Test 2
Nursing Pharmacology with Burnitt at Goldfarb School of Nursing
About this deck
By: Amanda Lutz
Textbook:
Pharmacology and the Nursing Process
Created: 2011-09-26
Size: 113 flashcards
Views: 69
Textbook:
Pharmacology and the Nursing ProcessCreated: 2011-09-26
Size: 113 flashcards
Views: 69
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What are the two major divisions of the peripheral nervous system?
1. Autonomic Nervous System
2. Somatic Motor System
2. Somatic Motor System
What are the two major divisions of the autonomic nervous system?
1. The sympathetic nervous system
2. The parasympathetic nervous system
2. The parasympathetic nervous system
What are the principle functions of the sympathetic nervous system?
1. Regulation of the cardiovascular system
2. Regulation of body temp
3. Implementation of fight-or-flight
2. Regulation of body temp
3. Implementation of fight-or-flight
Which system regulates most organs - parasympathetic or sympathetic?
Parasympathetic
Which system regulates blood vessels - parasympathetic or sympathetic?
Sympathetic
What are the three transmitters of the peripheral nervous system?
1. Acetylcholine
2. Norepinephrine
3. Epinephrine
2. Norepinephrine
3. Epinephrine
What are the three major subtypes of cholinergic receptors?
1. Nicotinic N
2. Nicotinic M
3. Muscarinic
2. Nicotinic M
3. Muscarinic
What are the four major subtypes of adrenergic receptors?
1. Alpha 1
2. Alpha 2
3. Beta 1
4. Beta 2
2. Alpha 2
3. Beta 1
4. Beta 2
Is the autonomic nervous system responsible for voluntary or involuntary processes?
Involuntary
What are the three major functions of the autonomic nervous system?
1. Regulation of the heart
2. regulation of secretory glands (Salivary, gastric, sweat, bronchial.)
3. Regulation of smooth muscles (bronchi, blood vessels, urogenital system, GI tract)
2. regulation of secretory glands (Salivary, gastric, sweat, bronchial.)
3. Regulation of smooth muscles (bronchi, blood vessels, urogenital system, GI tract)
Where are baroreceptors located?
1. In the cartoid sinus
2. in the aortic arch
2. in the aortic arch
What is the role of the adrenal medulla?
Sympathetic nervous system component - Releases epinephrine into the blood stream
Which transmitter is employed at most junctions of the PNS?
Acetylcholine
Where is epinephrine the transmitter?
Adrenal Medulla
What function do cholinergic drugs have on the eye?
1. Contraction of the cilary muscle focuses the lens for near vision
2. contraction of the iris sphincter muscles cause miosis (decreased pupil diameter), which causes problems for night vision or bright light.
2. contraction of the iris sphincter muscles cause miosis (decreased pupil diameter), which causes problems for night vision or bright light.
What impact do cholinergic drugs have on the heart?
Decreased heart rate.
What impact do cholinergic drugs have on the lungs?
Constriction of bronchi
Increased bronchial secretions
Increased bronchial secretions
What impact do cholinergic drugs have on the bladder?
Contraction of detruser increases bladder pressure.
Relaxation of trigone and sphincter allows urine to leave the bladder.
These two equal voiding.
Relaxation of trigone and sphincter allows urine to leave the bladder.
These two equal voiding.
What impact do cholinergic drugs have on the GI tract.
Salivation
Increased gastric secretions
Increased intestinal tone and motility
Defecation
Increased gastric secretions
Increased intestinal tone and motility
Defecation
What impact do cholinergic drugs have on sweat glands?
Generalized sweating
What impact do cholinergic drugs have on sex organs?
Erection
What impact do cholinergic drugs have on blood vessels?
Vasodilation
What organs do Alpha 1 receptors affect?
Eye, Veins, Sex Organs, Prostate, Bladder, Arterioles: skin, viscera, mucous membranes
What effect do Alpha 1 drugs have on the eyes?
Contraction of the radial muscle of the iris causing mydriasis (Increased pupil size)
What effect do Alpha 1 drugs have on the arterioles?
