Pharmacology Midterm reviewer Flashcards
(141 cards)
1
Q
Drugs affecting the
A
ANS
CNS
Respiratory
Cardiovascular
2
Q
ANS Agents
A
Autonomic nervous system
3
Q
stimulate sympathetic response
A
Agonist
4
Q
block sympathetic response
A
Antagonist
5
Q
-heart rate, bp = increased, GI decreased, mydriaisis (dilation
of the pupils)
A
SYMPATHETIC NERVOUS SYSTEM
6
Q
epinephrine, adrenaline
A
Neurotransmitters
7
Q
alpha and beta receptors
A
Receptors
8
Q
vasoconstriction - increase heart rate, contraction, mydriasis,
increases blood pressure
Example: phenylephrine, epinephrine
A
Alpha 1 receptor agonist
9
Q
vasodilation – decrease in bp
ex: Clonidine
A
Alpha 2 receptor agonist
10
Q
increased heart contractility and heart rate
(presence of dysrhythmia – hold the ordered dose and inform the
doctor) - Increased myocardial contractility
A
Beta 1 receptor agonist
11
Q
bronchodilation
A
Beta 2 receptor agonist
12
Q
the nurse should monitor the patient for palpitations
A
Albuterol
13
Q
blocks both A1 and A2
ex: Phentolamine
A
Non-Selective Alpha Antagonist
14
Q
blocks only Alpha 1 causing vasodilation,
decrease heart rate, contractility and bp.
ex: Prazosin
A
Alpha 1 Selective Antagonist
15
Q
Beta Blockers
A
Non Selective
Selective B1 antagonist/blocker
16
Q
blocks both B1 and B2 causing vasodilation
decreasing bp but bronchoconstriction – don’t give to patient with
asthma or respiratory problems.
Eg : Propranolol
A
Non Selective
17
Q
blocks only B1 causing
vasodilation causing a decrease in BP but no bronchoconstriction.
Eg: Metoprolol – less likely to precipitate bronchoconstriction
A
Selective B1 antagonist/blocker
18
Q
PARASYMPATHETIC NERVOUS SYSTEM
A
Parasympathomimetics
Neurotransmitters
cholinergic agonists
Receptors
Muscarinic agonist
19
Q
heart rate, bp = decreased, GI
increased, miosis
A
PARASYMPATHETIC NERVOUS SYSTEM
20
Q
Cholinesterase inhibitors
A
Parasympathomimetics
21
Q
Acetylcholine
A
Neurotransmitters
22
Q
mimic Acetylcholine
A
cholinergic agonists
23
Q
Nicotinic and Muscarinic
A
Receptors
24
Q
increase salivation, sweating, urination, gastric acid
Pilocarpine
A
Muscarinic agonist
25
skeletal muscle contraction
Nicotinic receptor agonist
26
will cause miosis, diarrhea and bradycardia
Bethanechol
27
Perform
urinary assessment
28
clinical manifestation of extreme
muscarinic stimulation
Excessive perspiration
29
as a neuromuscular relaxant
Succinylcholine
30
cholinesterase inhibitor
Physostigmine
31
bradycardia, hypotension, bronchospasm
Side effects
32
antimuscarinic agents causing bladder relaxation
preventing urinary incontinence.
Vasico selective
33
treatment for bladder incontinence – will
cause decrease unrination
Oxybutynin
34
muscarinic antagonists – decrease saliva, mucus
secretions, prevent vomiting
Atropine
35
for excessive dosing of bethanechol
Antidote
36
increase temp, confusion, flushed face,
dryness of mouth, very thirsty
Atropine overdose
37
muscle relaxation
Neuromuscular blocking drugs
38
Parasympatholitics
Spasmolytics
Mydriatics
Antiparkinsonian
Scopolamine
39
nicotinic receptor antagonist
Spasmolytics
## Footnote
Dantrolene
40
# Spasmolytics
skeletal muscle relaxation
Dantrolene
41
dilation of pupils
Mydriatics
42
increase dopamine
Antiparkinsonian
## Footnote
Levodopa
43
muscarinic receptor antagonist – given to patient with
motion sickness
Scopolamine
44
increase the release of and block the reuptake of
excitatory neurotransmitters
CNS Stimulants
45
CNS Stimulants Indications
* Narcolepsy- excessive daytime sleepiness
* attention deficit disorder in children
* endogenous obesity
* reversal of respiratory distress
46
CNS
Central nervous system
47
# CNS
Common Drugs:
Amphetamines
Methylphenidate (Ritalin)
Analeptics
Anorexiants
48
for ADHD to increase a child’s attention span,
decrease a child’s hyperactivity and decrease impulsiveness
## Footnote
* Given in the morning on an empty stomach.
