Pharm Module 3

Front 1

The Central Nervous System consists of?

Back 1

Brain & Spinal cord

Front 2

Peripheral Nervous system is made up of what two types of neurons?

Back 2

efferent & afferent

Front 3

The Efferent neurons compose what two systems?

Back 3

Autonomic & Somatic

Front 4

The autonomic nervous system is composed of what two systems?

Back 4

Sympathetic & Parasympathetic

Front 5

Sympathetic nervous system is also known as?

Back 5

Adrenergic

Front 6

The Parasympathetic system is also known as?

Back 6

Cholinergic

Front 7

The neurotransmitter for the adrenergic system is?

Back 7

norepinephrine

Front 8

Adrenergic receptor cells include?

Back 8

Alpha 1
Alpha 2
Beta 1
Beta 2
Dopamine

Front 9

Drugs that mimic effect of norepinephrine are called?

Back 9

adrenergics
sympathomimetics
adrenergic agonists

Front 10

Drugs that block the effects of norepinephrine are called?

Back 10

sympahtolytics
adrenergic blockers
adrenergic antagonists

Front 11

Classification of adrenergic drugs:

Back 11

Direct-acting
Indirect-acting
Mixed acting

Front 12

Receptor site of adrenergic system include what types?

Back 12

Selective
Non-selective

Front 13

Parasympathetic system is also known as:

Back 13

Cholinergic system

Front 14

Cholinergic neurotransmitter:

Back 14

Acetylcholine ACh

Front 15

Cholinergic receptor cells are what types?

Back 15

nicotinic & muscarinic

Front 16

Drugs that mimic ACh:

Back 16

cholinergic drugs
parasympatheticomimetics
cholinergic agonists
cholinergic stimulants

Front 17

Drugs that block the effect of ACh:

Back 17

anticholinergics
parasympatheticolytics
cholinergic antagonists

Front 18

Classification of cholinergic drugs:

Back 18

Direct-acting
Cholinesterase inhibitors

Front 19

Prototype adrenergic drug:

Back 19

epinephrine

Front 20

Action and effects of epi

Back 20

Stimulates ALL adrenergic receptors, particularly those of CV and CNS. (non-selective)

Front 21

Therapeutic uses of epi.

Back 21

Treats shock, cardiac emergencies, asthma, glaucoma & other.

Front 22

Contraindications of epi:

Back 22

Hypersensitivity, during active labor, closed angle glaucoma, general anesthesia, severe organic cardiac disease, shock states other than anaphalactic.

Front 23

Side effects of epi:

Back 23

fatigue, sleep disturbances, tremor, weakness, dizziness, cardiovascular stimulation

Front 24

Nursing implications Epi:

Back 24

Monitor CV status closely.
Schedule doses to minimize sleep disruption & allwo appetite and meals to coincide.

Front 25

Education Epi:

Back 25

Use of inhalers and nebulizers

Front 26

Prototype nonselective adrenergic agonist:

Back 26

epinephrine (adrenaline)

Front 27

Alpha 1 agonist prototype:

Back 27

Phenylephrine (Dristan)

Front 28

Phenylephrine action and effects: (Alpha 1 agonist)

Back 28

Alpha adrenergic agonist and vasopressor (constricts vessels, raises blood pressure)

Front 29

Phenylephrine (Alpha 1 agonist) therapeutic uses:

Back 29

Treats hypotension, shock related to vascular failure, nasal congestion; also used during anesthesia.

Front 30

Phenylephrine (Alpha 1 agonist) Contraindications:

Back 30

Hypersensitivity, severe hypertension, ventricular tachycardia and closed-angle glaucoma.

Front 31

Therapeutic uses of epi.

Back 31

Treats shock, cardiac emergencies, asthma, glaucoma & other.

Front 32

Contraindications of epi:

Back 32

Hypersensitivity, during active labor, closed angle glaucoma, general anesthesia, severe organic cardiac disease, shock states other than anaphalactic.

Front 33

Side effects of epi:

Back 33

fatigue, sleep disturbances, tremor, weakness, dizziness, cardiovascular stimulation

Front 34

Nursing implications Epi:

Back 34

Monitor CV status closely.
Schedule doses to minimize sleep disruption & allwo appetite and meals to coincide.

Front 35

Education Epi:

Back 35

Use of inhalers and nebulizers

Front 36

Phenylephrine (Alpha 1 agonist) Side affects:

Back 36

hypertension, headache, sleep disturbances. Most serious adverse: reflex bradycardia.

Front 37

Phenylephrine (Alpha 1 agonist) Nursing Implications:

Back 37

Instill eye drops in conjunctival cul-de-sac. Avoid situations that increase blurred vision.

Front 38

Phenylephrine (Alpha 1 agonist) Patient Education:

Back 38

Stress safety related to blurred vision.

