Exam 3

Created by BNwinwin 

Upgrade to
remove ads

156 terms

Zolpidem

benzodiazepine (sleeping pill/treatment of insomnia)

Diphenhydramine

1st generation antihistamine (Benadryl)

Eszopiclone

benzodiazepine

temazePAM

benzodiazepine

ramelton

benzodiazepine (treatment of long term insomnia)

secobarbital

benzodiazepine

citalopram

SSRI antidepressant

paroxetine

SSRI antidepressant

fluoxetine

SSRI antidepressant

sertraline

SSRI antidepressant

amitryptiline

TCA antidepressant (trycycline antidepresant)

Phenelzine

MAOI antidepressant

tranylcypromine

MAOI antidepressant

isocarboxazid

MAOI antidepressant

loraZePAM

Benzodiazepine

ClonaZePAM

Benzodiazepine

DiaZePAM

Benzodiazepine

AlpraZolAM

Benzodiazepine

methypheniDATE

ADHD

dexmethylpheniDATE

ADHD

atomoxetine

ADHD

lithium

schizophrenia

aripiprazole

schizophrenia

haloperiodol

schizophrenia

risperidone

schizophrenia

divalproex

antiepileptics

phenytoin

antiepileptics

levetiracetam

antiepileptics

lamotrigine

antiepileptics

pregabalin

antiepileptics

gabapentin

antiepileptics

carbamazepine

antiepileptics

topiramate

antiepileptics

oxycarbazepine

antiepileptics

donepezil

alzheimer

levodopa/carbidopa

parkinson

selegeline

parkinson

pramipexole

parkinson

meclizine

anti-vertigo

scopolamine

motion sickness

dantrolene

muscle relaxation

baclofen

muscle relaxation

The principal structures affected by muscarinic activation are the

heart, exocrine gland, smooth muscle

the primary indication for the use of bethanechol is

urinary retension

the best-known muscarinic antagonist is

atropine

blockage of muscarinic receptors on salivary glands can ______ thereby causing ___ also known as ___-

inhibiti salivation, dry mouth, zero stomia

___ and ____ are the two drugs most often used for urge incontinence

oxybutin and troterodine

the principal indication for ___ is the treatment of myasthenia gravis

neostigmine

overdose with cholinesterase inhibitors causes ___ and ___

excessive muscarinic stimulation and respiratory depression

____ is the drug of choice for treating poisoning by atropine and other drugs that cause muscarinic blockade

physostigmine

the only clinical indication for the irreversible cholinesterase inhibitors is ___

glocoma

___ is the only depolarizing neuromuscular blocker in clinical use in the US

succinylcholine

paralysis with succinylcholine peaks about __ minute after administration and fades completely __ to __ minutes later

1, 4, 10

treatment of malignant hyperthermia consists of ____ ____ and _____

stop druc (d/c), ice pack -cool them, dantrolone-antidote

use of succinylcholine promotes which electrolyte disturbance?

hyperkalimia

the two therapeutic responses to activation of alphaz receptors are ___ and ___

vasoconstriction and mydriasis

therapeutic applicaiton of beta1 activation include __ __ __ __

cardiac arrest, heart failure, shock, and atrioventricular heart block

therapeutic applicaitons of beta2 activation include _ and ___

asthma and delayed preterm laybor

the most important adverse response to beta activation is ___-

hyperglycemia

dopamine is used in schock because it can ___ thereby ___ . Success is evaluted by monitoring __

dilate renal blood vessels, increase renal profussion, increase urine output

alpha antagonist lower blood pressue by ___

vasodialation

alpha-adrenergic blocking agents are effective in treating which peripheral vascular disease?

