test 1 Flashcards

1
Q

what makes us the CNS

A

brain and spinal cord

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2
Q

what makes up the PNS

A

motor neurons and sensory neurons

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3
Q

what systems deprive from motor nuerons

A

somatic and autonomic

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4
Q

what divisions are under ANS

A

sympathetic and parasympathetic

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5
Q

sympathetic recpector

A

adrenergic receptors

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6
Q

parasympathetic receptor

A

cholinergic receptor

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7
Q

fight or flight – stressfull or energetic activity

A

sympthetic

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8
Q

rest and digest – maintenance activity

A

parasympathetic

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9
Q

controls voluntary movements by activating skeletal muscles

A

somatic nervous system

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10
Q

controls involuntary responses by influencing organs, glands, and smooth muscle

A

autonomic nervous system

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11
Q

function of ANS

A

achieve homeostasis

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12
Q

effects of parasympathetic

A

constricts pupils
stimulates salvation
slows heart rate & contractility
constricts bronchioles
stimulates digestion
stimulates gallbladder function
controls bladder
stimulates erection/vaginal lubrication

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13
Q

effects of sympathetic

A

dilates pupils
inhibits salvation
accelerates heart rate
dilates bronchioles
inhibits digestion
stimulates release of glucose
secretes epinephrine and norepinephrine
relaxes bladder
stimulates ejaculation/orgasm

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14
Q

sympathetic nervous system neurotransmitter

A

norepinephrine

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15
Q

parasympathetic nervous system neurotransmitters

A

acetylcholine

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16
Q

what meds cause sympathetic nervous system responses

A

sympathomimetics
adrenergics
anticholinergics
parasympatholytics

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17
Q

what meds cause parasympathetic effects

A

parasympathomimetics
muscarinics
cholinergics
adrenergic antagonist
sympatholytics

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18
Q

types of cholinergic receptors

A

nicotinic, muscarinic

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19
Q

bethanechol (urecholine) ther. class, pharm class, and pregnancy class

A

ther class- non obstructive urinary retention drug

pharm class- muscarinic cholinergic receptor

pregnancy class= C

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20
Q

bethanechol (urecholine) action and uses

A

direct acting parasympathomimetic that interacts with muscarinic receptors to cause actions of parasympathetic effects. effects are mostly noted in urinary and Gi tract where it stimulates smooth muscle contraction.

uses: urinary retention, myasthenia gravis, alzheimer’s, glaucoma

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21
Q

bethanechol (urecholine) adverse effects, admin concerns and contraindications

A

adverse effects- profuse salivation, sweating, increased muscle tone, urinary frequency, bradycardia

admin concerns- never admin IM or IV, monitor vitals

contraindications- asthma, epilepsy, parkinsonian, hyperthyroidism, peptic ulcer disease, bradycardia

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22
Q

treatment of OD for bethanechol (urecholine)

