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204 Cards in this Set

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CNS stimulants can treat: (4)
ADHA in children
narcolepsy
obesity (for a short time)
severe resp. depression
Long term use of CNS stimulants can lead to:
psychologic dependence & tolerence
Amphetamines are used to treat:
attention deficit
Amphetamines work by:
stimulating the release of neurotransmitters-norepinephrine & dopamine from the brain & sympathetic nervous system (peripheral nerve terminals)
SE of amphetamines: (7)
euphoria
alertness
weight loss, anorexia
tremors
irratibility
dry mouth
diarrhea, constipation
Cardiovascular problems related to amphetamines due to prolonged use:
increased HR
palpitations
cardiac dysrhythmias
increased BP
hypertension
When should amphetamines be used:
early in the day or no later than 6hrs before bed
Why are amphetamines dangerous:
psychological and physical dependence & tolerence, withdraw meds gradually
Why should amphetamines all have warnings:
cause hallucinations in children, cardiovascular SE
4 examples of amphetamines:
Adderall
Ritalin
Cylert
Strattera (black box for suicide)
Ritalin is used to: (4)
correct hyperactivity caused by ADHD
increase attention span
treat fatigue
control narcolepsy
SE of Ritalin: (5)
anorexia
diarrhea
insomnia
dizziness
nervousness
irritability
Adverse Rx of Ritalin:
tachycardia
growth suppression (regain after stopping)
palpitations
transient weigh loss in kids
increase hyperactivity
What are analeptics:
CNS stimulants
Analeptics mostly affect:
brainstem
spinal cord
cerebral cortex
Main use of analeptics:
stimulate respiration
What is an example of an analeptic:
Caffeine
How does caffeine work:
stimulates the CNS
Large doses of caffeine are used to:
stimulate respiratory
Caffeine is used for: (3)
fatigue
drowsiness
mild diuretic
How many mg of caffeine affect the CNS & heart:
500mg
What kind of doses can cause psychological dependence:
high doses in coffee
chocolate
cold-relief meds
What medications may contain caffeine:
analgesics
What can happen from withdrawing caffeine:
anxiety
Who should not take caffeine:
cardiac patients
SE of caffeine: (3)
nervousness
palpitations
GI irritation
What kind of drug is Dopram:
Respiratory CNS stimulant
Dopram is used to treat:
respiratory depression
What causes migraines:
vasodilation & inflammation of arteries
What is the most recently developed drugs for migraines:
Triptans
What kind of drug is Triptan:
5HT1 (serotonin) receptor agonists
What is imitrex used for:
migraines and cluter HA
How does Imitrex work:
causes vasoconstriction of cranial cartoid arteries to relieve migraine attacks
SE of Imitrex: (5)
dizziness/fainting
tingling/numbness
warm sensation
drowsiness
muscle cramps
Adverse Rx of Imitrex: (9)
hypotension
hypertension
heart block
angina
dysrhythmias
thromboembolism
seizures
CNS hemorrhage
stroke
Life threatening effects of Imitrex:
coronary artery vasospasm
MI
cardiac arrest
What is a sedative:
decreases excitement & produces drowsiness, given during day
What is a hypnotic:
induces sleep
larger doses of med given
3 classes of CNS depressants:
benzodiazepines
barbiturates
nonbenzodiazepines/nonbarbituates
Why are barbiturates hardly used:
because of danger
Examples of nonbenzodiazepines/ nonbarbituates: (2)
Ambien
Lunesta
Action of barbituates: (3)
decrease overall CNS altertnes
decrease motor activity
alters cerebral function
Barbituates produce: (3)
drowsiness
sedation
hypnosis
How does barbituates affect sleep patterns:
3&4 NREM and REM (dream) sleep
SE of barbituates: (4)
drowsiness/lethargy
hangover
mental depression
vertigo
What problems occur with overuse of barbituates:
respiratory & cardiovascular prolems
What schedule are barbituates:
Schedule II, very dependent
How are barbituates classified:
according to action
Short-acting barbituates:
used to induce sleep for those who have difficulty
Long-acting barbituates:
Phenobarbital (measure therapeutical levels 10-40ug/ml) used to control seizures
Long-acting barbituates are used for:
controlling seizures in epilepsy
What precaution is needed with long-acting barbituates:
2nd contraceptive, harms fetus
Ultrashort-acting barbituates:
general anesthetic
What barbituate classification is a sleep agent:
short term
Two examples benzodiazepines:
Dalmane
Restoril
Benzodiazepines are under what schedule:
IV less potential for dependence
What is an example of nonbenzodiazepines:
Ambien
What is ambien used for:
treats short term insomnia less than 10days
When taking ambien how long does it take to fall asleep
1/2hr to 45min
How is ambien classified:
sedative/hypnotic & nonbenzodiazepine
What schedule is ambien:
IV
How does ambien work:
depresses CNS
Which has a faster onset ambien or lunesta
lunesta
What do general anesthetics do: (3)
depress CNS
alleviate pain
cause loss of conciousness
General anesthetics cause: (4)
amnesia
muscle relaxation
loss of sensory
autonomic reflexes
How is general anesthetics administered:
IV followed by inhalation
Two types of IV anesthetics:
Versed
Diprivan
Why are Versed and Diprivan administered:
induction & maintenance of anesthesia or concious sedation for minor surgery or procedures, clients sedated but respond to commands
