Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/74

Click to flip

74 Cards in this Set

  • Front
  • Back
  • 3rd side (hint)
WHAT IS THE MOA OF DIAZEPAM(VALIUM)
*Depression of the brainstem and the limbic system

*INC. GABA by binding with specific receptor sites, resulting in DEC Neuro transmission in the CNS

*Result is DEC in Anxiety, INC Sedation and muscle relaxation. Also, good for seisure control and works very quickly.
BENZODIAZEPHINES
What are the adverse effects of DIAZEPAM(VALIUM)?
* Excessive sedation
*psycho motor slowing
*potential for addiction
*GI symptoms
*Paradoxical Reactions
* Toxicity
* Respiratory Depression
* Addiction; w/ used with alchohol
* withdrawal; anxiousness & paranoia
When are BENZODIAZEPINES *DIAZEPAM(VALIUM)* used?
IND:

*Anxiety
*Drug and alcohol withdrawal
*muscle relaxation
*sleep promotion
what are the nursing consideration when a patient is on BENZODIAZEPINES *DIAZEPAM(VALIUM)*?
* TAPER OFF GRADUALLY TO AVOID WITHDRAWAL SYMPTOMS
What are the TOXICITY for
BENZODIAZEPINES
*DIAZEPAM(VALIUM)*?
* Respiratory depression or arrest.
-if used with other sedating medications, alchohol, etc
-may accumulate to toxic levels if poor kidney function

Rx for toxicity

-supportive care
-Antidote FLUMAZENIL 2mg IV over 15 sec. May repeat q 60 sec x's 4. last about an hour
Anti-anxiety Drugs

What is the MOA of
Buspirone ( Buspar)?
-unknown but not a CNS depressant
-slow response = 2-4 weeks
-extensive first pass effect
-no abuse potential
-aims at a certain receptor site
-disadvantage: take a long time for the appropriate therapeutic level.
What are the Adverse Effects of Buspirone ( Buspar)?
-dizziness
-nausea
-nervousness
-dysphoria, spacey feeling
Anti-anxiety Drugs
What are the drug interaction of Buspirone ( Buspar)?
-Erythromycin (anti-biotic)
-Ketoconazole (anti-fungal)
-grapefruit
Anti-anxiety Drugs
Anti-Histamines

What is the MOA of
HYDROYXINE (Vistaril, Atarax)?
-Blocks the histamine receptors which, blocks the histamine effect, works good with allergies
-depression of the CNS
-sedation
Anti-Histamines

When do you used this med
HYDROYXINE (Vistaril, Atarax)?
IND:
*Pain relief
*Anxiety
*Sedation
*Anti-Depressants*

What is the MOA?
SSRI's
(Selective Sertonin Reuptake inhibitors)

FLUOXETINE (Prozac)
-acts to inhibit the re-uptake of serotonin. the serotonin stays in the gap.
-may also act on norepinephrine and dopamine
-some have multiple receptor actions; others very specific receptor action
-results in INC concentrations of Neurotransmitters at nerve endings in the CNS.
WHEN DO you use Prozac?
IND:
-Depression
-Anxiety
-Bulimia
-Alcoholism
-Migraines
-etc.
Selective Sertonin Reuptake inhibitors)

What are the adverse effects for SSRI's FLUXETINE (Prozac)?
AE:
-Very safe and well tolerated
-Nausea and vomitting
-sexual dysfunction
-INC suicide risk (w-young children and young adults)
-Serotonin Syndrome
-Withdrawal syndrome-Taper it off
-neonatal withdrawal- if the mother's been on prozac
What are the Drug Interactions for SSRI's Fluoxetine (Prozac)?
DI:
-Monoamine oxidase inhibitors (MOAI's)
-Warfarin
-Tricyclic antidepressants and Lithium
Tricyclic Anti-depressants

MOA of CLOMIPRAMINE (Anafranil)?
-older drug group
-effective but many side effects
-Tachycardia
-dysrhythmias
-nausea
-weight gain, drymouth
-toxic overdose and not reversible
What are MOAI ant-depressants?
(Monamine oxidase inhibitors)
-older anti-depressant
-hypertensive crisis possible when taking Tyramine
*must avoid many foods including cheese, chocolate, soy sauce
-many drug interactions
Anti-psychotic Agents Notes
psychosis includes bipolar disorder, schizophrenia, autism and others
-act to block dopamine receptors and DEC dopamine in tne CNS.
-can cause extra pyramidal symptoms
-Also calleld Tranquilizers
**Risperidone
**Haldolol
**Thorazine
Anti-manic Agents

