Neurologic

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bailey9906
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148179
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Neurologic
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2012-04-17 20:15:07
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pharm neurologic
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Neurologic Pharm Chapters 27, 28, 29, 32, 33, 34 Med/Surg Chapter 54
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  1. What is a hangover?
    nv, headache
  2. What is the most important consideration when monitoring a patient when Versed is admin?
    respiratory monitoring
  3. Does Phenobarbital and Coumadin mix?
    yes but it weakens their action
  4. Benzodiazepines used as hypnotic agents (give information)
    monitor for vertigo, dizziness, oversedation, effectiveness, adverse side effects in children and elderly. provide safety. do not use in pts who are suicidal, depressed or drug abusers
  5. Cholral hydrate and effects on REM sleep
    does not suppress REM sleep at therapeutic doses
  6. Safety measures for hospitalized patients taking hypnotics drugs
    monitor ambulation, side rails up, call light within reach, and call nurse before attempting to move
  7. Barbiturates
    adverse effects-excessive CNS depression, hypersensitivity reactions and excitement. avoid operation of machinery or cars and use of other cns depressants. observe elderly for paradoxial excitement
  8. Safety measures for patients taking sedatives or hypnotics:
    do not put on nightstand
  9. How many days is chloral hydrate effective?
    short term therapy-10 days
  10. Barbituates lose effectiveness after how long of regular use?
    after 2 weeks of continual use
  11. Ultra short acting barbituates are used for what purpose
    intravenous anesthetics-surgery
  12. s/s of barbiturate toxicity
    confusion, excitement, heavy sleep, coma, pupillary constriction, cyanosis, clammy skin, hypotension
  13. implementation for adminidtering sleeping aids
    promote rest and sleep, relieve pain, anxiety, hunger, encourage consistent times for sleeping/awaking, encourage exercise during day, avoid CNS stimulants and provide info about sleep and conditions that disrupt sleep
  14. When will Buspar show optimum therapeutic response
    3-4 weeks of therapy
  15. Can antidepressants be used on a PRN basis? Why or Why not?
    no bc it takes 2-3 weeks to see therapeutic results
  16. Do people recover from mental illness
    yes many recover and may eventually be free of taking meds
  17. Therapeutic effects for anxiolytics
    decrease in bp or frequency of seizures, decrease muscle spasms or decrease anxiety
  18. When would you know a patient understands anxiolytic medication regime
    pt will verbalize
  19. Mellaril
    thoridazine, oral 150-800mg, increase sedative effect, decrease eps, increase anticholinergic effects and orthohypotension
  20. Lithium therapy and toxicity
    serum tests must be preformed at least weekly about 12 hours after last dose. toxicity-nvd, fatigue, tremors, hypothyroidism, diabetes insipidus. acute-severe vd, ataxia, coma, convulsions, death. "gold stardard" for tx of bipolar disorders
  21. what type of fluids must be limited while taking lithium
    caffine and alcohol which produce polyuria and polydipsia
  22. what do you do if a dose of antipsychotic med has been skipped
    do not double up
  23. prevention of orthostatic hypotension
    baseline ecg prior to initiating therapy to readily detect the cardiac alterations produced by antipsychotic drugs
  24. s/s of withdrawal of abruptly d/c anxiolytic medications
    insomnia, weakness, anxiety, irritability, muscle tremors, anorexia, nv, headache
  25. observations of clients taking antipsychotic agents include
    behavorial, sleeping, eating habits, speech patterns and content, personal hygiene, appearance, interactions with others and levels and purposefulness of activity, presence of delusions or hallucinations and any unusual behaviors
  26. an anxiolytic drug and ________ should not be used together
    cns depressants, alcohol
  27. Meprobamate is a _______ compound used as an ________
    carbamate; anxoliytic
  28. Tardive dyskinesia develops in clients on antipsychotic agents include
    usually after 2 years of therapy and drug doses are lowered or discontinued
  29. when you take MAOI's you may not consume what
    • foods rich in tyramine-containing aged protein
    • cheddar cheese, other aged cheese, chicken livers, pickled herring, chianti wine, sour cream, yogurt, canned figs, raisins, bananas, avacados, soy sauce, yeast extracts, beer
  30. what is a paradoxial reaction
    reponse opposite to that which is expected
  31. antipsychotic medications have anticholinergic effects. they include:
    dry mouth, constipation, urinary retention, blurred vision and interference with ejaculation in males
  32. what benzodiazepines are most appropriate to administer in elderly.
