Lesson 3; Power point questions

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Lesson 3; Power point questions
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  1. What is the basic principal of Adrenergic drugs?
    They stimulate the SNS & are also called sympathomimetics or adrenergic agonists
  2. What are the characteristics of Adrenergic drugs?
    The mimic the effects of the SNS neurotransmitters.
  3. What are the neurotransmitters of the SNS?
    • Norephinephrine (NE)
    • Epinephrine (EPI)
    • Dopamine
  4. Where are the Adrenergic receptors located?
    t/o the body
  5. Name the Adrenergic receptors:
    • Alpha 1 & 2
    • Beta 1 & 2
    • Dopaminergic: respond only to domapine
  6. What are the effects of the Alpha 1 Adrenergic receptor sites?
    • ^cardiac contractility
    • vasoconstricion (^BP)
    • Dilate pupils
    • <salivary gland secretion
    • ^bladder & prostate contraction
  7. What are the effects of the Alpha 2 Adrenergic receptor sites?
    • Inhibit norepinephrine release
    • Vasodilation (<BP)
    • <GI motility & tone
  8. What are the effects of the Beta 1 Adrenergic receptor sites?
    • ^cardiac contractility & ^HR
    • ^renin secretion = ^BP
  9. What are the effects of the Beta 2 Adrenergic receptor sites?
    • (lungs)
    • Bronchodilation
    • ^blood flow in skeletal muscles
    • <uterine tone
    • <GI motility & tone
    • Activates liver glycogenolysis which ^blood glucose
  10. What are the effects of the Dopaminergic Adrenergic receptor sites?
    Vasodilation ^blood flow
  11. What are the classifications of Adrenergics?
    • Direct-acting sympathomimetic (Epinephrine)
    • Indirect-acting sympathomimetic (Amphetamine)
    • Mixed-acting sympathomimetic (Ephedrine)
    • Catecholamines
    • Noncatecholamines
  12. Catecholamines produce what types of sympathomimetic responses?
    • ^HR
    • Vasoconstriction
    • Bronchial dilation
    • Dilates pupils
  13. Noncatecholamines produce what types of sympathomimetic responses?
    • act on Beta 2
    • Bronchodilation
    • ^blood flow in skeletal muscles
    • <uterine tone
  14. What is the action of Epinephrine (Adrenalin)?
    • Vasoconstriction (alpha 1)
    • ^BP (beta 1)
    • Promote bronchodilation (beta 2)
  15. Why would Ephinephrine (Adrenaline) be used?
    • Anaphylaxis (shock)
    • Bronchospasms
    • Cardiac arrest
  16. What types of patients would Epinephrine be contraindicated in?
    • Cardiac dysrhythmias
    • HTN
    • Hyperthyroidism
    • pregnancy
  17. What are the s/e of Epinephrine (Adrenalin)?
    • N/V
    • HTN
    • Tachycardia
    • Nervousness
    • Tremors
    • Agitaion
  18. What are the adverse reactions to Epinephrine (Adrenalin)?
    • Ventricular Fibrillation (V-fib)
    • Pulmonary edema
    • (drug interaction: work opposite of beta-blockers)