Topical anesthetics work to:
prevent itching & discomfort
How are topical anesthetics absorbed:
not systemically
How do local anesthetics work:
block pain at the site where the drug is administered allowing consciousness maintained
Local anesthetics are used for: (5)
dental procedures
suturing skin lacerations
minor surgery
nerve block
diagnostic procedures
Two types of local anesthetics:
Novocain
Xylocaine
What are local anesthetics paired with:
vasoconstrictor (epinephrine/norepinephrine) to prevent systemic absorption
How is an anesthetic chosen:
length of action desired
What is a short acting local anesthetic:
Novacain 1/2hr to 1 hr
What is a moderate acting local anesthetic:
Xylocaine 1-3h
What is a long acting local anesthetic:
Marcaine 3-10hrs
Things to remember when using administering spinal anesthesia:
lay flat after administration to prevent HA
Examples of nonnarcotics: (4)
aspirin
acetaminophen
ibuprofen
naproxen
How are nonnarcotics different from narcotics:
not addictive
less potent
OTC
Nonnarcotics used to treat: (6)
dull HA
dysmenorrheal
inflammation
minor abrasions
muscular pain
mild to moderate arthritis
What does NSAIDS stand for:
nonsterodial anti-inflammatory drugs
NSAIDS can cause
renal, liver toxicity
NSAIDS are sometimes paired with:
narcotics to enhance effect
Description of aspirin:
salicylate NSAID
Beside relieving pain aspirin is also:
decreases platlet aggregation (clotting)
How do NSAIDS work:
inhibit or block both COX1 and COX2
What happens when COX1 is blocked:
protection of stomach lining is decreased,
fever & pain reduced,
blood clotting decreases
What happens when COX 2 is blocked:
pain reduced
inflammation suppressed
How do new drugs for arthritis work:
only block COX 2
What is Celebrex:
COX 2 inhibitor anagelsic and antiinflammatory
What is mobic:
COX2 inhibitor
What is Vioxx:
COX 2 inhibitor taken off the market
Which has less heptotoxicity COX 1 or COX 2:
COX 2
A hypersensitivity to aspirin may cause:
tinnitus
An overdose of aspirin may cause:
tinnitus
agitation
confusion
lethargy
Reyes Syndrome:
occurs in children when taking asprin or NSAIDS while having a viral infection..can cause death
How is acetaminophen used:
analgesic
antipyretic
How does acetaminophens work:
release/synthesis of prostoglandins
When does death occur from hepatic necrosis:
1-4 days
SE of tylenol: (2)
rash
anorexia
Adverse rx of tylenol: (3)
severe hypoglycemia
urticaria
oliguria
Life threatening effects of tylenol:
hepatotoxicity
hemmorhage
hemolytic anemia
leucopenia
thrombocytopenia
Another name for narcotic analgesics:
narcotic agents
Narcotic analgesics acts on:
CNS
How do narcotic analgesics work: (2)
suppress pain impulses
suppress respiration & cough
An effect narcotics possess:
antidiarrheal
Things narcotics alter:
perception of pain and emotional response to pain
What are opioids used for:
intense pain
Morphine should not be used with:
brain injury bc more respiratory depression or asthmatics bc of bronchodialation
What schedule are narcotics:
II
4 examples of narcotics:
codeine
vicodin
demerol
oxycontin
Is morphine sulfate an antagonist or agonist
agonist so it produces a response
How is morphine sulfate administered:
Not given PO
What does a nurse need to do before giving morphine sulfate:
count respiratory if less than 12 dont give
Why is morphine sulfate given:
relieve severe pain
How does morphine sulfate decrease pain:
binding with opiate receptor in CNS
SE of morphine sulfate: (4)
pinpoint pupils
constipation
sedation
euphoria
Life threatening effects of morphine sulfate:
resp. depression
Why is it important to have Narcan available when giving morphine sulfate:
reverse resp depression resulting from overdose
Why were narcotic agonist-antagonists developed:
decreasing narcotic abuse
Benefits of narcotic agonist-antagonist:
less potent as analgesic and withdraw symptoms less severe
When are narcotic agonist-antagonist used:
labor and delivery
2 examples of narcotic agonists-antagonists:
nubain and stadol
What is barbituates and an example:
anticonvulsants, phenobarbital
what is benzodiazepines and an example:
anticonvulsants, klonopin
What is hydantoins-dilantin and therapeutic range:
anticonvulsants, 10-20mcg/ml
What is succinimides and example:
anticonvulsants, zarontin
Why are anticonvulsants used:
epileptic seizures
First way anticonvulsants work:
suppress Na influx through drug binding to the Na channel when it is inactivated prolonging channel inactivation & preventing neuron firing
Second way anticonvulsants work:
suppress Ca influx preventing the electric current generated by the Ca ionts to the T Ca channels
Third way anticonvulsants work:
increasing the action of GABA which inhibits neurotransmitter through the brain
Pregnancy category of phenytoin:
D
Phenytoin is used for
prevent grand mal and complex partial seizures
SE of phenytoin: (4)
pink-red/brown discoloration of urine
drowsiness
increase hairyness
blood abnormal
Adverse rx of phenytoin (2)
gingival hyperplasia
hirsutism
toxicity of phenytoin (4)
ataxia
slurred speech
confusion
double vision
When taking phenytoin important to monitor (2)
renal
CBC
What kind of drug is trileptal?
