Pharmacology Exam Lessons 11&12

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Pharmacology Exam Lessons 11&12
2013-04-14 21:12:47
Pharmacology Exam

Autonomic nervous system/Drugs affecting the CNS
Show Answers:

  1. The nervous system is divided into 2 major divisions:
    • Central Nervous system (CNS)
    • Peripheral Nervous System (PNS)
  2. The CNS is composed of the:
    brain and spinal cord
  3. The _______ nervous system receives signals from sensory receptors, processes them, and transmits message back as motor response.

    • sensory receptors send signals TO the CNS
    • CNS processes them
    • transmits message back as motor response
  4. All nerves located outside the CNS are part of the:
    PNS:  peripheral nervous system
  5. _______ nerves carry impulses to the CNS.
    Sensory (afferent)
  6. _______ nerves carry impulses from the CNS.
    Motor (efferent)
  7. A way to remember sensory/afferent & motor/efferent
  8. The somatic (motor) nervous system controls _______ skeletal muscle function.
  9. The autonomic nervous system helps regulate _______ (smooth and cardiac) muscle function and gland secretion.
  10. The autonomic nervous system is divided into 2 major divisions:
    • sympathetic ("fight or flight")
    • parasympathetic ("feed" and breed" or "rest & digest")
  11. The _______ system maintains homeostasis/resonds to emergencies.
    autonomic nervous system
  12. 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
  13. The sympathetic system is activated by:
    • noradrenaline (norepinephrine)
    • adrenaline (epinephrine)
  14. The system that is activated by emergency conditions and is considered the "fight or flight" response:
    sympathetic system
  15. 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
  16. The _______ system regulates "normal" conditions and acts as a balance after sympathetic crisis (homeostasis).
  17. The peripheral nervous system is divided into the:
    • somatic nervous system
    • autonomic nervous system
  18. The ANS has 3 major types of receptors:
    • alpha
    • beta
    • dopaminergic
  19. _______ and _______ stimulate or inhibit the receptors of the ANS.
  20. The conducting cell of the nervous system; nerve cell:
  21. Parts of the neuron:
    • nucleus
    • cell body
    • dendrites
    • axon
    • nodes
    • axon terminals
  22. _______ conduct messages away from the cell body to the next cell.
  23. The _______ conducts messages away fromt he cell body to next cell
  24. Neurons require _______ at synapse to conduct messages.
  25. Neurotransmitters work at the _______.
  26. Neurotransmitters can be _______ (stimulate the next neuron) or _______ (injibit the next neuron.
    • excitatory
    • inhibitory
  27. Two major neurotransmitters are:
    • norepinephrine (noradrenaline)
    • acetylcholine
  28. The autonomic nervous system relays information from:
    CNS to the body
  29. The autonomic nervous system controls:
    all tissue except striated muscle
  30. Another name for adrenergic drugs is:
    sympathomimetic or sympathetic agents
  31. Parasympathetic agents are also called:
  32. Adrenergic drugs have what effect on the heartbeat?
    increases the rate and force
  33. Adrenergics are stimulated by:
    • catecholamines
    • noncatecholamines
  34. Stimulation of alpha receptors causes:
    • vasoconstriction
    • hypertension
    • tachycardia
  35. Patients receiving beta-adrenergic blocking agents should be taught:
    not to discontinue the drug suddenly
  36. Before administration of an anticholinergic agent, the patient's chart should be checked to be certain there is no history of:
  37. Which class of drugs causes tachycardia, palpitations, and tremors?
    adrenergic agents
  38. Beta adrenergic agents _______ the blood sugar.
  39. Beta adrenergic agents _______ cardiac output.
  40. Cholinergic agents cause _______ of bronchial vessels.
  41. Anticholinergic agents _______ peristaltic action within the intestines.
  42. Beta adrenergic agents require the nurse to monitor for _______ in a diabetic patient.
  43. _______ is the neurotransmitter for adrenergic fibers.
  44. Major uses for adrenergics:
    • relaxation of smooth muscle of bronchi (bronchodilation)
    • constriction of blood vessels (vasoconstriction)
  45. _______ agents act by "plugging" (blocking) alpha or beta adrenergic receptors, thus, preventing adrenergic effects.
    adrenergic-blocking agents
  46. _______ agents act by stimulating the peripheral nervous system or by inhibiting the enzyme acetylcholinesterase.
  47. What nursing assessment is done before starting a pt on a beta-adrenergic blocking agent?
    blood pressure and heart rate
  48. What is the difference between a sedative and hypnotic?
    • sedative:  quiets/relaxes, but does not necessarily produce sleep
    • hypnotic:  produces sleep
  49. What are the classes of sedatives and hypnotics?
    • barbiturates
    • benzodiazepines
    • miscellaneous
  50. Stages of sleep: 
    • I    Easily roused
    • II   REM
    • III  Transitional stage
    • IV   Deep, dreamless, restful sleep