raynaud's disease

the most serious response to alpha-adrenergic blockade is ____

orthostatic hypotension

a relatively new use for beta blockers is its role as a standard treatment for ___

myocardial infarction

adverse effects of beta2 blockers include ___ and ___

bronchoconstriction and inhibition of glycogendysis

the primary indication for reserpine is ___ and the side effect of greatest concern is ___

hypertension, depression

adverse effects of reserpine on the cardiovascular system include ___ ___ and ___

bradycardia, orthostatic hypotension, and nasal congestion

the only indication for the use of methyldopa is ___-

hypotension

two potentially severe side effects of methyldopa are ___ and ___

hemolytic anemia and hepatotoxicity

neuroleptic-induced parkinsonism is treated with some of the drugs used for parkinson's disease. However, ___ and ___ must not be used, because the will counteract the beneficial effects of the antipsychotic treatment

levodopa, and direct dopamine agonist

___ is characterized by pacing and squirming borught on by an uncontrollable need to be in motion. The three drugs used to suppress symptoms include ____ _____ and ___-

betablockers, benzodiazepines, and antichilinergics

___ is characterized by involuntary choreoathetoid movements of the tongue and face.

tardive dyskinesia

neuroleptic malignant syndrome is characterized by _____ _____ _____and ____.

lead pipe rigidity ,sudden high vever, sweating, and autonomic stability

___ is the prototype of the high-potency first generation antipsychotics

haloperiodol

____ are the most widely prescribed antidepressants

SSRI

What is the mechanism of action of fluoxetine?

inhibition of serotonin reuptake

initial responses to antidepressants develop in _____weeks and maximal resposes develop over _____

1-3 weeks, 12 weeks

MAOIs can cause severe hypertension if the patient eats food rich in ____

tyramine

the most serious adverse effect of bupropion therapy is ____

seizures

although the exact causes of bipolar disorder is unknown, it is clear that symptoms are caused by ____

altered

the principal mood stabilizers for bipolar disorder are ___ ___ and ___

carbamazepine, lithium, and valprolic acid

the two drugs used for acute management of manic episode are __ and __-

lithium an dvalproic acid

patients receiving lithium therapy are advised to maintain a normal intake of foods containing which electrolyte?

Na+

Maintenance levels of lithium should be kept between___ and ___

0.4-1.0 mEq/L

For therapeutic doses of benzodiazepine therapy can result in __ __ __ __ __ and __

anxiety, insomnia, seizure disorders, muscle spasm, panic disorder, and perioperative applicaiton

3 adverse effects for a patient who overdoses on oral benzodiazepines are

CNS depression, anterograde amnesia, and cannot use w/pregnancy

Barbiturates reduce ventilation through ___ and ___

respiratory drive chemoreceptive mechinism

Acute barbiturate overdose produces a classic triad of symptoms __ __ and __

respiratory depression, coma, and pinpoint pupils (myosis)

___ are drugs of first choice for the short-term treatment of insomnia

Benzodiazepine

The 2 classes of drugs used most commonly for anxiety disorders are ___ and ___

Benzos, and SSRI

____ are the first-choice drugs for anxiety

Benzos

Only three antidepressants __ __ and __ are approved for general anxiety disorder

venlafaxine-SNRI, paroxietine-SSRI, and escitalopram-SSRI

Panic disorders respond well to all three major classes of antidepressants

SSRI, tricyclic antidepressants, and monoamine oxidase inhibitors (MAOI)

The amphetamines work primarily to ___ and partly to ___

release norepinephrine (NE) , release dopamine (DA) & prevent reuptake of NE & DA

Adverse effects of amphetamine include __ __ __ and __

CNS stimulation, weight loss, cardiovascular effects, and psychosis

Methyphenidate has two indications __ and __

ADHD, Narcolepsy

Caffeine is thought to relieve headaches because of it's ability to ___

constrict cerebral blood vessels

the first nonstimulant approved for ADHD is

stritera

Symptoms of Parkinsions disease include __ __ __ and __

tremor @ rest, rigidity, postural instability, and brady kinesia

What is the neurochemical basis of parkinsonism

imbalance of dopamine & ACH

___ is the most effective treatment for Parkinsions

Dopaminergic (Levodopa)

why is Parkinsions treated with levodopa and not wth dopamine?

