-levodopa it lessens the β€œwearing off” effects of levadopa

106
Q

What are some common side effects of drugs used to treat Parkinson’s

A

*increased suicidal thoughts πŸ’­ *

Fatigue, insomnia 
Dry mouth 
Blurred vision 
Orthostatic hypotension/palpitations/dysrhytmias 
Urinary retention 
Nausea, vomiting 
Dyskinesia/psychosis/severe depression
107
Q

What is dyskinesia

A

Uncontrolled, involuntary muscle

Movement

108
Q

What are some nursing interventions for people taking drugs to treat Parkinson’s

A
  • monitor for orthostatic hypotension
  • avoid excessive vitamin B6 intake (foods like Lima,navy, kidney beans,cereals)
  • don’t stop taking them abruptly
  • warn of harmless brown discoloration of urine and sweat
  • assess for dividing tendencies
  • take on regular schedule
  • assess symptom status and β€œon-off” phenomenon
  • monitor blood cell counts, liver and kidney function
  • no drivung
109
Q

What are some causes of dementia

A
Alzheimer's
Stroke
AIDS 
Atherosclerosis 
Medications 
Parkinson's
110
Q

What are the symptoms of Alzheimer’s caused by

A

The loss of acetylcholine

111
Q

Name two conditions that cholinesterase inhibitors are used to treat

Hint:from chapters 24 and 23

A

Myasthenia gravis and Alzheimer’s

112
Q

What is Alzheimer’s disease characterized by

A

The loss of cholinergic neurons that secrete acetylcholine

113
Q

What is the purpose/action of drugs used to treat Alzheimer’s

A
  • increased acetylcholine available at the receptors

- increase cognitive function

114
Q

Monepril

A

Aricept

Type: cholinesterase inhibitor

Use: to treat mild to moderate Alzheimer’s

115
Q

Rivastigmine

A

Exelon

Slows the disease process

Type: cholinesterase inhibitor

Use: to treat mild to moderate Alzheimer’s

116
Q

Memantine

A

Namenda

Type: N-methyl D-aspartate (NMDA) antagonist

Use: to treat later stages of Alzheimer’s

Action: regulates the activity of glutamate, a chemical messenger involved in learning and memory

117
Q

What are some contraindications of drugs used to treat Alzheimer’s

A

Reduced kidney or liver function

118
Q

What are some side effects of drugs used to treat Alzheimer’s

A

ANVD, dizziness, headache

119
Q

What are some nursing implications for drugs used to treat Alzheimer’s

A
  • monitor side effects, especially safety related

- evaluate effectiveness

120
Q

What is a seizure

A

Abnormal electrical activity in the brain; may result in alteration in consciousness, motor or sensory ability and/or behavior

121
Q

What is a convulsion

A

Involuntary, spasms of the large skeletal muscles of the face, neck, arms and legs that may accompany seizures

122
Q

What is epilepsy

A

Chronic disorder with recurrent, unprovoked seizure activity

123
Q

What is status epilepticus

A

Repeated, unremitting occurrence of a seizure; can cause brain damage and ultimately death

Lasts greater than 5 mins

124
Q

What are a few things to note about antiepileptics (AEDS)

A
  • stabilize nerve cell membranes and suppress the abnormal electric impulses in the cerebral cortex
  • affect concentration and movement of sodium, calcium and chloride ions across the neuronal cell membrane
  • depress excitability of neurons by enhancing GABA (inhibitory) receptors
125
Q

How do antiepileptics work

A

Suppress abnormal neuron firing

126
Q

List 8 antiepileptics that’s suppress sodium influx

A
Phenytoin (Dilantin) 
Fosphenytoin 
Carbamazepine 
Oxcarbazepine 
Valporic acid 
Topiramate 
Zonisamide 
Lamotrigine
127
Q

List 2 antiepileptics that suppress calcium influx

A
Valporic acid (depakane) 
Ethosuximide
128
Q

List 3 antiepileptics that enhance action of GABA

A

Barbiturates
Benzodiazepines
Tiagabine

129
Q

List an antiepileptic that promotes GABA release

A

Gabapentin

130
Q

How do barbiturates and benzodiazepines work to stop seizures

A

Increase the action of the neurotransmitter GABA (gamma amino butyric acid)