Constriction
What effect effect do Alpha 1 drugs have on veins?
Constriction, will increase BP
What effect do Alpha 1 drugs have on sex organs?
Ejaculation
What effect do Alpha 1 drugs have on the prostate capsule?
Contraction
What effect to Alpha 1 drugs have on the bladder?
Contraction of the trigone and sphincter, making it harder to pee.
What organs do Beta 1 drugs effect?
Heart and kidney
What effect do Beta 1 drugs have on the heart?
Increased rate, increased force of contraction, increased AV conduction velocity
What effect do Beta 1 drugs have on the kidney?
Increased renin release
What organs to Beta 2 receptors effect?
Bronchi, Uterus, Liver, Skeletal muscles, arterioles: heart, lung skeletal muscle
What effect do Beta 2 drugs have on arterioles?
Heart, lung, skeletal muscle dilation, which increases blood flow to these areas for more oxygen.
What effect do beta 2 drugs have on the bronchi?
Dilation
What effect do beta 2 drugs have on the uterus?
relaxation
What effect do beta 2 drugs have on the liver?
Glycogenolysis
What effect do beta 2 drugs have on the skeletal muscles?
enhanced contraction, glycogenolysis
What organs are effected by dopamine?
Kidney
What effect does domapine have on the kidney?
dilation of kidney vasculatrue.
What are all the names for choliergic mimicing drugs?
Choliergic agents, parasympathomimetics, Muscarinic Drugs
What are all the names for Anticholiergic drugs?
parasympatholytic, cholinergic antagonists, antimuscarinics. Muscinaric blocking agents
List 5 cholinergic drugs
1. Pilocarpine, Bethanecol (Urecholine), Cevimelilne, Acetylcholine
List 5 anticholinergic drugs used to treat overactive bladder
1. Oxybutynin
2. Solifenacin
3. Darifenacin
4. Tolterodine
5. Trospium (Sanctura)
2. Solifenacin
3. Darifenacin
4. Tolterodine
5. Trospium (Sanctura)
How do cholinesterase inhibitors work?
Prevent breakdown of ACh, which activates muscarinic receptors.
What is the major use of reversible cholinesterase inhibitors?
Myasthenia gravis.
What are secondary uses for reversible cholinesterase inhibitors?
Reversal of nondepolarizing neuromuscular blockade, treatment of glaucoma, Alzheimer's disease, and poisoning by muscarinic antagonists.
Which drug is the preferred cholinesterase inhibitor for treating poisoning by muscarinic antagonists, and why?
Physostigmine b/c it crosses membranes easily.
What is the major use for irreversible cholinesterase inhibitors?
Insecticides and glaucoma.
Describe cholinergic crises.
Depolarizing meuromuscular blockade plus signs of excessive muscarinic stimulation (WETBED). Death from respiratory depression.
How would irreversible cholinesterase poisoning be treated?
atropine, mechanical ventilation, pralidoxime (to reverse inhibition of cholisterase), and diazepam to suppress seizures.
Myasthenia Gravis
Neuromuscular disorder characterized by fluctuation muscle weakness and rapid fatigue. Symptoms include ptosis (drooping of eyelids), difficulty swallowing, weakness of skeletal muscles. Immune system attacks NicotinicM.
What is the number one most common neurodegenerative disease?
1. Alzheimer's
What is the second most common neurodegenerative disease?
Parkinson's
What are some common sources of anticholinergic poisoning?
Atropa belladonna
antihistamines
phenothiazines
TCAs
Atropine
Scopolamine
Zyrtec
antihistamines
phenothiazines
TCAs
Atropine
Scopolamine
Zyrtec
What are symptoms of anticholinergic poisoning?
Dry mouth, blurred vision, photophobia, no sweating, flushing, hallucinations, respiratory depression
How do you treat anticholinergic poisoning?
Minimize absorption - vomiting, tube
Administer antidote: Phystigmine (neostigmine), which will compete for antimuscinaric for receptors
Administer antidote: Phystigmine (neostigmine), which will compete for antimuscinaric for receptors
What are the side effects for cholinesterase inhibitors?
