NUR 2474 Rasmussen Pharmacology Exam 1
dopaminergic agent - Answer levodopa/carbidopa
anticholinergic agent - Answer benzotrophine
cholinesterase
... [Show More] inhibitor - Answer donepezil
Immunomodulators - Answer interferon beta
traditional anti epileptic drugs - Answer phenytoin, carbamazepine, valproic acid
atypical anti epileptic drugs - Answer oxcarbazepine
lamotrigdine
barbiturates - Answer Phenobarbital
muscle spams drugs - Answer baclofen
dantrolene
1st generation antipsychotics - Answer low potency: chlorpromazine
high potency: haloperidol
2nd generation antipsychotic - Answer clozapine
risperdone
olanzapine
SSRIs - Answer fluoxetine
sertraline
paroxetine
SNRI - Answer venlafaxine
duloxetine
TCA - Answer amitriptyline
MAOI - Answer phenelzine
atypical antidepressant - Answer Bupropion, trazodone
OTC herbal for depression - Answer ST. Johns Wort
mood stabilizer - Answer lithium
benzodiazepines - Answer lorazepam, diazepam
alprazolam
benzodiazepine like drugs - Answer zolpidem
insomnia drugs used - Answer trazodone
doxepin
OTC drug for insomnia - Answer melatonin
Atypical Anxiolytic - Answer Buspirone
amphetamines - Answer amphetamine,
lisdexamfetamine
methamphetamine
methylxanthines - Answer methylphenidate
when should we complete blood testing with use of lithium? - Answer early in therapy- every 2-3 days, until a therapeutic dose has been established, then long term-every 3 to 6 months
therapeutic level of lithium - Answer 0.8-1.4 mEq/L
toxic level of lithium - Answer greater than 1.5 mEq/L
when can we start to see side effects of lithium? - Answer when the drug is at a therapeutic level. they are expected.
what are the side effects of lithium (therapeutic level)? - Answer GI effects, tremors, polyuria, renal toxicity, goiter, hypothyroidism, teratogenesis.
what will happen to side effects when one has a toxic level of lithium? - Answer the effects will be much worse and possibly life threatening i.e. tremor that becomes larger with muscle incoordination
what medications can we use to treat the cyclic effects of bipolar (mood-depression- psychosis)? - Answer mood stabilizer (lithium)= control mood
antidepressant (SSRI,TCA,MAOI)= control depression
antipsychotic (Ist/2nd generation)= control the psychosis
how does a benzodiazepine help with ETOH withdrawal? - Answer it will decrease the withdrawal manifestations and intensity, while making one sleepy and having CNS depression. plus, it is easy to give IM and will work quickly.
what is a popular benzodiazepine that is used to treat anxiety? - Answer alprazolam (think A-anxiety)
how does alprazolam work to reduce anxiety? - Answer it inhibits GABA in the CNS, depressing the CNS.
what are the side effects of alprazolam use? - Answer a. CNS depression, anterograde amnesia (patient cannot remember much), sleep driving (not safe), paradoxical effects (still anxious, stays up, rowdy), respiratory depression.
what drugs does alprazolam interact with? - Answer CNS depressant medications (additive effects), ETOH
what are various treatments and drugs used to treat anxiety patients? - Answer benzo's (pam/lam), atypical anxiolytic buspirone, SSRIs paroxetine/fluoxetine, TCAs, MAOIs, trazodone.
explain what a sedative hypnotic does - Answer cause the patient to have sedation, sleepiness, CNS depression, anterograde amnesia (patient cannot remember much), sleep driving (not safe),respiratory depression
what things should we teach the patient using a drug to treat anxiety? - Answer drug should be tapered only by the HCP, not patient
no ETOH use
what withdrawal effects may look like
what does anxiety medication PO withdraw look like? - Answer drowsiness, lethargy, confusion
what does anxiety medication IV withdraw look like? - Answer hypotension, respiratory arrest, cardiac arrest.
explain what methylphenidate does - Answer increases attention and focus in children (NOTHING DEALING W/ BEHAVIORS)
other effects of methylphenidate use in children - Answer decreased appetite
insomnia if given late in the day
what things should we always do when giving methylphenidate to a child with ADHD? - Answer ALWAYS: give the drug in the morning, after breakfast, and give the last dose before 4pm, or else the child will not sleep at night
which 3 drugs are controlled substances and highly abused? - Answer amphetamines, barbiturates, methylphenidate
what is the purpose of drug treatment with Alzheimer Disease patients? - Answer there is treatment to help slow down the progression of the disease, but to not cure it
how does donepezil works? - Answer it slow the progression of Alzheimers disease by causing reversible inhibition of cholinesterase and the cholinergic receptors.
what should we do when discontinuing an antidepressant (or any medication)? - Answer if antidepressant is stopped cold turkey, withdrawal syndrome can occur.
we must gradually taper the drug slowly and have the HCP taper it.
do not let patient taper drug by themselves.
what are signs and symptoms of withdrawal syndrome? - Answer HA, Nausea, visual disturbances, sweating, dizziness, tremors
what is the relationship between sertraline and nursing infants? - Answer when this drug is used with a patient who is pregnant or nursing infants, the infant can have neonatal abstinence syndrome occur
what should we educate pregnant or nursing moms about when using sertraline? - Answer We must educate the patient on potentially using other medications during this time period, as it can cause potential birth defects and the baby to become sick.
explain the relationship between fluoxetine and alcohol abuse - Answer when this drug is used with alcohol abuse, it can interact with the medication and make the patient very sick..
