Pharmacology Ans & Cns

Front 1

Sympathetic Nervous System is also known as the??

Back 1

Andrenergic system

Front 2

What are the 3 primary neurotransmitters of the sympathetic nervous system?

Back 2

* Norepinephrine
* Epinephrine
* Dopamine

Front 3

Which nervous system is responsible for "fight" or 'flight" response?

Back 3

Sympathetic

Front 4

Which nervous system "speeds up" many physiological responses?

Back 4

Sympathetic

Front 5

______ is an example of internal stress.

Back 5

Illness

Front 6

_______ is an example of external stress

Back 6

Danger

Front 7

The parasmpathetic nervous sytem is also known as the __________.

Back 7

cholinergic system

Front 8

The parasympathetic nervous systems primary neurotransmitter is?

Back 8

acetylcholine

Front 9

Which nervous system "slows down" many physiological responses?

Back 9

parasympathetic/cholinergic system

Front 10

Which nervous system is responsible for "rest and digest"?

Back 10

parasympathetic

Front 11

What are the four categories of the drugs that affect the Autonomic Nervous system?

Back 11

1. adrenergic agonists
2. adrenergic antagonists
3. cholinergic agonists
4. cholinergic antagonists

Front 12

Adrenergic agonists are also known as the?

Back 12

sympathomimetics

Front 13

Adrenergic antagonists are also known as the?

Back 13

sympatholytics

Front 14

Cholinergic agonists are also known as the? (2)

Back 14

*parasympathomimetics
*acetylcholinesterase inhibitors

Front 15

Cholinergic antagonists are also known as the?

Back 15

parasympatholytics

Front 16

Which drug classification stimulates the sympathetic nervous system?

Back 16

adrenergic agonists

Front 17

Which drug classification depresses the sympathetic nervous system?

Back 17

adrenergic antagonists

Front 18

Which drug classification stimulates the parasympathetic nervous system?

Back 18

cholinergic agonists

Front 19

Which drug classification depresses the parasympathetic nervous system?

Back 19

cholinergic antagonists

Front 20

Adrenergic agonists mimic what three neurotransmitters?

Back 20

1.norepinerphrine
2.epinerphrine
3.dopamine

Front 21

What receptor sites do the adrenergic agonist act on?

Back 21

alpha 1, alpha 2, beta 1, beta 2, and dopaminergic

Front 22

When alpha1 is stimulated what neurotransmitters are released? (3)

Back 22

1. norepinephrine
2. epinephrine
3. dopamine

Front 23

Which RECEPTOR when stimulated releases norepinephrine, epinerphrine and/ or dopamine, to force cardiac contraction to increase, vasoconstrict arterioles to elevated blood pressure, vasoconstrict venuels to increase blood return to the heart, is responsible for dilating pupils to facilitate vision, contracts the bladder neck and relaxes the bladder to prevent urine loss and also decreases salivation?

Back 23

alpha 1

Front 24

When this receptor is stimulated the release of norepinephrine and/or epinephrine is inhibited. Blood pressure decreases. This receptors stimulation is responsible for maintaining homeostasis to avoid excess stimulation by norepinerphrine and epinephrine.

Back 24

alpha 2

Front 25

Which receptor when stimulated by norepinephrine, epinephrine and/or dopamine force the cardiac contraction of the heart to increase, increases the release of renin from the kidneys which increases the angiotensin level in the blood and raises the blood pressure. This receptors stimulation also increases intra-ocular pressure.

Back 25

beta 1

Front 26

When this receptor is stimulated epinephrine is released, the bronchioles are dilated, gastrointestinal and uterine relaxation occurs, and blood sugar rises due to glycogenoltysis in the liver

Back 26

beta 2

Front 27

When this receptor is stimulated the coronary, renal and visceral vessels are dilated to supply oxygenated blood to these organs. The peripheral arterial vessels are vasoconstricted to shunt blood from the extremities to the major organs. Dopamine is the only neurotransmitter that acts on this receptor

Back 27

dopaminergic

Front 28

Direct Acting (catecholamines) are the endogenous substance forms of what 3 neurotransmitters?

