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Pharm Fall 2020 > Week 3 - Neuro > Flashcards

Week 3 - Neuro Flashcards

1
Q

SNS receptor - pupils

A

Alpha 1

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2
Q

SNS receptor - Heart rate

A

Beta 1

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3
Q

SNS receptor - Heart contraction

A

Beta 1

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4
Q

SNS receptor - coronary arteries

A

Alpha 1

Beta 2

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5
Q

SNS receptor - peripheral blood vessels

A

Alpha 1

Beta 2

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6
Q

SNS receptor - bronchi

A

Beta 2

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7
Q

SNS receptor - intestinal blood vessels

A

Alpha 1`

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8
Q

SNS receptor - bladder body

A

Alpha 1

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9
Q

SNS receptor - bladder sphincter

A

Alpha 1

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10
Q

SNS receptor - uterus

A

Alpha 1

Beta 2

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11
Q

Neurotransmitter of SNS

A

NE

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12
Q

Epinephrine category class

A

Adrenergic Agonist

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13
Q

What is epinephrine’s expected pharmacological Action?

A
  • antagonize A1, B1 and B2 receptor sites
  • increased vascular resistance
  • decrease mucosal edema
  • decrease mast cell and basophil action
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14
Q

Epinephrine’s therapeutic uses?

A

anaphylaxis treatment
bronchospasm
local vasoconstriction

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15
Q

Epinephrine complications

A
  • tremor
  • palpitations
  • anxiety
  • restlessness
  • tachycardia
  • dysrythmias
  • HTN
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16
Q

Epinephrine medication administration

A

Subcutaneous
IM
IV
Local injection

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17
Q

epinephrine contraindications/precautions

A

no absolute contraindications

precaution - preexisting tachy/dysrhythmia

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18
Q

Nursing interventions - epinephrine

A
  • manage airway (pt should be connected to cardiac monitor, listen to lung sounds)
  • reassessment
  • O2
  • BP
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19
Q

Interactions - epinephrine

A

none

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20
Q

Evaluation of medication effectiveness - epinephrine

A
  • improvement of symptoms

- lack of localized bleeding (localized vasoconstriction and decreased blood flow to area) (with intra-dermal injection)

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21
Q

Client education - epinephrine

A
  • always carry auto-injector
  • how to use auto-injector
  • unpredictability of anaphylaxis
  • use with H1 and H2 blockers
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22
Q

atenolol category class

A

anti hypertensive beta adrenergic blockers (sympatholytics)

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23
Q

Expected pharmacological action - atenolol

A

decreased HR

decreased peripheral resistance

Decreased BP

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24
Q

Therapeutic use - atenolol

A

HTN - esp. with aldosterone-mediated fluid retention

Long term treatment of angina pectoris

may be used to prevent reinfarction following an MI

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25
Complications - atenolol
Hypotension (at baseline and orthostatic hypotension) Bradycardia
26
Medication administration - atenolol
PO: give one dose per day IV: administer slowly
27
Contraindications/precautions - atenolol
Contraindicated: 1. sinus bradycardia 2. first degree heart block (conduction delay) 3. cardiac failure shock 4. orthostatic hypotension Precaution: history of asthma; obstructive lung disease; DM (both)
28
Interactions - atenolol
Ca++ channel blockers | -- Esp. Verapamil and Diltiazem
29
Nursing interventions - atenolol
Monitor HR before and after administration Hold medication if HR is below 60 bpm and report Monitor BP before and after treatment Monitor for signs of HF
30
Client education - atenolol
Do not discontinue without consulting provider Avoid sudden changes in position Do not crush or chew extended release tabs self monitor BP and HR
31
Evaluation of Medication effectiveness - atenolol
Absence of chest pain Absence of dysrhythmias Normotensive BP Control of HR s/s
32
Why is a heart block a risk of atenolol?
There are multiple B 1 sites on the heart so different levels of heart block can occur with beta blockers (verify)
33
Why is atenolol not the best drug for those with DM?
It can block the signs and symptoms consistent with hypoglycemia - (shaky, nervous, anxious, fast heart rate)
34
Why is atenolol not the best drug for those with DM?
It can block the signs and symptoms consistent with hypoglycemia
35
bethanechol category class
Cholinergic agonist
36
Expected pharmacological action - bethanechol
Increase acetylcholine in circulation increase urinary bladder muscle tone stimulates gastric motility
37
Therapeutic use - bethanechol
urinary retention
38
Complications - bethanechol
wheezing (bronchospasm) hypotension Bradycardia peptic ulcer dizziness fainting
39
Medication administration - bethanechol
PO
40
Contraindications/precautions - bethanechol
Contraindicated - 1. hyperthyroidism 2. PUD 3. asthma 4. CAD 5. Parkinson's Precaution - UTIs
41
Interactions - bethanechol
Acetylcholinesterase inhibitors betablockers
42
Nursing interventions - bethanechol
vital signs (HR and BP) I's & O's Implementation of fall risk Interventions
43
Evaluation of medication effectiveness - bethanechol
increased UOP/GI
44
Client education - bethanechol
Pregnancy category C* Report difficulty breathing Check BP and HR Don't take if allergic Report dizziness or passing out
45
oxybutynin - category class
anticholinergic
46
Expected pharmacological action - oxybutynin
blocks muscarinic receptors in detrusor muscles (relaxes) causes contraction of the internal sphincter of the bladder
47
Therapeutic use - oxybutynin
overactive bladder neurogenic bladder
48
complications - oxybutynin
1. Xerostomia 2. constipation 3. pupil dilation 4. drowsiness contraindications - urinary retention, blurry vision, fever
49
methods of administration - oxybutynin
PO (extended release - never crushed) Transdermal patch (rotate site)
50
What should transdermal patch administration education include?
rotating the site as it could irritate the epidermis if it's placed on the same site more than once for an extended time
51
Contraindications - oxybutynin
Angle-closure glaucoma Mysthenia gravis (decreased cholinergic activity at neuromuscular junction) GI obstruction GU obstruction Active cardia dysfunction (dysrhythmia or MI) Precautions: UTI, Hyperthyroidism, HTN, BPH, Liver or
52
Nursing interventions - oxybutynin
Monitor UOP Monitor bowel elimination patterns Monitor for urinary pattern (retention)
53
Interactions - oxybutynin
grapefruit juice | phenytoin
54
Evaluation of medication effectiveness - oxybutynin
prevention of release of urine at undesired times
55
client education - oxybutynin
hard candy for dry mouth increase fluid and fiber intake report urinary retention/infection report dizziness or fainting
56
Why shouldn't oxybutynin be given to someone with narrow angle glaucoma?
Anticholinergic medications can cause increase in ocular pressure
57
Why shouldn't oxybutynin be given to someone previously diagnosed with Mysthenia gravis?
It can cause acute exacerbation
58
Why shouldn't oxybutynin be given to someone with GI obstruction
It can worsen obstruction by decreasing GI motility
59
Why shouldn't oxybutynin be given to someone with GU obstruction?
It can cause urinary retention
60
Anticholinergic side effects
can't pee, can't see, can't spit, can't poop
61
What can urinary retention cause?
UTI

Pharm Fall 2020 (5 decks)

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