    diazepam, lorazepam
  33. give examples of extrapyramidal symptoms
    uncontrollable, involuntary Parkinson-like tremors and movements, AKATHISIA, dystonias, prolonged tonic contractions of various muscle groups, dykinesias, spasms, tics, tardive dyskinesia
  34. name some MAOI's
    isocarboxazid (Marplan), phenelzine sulfate (Nardil), tranylcypromine sulfate (Parnate)
  35. the nurse should be aware of when administering and monitoring mediations given to clients for psychiatric disorders
    compliance, make sure meds are swallowed
  36. the use of anorectic drugs is contraindicated in clients
    in children under 12
  37. characterisitics of attention deificit hyperactivity disorder
    • KELLY
    • inattention, hyperactivity, and impulsivity
  38. a pt is obese and c/o pain in legs due to osteoarthritis. the oa is aggrevated by the weight. come up with goals and outcomes for this pt.
    pt will lose 2 pounds in one month
  39. what is Didrex
    anorectic agent-can cause pulmonary hypotension
  40. anorectic agents
    drugs that reduce appetite, used as short-term adjuncts to caloric restriction in pts who are on a weight reducing regimen
  41. what is the optimal time to take a sustained action anorectic
    once daily midmorning
  42. what neurotransmitter does alzheimer's pts lack
    acetylcholine
  43. Cylert, Ritalin, and Dexedrine are used for what
    tx of ADHD
  44. a cup of coffee equals how much in a caffine tablet
    • 170-180mg
    • answer was 3 cups
  45. what is dopram
    • nonanorectic central nervous system stimulant
    • helps improve breathing after surgery or drug overdose, also COPD
  46. name some anorectic agents
    amphetamine mixture (adderall), benzphetamine HCL (Didrex), diethylpropion HCL (Desoxyn, Tenuate, Tepanil), methamphetamine HCL (Desoxyn), phendimetrazine (Bontril)
  47. common symptoms of seizures
    abnormal eeg, abnormal motor function, psychic changes
  48. Cerebyx can only be given which route
    IV
  49. Client teaching for anticonvulsant therapy
    accurate understanding of health problem, about the med they will be taking, the relationship between drug therapy and seizure control
  50. generalized tonic clonic seizures are characterized by
    sudden cry, falling, rigidity followed by muscle jerks, shallow breathing or temporary apnea and possible loss of bladder and bowel control
  51. nursing interventions for pts in status epilepticus
    ensure pt has airway and provide safety by protecting the pt against self-injury, notify dr, prepare equipment for iv admin of anticonvulsants, nasopharyngeal suctioning and o2 admin
  52. why is folic acid supplements given with Dilantin therapy
    adverse effect is anemia due to folic acid deficiency and may be associated with mental deterioration
  53. anticonvulsant indicated for tx of trigeminal neuralgia
    Tegretol
  54. when might a person need surgical intervention for intractable seizures
    pt must have tried the standard meds without results, have seizures, that consistency begin in just 1 part of the brain and have seizures in a part of the brain that can be successfully removed without damage to speech, memory, or vision
  55. Cerebyx is used for what
    designed for short term parenteral admin primarily to treat status epilepticus and to treat or prevent seizures during neurosurgery
  56. Phenytoin oral capsules extended release
    phenytoin sodium extended (Phenytek), dissolve more slowly in the GI tract and may be used to provide the entire daily dosage in 1 dose, those labeled as prompt whould not be used for once-a-day dosing
  57. drug of choice for tx of status epilepticus
    Diazepam
  58. monitor carefully patients taking Tegretol for the development of
    blood abnormalities including fatal aplastic anemia and hypoatremia. pt needs regularly scheduled lab work and should report any fever, sore throat, mouth ulcers and easy brusing
  59. Dilantin IV should be admin at what rate
    10-15mg/kg iv slowly then 100mg every 6-8hrs if necessary, do not exceed an iv infusion rate of 50mg/kg in adults or 1-3mg/kg/min in neonates
  60. rapid iv admin of Cerebyx can cause what major adverse side effect
    cardiovascular collapse, cns depression, pruritus, dizziness, somnolence, nystagmus
  61. alcohol can cause what medical effects
    acute alcohol intoxication, alcohol dependence, acute alcohol withdrawal syndrome, medical complications, fetal alcohol syndrome
  62. alcohol in the blood produces impairment of judgement, speech, motor coordination, and reaction time at what level
    50-15-mg/dl
  63. what is habituation
    pattern of repeated substance use in which a person feels better when using a particular substance then when not using it
  64. Heroin
    currently considered to be an important cuase of death in urban meales between 15-35 yr of age, most commonly abused opiate
  65. piloerection is an indication of
    LSD, central synpathomimetic response, symptomatic of opiate withdrawal
  66. tx for the prevention of absorption of drug that has been taken orally