Back 28

1. norepinephrine
2. epinephrine
3. dopamine

Front 29

Synthetic form of epinephrine is called?>

Back 29

Adrenaline

Front 30

This neurotransmitter stimulates alpha and beta 1 receptors and beta 2 receptors. This drug is usually used for bronchospasms. The beta2 stimulation causes bronchodilation. Can be given for cardiac standstill. The beta 1 stimulation can initiate cardiac contractions. The stimlulation of alpha1 and beta1 receptors can cause adverse effects of increased heart rate and increased blood pressure. Can be given IM, IV,SC and inhaled.

Back 30

epinephrine

Front 31

What is the synthetic form of norepinephrine?

Back 31

Levophed

Front 32

The synthetic form of dopamine is called?

Back 32

Intropin

Front 33

This drug stimulates dopaminergic, alpha1 & beta 1 receptors. Used for an acute hypotensive state. Increases peripheral vasoconstriction while vasodilating the vessels supplying the blood to the major organs. Can be used to improve renal perfusion due to vasodiation of the renal arteries. Increases cardiac output. IV use only

Back 33

dopamine (Intropin)

Front 34

This drug stimulates the beta 1 receptors. It increases cardiac output by increasing the force of the cardiac contraction and slightly decreases peripheral vascular resistance. Is used for cardiogenic shock; Not for hypovolemic shock. IV used only

Back 34

dobutamine (Dobutrex)

Front 35

What are the TWO adrenergic Agonist sub groups?

Back 35

1. Direct Acting Catecholamines
2. Sympathetic Amines (Non-catecholamines)

Front 36

Which non-catecholamine stimulates beta 2 receptors to cause bronchodialation and alleviates bronchospasms in COPD. This drug can be given PO via inhaler or SC

Back 36

albuterol (Proventil)

Front 37

This non-catecholamine stimulates beta 2 receptors. It is used for bronchodilation to relieve bronchospasms caused by COPD and used to slow or stop contractions in pre-term labor. PO, SC

Back 37

terbutaline (Brethine)

Front 38

This non-catecholamine stimulates alpha 1 receptors. It can be given parenterally to treat acute hypotensive states. Mostly used to produce nasal mucosal vasoconstriction to relieve nasal stuffiness caused by colds and allergies. PO OTC

Back 38

phenylephrine ( Neo-Synephrine)

Front 39

This non-catecholamine drug stimulates alpha 1 receptors and slightly stimultes beta 1 receptors. Produces nasal mucosal vasoconstriction to relieve nasal stuffiness caused by colds and allergies. PO OTC

Back 39

psuedoephedrine

Front 40

What is the antidote for dopamine?

Back 40

regatine

Front 41

Assessment for tachycardia and hypertension when alpha and beta 1 are stimulated is important For which ANS drug class?

Back 41

Adrenergic Agonist (sympathomimetics)

Front 42

This drug class should be used cautiously in clients with coronary artery disease or hypertensive disease.

Back 42

Adrenergic Agonist
(sympathomimetics)

Front 43

When using which ANS drug class assessment for coolness and/ or cyanosis is important due to vasoconstriction

Back 43

Adrenergic Agonist
(sympathomimetics)

Front 44

dopamine, norepinephrine and phylephrine should be given how?

Back 44

IV ONLY

Front 45

What drugs if infultrated in a peripheral line causes vasoconstriction that could be severe enough to cause necrosis?

Back 45

dopamine, norepinephrine and phenylephrine

Front 46

Overconstriction nasal sprays can cause what?

Back 46

rebound vasodilation of the nasal mucosa

Front 47

Drugs that depress the sympathetic nervous system?