A

atropine sulfate

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23
Q

what are cholinergic blocking drugs

A

drugs that inhibit parasympathetic nervous system

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24
Q

physostigmine (antilirium) ther. class, pharm class, and pregnancy class

A

ther class- antidote for anticholinergic toxicity

pharm class- acetylcholinesterase inhibitor

pregnancy class- C

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25
physostigmine (antilirium) action and uses
indirect acting parasympathomimetic that inhibits acetylcholinesterase (ACHe), the enzyme responsible for breakdown of acetylcholine, stimulating muscarinic and nicotinic receptors uses- treat glaucoma, and anticholinergic activity
26
physostigmine (antilirium) adverse effects, admin concerns and contraindications
adverse effects-Bradycardia, asystole, restlessness, sweating, seizures, salvation, Urinary frequency, muscle twitch, resp distress admin concerns- Admin slowly over 5 mins to avoid seizures, monitor vitals; Discontinue med if excessive sweating, diarrhea or frequent Urination occurs contraindications- Use with caution in patients with asthma, epilepsy, diabetes, cardiovascular disease, bradycardia
27
atropine (atropen) ther. class, pharm class, and pregnancy class
ther class-Antidote for anticholinesterase poisoning pharm class-Muscarinic cholinergic receptor blocker pregnancy class- C
28
Atropine (AtroPen) action and uses
by occupying muscarinic receptors, atropine blocks parasympathetic actions of ACh and induces symptoms of fight or flight such as increasing HR, bronchodilation, decreased mobility in GI tract, mydriasis uses- peptic ulcers, Ibs, mydriasis for eye exam, bradycardia
29
atropine (atropen) adverse effects, admin concerns and contraindications
adverse effects- tachycardia, CNS stimulation, dry mouth, constipation, urinary retention, dry eyes, photophobia admin concerns- monitor vitals, PO and subq doses are not interchangeable contraindications- Glaucoma, obstructive GI patients, bladder neck obstruction, BPH, MG, acute hemorrhage, cardiac insufficiency
30
what receptor does norepinephrine go to and what does it do
adrenergic receptor, causes adrenaline like response
31
alpha 1 adrenergic receptor
in all sympathetic organs except heart; constricts blood vessels and dilates pupil primarly used for nasal congestion, hypotension, and dilation of pupil
32
alpha 2 adrenergic receptor
at presynaptic adrenergic nerve terminals; inhibits release of norepinephrine used for hypertension
33
beta 1 adrenergic receptor
in heart and kidneys; increases heart rate and force of contraction and releases renin used in cases of cardiac arrest, heart failure and shock
34
beta 2 adrenergic receptor
in all sympathetic target organs except heart; inhibits smooth muscle used in asthma and premature labor contractions
35
beta 3 adrenergic receptor
adipose tissue- lipolysis urinary bladder- relaxation of the detrusor
36
phenylephrine (neo-synephrine) therapeutic class , pharm, and pregnancy cat.
ther- nasal decongestant; mydriatic drug; antihypotensive pharm- adrenergic drug pregnancy class C
37
phenylephrine (neo-synephrine) action and uses
a selective alpha adrenergic agonist that is available in different formations, causing sympathetic stimulation uses- Nasal- reduce nasal congestion Topical (in eye)- dilate pupil Parenteral- reverse acute hypotension caused by spinal ane
38
phenylephrine (neo-synephrine) adverse effects, admin concerns and contraindications
adverse effects- side effects are uncommon in nasal and topically; High doses can cause bradycardia, possible death with IV use admin concerns- Parenteral can cause tissue damage with extravasation Drops may damage soft contacts contraindications- Don’t use if patient has pancreatitis, heart disease, hepatitis, or narrow angle glaucoma
39
prazosin (minipress) therapeutic class , pharm, and pregnancy cat.
ther class- antihypertensive pharm class- adrenergic blocking drug pregnancy category- not established
40
prazosin (minipress) action and uses
Selective alpha 1 adrenergic that competes with norepinephrine at its receptors on vascular smooth muscle in arterioles and veins. Causes rapid decrease in peripheral resistance that reduces BP. uses- treat hypertension
41
prazosin (minipress) adverse effects, admin concerns and contraindications
adverse effects- Orthostatic hypotension due to alpha 1 inhibition in vascular smooth muscle; dizziness, drowsiness admin concerns- give low dose first to avoid severe hypotension contraindications- safety in pregnancy and lactation not established
42
what are bronchioles
muscular tube like structures whose diameter (lumen) varies on contraction or relaxation of smooth muscle which is controlled by ANS
43
respiration
