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204 Cards in this Set
- Front
- Back
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CNS stimulants can treat: (4)
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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:
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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
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lunesta
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What do general anesthetics do: (3)
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depress CNS
alleviate pain cause loss of conciousness |
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General anesthetics cause: (4)
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amnesia
muscle relaxation loss of sensory autonomic reflexes |
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How is general anesthetics administered:
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IV followed by inhalation
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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:
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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:
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Novocain
Xylocaine |
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What are local anesthetics paired with:
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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
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What is a moderate acting local anesthetic:
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Xylocaine 1-3h
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What is a long acting local anesthetic:
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Marcaine 3-10hrs
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Things to remember when using administering spinal anesthesia:
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lay flat after administration to prevent HA
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Examples of nonnarcotics: (4)
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aspirin
acetaminophen ibuprofen naproxen |
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How are nonnarcotics different from narcotics:
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not addictive
less potent OTC |
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Nonnarcotics used to treat: (6)
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dull HA
dysmenorrheal inflammation minor abrasions muscular pain mild to moderate arthritis |
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What does NSAIDS stand for:
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nonsterodial anti-inflammatory drugs
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NSAIDS can cause
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renal, liver toxicity
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NSAIDS are sometimes paired with:
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narcotics to enhance effect
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Description of aspirin:
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salicylate NSAID
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Beside relieving pain aspirin is also:
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decreases platlet aggregation (clotting)
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How do NSAIDS work:
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inhibit or block both COX1 and COX2
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What happens when COX1 is blocked:
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protection of stomach lining is decreased,
fever & pain reduced, blood clotting decreases |
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What happens when COX 2 is blocked:
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pain reduced
inflammation suppressed |
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How do new drugs for arthritis work:
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only block COX 2
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What is Celebrex:
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COX 2 inhibitor anagelsic and antiinflammatory
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What is mobic:
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COX2 inhibitor
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What is Vioxx:
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COX 2 inhibitor taken off the market
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Which has less heptotoxicity COX 1 or COX 2:
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COX 2
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A hypersensitivity to aspirin may cause:
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tinnitus
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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 |
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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
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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:
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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:
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resp. depression
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Why is it important to have Narcan available when giving morphine sulfate:
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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:
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anticonvulsants, zarontin
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Why are anticonvulsants used:
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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
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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
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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:
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D
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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)
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renal
CBC |
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What kind of drug is trileptal?
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anticonvulsants
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What warning comes with trileptal?
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stevens-johnson syndrome
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how long do patients stay on anticonvulsants:
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for life
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Antipsychotics are used to treat:
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acute and chronic psychoses
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How do antipsychotics work:
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decrease levels or block actio of dopamine in the brain
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SE of antipsychotics: (7)
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anticholinergic
sedation photosensitivity hormonal effects agranulocytosis extrapyrimidal symptoms tardive dyskinesia |
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How are antipsychotics ard divided into:
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typical and atypical
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what are typical antipsychotics:
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dopamine receptors
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What are atypical antipsychotics:
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works on dopamine and serotonin receptors
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SE of typical and atypical antipsychotics: (4)
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pseudoparkinsonism
acute dystonia akathisia (always moving) tardive dyskinesia |
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What is haldol
|
typical antipsychotic
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Characteristics of Haldol:
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long lasting
good alternative for pts who wont take meds |
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What is an example of atypical antipsychotic:
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Risperdol
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SE of risperdol:
|
Pictures from book
|
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Classes of antiolytics:
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benzodiazepines
buspirone barbituates |
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What are benzdiazepines more effective than barbituates:
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they enhance GABA
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Benzodiazepines (antiolytics) are used for:
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daytime & preanesthetic sedation
sleep induction relief of anxiety & tension skeletal muscle relaxant anti-convulsant |
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SE of benzodiazepine (antiolytics)
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sedation
hangover ataxia rebound insomnia dizziness fatigue |
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Use caution with benzodiazepines (anxiolytics)with:
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elderly
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What should not be used with benzodiazepines (anxiolytics)
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alcohol
CNS depressants bc of resp depression |
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What are 2 examples of benzodiazepines (anxiolytic)
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Valium
Ativan |
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What schedule is benzodiazepines (anxiolytic)
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4
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What kind of drug is buspar:
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buspirone anxiolytic
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Action of buspar:
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midbrain modulator
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SE of buspar:
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dizziness
lightheadedness insomnia Ha |
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What should be discontinued with using buspar:
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benzodiazepine
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How long does it take buspar to work:
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14days
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What schedule is buspar
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not a schedule drug
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How long do antidepressants take to work:
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4-6 wks
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How do antidepressants work:
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make more serotonin available
|
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What is important to assess with those taking antidepressants:
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suicide
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What are TCA's
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oldest antidepressants
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What is elavil:
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antidepressants
|
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SE of elavil:
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sedation
dry mouth and eyes urinary retention constipation weight gain endocrine problems sexual dysfunction |
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Adverse rx of elevil:
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cardiovascular problems
dysrthymias from high doses |
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What are SSRI's
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2nd generation antidepressants
|
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SE of SSRI's
|
less than TCA's bc target more serotonin
insomnia HA weight loss/gain sexual dysfunction no cardiovascular |
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What is prozac
|
antidepressant
|
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SE of prozac:
|
HA
nervousness restlessness insomnia tremors GI distress sexual dysfunction |
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What are MAOI's
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monoamine oxidase inhibitors
|
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SE of MAOI's
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HTP
cardiovascular problems |
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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 |
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Why are foods restricted with MAOI
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can cause hypertensive crisis
|
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1 example drug of MAOI
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nardil
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What are atypical antidpressants used for
|
panic rx
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Two drugs given for panic rx
|
wellbutrin
effexor |
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How much water is needed with a mood stabilizer
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2-3L
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what supplement is needed with mood stabilizers
|
sodium
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mood stabilizers are used for
|
controlling the manic phase of bipolar disorder
|
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What effect does lithium have
|
calming without effecting intellectual activity
|
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What does lithium control:
|
flight of ideas
hyperactivity |
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What happens if a person stops taking lithium
|
manic bx returns
|
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Lithium therapeutic range
|
narrow .5-1.5meq
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What levels of lithium are toxic
|
1.5-2
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What does lithium deplete
|
sodium
|
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if lithium doesnt work try:
|
miscellaneous anticonvulsants
|
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Lithium treats
|
bipol/manic depres. psychosis
manic episodes levels out mood |
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SE of lithium
|
polydipsia
polyuria weight gain tremors polyphasia |
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What is tegretol
|
anticonvulsant
|
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what is depekene
|
anticonvulsant
|
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what is depekote
|
anticonvulsant
|
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what is mysoline
|
anticonvulsant
|
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what is neurotonin
|
anticonvulsant
|
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what is lamictal
|
anticonvulsant
|
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what is topamax
|
anticonvulsant
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