131
Q

What type of seizures are barbiturates and benzodiazepines used to treat

A

Petit/grand mall seizures and status epilepticus

132
Q

What are some side effects of barbiturates and benzodiazepines in reference to antiepileptics

A

Drowsiness/CNS effects
Addictive- produce tolerance and withdrawal
Barbiturates: respiratory depression

133
Q

Phenobarbital

A

Type: barbiturates

Use: to treat seizures

134
Q

Diazepam

A

Valium

Type: benzodiazepines

Used: to treat seizures

135
Q

Clonazepam

A

Klonopin

Type: benzodiazepines

Use: to treat seizures

136
Q

Phenytoin

A

Dilantin

Type: hydantoins

Action: inhibit sodium influx

Use: to treat seizures

137
Q

Valporic acid

A

Depakote

Possible hepatotoxicity, monitor liver enzymes

Not given to children under 12

Type: antiepileptics

138
Q

What is something to note about Carbamazine

A

Tegretol

Grapefruit juice can cause toxicity

Type: antiepileptic

139
Q

Lamotrigine

A

Lamictal

Type: antiepileptic

140
Q

Topiramate

A

Topamax

Type: antiepileptic

141
Q

What is something important to note about tigabene

A

Gabitril

Only taken with epilepsy- can cause increase in seizures

142
Q

What are some side effects of neurologic and psychiatric antiepileptics

A
Slurred speech 
Headache 
Confusion 
Depression 
Trouble with attention 
Hypertrophy of the gums (can cause bleeding)
143
Q

What are some common side effects of phenytoin

A
  • thrombocytopenia (low platelet)
  • leukopenia (low WBC count)
  • gingival hyperplasia (overgrowth or redness of gums)
  • hyperglycemia
  • nausea/vomiting/constipation
  • drowsiness
  • pinkish-brown urine
144
Q

What is a warning issued by the FDA in reference to antiepileptics

A

11 popular antiseizure drugs were found to almost double the risk of suicidal behavior and ideation/violent deaths amount patients

Gabapentin, lamotrigine, oxcarbazepine, tiagabine, valproate

145
Q

List some nursing considerations for patients taking antiepileptics

A
  • evaluate most current blood level of medications, if appropriate
  • be aware of drug-drug and drug-food interaction
  • maintain therapeutic blood levels for maximal effectiveness
  • observe children for cognitive changes
  • assess for suicidal ideation a
146
Q

List some teaching implications for patients taking antiepileptics

A
  • effective seizure management involves strict adherence to drug therapy
  • be aware of CNS side effects
  • dont stop the medication abruptly, unless a rash presents
  • inform doctors that you take anticonvulsants
  • should receive pre-operatively
  • do not skip doses
  • wear medic alert tag
  • good oral hygiene
  • some teratogenic effects
147
Q

What are the directions for administering medication during status epilepticus

A
  1. Diazepam (Valium) or lorazepam (Ativan) via IV - benzodiazepine
  2. Give phenytoin (Dilantin) via IV - barbiturate
    * if seizures persist, intubate for airway*
  3. Midazolam (versed) or propofol (diprivan)
148
Q

What are adrenergics

A

Drugs that stimulate the sympathetic nervous system

149
Q

Which neurotransmitter(s) stimulate the sympathetic nervous system (adrenergic system)

A

Norepinephrine and epinephrine

150
Q

Which neurotransmitter stimulates the parasympathetic nervous system (cholinergic system)

A

Acetylcholine

151
Q

How does the sympathetic response vs the parasympathetic response affect the eye

A

Sympathetic- dilates pupils

Parasympathetic- constricts pupils

152
Q

How does the sympathetic response vs the parasympathetic response affect the lungs

A

Sympathetic- dilates bronchioles

Parasympathetic- constricts bronchioles, increases secretions

153
Q

How does the sympathetic response vs the parasympathetic response affect the ❀️

A

Sympathetic- increase heart rate

Parasympathetic- decreases heart rate

154
Q

How does the sympathetic response vs the parasympathetic response affect the blood vessels