bringing o2 in body and co2 out
44
beta 2 adrenergic receptors
activated by sympathetic, causes smooth muscle to relax and diameter increases
45
how does parasympathetic branch control airways
causes bronchiolar smooth muscle to contract, narrowing airway
46
why is pulmonary inhalation drugs efficient
it goes straight into resp system
47
oral drugs
frequent side effects because it goes everywhere in body
48
how is nebulizer used
patient breathe normally, difficult to measure dose received
49
metered dose inhaler
propellent delivers measured drug of dose
50
dry powder inhaler
patient inhales powdered drug from inhalation
51
bronchospasm
spasm of bronchi; causes wheeze
52
status asthmaticus
prolonged asthma attack; med emergency
53
quick relief asthma drugs
beta 2 adrenergic agonist, anticholinergic, systemic corticosteroids
54
long acting asthma meds
inhaled corticosteroids, mast cell stabilizers leukotriene modifier, long acting beta 2 adrenergic agonist, methylxanthines, immunomodulators
55
short acting beta 2 adrenergic agonist (SABAs)
bronchodilation, preferred drug for relief of acute symptoms
56
anticholinergic for asthma
causes bronchodilation, alternate to those who cant take SABAs
57
systemic corticosteroids for asthma
anti-inflammatory, used for short periods to reduce frequency of acute exacerbations
58
inhaled corticosteroids for asthma
anti inflammatory, preferred drugs for long term asthma management
59
mast cell stabilizers for asthma
anti inflammatory, control of mild, persistent asthma or exercise induced asthma
60
leukotriene modifier for asthma
anti-inflam, control mild, persistent asthma, or adjunctive therapy with inhaled corticosteroid
61
long acting adrenergic agonist (LABAs)
bronchodilation, used in combination with inhaled corticosteroids for preventing moderate to severe asthma
62
methylxanthines
for bronchodilation, used in combination with inhaled corticosteroids for preventing moderate to severe asthma. long term common side effects - nauasea, vomiting, CNS stimulation given IV or orally
63
immunomodulators for asthma
monoclonal antibody, for patients who have allergies and severe persistent asthma
64
albuterol (proair HFA, proventil HFA, ventolin HFA) ther class, pharm class, preg category
ther- bronchodilator pharm- beta 2 adrenergic agonist preg class C
65
albuterol (proair HFA, proventil HFA, ventolin HFA) action and uses
A SABA (short acting beta agonist) that used to relieve bronchospasm of asthma. Rapid onset. Selectively binds to beta 2 for quick acting asthma relief
66
albuterol (proair HFA, proventil HFA, ventolin HFA) adverse effects, admin concerns and contraindications
adverse effect- Uncommon, palpitations, headaches, throat irritation, tachycardia, tremor, allergic reaction, chest pain, dry mouth admin concerns- may cause hypokalemia at large dose, concurrent use with beta blockers will inhibit. avoid caffeine contraindications- People who are hypersensitive to drug. Caution in CAD, HTN
67
ipratropium (atrovent) ther class, pharm class, preg class
ther class- bronchodilator pharm class- anticholinergic preg class- B
68
ipratropium (atrovent) action and uses
Blocks cholinergic receptors, causing bronchodilation. delivered by inhalation or intranasally. If nasal, inhibits secretions but don't decongest for COPD, bronchitis, emphysema. Relief of acute bronchospasm
69
ipratropium (atrovent) adverse effects, admin concerns and contraindications
adverse- Irritation of upper resp tract, bitter taste- inhalation Epistaxis, drying of nasal mucosa- intranasal admin concerns- Dry's things- be ware if patient has urinary retention, constipation, troubles seeing or salivating contraindicated if have peanut allergy
70
how many days should someone use corticosteriod
no longer than 10
71
beclomethasone (QVAR) ther class, pharm class, preg category
ther class- anti inflammatory drug for asthma and allergic rhinitis pharm class- inhaled corticosteroid preg category- C
72
beclomethasone (QVAR) action and uses
Corticosteroid available through aerosol inhalation for asthma and a nasal spray for allergic rhinitis. reduce inflammation, for prevention
73
beclomethasone (QVAR) adverse effects, admin concerns and contraindications
adverse effects- Corticosteroid toxicity, hoarseness, dry mouth, long term can cause oral thrush not for acute attacks. be careful with children as it could stunt growth contraindications- prior hypersensitivity.
74
montelukast (singulair) ther class, pharm class, and preg class
ther class- Anti inflammatory drug for asthma prophylaxis pharm class- leukotriene modifier preg class- B
75
Montelukast (singulair) action and uses
Prevents airway edema and inflammation by blocking leukotriene receptors in the airway. Given PO and acts rapidly Used for prophylaxis of persistent, chronic asthma, exercise induced bronchospasm, and allergic rhinitis