what should we teach the patient regarding alcohol use - Answer the patient must avoid alcohol while taking most medications
what is the first line medication used to stop a seizure? - Answer diazepam (benzo) by IM
explain side effect - Answer unavoidable secondary drug effects produced at therapeutic doses. May be unwanted, but unavoidable and expected.
explain adverse effect - Answer undesired and unexpected severe responses to a medication. They do have the potential to cause harm.
explain allergies/anaphylaxis - Answer an immune response to a medication that causes a reaction that can be mild to life threatening.
what are s/s of allergic reactions? - Answer i. itchy, rash, hives, wheezes, SOB, swelling of face, lips and throat.
what should we do if we a patient actively in allergic reaction? - Answer stop the medication, call the doctor, D/C lines, check for antidotes, and give emergency care based on ABC's.
what should we do before giving any medication? - Answer ask about patient allergies to medications and what happens when they take them.
remember if they report they get any s/s of allergic run with medication use, we must hold med and call dr.
explain intended drug effects - Answer effects that we want to see and that are therapeutic when using the drug. Ex: with an antidepressant, we want to see a mood change, because that is the intended use of the drug.
explain teratogenic effect - Answer a drug induced birth defect that can cause harm to the fetus.
Why we do not allow pregnant moms or those lactating to not take certain medications so they do not harm their child.
explain paradoxical effect - Answer The opposite of the intended drug response.
example of paradoxical response - Answer Benzo's may be used for sedation and insomnia treatment, but may instead cause them to stay up, have excitement, and to be rowdy. The opposite.
explain tolerance - Answer occurs when there is a long term reduced responsiveness to a medication over time, causing the medication to not produce a therapeutic effect. Will need to increase the dose to get the same effect. Will be higher dose but the effects will be seen. will take longer to wean also
explain dependence - Answer the patient gets used to the drug and cannot stop using it. When they do stop the med cold turkey they can have withdrawal symptoms. Why we have to wean and taper the drug.
explain addiction - Answer occurs when the patient abuses the drug and uses it for pleasure instead as prescribed.
why may we give a atypical antipsychotic medication (2nd generation)? - Answer when one cannot handle the EPS that the 1stgeneration drugs produce.
which patient populations should we not use a atypical antipsychotic with? - Answer those with diabetes, those with high cholesterol
what can the atypical antipsychotics cause? - Answer drug onset diabetes, drug onset high cholesterol, weight gain
why should not we use an atypical antipsychotic with a patient with dementia? - Answer It will not work to control the disease and will exaggerate the psychosis. They will need a cholinesterase inhibitor
how can we give antipsychotic medications? - Answer Depot IM injection or PO
what can atypical antipsychotics be used to treat? - Answer schizophrenia, bipolar and depression
what does phenytoin treat? - Answer epilepsy, partial and tonic clonic seizures
what is the interactions between phenytoin and pregnancy? - Answer can be teratogenic and cause fetal deformities. Can also interfere with clotting factors of newborns, causing bleeding
Can also interfere and decrease effectiveness of oral contraceptive use
what should we teach pregnant moms to do when taking phenytoin? - Answer Will need to teach the patient importance of taking folic acid while use of the drug and importance of taking the vitamin K shot before delivery of the baby, potential to switch oral contraceptive use to another way to increase effect of the anti-epileptic
what is there therapeutic level of phenytoin? - Answer 10-20
what is the therapeutic level of carbamazepine? - Answer 5-12
what can we use carbamazepine to treat? - Answer epilepsy, bipolar, and trigeminal neuralgias
why is a therapeutic level important with some medications? - Answer if the drug is not in a certain range, it can be toxic. broad therapeutic range= good drug to use, narrow range= not so good. must draw blood levels if in a narrow therapeutic range medication.
what medications cause EPS? - Answer antipsychotic drugs- 1st generation
what are the early EPS? - Answer acute dystonia, oculogyric crisis, opisthotonus, joints dislocation, impaired breathing, akathisia, parkinsonism
what are the late EPS? - Answer tardive dyskinesia
explain acute dystonia - Answer slow muscle movement and spasticity
explain oculogyric crisis - Answer upward deviation of the eyes
explain opisthotonus - Answer back spasticity
explain joint dislocation - Answer from the muscle spasms, can be painful
explain impaired breathing - Answer the diaphragm cannot work correctly due to slowing of movement
explain akathisia - Answer compulsive, restless movement, need to be in motion with anxiety.
explain Parkinsonism - Answer drug induced Parkinson's: bradykinesia, mask like face, tremor, rigidity, shuffling gait, drooling, cog wheeling, stooped posture
how do we treat early EPS? - Answer anticholinergics, bentos, beta blocker
explain tardive dyskinesia - Answer choreoathetoid movements of the tongue and face, lip smacking movement, fly catching tongue, slow worm like tongue movement, involuntary movements of limbs, tones, hips and fingers.
how do you treat late EPS? - Answer no treatment, but you can prevent it. D/C all medications and switch to 2nd generation antipsychotic
what do TCAs treat? - Answer major depression
how do TCAs work - Answer blocks serotonin and NE reuptake
what are the side effects of TCAs - Answer sedation, orthostatic hypotension, anticholinergic
what is the most dangerous effect of TCAs - Answer cardiac toxicity
S/S of cardiac toxicity in TCAs - Answer dysrhythmias, tachycardia, heart blocks, v tach, v fib [Show Less]