Back 47

adrenergic antagonists, adrenergic blockers, sympatholitics

Front 48

These drugs block the effects of the sympathetic neurotransmitters.

Back 48

anti-adrenergic, adrenergic antagonists, sympatholytics

Front 49

Which adrenergic blocker vasodiolates arterioles, is used for hypertension HTN, peripheral vascular disease PVD and benign prostatic hyertrophy. Theses drugs are also used to relax smooth muscles of the urethra which improves urine flow. Tachycardia can occur is the blood pressure is decreased too much too rapidly and because these drugs decrease cardiac contraction, a client can be predisposed to CHF

Back 49

alpha 1 adrenergic blockers

Front 50

Examples of alpha 1 adrenergic blockers (2)

Back 50

Cardura
Regitine (phentolamine)
Minipress

Front 51

These adrenergic blocker slows the heart rate, decreases blood flow through decreased vasodialation and decreased release of renin from the kidneys. These drugs make heart beat slower and more efficient. Predispotion of CHF is also a risk of this drugs use.

Back 51

Beta adrenergic blockers

Front 52

Blocks beta 1 and beta 2 receptors. Used to treat tachycardia, hypertension and coronary artery disease. Can cause bronchoconstriction due to beta 2 receptor blocking action. Use caution with COPD given PO

Back 52

Inderall (propranolol HCL)

Front 53

Blocks beta 1 receptors. Used for hypertension and coronary artery disease. Acts only on the heart with low to moderate doses. Can cause bronchconstriction at high doses. PO

Back 53

Lopressor (short acting)
Toprol XL (long acting)
( metoprolol )

Front 54

examples of beta adrenergic blockers are ? (4)

Back 54

* Inderall
* Lopressor & Toprol XL
* Atenolol- tenormine
* Timoptic opthalmic

Front 55

What class of drugs increase the risk of hypotension and blood pressure should be monitored closely?

Back 55

Sympatholytics/ Adrenergic blockers

Front 56

Which adrenergic blocker (alpha or beta 1 or 2) can cause tachycardia?

Back 56

alpha 1 adrenergic blocker

Front 57

which drugs cause decreased cardiac output and signs of SOB and activity intolerance should be monitored. These drugs also decrease the force of cardiac contractions

Back 57

alpha1 and beta1 adrenergic blockers

Front 58

Which adrenergic blocker can cause bronchoconstriction?

Back 58

beta 2

Front 59

Which blockers when given in high doses can affect beta 2 receptor sites?

Back 59

beta 1

Front 60

Which drugs stimulate the parasympathetic nervous system?

Back 60

parasympathomimetics/
cholinergic agonists/ acetylcholinesterase inhibitors

Front 61

What are the two types of cholingergic receptors?

Back 61

1) muscarinic receptors that affect smooth muscles
2) nicotinic receptors that affect skeletal muscles

Front 62

What are the two sub classes of cholinergic agonists?

Back 62

1)Direct Acting
2)Indirect Acting/Acetylcholihesterase Inhibitors

Front 63

What do acetylcholinesterase inhibitors/ direct acting cholinergic agonists do?

Back 63

destroy acetylcholinesterase allowing acetylcholine to remain on the receptors for a longer period of time.

Front 64

When this system is STIMULATED, the heart rate and blood pressure decreases, bronchococonstriction occurs, bronchial secretions, salivation, peristalsis,bladder tone, sweating, and gastric acid secreations increase, urinary sphincter relaxes and intra-occular pressure decreases.

Back 64

cholinergic system

Front 65

This type of cholinergic agonist introduces more acetylcholine into the system

Back 65

DIRECT ACTING cholinergic agonists

Front 66

An example of direct acting cholinergic agonist is?

Back 66

pilocaropine

Front 67

2 examples of Indirect/ Acetylcholinesterace inhibitor is?

Back 67

Cognex and Aricept

Front 68

What drugs can cause diarrhea, and abdominal cramping?