A

Sympathetic- constricts blood vessels

Parasympathetic- dilates blood vessels

155
Q

How does the sympathetic response vs the parasympathetic response affect the gastrointestinal

A

Sympathetic- relaxes smooth muscles of gi tract

Parasympathetic- increases peristalsis

156
Q

How does the sympathetic response vs the parasympathetic response affect the bladder

A

Sympathetic- relaxes bladder muscles

Parasympathetic- constricts bladder

157
Q

How does the sympathetic response vs the parasympathetic response affect the uterus

A

Sympathetic- relaxes uterine muscle

158
Q

How does the sympathetic response vs the parasympathetic response affect the salivary glands

A

Parasympathetic- increases salivation

159
Q

How does the sympathetic response vs the parasympathetic response affect the skeletal muscle

A

Parasympathetic- increased contraction

160
Q

What are the 3 steps to norepinephrine function

A
  1. NE is released
  2. NE binds with its receptor
  3. The action of NE is terminated by MAO and COMT

*if MAO-I is present, NE is not broken down

161
Q

What two enzymes inactive norepinephrine

A

MAO (inside the neuron) and COMT (outside the neuron)

162
Q

What are the 3 steps to acetylcholine function

A
  1. Ach is released
  2. Ach binds with its receptor
  3. The action of Ach is terminated by Ach E

*if Ach E-I is present, Ach is not broken down

163
Q

Sympathetic nervous system stimulants are also known as

A

Sympathomimetics
Adrenergic agonists
Adrenergics
Adrenomimetics

164
Q

Sympathetic nervous system depressants are also known as

A

Sympatholytics
Adrenergic antagonist
Adrenergic blockers
Adrenolytics

165
Q

Alpha1 adrenergic receptor site

A

Located primarily in blood vessels

Vasoconstriction, increase BP and improved circulation

166
Q

Alpha2 adrenergic receptor site

A

Located in the CNS

Inhibits the release of norepinephrine, vasodilation and decrease BP

167
Q

Beta1 adrenergic receptor site

A

Located in the ❀️

Increases heart rate and contractility

168
Q

Beta2 adrenergic receptor site

A

Located in the lungs

Bronchodilation

169
Q

Nonselective

A

Activates more than one receptor SITE

Ex: epinephrine acts on alpha 1/2, beta 1/2

170
Q

Adrenergic agonists are frequently used to treat what types of conditions

A
Hypotension 
Bronchospasm 
Asthma 
COPD
nasal congestion 
Orthostatic hypotension 
Shock
171
Q

Catecholamines

A

Produce an adrenergic RESPONSE

Ex: epinephrine, norepinephrine, dopamine and dobutamine

172
Q

Noncatecholamines

A

Stimulate the adrenergic RECEPTORS

Ex: phenylephrine, albuterol

173
Q

Direct-acting adrenergics (sympathomimetics)

A

Directly stimulate receptor SITE

Ex: epinephrine and albuterol

174
Q

Epinephrine is used to treat anaphylaxis, why?

A

Because it increases BP, heart rate and airflow through the lungs

175
Q

Albuterol

A

Proventil, ventolin

Beta2 agonist, that cause bronchodialation for asthmatics

176
Q

Indirect-acting adrenergic

A

Stimulate the release of norepinephrine

Ex: amphetamines

177
Q

Mixed-acting adrenergic

A

Act on the receptor site AND stimulate release of norepinephrine

Ex: ephedrine

178
Q

Central-acting adrenergic

A

Depress the release of norepinephrine through stimulating alpha2 RECEPTORS in CNS

Ex: clonidine and methyldopa

179
Q

Clonidine

A

Catapress

Type: central-acting adrenergic

Use: to decrease BP

180
Q

What is something important to note about clonidine

A

Catapres

Don’t touch the patch, will drop your BP

181
Q

Methyldopa

A

Aldomet

Type: central-acting adrenergic

Use: to lower BP

182
Q

What are some common uses of sympathomimetics

A
Allergic reaction 
Anaphylaxis 
Asthma 
Bronchospasm 
Severe hypotension 
Cardiac arrest
183
Q