EX: LITHIUM
MOA: unknown

used for bi-polar disorder
Anti-psychotic Agents
What are the Adverse effects of Lithium?
*toxicity including cardiac dysrhythmia
*slurred speech
*hypotension
*narrow therapeutic window
What are the nursing implications for patients on LITHIUM ?
*monitor levels for Toxicity
*High levels are needed for effectiveness
Meds for Bipolar Disorder
Valproic Acid

*First line for bi-polar disorder
*Faster, effective
*can cause serious toxicity
Anti-psychotic Agents
Notes for Antipsychotic agents for Schizophrenia
*clinical picture of Schizo
*conventional anti-psychotic agents

*atypical agents
-Clozapine, Risperidone
What is the MOA of

Chlorpromazine (Thorazine)?
MOA:

*blocks multiple CNS receptors
-dopamine, histamine, Norepinephrine, Ach
*Dopamine is probably the most important
*low potency
When is Chlorpromazine (Thorazine)used?
*Schizoprenia
*bi-polar
*other psychosis
What are the adverse effects of Chlorpromazine (Thorazine)?
AE:

*Extrapyramidal symptoms
-dystonia, parkinsonism, etc
*anticholingeric effects
-contstipation, dry mouth,tachycardia etc.
*sedation
*Hypotension
*Seizures
*Dysrhythmias
What are the Drug Interactions for Chlorpromazine (Thorazine) ?
*CNS Depressants
*Levodopa ( for Parkinson's Dis)
*anti-cholinergics
What are the Nursing Implications for
Chlorpromazine (Thorazine) ?
HALOPERIDOL (Haldol)

high potency and less sedation
Schizoprenia Atypical Agents

What is the MOA of Clozapine?
MOA:
blocks dopamine and sertonin receptors

Advantage-fewer extrapyramidal reactions
What are the adverse effects of Clozapine?
-DEC in Agranulocytosis in WBC
-Seizures
-Diabetes
Risperidone
is a strong dopamine blocker and its also used for Schizophrenia.
Sedative-Hypnotic Drug

**Barbiturates**
Ex: Thiopental, Secobarbital, Phenobarbital

Choral Hydrate-CNS depressant similar to Barbitates
Sedative-Hypnotic Drug

**Benzodiazepines**
*Xanax, Valium, Ativan
Sedative-Hypnotic Drug

**Melantonin Agonist**
Ramelteon (Rozem)
This will make you sleepy
Agents for ADHD
*Amphetamines
*Methylphenidate (Ritalin, Concerta)
*Adderall
*Strattera-first non-stimulant drug
What is the MOA of ALBUTEROL?
MOA

*Activates beta2 adrenergic receptors in smooth muscle of lungs causing bronchodilation.
*Relaxes muscles to relieve bronchospasms.
When do you use ALBUTEROL?
IND INHALTION:
*acute bronchospams,acute asthma attack
*Exacerbation of COPD
*Prophylaxis of excercise induced asthma

PO: long term control
- not used alone
What is the Pharmacokinetics for Albuterol INH and PO?
PK INH:
*fast onset of action, <5mins
*peaks in 30-60mins
*duration 3-5hrs
*used prn: 1-2 puffs 3-4x/day

PO: 3-4x/day
What are the adverse effects of albuterol for INH and PO?
INH:
Minimal systemic effects
*INC HR
*palpitations
*Tremors

PO:
Less adverse effects
*INC HR
*palpitations
*angina
*tremors
(not a good drug w/ heart problems)
Drug: SEREVENT
*is long acting and long term control
*used for prophylactic acute asthma or COPD
*nocturnal asthma
Bronchodilators
What is the Pharmacokinetics for SEREVENT?
*dosing is fixed, not used alone
*slower onset-30mins
*duration-12hrs

if they have an attack they use their albuterol.
what are the adverse effects of Serevent?
*minimal AE, can see slight INC HR and Tremors
MOA of THEOPHYLLINE?
*relax bronchial smooth muscle causing bronchodilation.
*DEC in inflammation
*INC ability of Cilia to clear Mucus.
Same as SEREVENT: long term control of ASTHMA
IND for THEOPHYLLINE?
PO: maintenance treament for chronic asthma

IV: acute attacks and emergency use only
AE of THEOPHYLLINE?
at therapeutic levels:
*N/V , reslessness, insomnia

Toxic levels: severe dysrhythmias, seizures, cardioresp collapse
DI of THEOPHYLLINE?
*caffeince
*smoking
*Phenobarbital, dilantin
*Cimetidine
MOA of Ipratropium/ Atrovent?
MOA
*blocks muscarinic receptorsin bronchi causing bronchodilation
IND for Ipratropium/ Atrovent?
*COPD
*Chronic Asthma
*Exercise induced asthma
PK for Ipratropium/ Atrovent?
*action = <5mins
*duration = 6hrs
*used alone or in combo with beta 2 agonist 2 MDIs. or combined in one MDI as Combivent or nebulizer med Duoneb
What are the adverse effects of Ipratropium/ Atrovent?
Minimal
-dry mouth
-irritation
-of the pharynx
MOA of Glucocoticoids?