Back 68

parasympathomimetics/
acetylcholinesterse inhibitors

Front 69

When administering these 2 classes of drugs assessing bronchoconstriction especially in patients with COPD is important.

Back 69

Sympatholytics (adrenergic blockers) and parasympathomimetics (acetylcholinesterase inhibitors)

Front 70

When giving this type of drug a "cholinergic crisis" can occur characterized by extreme muscle weakness and respiratory distress

Back 70

Parasympathomimetics/ acetylcholinesterase inhibitors

Front 71

When administering this type of drug it is every important that administer any medication on time that is used to maintain muscle strength in myasthenia

Back 71

Parasympathomimetics/ acetylcholinesterase inhibitors

Front 72

What drugs inhibit the action of acetylcholine by competing with it for space on the acetylcholine receptors.

Back 72

Cholinergic Antagonists (anticholinergics
/parasympatholytics)

Front 73

These drugs have the opposite effect of cholinergic agonists. The heart rate increases, bronchodilation occurs, bronchial secretion decreases, salivation is decreased, gastro-intestinal motility and gastric acid secretion are decreased, bladder tone is decreased and urinary sphincter tone is increased. Intra-ocular pressure is increased.

Back 73

cholinergic antagonists (anticholinergics/parasympatholytics)

Front 74

Examples of cholinergic antagonists (anticholinergic/parasympatholytics)

Back 74

atrovent
bentyl
cogentin
artane
atropine

Front 75

dry mouth, possible dehydration, constipation, urinary retention is possible and pt with enlarged prostates, intra-ocular pressure can increase (use caution with clients with glaucoma) Blurry vision can occur

Back 75

Parasympatholytics

Front 76

What are the neurotransmitters associated with the CNS? (5)

Back 76

*GABA
*Serotonin
*Norepinephrine
*Acetylcholine
*Dopamine

Front 77

GABA is associated with the regulation of?

Back 77

anxiety

Front 78

Serotonin is associated with what bodily functions?

Back 78

* sleep
* wakefulness
* mood

Front 79

Norepinephrine is associated with what bodily functions?

Back 79

wakefulness
mood
anxiety

Front 80

Dopamine is associated with what bodily functions?

Back 80

cognition
emotional responses

Front 81

Caused by abnormal electrical activity in the brain.

Back 81

seizure

Front 82

What drugs raise the seizure threshold by inhibiting excitatory activity in the motor cortex of the brain.

Back 82

anti-seizure agents

Front 83

What are the three ways excitatory activity in the brain can be decreased to prevent seizures?

Back 83

1) suppression of sodium influx
2) suppression of calcium influx
3) potentiation of GABA

Front 84

Decrease excitability in the motor cortex by suppressing sodium influx through sodium channels. This in turn decreases the neuronal action potential. This drugs are highly protein bound and have a narrow therapeutic index. These drugs prevent seizures

Back 84

Hydrantoins

Front 85

Example of Hydrantoins?

Back 85

Dilantin (phenytoin)

Front 86

These drugs suppress sodium influx through channels, they are used for generalized seizures and bipolar disease?

Back 86

Iminostilbenes

Front 87

Example of iminostilbenes?

Back 87

Tegretol

Front 88

This drug is used treat seizures, it causes cardiac arrest if given iv too rapidly and crystallizes if given iv too slowly

Back 88

Dilantin (phenytoin)

Front 89

These drugs potentiate GABA and decrease the conduction of impulses in the ascending reticular formation of the brain.

Back 89

Barbituates

Front 90

Example of Barbituate?

Back 90

Luminal (phenobarb) Amytal

Front 91

These drugs potentiate GABA and inhibit impulses subcortically in the limbic system, thalmus and hypothalmus.