List some side effects of patients taking sympathomimetics

A
Anorexia 
Nausea 
Nervousness 
Tremor
Agitation
Headache
Insomnia 
Syncope
Dizziness
184
Q

What are some adverse effects of taking sympathomimetics

A

Palpitations, tachycardia , hypertension, cardiac arrhythmia

185
Q

List some contraindications for taking sympathomimetics

A

Cardiac disease
Hypertension
Diabetes (in some cases)
Narrow angle glaucoma

186
Q

What are some food/drug interactions to be mindful of while taking sympathomimetics

A

Increased effects with tricyclic antidepressants and MAOI’s

187
Q

List some nursing implications for taking sympathomimetics

A
  • monitor blood glucose and serum potassium levels
  • monitor for urinary retention
  • monitor blood pressure, heart dysrrythmias

Teaching
-OTC med’s

188
Q

What are adrenergic blockers frequently used to treat

A
Hypertension 
Angina 
Dysrhythmias 
Myocardial infarction (after initial injury) 
Open angle glaucoma 
Migraines
189
Q

How do adrenergic blockers work

A

Block the effects of the sympathetic nervous system neurotransmitters by occupying the alpha or beta receptor sites or inhibiting the release of neurotransmitters

190
Q

What are adrenergic antagonist primarily used to treat

A

Hypertension

191
Q

Prazosin

A

Minipress

Type: alpha 1 blocker

Use: to treat high BP

192
Q

Atenolol

A

Tenormin

Type: beta 1 adrenergic antagonist

Use: treat high BP

193
Q

Metoprolol

A

Lopressor

Type: beta 1 adrenergic antagonist

Use: treat high blood pressure

194
Q

Propranolol

A

Inderal

Type: nonselective (blocks beta 1 and 2) adrenergic antagonist

Use: to treat high BP

195
Q

Carvedilol

A

Coreg

Type: nonselective (blocks beta 1 and 2) adrenergic antagonist

Use: to treat high BP

196
Q

What are some common uses of beta blockers

A

Hypertension
Angina
Myocardial infarction
Heart failure

197
Q

What are some side effects of taking beta blockers

A

Drowsiness, dizziness, fainting, depression, weakness, flushing, cool extremities, leg pain, impotence, decreased libido

198
Q

What are some adverse effects of taking beta blockers

A

Bradycardia, hypotension , heart failure, pulmonary edema, hypoglycemia, bronchospasm , dysrhythmia, respiratory difficulty

199
Q

Contraindications of taking beta blockers

A

Use with caution with diabetes, impaired renal function

Beta2 blockers with asthma/COPD

200
Q

Nursing implications with beta blockers

A
  • observe for and teach about side effects
  • safety precautions ; CNS type effects
  • teaching to avoid orthostatic hypotension
  • may need to take pulse and/or BP before administration
201
Q

Most alpha and beta agonists end in what

A

-ine or ol

Ex: epinephrine , midodrine, pseudophedrine, albuterol

202
Q

Most alpha blockers end in what

A

-zosin

Ex: doxazosin, prazosin, terazosin

203
Q

Most beta blockers end in what

A

-lol

Ex: carvedilol, metoprolol , propranolol, timolol, atenelol

204
Q

Parasympathetic nervous system stimulants are also known as

A

Parasympathomimetics
Cholinergics
Cholinergic agonists
Cholinesterase inhibitors

205
Q

What two groups of drugs affect the parasympathetic nervous system

A

Cholinergic agonist (parasympathomimetics)

Anticholinergics (parasympathytic)

206
Q

The sympathetic nervous system is

A

Fight of flight

207
Q

The parasympathetic nervous system is

A

Rest and digest

208
Q

The sympathetic NS receptor sites are

A
Alpha 1
Alpha 2
Beta 1
Beta 2
Dopaminergic
209
Q

The parasympathetic NS receptor sites are

A

Nicotinic

Muscarinic

210
Q

Muscarinic receptor SITE

A

Stimulates smooth muscle and slow heart rate

Construct bronchioles, increase salivation, construct pupils, dilate blood vessels

