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204 Cards in this Set
- Front
- Back
CNS stimulants can treat: (4)
|
ADHA in children
narcolepsy obesity (for a short time) severe resp. depression |
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Long term use of CNS stimulants can lead to:
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psychologic dependence & tolerence
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Amphetamines are used to treat:
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attention deficit
|
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Amphetamines work by:
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stimulating the release of neurotransmitters-norepinephrine & dopamine from the brain & sympathetic nervous system (peripheral nerve terminals)
|
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SE of amphetamines: (7)
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euphoria
alertness weight loss, anorexia tremors irratibility dry mouth diarrhea, constipation |
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Cardiovascular problems related to amphetamines due to prolonged use:
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increased HR
palpitations cardiac dysrhythmias increased BP hypertension |
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When should amphetamines be used:
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early in the day or no later than 6hrs before bed
|
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Why are amphetamines dangerous:
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psychological and physical dependence & tolerence, withdraw meds gradually
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Why should amphetamines all have warnings:
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cause hallucinations in children, cardiovascular SE
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4 examples of amphetamines:
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Adderall
Ritalin Cylert Strattera (black box for suicide) |
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Ritalin is used to: (4)
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correct hyperactivity caused by ADHD
increase attention span treat fatigue control narcolepsy |
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SE of Ritalin: (5)
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anorexia
diarrhea insomnia dizziness nervousness irritability |
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Adverse Rx of Ritalin:
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tachycardia
growth suppression (regain after stopping) palpitations transient weigh loss in kids increase hyperactivity |
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What are analeptics:
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CNS stimulants
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Analeptics mostly affect:
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brainstem
spinal cord cerebral cortex |
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Main use of analeptics:
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stimulate respiration
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What is an example of an analeptic:
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Caffeine
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How does caffeine work:
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stimulates the CNS
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Large doses of caffeine are used to:
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stimulate respiratory
|
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Caffeine is used for: (3)
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fatigue
drowsiness mild diuretic |
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How many mg of caffeine affect the CNS & heart:
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500mg
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What kind of doses can cause psychological dependence:
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high doses in coffee
chocolate cold-relief meds |
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What medications may contain caffeine:
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analgesics
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What can happen from withdrawing caffeine:
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anxiety
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Who should not take caffeine:
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cardiac patients
|
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SE of caffeine: (3)
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nervousness
palpitations GI irritation |
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What kind of drug is Dopram:
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Respiratory CNS stimulant
|
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Dopram is used to treat:
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respiratory depression
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What causes migraines:
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vasodilation & inflammation of arteries
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What is the most recently developed drugs for migraines:
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Triptans
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What kind of drug is Triptan:
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5HT1 (serotonin) receptor agonists
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What is imitrex used for:
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migraines and cluter HA
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How does Imitrex work:
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causes vasoconstriction of cranial cartoid arteries to relieve migraine attacks
|
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SE of Imitrex: (5)
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dizziness/fainting
tingling/numbness warm sensation drowsiness muscle cramps |
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Adverse Rx of Imitrex: (9)
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hypotension
hypertension heart block angina dysrhythmias thromboembolism seizures CNS hemorrhage stroke |
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Life threatening effects of Imitrex:
|
coronary artery vasospasm
MI cardiac arrest |
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What is a sedative:
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decreases excitement & produces drowsiness, given during day
|
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What is a hypnotic:
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induces sleep
larger doses of med given |
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3 classes of CNS depressants:
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benzodiazepines
barbiturates nonbenzodiazepines/nonbarbituates |
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Why are barbiturates hardly used:
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because of danger
|
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Examples of nonbenzodiazepines/ nonbarbituates: (2)
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Ambien
Lunesta |
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Action of barbituates: (3)
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decrease overall CNS altertnes
decrease motor activity alters cerebral function |
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Barbituates produce: (3)
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drowsiness
sedation hypnosis |
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How does barbituates affect sleep patterns:
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3&4 NREM and REM (dream) sleep
|
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SE of barbituates: (4)
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drowsiness/lethargy
hangover mental depression vertigo |
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What problems occur with overuse of barbituates:
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respiratory & cardiovascular prolems
|
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What schedule are barbituates:
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Schedule II, very dependent
|
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How are barbituates classified:
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according to action
|
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Short-acting barbituates:
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used to induce sleep for those who have difficulty
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Long-acting barbituates:
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Phenobarbital (measure therapeutical levels 10-40ug/ml) used to control seizures
|
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Long-acting barbituates are used for:
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controlling seizures in epilepsy
|
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What precaution is needed with long-acting barbituates:
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2nd contraceptive, harms fetus
|
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Ultrashort-acting barbituates:
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general anesthetic
|
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What barbituate classification is a sleep agent:
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short term
|
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Two examples benzodiazepines:
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Dalmane
Restoril |
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Benzodiazepines are under what schedule:
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IV less potential for dependence
|
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What is an example of nonbenzodiazepines:
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Ambien
|
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What is ambien used for:
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treats short term insomnia less than 10days
|
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When taking ambien how long does it take to fall asleep
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1/2hr to 45min
|
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How is ambien classified:
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sedative/hypnotic & nonbenzodiazepine
|
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What schedule is ambien:
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IV
|
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How does ambien work:
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depresses CNS
|
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Which has a faster onset ambien or lunesta
|
lunesta
|
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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:
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IV followed by inhalation
|
|
Two types of IV anesthetics:
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Versed
Diprivan |
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Why are Versed and Diprivan administered:
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induction & maintenance of anesthesia or concious sedation for minor surgery or procedures, clients sedated but respond to commands
|
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Topical anesthetics work to:
|
prevent itching & discomfort
|
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How are topical anesthetics absorbed:
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not systemically
|
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How do local anesthetics work:
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block pain at the site where the drug is administered allowing consciousness maintained
|
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Local anesthetics are used for: (5)
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dental procedures
suturing skin lacerations minor surgery nerve block diagnostic procedures |
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Two types of local anesthetics:
|
Novocain
Xylocaine |
|
What are local anesthetics paired with:
|
vasoconstrictor (epinephrine/norepinephrine) to prevent systemic absorption
|
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How is an anesthetic chosen:
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length of action desired
|
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What is a short acting local anesthetic:
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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
|
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A hypersensitivity to aspirin may cause:
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tinnitus
|
|
An overdose of aspirin may cause:
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tinnitus
agitation confusion lethargy |
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Reyes Syndrome:
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occurs in children when taking asprin or NSAIDS while having a viral infection..can cause death
|
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How is acetaminophen used:
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analgesic
antipyretic |
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How does acetaminophens work:
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release/synthesis of prostoglandins
|
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When does death occur from hepatic necrosis:
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1-4 days
|
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SE of tylenol: (2)
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rash
anorexia |
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Adverse rx of tylenol: (3)
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severe hypoglycemia
urticaria oliguria |
|
Life threatening effects of tylenol:
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hepatotoxicity
hemmorhage hemolytic anemia leucopenia thrombocytopenia |
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Another name for narcotic analgesics:
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narcotic agents
|
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Narcotic analgesics acts on:
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CNS
|
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How do narcotic analgesics work: (2)
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suppress pain impulses
suppress respiration & cough |
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An effect narcotics possess:
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antidiarrheal
|
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Things narcotics alter:
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perception of pain and emotional response to pain
|
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What are opioids used for:
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intense pain
|
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Morphine should not be used with:
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brain injury bc more respiratory depression or asthmatics bc of bronchodialation
|
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What schedule are narcotics:
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II
|
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4 examples of narcotics:
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codeine
vicodin demerol oxycontin |
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Is morphine sulfate an antagonist or agonist
|
agonist so it produces a response
|
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How is morphine sulfate administered:
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Not given PO
|
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What does a nurse need to do before giving morphine sulfate:
|
count respiratory if less than 12 dont give
|
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Why is morphine sulfate given:
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relieve severe pain
|
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How does morphine sulfate decrease pain:
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binding with opiate receptor in CNS
|
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SE of morphine sulfate: (4)
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pinpoint pupils
constipation sedation euphoria |
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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
|
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Why were narcotic agonist-antagonists developed:
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decreasing narcotic abuse
|
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Benefits of narcotic agonist-antagonist:
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less potent as analgesic and withdraw symptoms less severe
|
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When are narcotic agonist-antagonist used:
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labor and delivery
|
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2 examples of narcotic agonists-antagonists:
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nubain and stadol
|
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What is barbituates and an example:
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anticonvulsants, phenobarbital
|
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what is benzodiazepines and an example:
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anticonvulsants, klonopin
|
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What is hydantoins-dilantin and therapeutic range:
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anticonvulsants, 10-20mcg/ml
|
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What is succinimides and example:
|
anticonvulsants, zarontin
|
|
Why are anticonvulsants used:
|
epileptic seizures
|
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First way anticonvulsants work:
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suppress Na influx through drug binding to the Na channel when it is inactivated prolonging channel inactivation & preventing neuron firing
|
|
Second way anticonvulsants work:
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suppress Ca influx preventing the electric current generated by the Ca ionts to the T Ca channels
|
|
Third way anticonvulsants work:
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increasing the action of GABA which inhibits neurotransmitter through the brain
|
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Pregnancy category of phenytoin:
|
D
|
|
Phenytoin is used for
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prevent grand mal and complex partial seizures
|
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SE of phenytoin: (4)
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pink-red/brown discoloration of urine
drowsiness increase hairyness blood abnormal |
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Adverse rx of phenytoin (2)
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gingival hyperplasia
hirsutism |
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toxicity of phenytoin (4)
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ataxia
slurred speech confusion double vision |
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When taking phenytoin important to monitor (2)
|
renal
CBC |
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What kind of drug is trileptal?
|
anticonvulsants
|
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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
|
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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
|