anticonvulsants
What warning comes with trileptal?
stevens-johnson syndrome
how long do patients stay on anticonvulsants:
for life
Antipsychotics are used to treat:
acute and chronic psychoses
How do antipsychotics work:
decrease levels or block actio of dopamine in the brain
SE of antipsychotics: (7)
anticholinergic
sedation
photosensitivity
hormonal effects
agranulocytosis
extrapyrimidal symptoms
tardive dyskinesia
How are antipsychotics ard divided into:
typical and atypical
what are typical antipsychotics:
dopamine receptors
What are atypical antipsychotics:
works on dopamine and serotonin receptors
SE of typical and atypical antipsychotics: (4)
pseudoparkinsonism
acute dystonia
akathisia (always moving)
tardive dyskinesia
What is haldol
typical antipsychotic
Characteristics of Haldol:
long lasting
good alternative for pts who wont take meds
What is an example of atypical antipsychotic:
Risperdol
SE of risperdol:
Pictures from book
Classes of antiolytics:
benzodiazepines
buspirone
barbituates
What are benzdiazepines more effective than barbituates:
they enhance GABA
Benzodiazepines (antiolytics) are used for:
daytime & preanesthetic sedation
sleep induction
relief of anxiety & tension
skeletal muscle relaxant
anti-convulsant
SE of benzodiazepine (antiolytics)
sedation
hangover
ataxia
rebound insomnia
dizziness
fatigue
Use caution with benzodiazepines (anxiolytics)with:
elderly
What should not be used with benzodiazepines (anxiolytics)
alcohol
CNS depressants
bc of resp depression
What are 2 examples of benzodiazepines (anxiolytic)
Valium
Ativan
What schedule is benzodiazepines (anxiolytic)
4
What kind of drug is buspar:
buspirone anxiolytic
Action of buspar:
midbrain modulator
SE of buspar:
dizziness
lightheadedness
insomnia
Ha
What should be discontinued with using buspar:
benzodiazepine
How long does it take buspar to work:
14days
What schedule is buspar
not a schedule drug
How long do antidepressants take to work:
4-6 wks
How do antidepressants work:
make more serotonin available
What is important to assess with those taking antidepressants:
suicide
What are TCA's
oldest antidepressants
What is elavil:
antidepressants
SE of elavil:
sedation
dry mouth and eyes
urinary retention
constipation
weight gain
endocrine problems
sexual dysfunction
Adverse rx of elevil:
cardiovascular problems
dysrthymias from high doses
What are SSRI's
2nd generation antidepressants
SE of SSRI's
less than TCA's bc target more serotonin
insomnia
HA
weight loss/gain
sexual dysfunction
no cardiovascular
What is prozac
antidepressant
SE of prozac:
HA
nervousness
restlessness
insomnia
tremors
GI distress
sexual dysfunction
What are MAOI's
monoamine oxidase inhibitors
SE of MAOI's
HTP
cardiovascular problems
What food can't you have with MAOI's
cheese
bananas
raisins
pickled foods
red wine
beer
cream
yogurt
chocolate
coffee
italian green beans
liver
yeast
soy sauce
Why are foods restricted with MAOI
can cause hypertensive crisis
1 example drug of MAOI
nardil
What are atypical antidpressants used for
panic rx
Two drugs given for panic rx
wellbutrin
effexor
How much water is needed with a mood stabilizer
2-3L
what supplement is needed with mood stabilizers
sodium
mood stabilizers are used for
controlling the manic phase of bipolar disorder
What effect does lithium have
calming without effecting intellectual activity
What does lithium control:
flight of ideas
hyperactivity
What happens if a person stops taking lithium
manic bx returns
Lithium therapeutic range
narrow .5-1.5meq
What levels of lithium are toxic
1.5-2
What does lithium deplete
sodium
if lithium doesnt work try:
miscellaneous anticonvulsants
Lithium treats
bipol/manic depres. psychosis
manic episodes
levels out mood
SE of lithium
polydipsia
polyuria
weight gain
tremors
polyphasia
What is tegretol
anticonvulsant
what is depekene
anticonvulsant
what is depekote
anticonvulsant
what is mysoline
anticonvulsant
what is neurotonin
anticonvulsant
what is lamictal
anticonvulsant
what is topamax
anticonvulsant