* Advise patient to report signs of palpitations
* Advise patients to avoid alcohol consumption
* Advise the patients to avoid driving and using hazardous equipment while on
this drug
Avoid giving beverages containing caffeine – will cause cardiac dysrhythmias
Methylphenidate (Ritalin)
49
Avoid giving beverages containing caffeine
will cause **cardiac dysrhythmias**
50
to stimulate respiration – Methylxanthine – caffeine,
aminophylline, theophylline
Analeptics
51
suppress appetite, given to control weight
## Footnote
imbalanced nutrition, less than body requirements – common nursing
diagnosis
Anorexiants
52
common nursing
diagnosis
imbalanced nutrition, less than body requirements
53
CNS Depressants
Common Drugs:
Sedative-hypnotics
Anesthetics
Analgesics
Anticonvulsants
Anxiolytics
Antidepressants
54
Sedative-hypnotics
Common Drugs:
Benzodiazepine
55
– action – amplify the effects of GABA– calming
effect
Benzodiazepine
56
notify the doctor
immediately if the RR is below 10
**Anticonvulsants**- Phenobarbital
57
Increase in 3Ds - drowsiness, dizziness, and decrease
in BP
Anxiolytics
58
TCA, MAOI, SSRI
Antidepressants
59
CNS Depressant drugs
Barbiturates
Benzodiazepine
60
sedative-hypnotic - cause chloride ions to flow into the cell
and hyperpolarize
## Footnote
○ have a higher risk of toxicity than Benzodiazepines.
○ have a narrow therapeutic index.
○ increase the effects of GABA.
○ a central nervous system depressant.”
Barbiturates
61
sedative – hypnotic
## Footnote
Example: Alprazolam, Lorazepam, Clorazepate
■ Should not be given together with antihistamine
Alprazolam ( Benzodiazepine overdose) - give flumazenil
Benzodiazepine
62
give flumazenil
Alprazolam (Benzodiazepine overdose)
63
drugs that relieve the sensation of pain
Analgesic
64
Analgesic
Non-narcotic analgesics
Narcotic analgesics
65
Non-narcotic analgesics
Salicylates
NSAID
Para aminophenols
66
Narcotic analgesics
Naloxone
67
Narcotic analgesics
Nursing implications
● assess respiratory status – Naloxone (Narcan) for opiod toxicity
● assess for hypotension
● monitor bowel elimination
● evaluate pain response to medication
68
Vasodilators
decrease bp, dilates vessels, decrease vascular resistance
69
Should never be given together with viagra because it could lead to widening
of the blood vessels, dropping the blood pressure so low, arrhythmia and heart
attack.
Nitroglycerin
70
Unrelieved pain in cardiac disease after morphine
administration
Myocardial Infarction
71
# Nursing Considerations
Do not leave the patients bedside when you are giving a
newly prescribed
antihypertensive especially beta blockers.
72
# Nursing Considerations
bp, breathing and blood sugar
bp, breathing and blood sugar
73
nausea and
vomiting and dizziness – the nurse should advise the patient to rise to a
sitting or standing position slowly.
Angiotensin-converting enzyme inhibitors - Side effect
74
are given to patients with low heart rate
Pril and sartan
75
are given as anti-clumping and anti- clogging effect for better
blood circulation
Aspirin
76
ACEI
Angiotensin antagonist
or
Angiotensin converting enzyme inhibitor
77
(Angiotensin converting enzyme inhibitor or
ACEI)
● PRILS
● enalapril
● lisinopril
● captopril
78
The “sartans”
Angiotensin II receptor blockers
79
Losartan
Angiotensin II receptor blockers
80
Valsartan
Angiotensin II receptor blockers
81
newest group, may only be indicated
when ACEI are intolerable, mostly
free of side effects but very costly
Angiotensin II receptor blockers
82
Will decrease blood pressure to
hypertensive patient
Angiotensin II receptor blockers
83
Angiotensin II receptor blockers
● The “sartans”
● Losartan
● Valsartan
● newest group, may only be indicated when ACEI are intolerable, mostly free of side effects but very costly.