WETBED
What is one common use for cholinesterase inhibitors?
Alzheimer's Disease
What are the therapeutic applications of Alpha 1 Agonists?
Increase blood pressure, stop bleeding, nasal decongestion, adjunct to local anesthetic, mydriasis (pupil dilation)
What are adverse effects of Alpha 1 agonists?
Hypertension, necrosis b/c lack of oxygen to tissues, bradycardia
What are some therapeutic uses for Beta 1 activation?
Cardiac arrest, heart failure, shock, AV heart block.
Adverse effects of Beta 1 Activation
chest pain, altered heart rate
What are some adverse effects of adrenergic agonists?
Hypertensive crisis, dysrhythmias, chest pain, necrosis at IV site, hyperglycemia, drug interaction are severe with MAOIs.
What are the two major groups of adrenergic drugs?
Alpha-adrenergic blocking drugs
Beta-adrenergic blocking drugs
Beta-adrenergic blocking drugs
What are the therapeutic uses of alpha blocker drugs?
Essential hypertension
Benign prostatic hyperplasia
Benign prostatic hyperplasia
What are adverse effects of alpha blockers?
Othostatic hypotension
Reflex tachycardia
Nasal congestion
Inhibition of ejaculation
Sodium retention
Reflex tachycardia
Nasal congestion
Inhibition of ejaculation
Sodium retention
What are the therapeutic uses of beta blocker?
Slow Heart rate
Slow contraction
Slow velocity
Slow contraction
Slow velocity
What are some adverse effects of beta blockers?
Bradycardia, reduced cardiac output, AV heart block, bronchoconstriction, inhibition of glycogenalysis
Methyldopa
Alpha 2 agonist
Hypertension in pregnancy
Adverse effects: hemolytic anemia, hepatoxicity
Hypertension in pregnancy
Adverse effects: hemolytic anemia, hepatoxicity
What are the two major classes of drug therapy in PD?
Dopaminergic, Anticholinergic
When is Sinemet contraindicated?
Malignant melanoma, MAOIs
Cautions with Sinemet?
Heart disease, psych disorders
What are the major side effects of sinemet?
Orthostatic hypotension, Dyskinesias (head bobbing, tics, grimacing), N/V (reduced if taken with food), Psych disturbances
Dosing notes on Sinemet
Regular dosing important b/c of on/off effect. Not high protein b/c protein will compete to cross BBB.
What are some side effects with dopaminergic agonists for PD?
Same as Sinemet, also aggrivates OCD, hallucinations, sleep attacks, fetal risk
Why is Tacrine (Cognix) not used as often in Alzheimer's care?
potential liver injury, and has to be dosed every 6 hours
What types of drugs are used to treat neuropathic pain with MS?
Anti epileptic drugs
Which is the most widely used AED?
Phenytoin (Dilantin, Phenytek)
Phenobarbital
Oldest, cheapest AED. Daily dosing. Major side effect is CNS depression, teratogenicity
What are some adverse effects with morphine?
constipation, respiratory depression, orthostatic hypotension, urinary retention, biliary colic, cough suppression, n/v, euphoria/dysphoria, sedation
What are some cautions with morphine?
Apnea, labor and delivery, head injury, hypotension, renal or liver impairment
What are some cautions with demerol?
can cause seizures, renal insufficency, daily dose ceiling of 600mg,
SIgns of opiod overdose:
Coma, respiratory depression, pinpoint pupils,
How do you treat opioid overdose?
Ventillator, Naloxone (Narcan) which is an opioid antagonist.
What drugs do you use for abortive migraine therapy?
First line: Triptans.
Analgesics: aspirin, naproxin, caffein combos. Opioids used as last line of defense
Analgesics: aspirin, naproxin, caffein combos. Opioids used as last line of defense
What are some adverse effects of Triptans?
Chest tightness, coronary vasospasm, teratogenesis
What are preventative measures for migraines?
Beta blockers, Calcium channel blockers, TCAs, AEDs
What is the most common Beta Blocker drug for preventative migraine therapy?
Propranolol
What is the most common TCA for migraine prevention?