Dopamine cannot cross the blood-brain barrior

The anticholinergic agents used most often in the treatment of Parkinsions are ___ and _-

Benztroine, Artane (trihexyphenidyl)

In patients with Alzheimer's disease, levels of acetylcholine are __ below normal

90%

___ are the first drugs approved by the US food and Drug administration for the treatment of Alzheimer

chollinesterase inhibitors

The three cholinesterase inhibitors recommended for the treatment of Alzheimer are

Donepezil, Galantamine, Rivastigmine

___ carries a significant risk of liver damage and should be avoided

tacrine

___ was able to stabilize or improve cognitive performance and social behavior for 6-12 months in patients with uncomplicated Alzheimer's disease

ginkgo biloba

Multiple sclerosis is a __ __ __ disorder that damages the __ of neurons in the CNS, causing a wide variety of sensory and motor deficits

chronic, inflammatory, autoimmune, myelin sheath

Initially, most patients experience periods of ___ alternating with periods of ___

relapses, intermission

The two main groups of disease-modifying drugs are __ and __

immunomodulators, immunosuppressants

A short course of ___ is the preferred treatment for an acute relapse

glucocorticords

At this time, only one immunosuppressant __ has been approved for the treatment of MS

mitoxantrone

___ is a general term that applies to all types of epileptic evens; in contrast, __- has a more limited meaning, applying only to abnormal motor phenomena

seizure, convulsion

Status epilepticus is defined as ___ min or longer

30 min or longer

The drug most widely use to treat epilepsy is ____

phenytonin

___ juice can cause the plasma levels of carbamazepine to rise

Grapefruit

The three traditional drugs for epilepsy are? ; the three new are ?

traditional- phenytonin, carbamazepine, valproic acid
new- oxcarbazepine, gabapentin, zonisamide

how do local anesthetics work?

by blocking sodium channels - blocking impuses conduction along axon

The two major groups of local anesthetics are __ and __

esters, amides

In what orders is sensation lost when a local anesthetic is used?

1st- pain perception, 2nd- cold, 3rd-warmth, 4th-touch, 5th-deep pressure

Local anesthetics are frequently administered in combination with a vasoconstrictor, usually __. The benefits of the vasoconstrictor include __ and __

epinephron, reduce toxicity, prolong anesthesia

___ refers specifically to loss of sensibility to pain, and ___ refers to the loss not only of pain, but also of all other sensation

analgesia, anesthesia

The risk of malignant hyperthermia, is greatest when an inhalation anesthetic is used in combination with ____

succinylcholine

Preanesthetic medications are administered to __ __ and __-

Benzodiazepines-reduce anxiety, may produce amnesia
Opiods-pain, suppress cough
Clonidine-allow to give lower dose
Anticholinergic-creat tachycardia

Anticholinergic druugs are given with general anesthesia to ___

prevent bradycardia

Dopamine is administered to a patient who has been experiencing hypotensive episodes. Other than an increase in blood pressure, which indicator would you use to evaluate a successful response?

increase urine output

A patient brought to the emergency department requires sutures. the prescriber orders a local anesthetic with epinephrine. Epinephrine is orders to:

prolong absorption of anestesia

A patient with asthma uses albuuterol (Ventolin) for wheezing. You assess the patient and notes vital signs of HR, 96 beats per minute; RR 18 breaths per minute; and BP 116/78 mm Hg. The patient has clear breath sounds and hand tremors. What will you do?

ask how often pt use inhaler

You are teaching parents how to use an Epi-Pen for their child, who has a peanut allergy. Which statement by the parents indicates understanding of the teaching regarding their need for emergent care after the shot is injected?

The child still needs to go to the hospital

Because they cause vasoconstriction, alpha1-adrenergic agonist are especially useful for

prolong duration of anestetic

A student ask why albuterol, which is selective for beta2 receptors, causes an increased heart rate in some patients. How should you respond? (Think about what happens at higher doses)

Lose selectivity (think about the heart)

A patient with pheochromocytoma is admited for surgery. The surgeon has ordered an alpha-blocking agent to be given preoperatively. Why?

tumor releases catacholamin- we give them epinephren to allow vasoconstriction to happen. All in all we are preventing a preoperative crisis

A patient with type I diabetes is taking NPH insulin, 30 units every day. The patient is also taking metoprolol (Lopressor) what education should you provide to the patient?

beta blockers will mask tachycardia

You are discussing home management with a patient who will begin taking an alpha-adrenergic antagonist for hypertension. Which statement by the patient indicates understanding of the teaching regarding the appropriate time of day for the mediation?

orthostatic hypotension, take it @ bedtime

You prepare to administer propranolol (inderal) to a patient recovering from acute myocardial infarction. The patient's heart rate is 52 beats per minute, and the rhythm is regular. What action should you take next?