● Will decrease blood pressure to hypertensive patient
84
BETA BLOCKERS
* Propanolol– Inderal
* Labetalil
* atenolol
* bisoprolol
85
block the effects
of the epinephrine/adrenaline.
Beta blockers
86
Reduces the sympathetic
stimulation in cardiac muscle.
Beta blockers
87
Causing the **heart** to beat more
slowly and with less force, which
lowers blood pressure.
Beta blockers
88
also help open up
veins and arteries to improve blood
flow.
Beta blockers
89
Increase blood flow to the kidney.
Beta blockers
90
monitor for wheezing
Propanolol– Inderal
91
# CARDIAC GLYCOSIDES
digoxin
(Lanoxin)
92
# CARDIAC GLYCOSIDES
digitoxin
(Crystodigin)
93
# CARDIAC GLYCOSIDES
increase force of contraction
positive inotropic effect
94
# CARDIAC GLYCOSIDES
decrease heart rate
Negative chronotropic effect
95
# CARDIAC GLYCOSIDES
Adverse reactions:decrease pulse rate . Monitor
apical pulse
digitalis toxicity
96
# CARDIAC GLYCOSIDES
0.5 to 2.0 nanograms/mL)
Therapeutic level
97
# CARDIAC GLYCOSIDES
Antidote:
digoxin immune fab (Digibind)
98
● digoxin (Lanoxin)
● digitoxin (Crystodigin)
Effects:
● positive inotropic effect – increase force of contraction
● Negative chronotropic effect - decrease heart rate
● Adverse reactions: digitalis toxicity – decrease pulse rate . Monitor apical pulse
● Therapeutic level is 0.5 to 2.0 nanograms/mL)
● Antidote: digoxin immune fab (Digibind)
CARDIAC GLYCOSIDES
99
digoxin (Lanoxin)
CARDIAC GLYCOSIDES
100
digitoxin (Crystodigin)
CARDIAC GLYCOSIDES
101
Effects:
● positive inotropic effect – increase force of contraction
● Negative chronotropic effect - decrease heart rate
● Adverse reactions: digitalis toxicity – decrease pulse rate . Monitor
apical pulse
● Therapeutic level is 0.5 to 2.0 nanograms/mL)
● Antidote: digoxin immune fab (Digibind)
CARDIAC GLYCOSIDES
102
DRUGS USED FOR ARRHYTHMIA
1. Class 1 Antiarrhythmic Drugs/
SODIUM CHANNEL BLOCKERS
2. CLASS II ANTIARRHYTHMIC DRUGS/
BETA BLOCKERS
3. CLASS III ANTIARRHYTHMIC DRUGS/
Potassium channel blockers
4. CLASS IV ANTIARRHYTHMIC DRUGS/ CALCIUM CHANNEL
BLOCKERS
103
# Mechanism of Action:
Decrease sodium influx to cardiac cells, decreasing
automaticity of the ventricular cells
## Footnote
- quinidine and procainamide
Class 1 Antiarrhythmic Drugs/
SODIUM CHANNEL BLOCKERS
104
EXAMPLE:
* Acebutolol
* Esmolol
* Propranolol
* Nadolol
CLASS II ANTIARRHYTHMIC DRUGS/
BETA BLOCKERS
105
acts directly on the muscle cells prolonging
the repolarization and the refractory period, increasing the threshold for
ventricular fibrillation.
## Footnote
EXAMPLE
Amiodarone Dofetilide
CLASS III ANTIARRHYTHMIC DRUGS/
Potassium channel blockers
105
ANTIANGINAL DRUGS
* Nitroglycerin
* Beta-blockers
* Calcium-channel blockers
105
Diltiazem
CLASS IV ANTIARRHYTHMIC DRUGS/ CALCIUM CHANNEL
BLOCKERS
105
# Mechanism of Action:
act directly on heart muscle cells to prolong repolarization and the refractory period, increasing the threshold for ventricular
fibrillation; also act on peripheral smooth muscle to decrease peripheral resistance
CLASS III ANTIARRHYTHMIC DRUGS/
Potassium channel blockers
106
for patient with chest pain
ANTIANGINAL DRUGS
107
Relaxes vascular smooth muscle with
resultant decrease in venous return and arterial bp
Nitroglycerin
108
# ANTIANGINAL DRUGS
Rapidly acting agents
● E.g. nitroglycerine (Nitrostat, Transderm Nitro)
● Usually given sublingually
● Used to terminate acute attack of angina
● Take 1 tablet, then an additional tablet every
5 minutes, for a total of 3 tablets. Calls the
physician if pain persist after 3 tablets.