76
Montelukast (singulair) adverse effects, admin concerns and contraindications
adverse effects- Headache, nausea, diarrhea, possible neuropsychic effects such as suicidal ideation, hallucinations, aggressiveness, depression if preventing exercise induced, take drug 2 hours prior. don't use for quick acting may increase ALT values don't use if have hepatic issues
77
beta blockers
type of adrenergic blocking drug prevents catecholamines from binding to beta receptors. used for hypertension, MI, heart failure ex- metoprolol, acebutolol
78
what does upper resp tract do
warm, humidifies and cleans incoming air
79
inflammation rhinitis
inflammation of nasal mucosa caused by exposure to antigen: histamine is released
80
allergic rhinitis : how does it work
Plasma cells release IgE antibodies, binds to mast cell and histamine is released, attaching to H1 receptors causing allergies
81
preventers for allergic rhinitis
antihistamine, intranasal corticosteroid, mast cell stabilizer
82
relievers for allergic rhinitis
oral and intranasal decongestant
83
what is histamine
chemical mediator of inflammatory response
84
diphenhydramine (benadryl) ther class, pharm class and pregnancy category
ther class- drug to treat allergies pharm class- H1 receptor antagonist; antihistamine preg category C
85
diphenhydramine (benadryl) similar drug
fexofenadine (allegra)
86
diphenhydramine (benadryl) action and uses
First gen H1 receptor antagonist whose primary use is to treat minor symptoms of allergy and the common cold such as runny nose, sneezing, tearing. This drug often combines with analgesic, decongestant, or expectorant
87
diphenhydramine (benadryl) adverse effects, admin concerns, and contraindictions
adverse effects- drowsiness (safety), paradoxical CNS stimulation, anticholinergic effects (dryness) admin concerns- increased risk of anaphylaxis when given iv contraindications- Hypersensitivity to the drug, BPH, narrow angle glaucoma, GI obstruction. Use cautiously with asthma or hyperthyroidism
88
what do intranasal corticosteroids do
reduce tissue edema, cause mild vasoconstriction
89
vasodilation vs vasoconstriction of airways
vasodilation- nasal mucosa thicker, airway smaller vasoconstriction- nasal mucosa thinner, airway diameter larger
90
fluticasone (flonase) ther class, pharm class, preg category
ther class- Drug for allergic rhinitis, asthma, and skin inflammation pharm class- corticosteroid preg category C
91
fluticasone (flonase) action and uses
Decrease local inflammation in nasal passage, reducing stuffiness- nasal Oral reduce bronchial inflammation Topical- reduce inflammation of skin
92
fluticasone (flonase) adverse effects, admin concerns, contraindications
adverse effects- Nasal irritation and epistaxis, inhalation can cause headache and nasopharyngitis. swallowing can cause issues admin concerns- follow directions. caution with licorice contraindications- prior hypersensitivity
93
oxymetazoline (afrin) ther class, pharm class, pregnancy category
ther class- nasal decongestant pharm class- sympathomimetic preg category C
94
oxymetazoline (afrin) action and uses
Activates alpha adrenergic receptors in the sympathetic NS, causes arterioles in the nasal passage to constrict, drying the mucous membranes, also can be used as eye drops to provide relief from red, dry eyed
95
oxymetazoline (afrin) adverse effects, admin concerns, contraindications
adverse effects- rebound congestion. stinging of mucosa admin concerns- wash hands after administering to avoid anisocoria contraindications- Patients with thyroid disorders, hypertension, diabetes, or heart disease
96
antitussives
inhibit coughs
97
expectorants
inhibit mucus production
98
mucolytics
loosen thick bronchial secretions -> thin them
99
mucolytics
loosen thick bronchial secretions -> thin them
100
drug similar to dextromethorphan
benzonatate (tessalon)
101
expectorant drug
guaifenesin (mucinex)
102
examples of mucolytics
acetylcysteine (mucomyst, cetylev), dornase alfa (pulmozyme)
103
dextromethorphan (Delsym) ther class, pharm class, pregnancy category
ther- cough suppressant pharm class- centrally acting antitussive pregnancy category C
104
dextromethorphan (Delsym) action and uses
Nonopioid drug that is a component in many OTC severe cold and flu preparations. Rapid onset action. Acts through medulla. Many formations
105
dextromethorphan (Delsym) adverse effects, admin concerns, contraindications
adverse effect-Uncommon. Dizziness, drowsiness, GI upset, CNS toxicity such as resp depression, stupor, seizure, coma admin concerns- don't drink grapefruit contraindications- In treatment of chronic cough due to excessive bronchial secretions, such as asthma, smoking, emphysema. Don’t use under children age 6