211
Q

Nicotinic receptor SITE

A

(Neuromuscular)

Affect the skeletal muscles

212
Q

Direct acting cholinergic agonist

A

Selective to muscarinic RECEPTORS but nonspecific

Ex: metoclopramide (reglan) for reflux disease it increases gi tone and motility , increases peristalsis

213
Q

Bethanechol

A

Urecholine

Use: urinary retention

Type: direct acting cholinergic agonist

Action: increases urination

214
Q

Pilocarpine

A

Pilocar

Use: relieve pressure in the eye related to glaucoma

Type: direct acting cholinergic agonist

Action: constructs the pupils

215
Q

What is xerostomia

A

Dry mouth

216
Q

Indirect acting cholinergic agonist

A

Don’t act on receptors; instead they inhibit the enzyme cholinesterase , allowing acetylcholine to accumulate at the receptor sites

217
Q

Donepezil

A

Aricept

Type: indirect acting cholinergic agonist

Use: to improve cognitive function in Alzheimer’s disease

218
Q

Drugs used to treat myesthenia gravis are what type

A

Indirect acting cholinergic agonist

219
Q

What are some contraindications of cholinergic agonist

A
  • Intestinal or urinary obstruction
  • COPD
  • bradycardia
  • hypotension
220
Q

List some side effects of cholinergic agonist

A

Nausea , vomiting, diarrhea, abdominal cramping, salivation, sweating, flushing, frequent urination, blurry vision, miosis

221
Q

What are some adverse effects of cholinergic agonist

A

Orthostatic hypotension, bradycardia, muscle weakness and twitching, bronchoconstriction, heart block, circulatory and respiratory collapse

222
Q

Nursing implications for cholinergic agonist

A
  • monitor vital signs and bowel sounds
  • check breath sounds (can cause increased secretions)
  • observe for cholinergic crisis (the antidote is atropine)
  • teach about side effect management
223
Q

Dicyclomine hcl

A

Bentyl

Used to treat irritable bowel syndrome

Type: anticholinergic

224
Q

Tolterodine tartrate

A

Detrol

Used for urinary frequency

Type: anticholinergic

225
Q

Cyclopentolate

A

Cyclogyl

Used to induce pupil dilation for eye exams

Type: anticholinergic

226
Q

Ipratropium

A

Atrovent

Used for COPD

Type: anticholinergic

227
Q

What are some contraindications when administering anticholinergics

A

Narrow angle glaucoma, obstructive gi disorders, paralytic ileus, tachycardia, BPH , myasthenia gravis, myocardial ischemia

228
Q

What are some adverse effects of taking anticholinergics

A
Tachycardia
Hypotension 
Paralytic ileus 
Coma 
Ventricular fibrillation
229
Q

Teaching implications for anticholinergics

A
  • increase fluid intake, fiber and exercise to avoid constipation
  • advise client to relieve dry mouth with ice chips, hard candy or sunglasses for photophobia
  • avoid becoming overheated
  • watch OTC’s with anticholinergic effects
230
Q

How do stool softeners work

A

Cause more water and fat to be absorbed into the stools; emulsifies and lubricates feces

231
Q

Docusate

A

Colace

Use: to decrease straining during defecation

Type: stool softener

232
Q

Lubiprotone

A

Amitiza

Use: to treat idiopathic constipation in adults

Type: chloride channel activator , stool softener

233
Q

How do stimulant laxatives work

A

Promote peristalsis by irritating the bowel

234
Q

Sennosides

A

Ex-lax

Type: stimulant laxative

235
Q

Biscodyl

A

Dulcolax, corrector

Type: stimulant laxative

236
Q

How do osmotic laxatives work

A

Cause water to be retained in the fecal mass to cause a more watery stool

237
Q

What are osmotic laxatives used for

A

Surgical and diagnostic prep

238
Q

What are some side effects of osmotic laxatives

A

Fluid and electrolyte imbalance, hypotension , weakness

239
Q

Magnesium hydroxide

A

Milk of magnesia

Type: osmotic laxative

240
Q

Polyethylene glycol

A

Miralax, goLytely

Type: osmotic laxative

241
Q

Constipation nursing implications

A

Don’t give with undiagnosed abdominal pain, inflammatory disorders of the gi tract (appendicitis, diverticulitis, etc) spastic colon or a bowel obstruction