Amitriptyline (Elavil)
What are some adverse effects from FG Antipsychotic agents?
Extrapyrammidal symptoms. Tardive Dyskinesia (facial twisting - permanent), sedation, seizures, sexual dysfunction, dysrhythmias, worseing depression
What are some adverse effects from second generation anti-psychotic agents?
Weight gain, diabetes, increased risk of cardiovascular disease, orthostatic hypotension. Also, more costly.
What are the 4 types of anti-depression drugs?
1. SSRIs
2. TCAs
3. MAOIs
4. Atypical antidepressants
2. TCAs
3. MAOIs
4. Atypical antidepressants
What are side effects of TCAs?
Orthostatic Hypotension, Sedation, Cardiotoxicity, Seizures, anticholinergic side effects
What are SSRIs used to treat?
Major depression, OCD, Bulemia, Panic, Premenstral Dysphoric Disorder
What are some adverse effects of SSRIs
Sexual dysfunction, nausea, headache, seratonin syndrom, weight gain
What three types of drugs treat bipolar disorder?
Mood Stabilizers, Antipsychotics, Antidepressants
What are some diet considerations when taking Lithium.
Sodium will lead to lithium accumulation. Diuretics cause sodium loss, so will increase lithium levels.
What are adverse effects of mood stabilizers used for bipolar treatment?
GI Effects, thirst, headache and poor memory, fatigue & muscle weakness.
What are the toxic effects of mood stabilizers used for bipolar treatments?
renal toxicity, ECG changes, CNS impairment, convulsions, death.
What are some therapeutic uses for benzodiazepines?
Anxiety, insomnia, siezure disorder, pre-operative, muscle spasm, panic disorder.
What are adverse effects of benzodiazepine?
CNS depression, Anterograde amnesia,abuse potential, teratogenic heart and face malfuncti
What are some therapeutic uses of barbituates?
daytime sedation, induction of sleep, supression of seizures, general anethesia.
What are some adverse effects of barbituates?
Respiratory and CNS depressions, high risk of abuse.
Buspirone (Buspar)
Non-Benzo used to treat general anxiety disorder.
High Loop and Thiazides are used to treat hypertension and edema with what conditions?
pulmonary edema with CHF
edema of hepatic cardiac renal origin that has been unresponsive to other diuretics
hypertension that cant be controlled with thiazide & K-sparing diuretics
patients who need diuretics but have low renal blood flow
edema of hepatic cardiac renal origin that has been unresponsive to other diuretics
hypertension that cant be controlled with thiazide & K-sparing diuretics
patients who need diuretics but have low renal blood flow
Where do thiazides work?
Early in the distal convoluted tubule.
What effect to Calcium Channel Blockers have on the heart?
Decrease force of contraction, SA node, reduce heart rate, AV node: slows velocity
Would you use dihydropyridine calcium channel blockers for disrrhythmis?
NO!
Should you use fast acting nifedipine SL? Why or why not?
No, because it kills people.
Should you combine beta blockers with non-dihydropyridine calcium channel blockers?
NO! BBs will increase the adverse effects.
What are some types of vasodilators?
ACEIs, ARBS, Direct Renin Inhibitors, Organic nitrates, CCBs, Alpha Blockers, Individual vasodilators.
What is the adverse effect of hydralazine vasodilator?
SLE like syndrome.
About this deck
By: Amanda Lutz
Textbook: Pharmacology and the Nursing Process
Created: 2011-09-26
Size: 113 flashcards
Views: 69
Textbook:
Pharmacology and the Nursing ProcessCreated: 2011-09-26
Size: 113 flashcards
Views: 69
About StudyBlue
STUDYBLUE makes things that make you better at school.
Things like online flashcards with photos and audio.
Things like personalized quizzes and friendly reminders about when (and what) to study next.
Think of it as a digital backpack™: access to all of your study materials online and on your phone.
STUDYBLUE exists to make studying efficient and effective for every student, for free. Join us.
“Simply amazing. The flash cards are smooth, there are many different types of studying tools, and there is a great search engine. I praise you on the awesomeness.”
Dennis
Dennis