108
DECREASE HEART RATE
Beta-blockers
108
DECREASE FORCE OF
CONTRACTION
Calcium-channel blockers
109
● E.g. nitroglycerine (Nitrostat, Transderm Nitro)
● Usually given sublingually
● Used to terminate acute attack of angina
● Take 1 tablet, then an additional tablet every
5 minutes, for a total of 3 tablets. Calls the
physician if pain persist after 3 tablets.
ANTIANGINAL DRUGS
Rapidly acting agents
110
# ANTIANGINAL DRUGS: Rapidly acting agents
E.g. nitroglycerine
(Nitrostat, Transderm Nitro)
## Footnote
Rapidly acting agents
111
Usually given sublingually
ANTIANGINAL DRUGS
## Footnote
Rapidly acting agents
112
Used to terminate acute attack of angina
ANTIANGINAL DRUGS
## Footnote
Rapidly acting agents
113
Take 1 tablet, then an additional tablet every
5 minutes, for a total of 3 tablets. Calls the
physician if pain persist after 3 tablets.
ANTIANGINAL DRUGS
## Footnote
Rapidly acting agents
114
antilipidemic agents – given to
patient with hypercholesterolemia ( increased cholesterol in the blood)
## Footnote
○ Atorvastatin
HMG CoA reductase inhibitors (statins)
115
monitor for signs of bleeding
For patient receiving tissue plasminogen activator like **alteplase**
116
○ Decrease bp
○ Dilate blood vessels
○ Decrease heart rate
○ Decrease vascular resistance
Vasodilators
117
Vasodilators
○ Decrease bp
○ Dilate blood vessels
○ Decrease heart rate
○ Decrease vascular resistanc
118
blocks H1 receptors thereby decreasing allergic
response.
## Footnote
○ Allergic responses like itchy, watery eyes, rhinitis.
○ Benadryl AH, Dimetapp
○ Can be taken 45 minutes before exposure to an allergen
○ First generation anti histamine has higher incidence of drowsiness
Antihistamine
119
Allergic responses like itchy, watery eyes, rhinitis.
Antihistamine
120
Benadryl AH, Dimetapp
Antihistamine
121
Can be taken 45 minutes before exposure to an allergen
Antihistamine
122
First generation anti histamine has higher incidence of
drowsiness
Antihistamine
123
eliminate or reduce congestion or swelling.
## Footnote
● Common drugs –pseudoephedrine, phenylephrine
● limit 5-7 days to prevent rebound nasal congestion.
● Side effects - hypertension
Decongestants
124
# Decongestants
Common drugs
pseudoephedrine, phenylephrine
125
limit 5-7 days to prevent rebound nasal congestion.
Decongestants
126
# Decongestants
Side effects
hypertension
127
promotes expectoration by reducing the viscosity of pulmonary secretion or by decreasing the tenacity with which
exudates adhere to the lower respiratory tract
Expectorant
128
common expectorant in over-the-counter medications
## Footnote
○ loosen bronchial secretions for effective coughing.
○ Benadryl, Robitussin
○ Increase water intake.
Guafenesin
129
supress the cough reflex. Non-productive cough.
## Footnote
● dextromethorphan (Robitussin DM)
○ reduce the frequency of cough.
○ Waits 15 to 20 minutes after taking the syrup before drinking any
liquid
○ Narcotic cough syrup – synergistic effect with alcohol
Antitussives
130
dextromethorphan (Robitussin DM)
Antitussives
131
Lower Respiratory Tract disorder
Common disorder:
Bronchial asthma
132
Reversible airway obstruction that is
characterized by hyperirritability and inflammation of the
airways.
Bronchial asthma
133
# Bronchial asthma
Main problems
bronchoconstriction and inflammation
134
# Bronchial asthma
Medications
Bronchodilators
135
# Bronchial asthma
Side effects:
tachyarrhythmias,
tachycardia
136