242
Q

What is reflux

A

Occurs when stomach contents back up through the LES into the esophagus

243
Q

Where are peptic ulcers most commonly found

A

In the proximal duodenum

244
Q

How do histamine 2 receptor antagonist work

A

Prevents histamine from stimulating the H2 RECEPTORS located on the gastric parietal cells, resulting in a reduction in the volume and concentration of gastric acid secretion

245
Q

Histamine 2 receptor antagonist are used to treat

A

Symptoms of gerd

246
Q

How should histamine 2 receptor antagonist be administered

A

Wait 30 mins-1 hour between taking an antacid and the H2 blocker

247
Q

Ranitidine

A

Zantac

Type: h2 receptor antagonist

Use: treat gerd

248
Q

Famotidine

A

Pepcid

Type: h2 receptor antagonist

Use: to treat gerd

249
Q

Cimetidine

A

Tagamet

Type: h2 receptor antagonist

Use: treat gerd

250
Q

What is something important to note about cimetidine and ranitidine

A

Can be given IV, but should not be taken with antacids

251
Q

How do proton pump inhibitors work

A

Reduce acid secretion by blocking the enzyme responsible for secreting hcl in the stomach

252
Q

What are proton pump inhibitors used to treat

A

Drug of choice for short term control of peptic ulcer disease and gerd

253
Q

Omeprazole

A

Prilosec

Type: proton pump inhibitors

Use: short term control of pud and gerd

254
Q

Iansoprozole

A

Prevacid

Type: proton pump inhibitors

Use: short term control of pud and gerd

255
Q

Esomeprozole

A

Nexium

Type: proton pump inhibitor

Use: short term control of pud and gerd

256
Q

Omeprazole and sodium bicarb

A

Zegrid

Type: proton pump inhibitor

Use: short term control of our and gerd

257
Q

What is zegrid given for

A

(Omeprazole and Na bicarb)

Only drug given to prevent stress ulcers in critically ill patients

Type: proton pump inhibitors

258
Q

Metronidazole

A

Flagyl

Type: antibiotics for h pylori

259
Q

Tetracycline

A

Achromycin V

Type: antibiotics for h pylori

260
Q

How do antacids work

A

Promote ulcer healing by neutralizing hydrochloric acid and reducing pepsin activity THEY DO NOT COAT THE ULCER

261
Q

Ca carbonate and Mg hydroxide

A

Rolaids,tums

Type: antacids

262
Q

Mg hydroxide and Al hydroxide

A

Maalox

Type: antacid

263
Q

Drugs with Al and Ca products cause

A

Constipation

264
Q

Magnesium products can cause

A

Diarrhea

265
Q

Simethicone

A

An antiflatulent is added to antacids to reduce gas bubbles that cause bloating and discomfort

266
Q

How do pepsin inhibitors work

A

Produces a thick, gel like substance that coats a gastric ulcer protecting it against further erosion and promoting healing

267
Q

How should pepsin inhibitors be administered

A

30 mins before meals

268
Q

Sucralfate

A

Carafate

Type: pepsin inhibitor

269
Q

Prostaglandin analogues are used for what

A

To prevent gastric ulcers in patients taking high doses of NSAIDS

270
Q

Misoprostol

A

Cytotec

Type: prostaglandin analogue

Use: to prevent gastric ulcers in patients taking high doses of NSAIDS

271
Q

What are sulfonamides used to for

A

To treat ulcerative colitis

272
Q

Balsalazide disodium

A

Colazal

Type: sulfonamide

Use: to treat ulcerative colitis

273
Q

Nursing interventions for antacids

A

May delay absorption of other meds, take 1-3 hours after meals and before bedtime, small amount of water, avoid with milk or foods high in vitamin d, report constipation/diarrhea