    remember:  4 stages every 90 minutes
  51. Types of insomnia:
    • initial:  inability to fall sleep when desired
    • intermittent:  inability to stay asleep
    • terminal:  awake early/unable to fall asleep again
  52. Beta-adrenergic blocking agents (beta blockers) _______ heart rate, _______ blood vessels, and _______ blood pressure.
    • decrease heart rate
    • dilate blood vessels
    • decrease blood pressure
  53. _______ 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.
    • barbiturates
    • paradoxic response
    • 2-4 week period
  54. _______ should NOT be used in the 1st trimester of pregnancy and should be avoided with breastfeeding.

    Smokers may need _______ doses.

    • benzodiazepines
    • larger
    • lorazepam (Ativan), midazolam (Versed)
  55. Monitor _______ with sedatives/hypnotics.
  56. _______ is a newer sedative/hypnotic that is most commonly used because it has less s/e.
  57. 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
    • dopamine and acetylcholine
    • levadopa
    • levadopa
  58. _______ increase GABA for calming effect.


    They are used in combo with _______.

    _______ are the most common.

    S/e include:

    Watch for _______.

    _______ has lower sedative effects, less abuse potential; great for the elderly.
    • anxiolytics
    • benzos, Azaspirones, SSRIs, misc
    • talk thereapy
    • Benzos
    • lethargy, drowsiness
    • dependence
    • Buspar
  59. _______ 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.
    • antidepressants
    • serotonin, norepinephrine, and dopamine
    • MAOIs, Tricyclics, SSRIs, Misc
    • 2-4 weeks
    • suicide
    • SSRIs; seratonin syndrome
    • MAOIs; tyramine
    • Tricyclics
  60. _______ 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

    S/e include:

    Lithium toxicity signs:

    May also use _______ and _______ in tx.
    • antimanics
    • Lithium
    • increases
    • fluid and salt
    • 0.6-1.2
    • n/v, anorexia, cramping, increased thirst, metallic taste, tremor
    • anticonvulsants; antipsychotics
  61. _______ balance dopamine levels to manage psychosis.

    Some medications:

    _______ long-acting injectable form; increases compliance; only need every 1-3 weeks.

    Monitor for for _______, especially seen w/ older drugs; use _______ to assess.

    Assess for:

    _______ syndrome is similar to serotonin syndrome except involves dopamine levels.
    • Antipsychotics
    • Thorazine, Prolixin, Haldol are typical; atypical are Risperdal, Seroquel, Geodon
    • Decanoate/Depot
    • EPSEs; AIMS
    • blood dyscrasias, hyperlipidemia, hyperglycemia, and hypothyroidism
    • Neuroleptic malignant syndrome
  62. _______ are used for motion sickness.

    Medication examples:

    They have _______ and _______ effects.

    May cause _______.
    • antiemetics for motion sickness
    • Dramamine, Transderm Scope, Benadryl, Antivert
    • antihistamine; anticholinergic effects (drying)
  63. _______ are used to decrease pain, manage fever, and decrease inflammation.


    _______ (aspirin) monitor for toxicity (tinnitus, decreased hearing.

    NSAID examples:

    Risk of _______, especially GI.

    Limit ibuprofen to _______mg.  Daily to avoid possible kidney damage.
    • Antiinflammatories
    • Salicylates, NSAIDs
    • Salicylates
    • ibuprofen (Motrin, Advil), ketorolac (Toradol; can only be used 5 days total via all routes)
    • bleeding
    • 3200mg
  64. ______________ 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
  65. _______ 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
  66. _______ 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.
    • anticonvulsants
    • aura; epileptic cry
    • gingival hyperplasia
    • ETOH; stimulants (caffeine)
    • confusion, drowsiness, slurred speech, SOB; 2-5 mg/dL
    • Valiumn
    • ystagmus, sedation/lethargy; 10-20 mg/L
    • Valproic acids