EX: QVAR (INHALED)
PREDNISONE (PO)
PREDNISOLONE (PO)
MOA:
*suppress inflammation in airways, leads to a DEC in Bronchial hyperactivity.
*DEC synthesis and release of anti-inflammatory mediators
*Dec Mucus production and INC number and sensitivity of beta 2 receptors
Anti-inflammatory Meds
IND for INH Glucocoticoids?
*Prophylaxis of chronic asthma and COPD
*fixed schedule, 2-4 puffs 2x's day, not used for acute attacks
AE for INH Glucocoticoids?
*Irriation of Pharynx -yeast infection
*Oropharyngeal Candidiasis- horse voice need to wash after use to prevent this
*Dysphonia
IND for PO Glucocoticoids (Prednisone)?
*treatment of Asthma, COPD exacerbation-short term use 5-7days, taper prophylaxis for chronic asthma, COPD-long term
AE for PO PO Glucocoticoids (Prednisone)?
AE

*short term/acute: mood swings, nausea

Long Term:

*PUD
*Immunosuppression
*Adrenal Suppression
*Osteoporosis
*Fluid and E-lyte imbalances
*hyperglycemia
Mast Cell Stabilizers
*non-steroidal anti-inflammatory.
*Prevent release of Broncoconstrictive and inflammatory substance from mast cells.
MOA for Cromolyn/ Intal?
MOA:

Suppress inflammation ny stabilizing cytoplasmic membrane of mast cells, prevents release of histamine and other mediators
IND for Cromolyn/ Intal?
IND: maintenance therapy for asthma, PO 1x/day
AE for Cromolyn/ Intal?
Well tolerated
MOA Anti-histamines: histamine antagonists?
MOA: blocks action of histamine, compete with histamine for specific receptor sites.

H1 receptors: mediate smooth muscle contraction, dilation of capillaries.
Meds for Allergic Rhinitis
IND for Anti-histamines?
*allergic rhinitis
*insomnia
*motion sickness
*cold: no real value
AE of Anti-histamines?
*1st generation med: sedation only
*anti-cholingergic effects more with the 1st than 2nd
DI for Anti-histamines?
*any CNS Depressant/ Alcohol
MOA of Intranasal Glucocorticoids?

Ex:Flonase
Dec inflammation in nasal passage, take at regular schedule during allergy season. Delivered in meter done spray, 1 spray /nostril 1-2xday
AE for Intranasal Glucocorticoids?

Ex:Flonase
*Drying of nasal mucosa
*burning, itching in nose
*sore throat
*Epistaxis-nose bleed
*HA
Intranasal Mast Cell Stablizers

MOA of Cromolyn/Nasalcrom?
MOA : suppresses release of mediators from mast cells, used prophylactically, administered on regular schedule (by the nose) 1 spray 4-6x a day.
MOA Sympathomimetics?
*decongestants: reduce nasal congestion
*activate alpha 1 adrenergic receptors on nasal blood vessels -> vasoconstriction, shrinkage of swollen membranes and nasal drainage
IND for Sympathomimetics?
allergic Rhinitis
Cold/sinusitis

Will relieve the symptoms
AE for Sympathomimetics?
Spray: rebound congestion
PO:
*CNS stimulation
*CV effects
*Potential for abuse
Meds for Cough
*Anitussives*

MOA??

A. Opioid: Codeine and hydrocodone
**suppress the cough

A. MOA: Act in the CNS to elevate cough threshold, dec frequency, intesity of cough.
Meds for Cough
*Anitussives*

A. Opioid: Codeine and hydrocodone

AE?
*Respiratory Depression
*Potential for Abuse
NON-Opiod

Dextromethorpahn MOA and AE ?
Dextromethorpahn: active ingredient in most non-prescription cough meds.

MOA: same as opioid, acts in the CNS to elevate cough threshold.

AE: Minimal effects
MOA:
Benzonatate/ Tessalon

MOA n AE?
Dec sensitivity of stretch receptors in respiratory tract

AE: dizziness n sedation
Robitussin MOA?
MOA: make cough more productive, stimuale flow of respiratory secretions.
Mucolytics

Ex: Acetlycysterine/ Mucomyst
MOA: react directly mucous to make it more watery, make cough more producitve. administered by inhalation