274
Q

Nursing interventions for ppi’s or H2 blockers

A

Give right before meals, avoid smoking, long term use effects b12 absorption

275
Q

Nursing interventions for pepsin inhibitors

A

Take on an empty stomach, allow 1-2 hour time lapse with meds

276
Q

How do amphetamine like drugs work

A

Suppress appetite by depressing the hunger center in the brain

277
Q

Phentermine

A

Adipex

Type: amphetamine , anorexiant

278
Q

How do fat blockers work

A

Block the enzyme lilase in the gi tract which blocks the absorption of fats

279
Q

Orlistat

A

Xenical

Type: fat blocker

280
Q

What is something important to note about fat blockers

A

They may also decrease absorption of other substances- like fat soluble vitamins and Coumadin

281
Q

How do pancreatic enzymes work

A

Contains the necessary enzymes to digest fats, carbs, and proteins

282
Q

Where do pancreatic enzymes come from

A

Obtained from pigs 🐷

283
Q

Pancrelipase

A

Pancrease

Type: pancreatic lipase

284
Q

What are some side effects of taking pancreatic enzymes

A
Diarrhea 
Constipation 
Abdominal pain and bloating 
Gas 
N/v
285
Q

Teaching implications for pancreatic enzymes

A

Take it with every meal or snack, drink plenty of fluids, may increase blood sugar in diabetics

286
Q

Cox 1

A

Protects stomach lining , decreases fever , promotes platelet aggregation (blood clotting)

287
Q

Cox 2

A

Triggers pain and inflammation

288
Q

How do NSAIDS work

A

Inhibit biosynthesis of prostaglandins

289
Q

What effects do NSAIDS have

A

Analgesic
Antipyretic
Inhibit platelet aggregation
Mimic corticosteroids

290
Q

Salicylic acid

A

Aspirin

Type: NSAIDS

291
Q

Ibuprofen

A

Advil, Motrin

Type: NSAIDS

292
Q

Naproxin sodium

A

Naprosyn

Type: NSAIDS

293
Q

Ketorolac

A

Toradol

Type: NSAIDS

294
Q

Celecoxib

A

Celebrex

Type: cox 2 inhibitor

295
Q

What are NSAIDS used for

A

Mild to moderate pain, inflammation

296
Q

Contraindications of NSAIDS

A

Hypersensitivity, bleeding disorders, Reye’s syndrome (asa only)

297
Q

Side effects with NSAIDS

A

ANVD, tinnitus, stomach pain

298
Q

Adverse effects with NSAIDS

A
Blood dycrasis
Bleeding 
Anaphylaxis 
Hearing loss 
Metabolic acidosis (asa only)
299
Q

What interactions should the nurse be mindful of with giving NSAIDS

A

Not taken with anticoagulants

300
Q

Nursing implications of NSAIDS

A

Check for allergy , assess gi status , observe for bleeding

301
Q

Teaching implications for NSAIDS

A

Avoid things that increase gastric upset, tell doctors you are taking NSAIDS, taking during period can increase bleeding

302
Q

What 4 drugs are used to treat rheumatoid arthritis

A

Glucocorticoids
Immunosuppressants
DMARDS
immunomodulators

303
Q

What glucocorticoid is used to treat rheumatoid arthritis

A

Prednisone

304
Q

Methotrexate

A

Mexate

Type: immunosuppressant

Use: treat rheumatoid arthritis

305
Q

What is the action of DMARDS

A

Slow down progression of rheumatoid arthritis

306
Q

When are DMARDS used

A

Only after other anti-inflammatory drugs are ineffective due to high side effects

307
Q

Gold salts

A

Crysotherapy

Type: DMARD

use: treat rheumatoid arthritis

308
Q

What is something important to note about gold salts

A

(Crysotherapy)

Don’t give to diabetics, those with renal/liver problems or allergic to gold or metal

309
Q

What is the action of immunomodulators

A

STOP rheumatoid arthritis disease profession ; may induce a long lasting remission