Front 39

Alpha 2 agonist prototype:

Back 39

Clonidine (Catapres)

Front 40

Clonidine (Catapres Alpha-2 agonist) Action and effects:

Back 40

Stimulates alpha-2 receptors centrally, which reduces sympathetic outflow from the CNS and results in decreased heart rate, BP, vasoconstriction, and renal vascular resistance.

Front 41

Phenylephrine (Alpha 1 agonist) Theraputic uses:

Back 41

Used as a second-line antihypertensive, also to relieve discomfort of withdrawal symptoms from narcotics.

Front 42

Phenylephrine (Alpha 1 agonist) Contraindications:

Back 42

Hypersensitivity, bleeding disorders, anticoagulants.

Front 43

Phenylephrine (Alpha 1 agonist) Side Affects:

Back 43

Dry mouth, drowsiness, dizziness, sedation and constipation. Most serious adverse affect: rebound hypertension (with abrupt stopping).

Front 44

Phenylephrine (Alpha 1 agonist) Nursing Implications:

Back 44

Give clonidine orally in combination with other antihypertensives; apply a new patch to a hairless area every 7 days. Do not stop therapy abruptly.
Be aware of abuse potential.

Front 45

Phenylephrine (Alpha 1 agonist) Patient Education:

Back 45

Teach patient how to manage adverse affects.

Front 46

Beta agonist prototype:

Back 46

isoproterenol (Isuprel) NON-SELECTIVE

Front 47

Beta agonist isoproterenol (Isuprel) Action and effects:

Back 47

Relaxes bronchial smooth muscle by stimulating beta-receptors. As a cardiac stimulant, acts on beta-1 receptors in the heart.

Front 48

Beta agonist isoproterenol (Isuprel) Therapeutic uses:

Back 48

Bronchospasm during anesthesia, heart block, ventricular arrhythmias, shock, postoperative cardiac patients with bradycardia, as an aid in diagnosing the cause of mitral regurgitation, and coronary artery disease or lesions.

Front 49

Beta agonist isoproterenol (Isuprel) Contraindications:

Back 49

Tachycardia or AV block caused by digoxin intoxications, arrhythmias other than those that may respond to drug, angina pectoris, angle-closure glaucoma.

Front 50

Beta agonist isoproterenol (Isuprel) Side affects:

Back 50

Headache, mild tremor, weakness, dizziness, nervousness, anxiety.
palpitations, rapid rise and fall in BP, tachcardic arrhythmias, cardiac arrest. nausea, vomiting, hyperglycemia, diaphoresis, swelling of parotid glands with prolonged use.

Front 51

Beta agonist isoproterenol (Isuprel) Nursing Implications:

Back 51

Use of infusion pump. Monitor blood pressure, urinary output, cardiac output and pulmonary wedge pressure throughout therapy.

Front 52

Beta agonist isoproterenol (Isuprel) Patient Education:

Back 52

Reassure patient that close monitoring will be maintained. Tell patient to report chest pain, fluttering in chest and other adverse reactions.

Front 53

Alpha angtagonist prototype:

Back 53

Prazosin (Minipres)

Front 54

Alpha angtagonist Prazosin (Minipres) Action and effects:

Back 54

Vasodilator

Front 55

Alpha angtagonist Prazosin (Minipres) Therapeutic Uses:

Back 55

Treat refractory CHF, hypertension, Raynaud vasospasm, prostatic obstruction.

Front 56

Alpha angtagonist Prazosin (Minipres) Contraindications:

Back 56

hypersensitivity

Front 57

Alpha angtagonist Prazosin (Minipres) Side Affects:

Back 57

Lightheadedness, dizziness, headache, drowsiness, weakness, lethargy, nausea, and palpitations. Most serious: "first dose syncope"

Front 58

Alpha angtagonist Prazosin (Minipres) Patient Education;

Back 58

Stress safety regarding CNS effects, safe ways to cope with postural hypotension.

Front 59

Alpha angtagonist Prazosin (Minipres) - Other alpha blockers

Back 59

Daxazosin (Cardura)
Terazosin (Hytrin)
Phentolamine (Regitine)
Phenoxybenzamine (Dibensyline)

Front 60

Beta Blocker Prototype (beta antagonist):

Back 60

Propranolol (Inderal)

Front 61

Beta Blocker Propranolol (Inderal) Action and effects;

Back 61

Beta blocker, treats hypertension, angina, cardiac arrhythmias, migraine.

Front 62

Beta Blocker Propranolol (Inderal): Therapeutic Uses:

Back 62

Decrases heart rate and contractility, slows conduction, suppresses automaticity.

Front 63

Beta Blocker Propranolol (Inderal): Contraindications:

Back 63

bradycardia, complete heart block, cardiogenic shock, uncompensated cardiac failure, reactive airway diseases, and Raynaud disease.

Front 64

Beta Blocker Propranolol (Inderal):Side affects:

Back 64

postural hypotension, bronchospasm. MI

Front 65

Beta Blocker Propranolol (Inderal): Patient Education:

Back 65

Take med exactly as prescribed. Minimize environmental stressors, stress self-monitoring techniques for pulse rate and heartbeat, safe mobility related to postural hypotension, never abruptly stop taking med.