  19. What are the nursing interventions for Epinephrine (Adrenalin)?
    • Monitor BP, PULSE, Urine output
    • Report tachycardia, palpitations, tremors, dizziness, HTN
    • Avoid cold meds/diet pills if HTN, diabetic, CAD, or dysrhythmias
    • Avoid adrenergics when nursing infants
    • Avoid continuous use of adrenergic nasal sprays
    • Monitor IV site for infiltration
  20. What receptor sites does Albuterol (Proventil) & Salmeterol (Serevent) effect?
    • Beta 2 adrenergic receptors
    • Promotes bronchodilation
  21. What is Albuterol (Proventil) & Salmeterol (Serevent) used for?
    • Tx/prevent
    • *Bronchospasms
    • *Asthma
    • *Bronchitis
    • *COPD
  22. Albuterol (Proventil) is only used what?
    • Tx of ACUTE bronchospasms
    • ONLY a rescue inhaler
  23. Salmeterol (Serevent) is used for short or long term?
    • long term, routine inhaler
    • *PREVENT bronchospasms
  24. What are the s/e or a/r to Albuterol (Proventil) & Salmeterol (Serevent)?
    • Tremors
    • Nervousness
    • Restlessness
    • Dizziness
    • Reflex Tachycardia
    • Hallucinations
    • Cardiac dysrhythmias
  25. What are the nursing implications for Albuterol & Salmeterol?
    • Avoid factors that exacerbate their condition
    • Encourage fluid intake to loosen thick mucosal secretions
    • Educate on proper dosing & equipment
  26. If the patient is using another inhaler that is a corticosteroid, what should the nurse instruct the patient to do?
    • Give bronchodilator first (Albuterol or Salmeterol) & wait 5 minutes before giving corticosteroid.
    • This helps open up the airways for better absorption of the corticosteroid (potent anti-inflammatory)
  27. What should the nurse monitor for with the use of Albuterol or Salmeterol?
    • Return to normal respiratory rate
    • Improved breath sounds
    • ^air exchange
    • Check pulse Ox
    • <cough
    • <dyspnea
    • ^blood gases
    • ^activity tolerance
  28. What is Dopamine used for?
    ^BP
  29. Dobutamine is used for?
    to Tx cardiac decompensation
  30. Pseudoephedrine (Sudafed, Afrin) are used to Tx what?
    Nasal congestion
  31. What can happen with over use of Afrin?
    Rebound congestion
  32. What is Terbutaline (Brethine) used for?
    Tx of bronchospasms
  33. What is the basic action of Adrenergic Blockers?
    Block the effects of adrenergic neurotransmitter
  34. What ways can Adrenergic blockers block the effects of adrenergic neurotransmitters?
    • By blocking the alpha or beta sites:
    • Directly: by occupying receptors
    • Indirectly: by inhibiting release of neurotransmitters epinephrine & norepinephrine
  35. What are other names for the Adrenergic Blockers?
    • Adrenergic Antagonists
    • Sympatholytics ("lyse" or inhibit SNS)
    • Alpha-blockers
    • Beta-blockers
    • Alpha/beta-blockers
  36. The Alpha-Adrenergic Blockers work by doing what?
    Blocking either Alpha 1 receptors (selective), or by blocking Alpha 1 & 2 receptors (Non-selective).
  37. Alpha 1 Blockers can cause what?
    • Vasodilation
    • <BP
    • Reflex tachycardia
    • Miosis (pupil constriction)
    • Suppresses ejaculation
    • <contraction of smooth muscles in bladder neck & prostate.
  38. The action of Alpha Blockers causes what to happen?
    • Arterial & venous dilation-->reducing peripheral vascular resistance & BP
    • Effects receptors on the prostate gland & bladder causing <resistance to urinary outflow (^possibility of incontinence)
  39. Name some Alpha Blockers & what they are used for.
    • Doxazosin (Cardura)
    •      *HTN & BPH
    • Prazosin (Minipress)
    •      *HTN & PTSD
    • Terazosin (Hytrin)
    •      * HTN & BPH
  40. What suffix indicates Alpha-Adrenergic Blockers?
    ZOSIN
  41. With the Alpha Blockers the nurse should warn the patients first starting these meds of what effect?
    The "first dose effect": may cause orthostatic hypotention, dizziness, & syncope
  42. What are the effects of Adrenergic Blockers at the beta 1 & 2 sites?
    • Beta 1; <cardiac contractility, <pulse
    • Beta 2; Bronchoconstriction, Contracts Uterus, Inhibits glycogenolysis
  43. What are indications for Beta Blockers use?
    • Antianginal: <demand for myocardial oxygen
    • Cardioprotective: Inhibits stimulation from circulating catecholamines
    • Class II Antidysrhythmics
    • Antihypertensive
    • Heart Failure (only some)
    • Tx of Migraine HA
    • Glaucoma
  44. Explain the action of selective beta blockers verses nonselective beta blockers.
    • Selective Beta blockers: <BP & Pulse
    • Nonselective Beta blockers: 