310
Q

Adalimumab

A

Humira

Type: immunomodulators

Use: treat rheumatoid arthritis

311
Q

Etanercept

A

Enbrel

Type: immunomodulators

Use: treat rheumatoid arthritis

312
Q

Infliximab

A

Remicade

Type: immunomodulators

Use: treat rheumatoid arthritis

313
Q

Allopurinol

A

Zyloprim

Use: to treat gout

Type: Uric acid inhibitor

Action: decrease production of uric acid

314
Q

Nursing interventions for Uric acid inhibitors

A

Monitor CBC, liver enzymes, renal function, yearly eye exams, increase fluid intake to excrete more Uric acid; limit alcohol and caffeine, no high purine foods (organ meats, salmon, sardines, legumes)

315
Q

What are Uric acid inhibitors used for

A

Long term management of gout

316
Q

Acetaminophen

A

Tylenol

Type: non opioid analgesic

Can cause hepatotoxicity. No anti-inflammatory effect. Good as antipyretic in children. Maximum dose 4 g/day

317
Q

How do triptans work

A

Constrict vessels in the brain

Use: treat migraines

318
Q

Sumatriptan

A

Imitrex

Use: to decrease the severity of migraines and to treat acute migraine pain

Type: triptan

319
Q

Rizatriptan benzoate

A

Maxalt

Type: triptan

Use: to treat migraines

320
Q

Eletriptan

A

Relpax

Type: triptan

Use: to treat migraines

321
Q

What are adjuvant analgesics

A

Have been developed for other purposes and later found to be effective for pain relief neuropathy

322
Q

Propranolol

A

Inderal

Type: beta blocker but also an adjuvant analgesic

323
Q

Amitriptyline

A

Elavil

Type: tricyclic antidepressants and an adjuvant analgesic

324
Q

Gabapentin

A

Neurontin

Type: anticonvulsant and adjuvant analgesic

325
Q

Pregabalin

A

Lyrica

Type: anticonvulsant and adjuvant analgesic

326
Q

Hydrocodone

A

Vicodin, lortab

Type: opiate

327
Q

Oxycodone

A

Percocet, OxyContin

Type: opiate

328
Q

Methadone

A

Dolophine

Use: to treat opioid dependence

Type: opioid

329
Q

Codeine sulfate

A

Codeine

Type: opioid

330
Q

Morphine sulfate

A

Morphine

Type: opioid

331
Q

What is something important to note about opioids

A

They can cross the placenta and don’t give them for neuro trauma

332
Q

Meperidine

A

Demerol

Type: opioid

333
Q

Levophanol

A

Dilaudid

Type: opioid

*is stronger via IV than morphine

334
Q

Fentanyl

A

Duragesic

Type: opioid

*is the strongest, is a transdermal for chronic pain

335
Q

Contraindications for opiates

A

Asthma/COPD, increase intracranial pressure, use with caution in children and older adults

336
Q

Side effects of opiates

A
N/v 
Constipation 
Sedation 
Urinary retention 
Blurred vision 
Hallucinations
337
Q

Adverse effects of opiates

A

Hypersensitivity
Respiratory depression
Increased ICP
Seizures

338
Q

Nursing implications for opiates

A
  • check for allergy
  • assess respiratory status
  • assess drug hx
  • monitor urinary output
  • HAVE NARCAN AVAILABLE
339
Q

Teaching implications for opiates

A

Avoid other CNS depressants (4 respiration), manage constipation, addictive potential

340
Q

Fentanyl

A

Sublimaze

Type: patient controlled analgesic

341
Q

Hydromorphone

A

Dilaudid

Type: patient controlled analgesia

342
Q

What are combination medications made of

A

Opioids and non narcotic analgesics

343
Q

What is Vicodin made of

A

Hydrocodone 5mg + acetaminophen 500mg

344
Q

What is Percocet made of

A

Oxycodone hcl 5mg + acetaminophen 325mg

345
Q

What is Tylenol with codeine made of

A

15-60 Mg of codeine phosphate + 300-1,000 mg acetaminophen

346
Q

How do opioid antagonist work

A

Compete with opioid agonists for access to the opioid receptor site

347
Q

Naloxone

A

Narcan

Type: opioid antagonist

348
Q

Naltrexone hydrochloride

A

Revia

Type: opioid antagonist

349
Q

Nursing implications for opioid antagonist

A
  • monitor vs and bleeding

- watch for reversal of analgesia