    inducing emesis or gastric lavage with the instillation activiated charcoal, naloxone by iv push for heroin
  67. tx for pt that has taken PCP
    place in quiet surroundings with minimal distractions, forced diuresis and urine acidification
  68. what drug is given to decrease tachycardia and excessive CNS stimulation to people who have taken large doses of cocaine
    iv propranlol (Inderal)
  69. nursing intervention for newly dx people addicted to drugs
    nonjudgemental and hopeful attitude that the addiction can be overcome, engage in mutual setting of goals and limits and share responsibility with the pt
  70. a person that has no eyebrows, eyelashes is smoking what
    crack cocaine
  71. sustance dependance
    broad term describing a state in which a person has difficulty functioning unless under the influence of a drug or other chemical substance
  72. peak of heroin or morphine withdrawal symptoms after last dose
    36-48 hrs after last dose adn the subside over the next 5-10 days
  73. what is Trexan
    naloxone, given to pts who have taken opiates, may cause an acute withdrawal syndrome-acute pulmonary edema, declining urinary output and cardiac arrhythmias
  74. a substance that primary pharmacological effect is to depress the CNS
    alcohol
  75. Post emergency tx for od of pcp
    forced diuresis and urine acidification
  76. if a person presents with substance abuse dependency what should be done
    nurse should be nonjudgemental and show concern for pts welfare, if pt is interested in tx a referral is made to appropriate agency
  77. tics, tremors, paranoia, and picking at clothes most likely use
    pt taken a large dose of cocaine, particulary crack
  78. what does marijuana do
    produces a loss of time perception as well as alterations in visual, auditory and tast perception. the user also experiences euphoria, relaxation, disorientation, ataxia, drowsiness, impaired motor performance, dysphoria or depression
  79. the somatic nervous system is a branch of the
    perpherial nervous system
  80. what is a neurotransmitter
    substances that excite or inhibit a target cell
  81. fight or flight is
    sympathetic branch of the ANS bc its action predominates when the body is confronted with physical or emotional stress. stimulates body processes that promote self preservation
  82. alpha 1 adrenergic receptors are found primarily in the
    in smooth muscle tissue or peripheral blood vessels, in the trigone and sphincter of the urinary bladder, in male sex organs and in many other tissues
  83. alpha 2 do what
    their stimulation reduces the release of neurotransmitter
  84. beta 1 receptor do what
    their stimulation increase heart rate and force of contraction
  85. asthma can be relieved by a drug that stimulates what receptor
    beta 2 stimulants (agonists)
  86. sympathomimetic drugs are referred as
    adrenergic, further classified as "direct acting" or "indirect acting"
  87. Mydriasis
    pupillary dilation
  88. neurotransmitter present in sympathetic and parasympathetic nervous system
    acetycholine
  89. give antispasmodics with care to whom and why
    elderly pts receiving anticholinergics and notify healthcare provider if urinary retention, or indications of acute glacoma occur
  90. admin of cholinergic agent is likely to result in
    homeostasis
  91. Glycopyrrolate
    common anticholinergic agents, decrease gi and respiratory secretions, atropine sulfate and glycopyrrolate are frequently use preop to decrease risk for emesis and aspiration during induction and maintence of general anesthesia
  92. how is tinture of belladonna admin
    may be mixed in a small amount of applesauce or juice, or give pt mouthwash or crackers after admin to rid of bitter taste
  93. most agents that have antispasmodics activity act by
    antagonizing the action of acetycholine at the postganglionic receptors in the parasympathetic nervous system
  94. side effects seen in use of antispasmodics
    impairs ability to perspire, constipation, decrease urinary output, skin rash, flushing, eye pain, elderly patients-excitement, confusion, agitation, drowsiness
  95. actions associated with atropine
    dilate pupils and interfere with the ability of the eye to properly focus an inmage as well as promote the retention of urine by the bladder
  96. d/c what drugs 1 week before test if having a thyroid function test
    adrenergic blockers
  97. adrengeric drugs mimic action of sympathetic nervous system. what are the responses
    act directly on the receptor but stimulate the sympathetic postganglionic neurons to release norepinephrine
  98. common adverse effect of alpha adrenergic blockers
    hypotension and dizziness
  99. priority nursing dx for pts at increased risk of falls when taking sympatholytic drugs
    risk for injury r/t excessive cns stimulation
  100. major cautions in using anticholinergic drugs is their narrow therapeutic index. this means
    that the difference between therapeutic and toxic doses is very small or narrow

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