Pharmacology Exam Lessons 11&12
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The nervous system is divided into 2 major divisions:
- Central Nervous system (CNS)
- Peripheral Nervous System (PNS)
The CNS is composed of the:
brain and spinal cord
The _______ nervous system receives signals from sensory receptors, processes them, and transmits message back as motor response.
receptors send signals TO the CNS
- CNS processes them
- transmits message back as motor response
All nerves located outside the CNS are part of the:
PNS: peripheral nervous system
_______ nerves carry impulses to the CNS.
_______ nerves carry impulses from the CNS.
A way to remember sensory/afferent & motor/efferent
The somatic (motor) nervous system controls _______ skeletal muscle function.
The autonomic nervous system helps regulate _______ (smooth and cardiac) muscle function and gland secretion.
The autonomic nervous system is divided into 2 major divisions:
- sympathetic ("fight or flight")
- parasympathetic ("feed" and breed" or "rest & digest")
The _______ system maintains homeostasis/resonds to emergencies.
autonomic nervous system
The sympathetic system is a division of the _______ system and is AKA as the _______ system.
- Sympathetic system is part of the ANS
- AKA adrenergic system
The sympathetic system is activated by:
- noradrenaline (norepinephrine)
- adrenaline (epinephrine)
The system that is activated by emergency conditions and is considered the "fight or flight" response:
The parasympathetic system is a division of the _______ nervous system and is AKA the _______ system.
- parasympathetic system is part of the ANS
- AKA the cholenergic system
The _______ system regulates "normal" conditions and acts as a balance after sympathetic crisis (homeostasis).
The peripheral nervous system is divided into the:
- somatic nervous system
- autonomic nervous system
The ANS has 3 major types of receptors:
_______ and _______ stimulate or inhibit the receptors of the ANS.
The conducting cell of the nervous system; nerve cell:
Parts of the neuron:
- cell body
- axon terminals
_______ conduct messages away from the cell body to the next cell.
The _______ conducts messages away fromt he cell body to next cell
Neurons require _______ at synapse to conduct messages.
Neurotransmitters work at the _______.
Neurotransmitters can be _______ (stimulate the next neuron) or _______ (injibit the next neuron.
Two major neurotransmitters are:
- norepinephrine (noradrenaline)
The autonomic nervous system relays information from:
CNS to the body
The autonomic nervous system controls:
all tissue except striated muscle
Another name for adrenergic drugs is:
sympathomimetic or sympathetic agents
Parasympathetic agents are also called:
Adrenergic drugs have what effect on the heartbeat?
increases the rate and force
Adrenergics are stimulated by:
Stimulation of alpha receptors causes:
Patients receiving beta-adrenergic blocking agents should be taught:
not to discontinue the drug suddenly
Before administration of an anticholinergic agent, the patient's chart should be checked to be certain there is no history of:
Which class of drugs causes tachycardia, palpitations, and tremors?
Beta adrenergic agents _______ the blood sugar.
Beta adrenergic agents _______ cardiac output.
Cholinergic agents cause _______ of bronchial vessels.
Anticholinergic agents _______ peristaltic action within the intestines.
Beta adrenergic agents require the nurse to monitor for _______ in a diabetic patient.
_______ is the neurotransmitter for adrenergic fibers.
Major uses for adrenergics:
- relaxation of smooth muscle of bronchi (bronchodilation)
- constriction of blood vessels (vasoconstriction)
_______ agents act by "plugging" (blocking) alpha or beta adrenergic receptors, thus, preventing adrenergic effects.
_______ agents act by stimulating the peripheral nervous system or by inhibiting the enzyme acetylcholinesterase.
What nursing assessment is done before starting a pt on a beta-adrenergic blocking agent?
blood pressure and heart rate
What is the difference between a sedative and hypnotic?
- sedative: quiets/relaxes, but does not necessarily produce sleep
- hypnotic: produces sleep
What are the classes of sedatives and hypnotics?
Stages of sleep:
- I Easily roused
- II REM
- III Transitional stage
- IV Deep, dreamless, restful sleep
remember: 4 stages every 90 minutes
Types of insomnia:
- initial: inability to fall sleep when desired
- intermittent: inability to stay asleep
- terminal: awake early/unable to fall asleep again
Beta-adrenergic blocking agents (beta blockers) _______ heart rate, _______ blood vessels, and _______ blood pressure.
- decrease heart rate
- dilate blood vessels
- decrease blood pressure
_______ decrease impulses to the cerebral cortex.
Elderly may react with restlessness, increased excitement, euphoria, and confusion when taking this med, this response is called _______.
This med should be gradually d/c over a _______ period.
- paradoxic response
- 2-4 week period
_______ should NOT be used in the 1st trimester of pregnancy and should be avoided with breastfeeding.
Smokers may need _______ doses.
- lorazepam (Ativan), midazolam (Versed)
Monitor _______ with sedatives/hypnotics.
_______ is a newer sedative/hypnotic that is most commonly used because it has less s/e.
Anti-parkinson's drugs increase _______ levels.
