Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
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
|
|