Front 66

Beta Blocker Propranolol (Inderal): Other Beta Blockers:

Back 66

Atenolol (Tenormin) beta-1 selective
Metoprolol (Lopressor) beta-1 selective
Timolol (Blockadren) beta non-selective.

Front 67

Cholinergic Ganglionic stumulating agent:

Back 67

Nicotine

Front 68

Nicotine Actions and uses:

Back 68

A direct-acting nicotinic agonist used as an adjunct to smoking cessation programs.

Front 69

Nicotine Contraindications:

Back 69

Immediately post MI, life-threatening dysrhythmias, severe angina.

Front 70

Nicotine Side affects:

Back 70

erythema, pruritius, burning, headache, insomnia. Most serious: vasculitis

Front 71

犬

Back 71

Dog

Hint 71

quan3

Front 72

Nicotine Patient Education:

Back 72

Correct use of multilple administration routes, avoidance of other stimulants.

Front 73

Cholinergic agonist Cholinesterase inhibitor:

Back 73

Neostigmine (Prostigmin)

Front 74

Cholinergic agonist Neostigmine (Prostigmin) Actions and effects:

Back 74

An indirect-acting cholinoceptor stimulant used in the management of myasthenia gravis.

Front 75

Cholinergic agonist Neostigmine (Prostigmin) Contraindications:

Back 75

GI obstruction or ileus, urinary tract obstruction, peritonitis.

Front 76

Cholinergic agonist Neostigmine (Prostigmin) Side affects:

Back 76

Nausea or vomiting, diarrhea, abd pain, miosis, salivation, diaphoresis, sinus bradycardia. Most serious: cholinergic crisis, cardiac arrest.

Front 77

Cholinergic agonist Neostigmine (Prostigmin) Nursing implications:

Back 77

Administer at regular intervals to ensure adequate blood levels.
Availability of atropine, the antidote for cholnergic crisis.
**Differentiate between cholinergic crisis and myasthenic crisis.

Front 78

Cholinergic agonist Neostigmine (Prostigmin) Patient Education:

Back 78

Symptoms of cholnergic crisis and need for immediate medical attention.

Front 79

Cholinergic antagonist (blocker) prototype:

Back 79

Atropine Sulfate

Front 80

Cholinergic antagonist Atropine sulfate Actions and effects:

Back 80

Anticholinergic drug given in evergency situations such as severe bradycardia or during CPR. Used routinely as a preoperative med to reduce intraoperative pulmonary secretions.

Front 81

Cholinee rgic antagonist Atropine Sulfate Contraindications:

Back 81

hypersensitivity to sulfites, myasthenia gravis, acute MI

Front 82

Cholinergic antagonist Atropine Sulfate Side Affects:

Back 82

blurred vision, constipation, dry mouth, urinary retention
Most serious: cardiac arrhythmias

Front 83

Cholinergic antagonist Atropine Sulfate Nursing implications:

Back 83

Take med exactly as prescribed and at required dosage, good oral hygene, fluid replacement.

Front 84

Cholinergic antagonist Atropine Sulfate Patient Education:

Back 84

Safety issues for blurred vision; avoid OTC and herbal medications without the direct approval of the health care provider.

Front 85

Cholinergic agonist Muscarinic agonist:

Back 85

Bethanechol (Urecholine)

Front 86

Cholinereimulatgic agonist Muscarinic agonist: Bethanechol (Urecholine) Actions and Uses:

Back 86

Stimulates muscarinic ACH receptors directly, mimics effects of parasymp nervous system stimulation. Stimulates gastric motility, micturition; increases lower esophageal sphincter pressure.

Front 87

Cholinergic agonist Muscarinic agonist: Bethanechol (Urecholine) Uses:

Back 87

Urinary retention (postop, postpartum)

Front 88

Cholinergic agonist Muscarinic agonist: Bethanechol (Urecholine) Contraindications:

Back 88

Hypersensitivity, severe bradycardia, asthma, severe hypotension, hyperthyroidism, peptic ulcer, parkinsonism, seizure disorders, CAD, COPD, coronary occlusion, recent urinary or GI surgery.i

Front 89

Cholinergic agonist Muscarinic agonist: Bethanechol (Urecholine)Nursing Implications:

Back 89

Assess B/P, pulse; observe after parenteral dose for 1 hour. I&O check for urinary retention or urge incontinence. Bradycardia, hypotension, bronchospasm, headache, dizziness, seizures, respiratory depression; product should be discontinued if toxicity occurs.

Front 90

Cholinergic agonist Muscarinic agonist: Bethanechol (Urecholine) Patient Education:

Back 90

Take exactly as prescribed; 1 hr before or 2 hr after meals. To make position changes slowly; orthstatic hypotension may occur. To avoid driving, hazardous activities until effects are known.