Hold dose- contact physician

A patient taking a beta blocker complains of shortness of breath. The patient has respirations of 28 breaths per minute, a blood pressure of 162/90 mm Hg, and a pulse of 88 beats per minute. you auscultate crackles in all lung fields. You understands that these assessments are consistent with what cardiac condition: left side heart failure

left side heart failure (CHF)

A male patient is being treated for benign prostatic hyperlasia and has stopped taking his alpha-adrenergic antagonist medication because of ejaculatory difficulties. Which medicaiton is available in its stead?

alfuzosine

How would a person take a Beta Blocker for migranous attacks?

take profalacticly- low dose

A patient has taken levodoopa (dopar) for parkinson's disease for 2 weeks but reports no improvement in the symptoms. What will you tell the patient about their progression?

takes several months

You are discussing motor symptoms with ap atient with parkinson's disease who has been taking levodopa/carbidopa (sinemet) and who is now having regular tics. Which statement by the patient indicates understanding of this symptom?

lower the dose of levodopa

A patient who has begun taking levodopa/carbidopa (Sinemet) reports feeling lightheaded and dizzy, especially when standing up from a sitting position. what will you recommend?

Increase fluid & salt intake

A patient with schizophrenia has been taking an antipsychotic drug for several days. You enter the patient's room to administer a dose of haloperidol (Haldol) and finds the patient having facial spasms. The patient's head is thrust back, and the patient is unable to speak. What medication might you give?

Didrohydromine - anticolonergic antihistamine

A patient taking a first-generation antipsychotic (FGA) medication develops severe parkinsonism and is treated with amantadine (symmetrel) the amantadine is withdrawn 2 months later, and the parkinsonism returns. You expect the provider to: give

2nd generation antispsychotics

A patient is taking an FGA for schizophrenia. You note that the patient has trouble speaking and chewing and observe slow, wormlike movements of the patient's tongue. You recognize which adverse effect in this patient?

Retarded dyskinesia

You provide teaching for a patient about to begin taking a first-generation antipsychotic drug for schizophrenia. which statement indicates a need for further teaching about side effects of these drugs?

anticholenergic effects, sedation, extra peramidol

A patient has been taking fluoxetine (Prozac) for 11 months and reports feeling cured of depression. the patient is sleeping well, participates in usual activities, and feels up beat and energetic most of the time. the patient's weight has returned to normal. What will you tell this patient?

can switch to delayed release weekly dosing or withdraw

A patient who has been taking a monoamine oxidase inhibitor for depression for several months tells the provider that the medication has not helped with symptoms. The provider plans to switch the patient to an SSRI. You will teach this patient to :

It will take at least 14 days to be effective

a patient taking fluoxetine (Prozac) complains of decreased sexual interest. A prescriber orders a "drug holidy." what teaching by the nurse would best describe a drug holiday?

Don't take on Friday and Saturday. This is a discontinuation of the drug to have the body not desensitize the drug. To keep the receptors open for the drug to stay effective.

See More

Please allow access to your computer’s microphone to use Voice Recording.

Having trouble? Click here for help.

We can’t access your microphone!

Click the icon above to update your browser permissions above and try again

Example:

Reload the page to try again!

Reload

Press Cmd-0 to reset your zoom

Press Ctrl-0 to reset your zoom

It looks like your browser might be zoomed in or out. Your browser needs to be zoomed to a normal size to record audio.

Please upgrade Flash or install Chrome
to use Voice Recording.

For more help, see our troubleshooting page.

Your microphone is muted

For help fixing this issue, see this FAQ.

NEW! Voice Recording

Click the mic to start.

Create Set