Back 91

Benzodiazepines

Front 92

example of Benzo

Back 92

Valuim (diazepam)

Front 93

These drugs suppress sodium and calcium influx and potentiate GABA. They can be used to treat bipolar disorder and for prophylaxis of migraine headaches. Moderately hepatotoxic and liver enzymes must be drawn on a regular basis. use great caution in elderly and children

Back 93

Valproic Acid

Front 94

Example of valproic acids

Back 94

Depakote (divalproex sodium)
Depakene (valproic acid)

Front 95

These drugs are used to treat absence seizures and work by reducing the synaptic nerve response to low frequency repetitive stimulation

Back 95

Succinamides

Front 96

Example of succinamides

Back 96

Zarontin (ethosuximide)

Front 97

This drug enhances GABA can be used for partial seizures, bipolar disorder, chronic pain, insomnia and anxiety

Back 97

Neurontin (gabapentin)

Front 98

This drug is thought to inhibit the burst firing of excitatory activity in the brain and is the most common seizure drug

Back 98

Keppra

Front 99

What is the BIGGEST nursing implication related to Anti-seizure drugs?

Back 99

SAFETY must be main concern because these drugs causes sedation

Front 100

What drug class has a side effect of trigiminal nerve neuralgia and can cause dyscrasias (crazy blood)?

Back 100

iminostilbenes

Front 101

This drug is commonly used in pregnant women to prevent eclampsia.

Back 101

magnesium sulfate

Front 102

These antidepressant drugs have a 3 ring structure in the molecule, they reduce the reuptake of serotinin 5HT and norepinephrine by the presynaptic regions. Exhibit anticholinergic effects and are rarely used do to the extensive side effects

Back 102

Tricyclic Anti-depressants (TCA's)

Front 103

Physiological depression is thought to be a depletion of what 3 neurotransmitters?

Back 103

serotonin, dopamine, and norepinephrine

Front 104

This enzyme causes depletion of the 3 neurotransmitters that causes depression.

Back 104

monomine oxidase MAO

Front 105

These antidepressant drugs should be given at hours of sleep in larger doses

Back 105

TCA's

Front 106

These drugs inhibit the enzyme that breaks down serotonin, norepinephrine and dopamine. They have many drug-drug and food-drug interactions. Foods high in tyramine (cheese, beer, wine, bananas, chocolate, and yogurt) should be avoided due to risk of dangerously high BP elevations.

Back 106

Monoamine Oxidase Inhibitors (MAOIs)

Front 107

Example of MAOI?

Back 107

Nardil and Marplan

Front 108

These drugs increase the levels of serotonin in the brain by decreasing pre-synaptic neural re-uptake. The agents have very few side effects bc of their selective nature.

Back 108

Selective Serotonin Reuptake Inhibitors (SSRIs)

Front 109

This SSRI increases violence and suicide risk in some individuals especially adolescents

Back 109

fluoxetine (Prozac)

Front 110

This drug when given at low doses inhibits reuptake of serotonin but in larger doses will inhibit the reuptake of norepinephrine and dopamine

Back 110

Effexor (venlafaxine)

Front 111

Onset of action when taking these drugs may take up to 4-6 weeks, tolerance can happen within 6 mon - 12 mon, and suicidal thoughts are a risk.

Back 111

ANTIDEPRESSANT

Front 112

When taking this type of drug grapefruit and grapefruit juice must be avoided to prevent toxicity..

Back 112

TCA's

Front 113

These types of drugs block the release of dopamine and norepi, are in pregnancy category D, and adequate fluid intake of 2500-3000mLs as well as adequate sodium intake are very important for the elimination of this drug. EXAMPLE

Back 113

ANTIMANIC DRUGS
Example - Lithium

Front 114

What are the 4 subcategories of drugs that are used to relieve anxiety, produces sedation before surgery and induce sleep.

Back 114

A. Benzodiazepines
B. Non-Benzodiazepine Anxiolytic
C. Non-Benzodiazepine Somnifacients
D. Hormones

Front 115

What is the antidote for Benzodiazepines?