These drugs balance _______ and _______.
Carbidopa by itself has no effect; it's used w/ _______ to make it work better.
_______ reacts w/ toilet bowl cleaners.
- dopamine and acetylcholine
_______ increase GABA for calming effect.
They are used in combo with _______.
_______ are the most common.
Watch for _______.
_______ has lower sedative effects, less abuse potential; great for the elderly.
- benzos, Azaspirones, SSRIs, misc
- talk thereapy
- lethargy, drowsiness
_______ stabilizes mood.
It increases _______, _______, and _______ levels.
All take _______ weeks to work/peak.
Monitor for _______.
_______ are newest and have less s/e; never use these in combo w/ other antidepressants; monitor for _______.
_______ are the oldest group; have the most s/e and risks for interactions; must avoid high amounts of _______ to prevent HTN crisis.
_______ are good for increasing appetite for someone depress and not eating; s/e: dry mouth.
- serotonin, norepinephrine, and dopamine
- MAOIs, Tricyclics, SSRIs, Misc
- 2-4 weeks
- SSRIs; seratonin syndrome
- MAOIs; tyramine
_______ are used to manage bipolar d/o.
_______ is a salt; works closely with Na
As sodium decreases, lithium _______.
Maintain balance in _______ and _______ intake.
Monitor serum level; _______mEq/L
Lithium toxicity signs:
May also use _______ and _______ in tx.
- fluid and salt
- n/v, anorexia, cramping, increased thirst, metallic taste, tremor
- anticonvulsants; antipsychotics
_______ balance dopamine levels to manage psychosis.
_______ long-acting injectable form; increases compliance; only need every 1-3 weeks.
Monitor for for _______, especially seen w/ older drugs; use _______ to assess.
_______ syndrome is similar to serotonin syndrome except involves dopamine levels.
- Thorazine, Prolixin, Haldol are typical; atypical are Risperdal, Seroquel, Geodon
- EPSEs; AIMS
- blood dyscrasias, hyperlipidemia, hyperglycemia, and hypothyroidism
- Neuroleptic malignant syndrome
_______ are used for motion sickness.
They have _______ and _______ effects.
May cause _______.
- antiemetics for motion sickness
- Dramamine, Transderm Scope, Benadryl, Antivert
- antihistamine; anticholinergic effects (drying)
_______ are used to decrease pain, manage fever, and decrease inflammation.
_______ (aspirin) monitor for toxicity (tinnitus, decreased hearing.
Risk of _______, especially GI.
Limit ibuprofen to _______mg. Daily to avoid possible kidney damage.
- Salicylates, NSAIDs
- ibuprofen (Motrin, Advil), ketorolac (Toradol; can only be used 5 days total via all routes)
______________ are formerly called narcotics.
They are used for _______.Define: perception, threshold, and tolerance
They interact w/ _______ to stimulate and/or inhibit.
Define: opiate agonists, Opiate partial agonists, opiate antagonists
Monitor for _______ depression.
These have a potential for _______.
GI s/e include:
_______ act similar to morphine to stimulate receptors; examples include:
_______ stimulate some receptors and inhibit others...examples:
Antagonists like _______, are used to reverse resp depression in opiate OD
_______ is used to reduce opiate/ETOH cravings.
Opiate anagesicspain managementperception: individual awareness of feeling/sensation of pain (what it is)threshold: point at which individual first acknowledges/interprets tolerance: individual's ability to endure pain being experiencedreceptorsopiate agonists: anagesics that act at the same sites in the brain to stimulate anagesic effects as morphine does; used for acute, moderate, to severe painopiate antagonists: reverse the CNS depressant effects of opiate agonists and opiate partial agonists; if addicted to opiate, will show s/s of withdrawalrespiratoryabusen/v, constipationagonistspartial agonistsNarcanReVia
_______ manage mild pain and fever; no antiinflammatory properties.
Watch for _______.
no more than _______g daily; no more than _______g daily if liver/renal impairment.
Very small amounts of _______ may be added to some pain meds to decrease CNS depression/make drug circulate better.
- non-opiate analgesics
- liver toxicity
- 4g; 2.5g caffeine
_______ treat chronic seizures.
Some people may have an _______ or _______ right before seize.
_______ therapy may be used.
Monitor gums for ______________.
Avoid _______ and _______ while taking these meds.
Phenobarb toxicity s/s: _______,_______,_______,_______; monitor level __ to __ mg/dL.
_______ can be used for status epilepticus; don't mix w/ anything.
Phenytoin (Dilantin) toxicity: _______/_______; monitor level __to__ mg/L; don't mix with anything.
_______ (Depakene, Depakote) are newer (misc); also used for bipolar; monitor level __to___mg/L.
- aura; epileptic cry
- gingival hyperplasia
- ETOH; stimulants (caffeine)
- confusion, drowsiness, slurred speech, SOB; 2-5 mg/dL
- ystagmus, sedation/lethargy; 10-20 mg/L
- Valproic acids
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