Back 115

Romazicon

Front 116

Example of Non-Benzodiazepine Anxiolytic that binds with the serotonin and dopamine receptors in the CNS resulting in the decrease transmission of these neurotransmitters

Back 116

BuSpar (buspirone)

Front 117

What drugs can cause EPS which can involve abnormal movements such as those seen is parakinson's disease, dystonia, and tardive dyskinesia due to dopamine deficit

Back 117

Non Benzodiazepine Anxiolytic

Front 118

These drugs also potentiate GABA but have a less residual effect and are thought to cause less dependence than benzos
EXAMPLE?

Back 118

Non-Benzodiazepine Somnifacients
Example Ambien

Front 119

This drug is a natural hormone synthesized from serotonin that is secreted by the pineal gland. It controls the sleep-wake cycle

Back 119

Melatonin

Front 120

These drugs when taken with alcohol can cause psychomotor impairments, should be given on an empty stomach and should be taken right before bed bc they act very quickly.

Back 120

melatonin
ramelteon (Rozerem)

Front 121

These drugs work by decreasing dopamine and serotonin levels. The anti-dopaminergic activity is responsible for their theraputic effects, they cause anticholinergic effects and are given to decrease violence
EXAMPLE

Back 121

anti-psychosis/agitation
risperidone

Front 122

These drugs bind with opiate receptors in the CNS alter the perception of and emotional response to pain. Activation of cells in the brain containing serotonin can also occur with some of these types of drugs.

Back 122

Analgesics - opioid
Morphine and all derivatives

Front 123

These analgesics are thought to have a lower addiction potential and are less likely to cause respiratory depression. Example

Back 123

Agonist/Antagonists
Talwin / butorphanol

Front 124

These drugs are used for opioid overdoses bc they compete for binding sites.
Ex

Back 124

Opioid Antagonists
Narcan (naloxone)

Front 125

Examples of analgesic
Non-opiods

Back 125

ASA (aspirin) NSAIDs

Front 126

What drugs should not be given if a pt has severe respiratory depression, head trauma, shock, asthma and can cause urinary retention and constipation?

Back 126

Opioids

Front 127

These drugs are used for muscle spasms, MUST be tapered off to prevent hallucinations and psychosis, can cause muscle weakness and drowsiness
EXAMPLE

Back 127

Central acting skeletal muscle relaxants
Example
Flexeril
Soma

Front 128

This disease is a degenerative disorder of the CNS caused by
destruction of the neurons in the substantis nigra that produce the neurotransmitter dopamine. Since dopamine cannot cross the supratentoral membrane, acetylcholine replaces it and stimulates the corpus striatum which results in tremors, muscle rigidity, posture instability and bradykinesia.

Back 128

Parkinson's disease

Front 129

These types of drugs are used to increase the levels of dopamine in the substantia nigra to treat parkinsons disease and must be tapered.

Back 129

Dopaminergic

Front 130

These types of drugs shut down over stimulation of ACH to treat symptoms of parkinsons disease

Back 130

Anti-Cholinergic

Front 131

Foods high in vitamin B6 can decrease the effects of what type of drugs?

Back 131

dopaminergic

Front 132

This disease is a degenerative process that occurs in the cerebral cortex. The cerebral cortex decreases in size, amyloid protein plaques are formed and the neurons became tangled. The enzyme active in producing acetylcholine is decreased. Causes memory impairment, language impairment, confusion and agitation.

Back 132

Alzheimers disease

Front 133

This drug is used to treat alzheimers disease although there is no evidence that it works. This drug is VERY hepatotoxic and liver function tests MUST be performed AT LEAST every 3 mon (2)

Back 133

Aricept
Cognex

Front 134

This drug is a newer drug used to treat alzheimers disease, isnt as hepatotoxic and there is evidence to show it works.

Back 134

Namenda (memantine)