    •      Blocks Beta 1: <BP & Pulse
    •      Blocks Beta 2: Bronchoconstriction
  45. Name some Beta Blockers.
    • Propranolol (Inderal)
    • Atenolol (Tenormin)
    • Metoprolol (Lopressor)
    • Carvedilol (Coreg)
    • Nadolol (Corgard)
    • Timolol (Blocadren, Timoptic: glaucoma)
  46. The "olol" drugs are what type of drugs?
    Beta Blockers
  47. Propranolol is a nonselective beta blocker, when is it contraindicated?
    in patients with COPD
  48. Propranolol is a nonselective beta blocker, what are it's s/e or a/r?
    • Weight gain
    • Impotence
    • <libido
    • Alopecia (reversible)
  49. Metoprolol (Lopressor), & Atenolol (Tenormin) are selective beta adrenergic blockers.  Which receptor do they block and what are the effects?
    • Blocks beta1 only
    •      *<BP & Pulse
    •      *fewer s/e
  50. What are the s/e of selective Beta1 adrenergic blockers like Metoprolol, or Atenolol?
    • Bradycardia
    • Hypotension
    • Dysrhythmias
    • CHF
    • Dizziness
    • Fainting
    • Fatigue
    • Mental Depression
    • Hypoglycemia
  51. What are the nursing implications with Adrenergic Blockers (Alpha & Beta blockers)?
    • Assess: Allergies, Hx of COPD, Hypotension, Cardiac dysrhythmias, Bradycardia, Heart Failure, etc. cardio problems.
    • NEVER stop taking abruptly d/t REBOUND TACHYCARDIA
    • Teach pt's to change position slowly
    • Avoid caffeine, alcohol & hazardous activites until blood levels become stable
  52. Nurses should monitor patients on Adrenergic Blocking drugs (Alpha & beta blockers) for what?
    • ***BP & PULSE
    • Dyspnea
    • N/V
    • Constipation
    • Urinary hesitancy
    • Bladder distention
  53. The nurse knows that a client on Beta Blockers should be educated to report what s/e?
    • Weight gain of >2#/1day, or >5#/1week.
    • Edema of feet or ankles
    • SOB
    • Excessive fatigue or weakness
    • Syncope or dizziness
  54. What are Cholinergic Drugs?
    • Drugs that stimulate the PNS
    • Mimic the effects of the PNS neurotransmitter (ACh; Acetylcholine)
  55. There are two different Cholinergic receptors, what are they?
    Muscarinic & Nicotinic
  56. What effects do Cholinergics have?
    • Cardiovascular: <BP & pulse, vasodilation, slows conduction of AV node
    • GI: ^tone & motility, ^parastalsis, relaxed sphincter muscles
    • GU: Contract bladder, ^uterer tone, relax sphincter muscles, stimulate urination
    • EYE: Miosis (pupil constriction), ^accommodation
    • LUNGS: Bronchial constriction, ^secretions
    • GLANDS: ^salivation, ^perspiration, ^tears
    • Striated Muscle: ^neuromuscular transmission
  57. Name a few Direct-acting Cholinergics & what they are used for.
    • GI: Metoclopramide (Reglan)
    •      *Tx of GERD & Gastroparisis (^gastric emptying)
    • GU: Bethanachol (Urecholine)
    •      *Stimulate urination (1-2hrs after taken)
    • EYES: Pilocarpine
    •      *Tx of glaucoma
    •      *topical app d/t poor oral absorbtion
  58. What are some diseases that Indirect-acting Cholinergics are prescribed for?
    • Myasthenia Gravis
    • Alzheimer's Dementia
  59. What are the Indirect-acting Cholinergics that are used for Alzheimer's Dementia?
    • Tacrine (Cognex)
    • Donepezil (Aricept)
    • Memantine (Namenda)
    • ***NOT A CURE***
    • Used to improve memory in A.D., helps slow progression of disease
  60. What are the s/e & nursing implications for Cholinergics?
    • Hypotention: Assess BP
    • Bradycardia: Assess HR
    • Bronchoconstriction: Assess Lungs
    • Excessive Salivation: Oral Hygeine
    • ^Gastric acid secretion & abdominal cramps: check GI system
    • Blurred vision: Safety concerns
    • Assess I & O
  61. What should a nurse teach a client who is about to start taking a Cholinergic drug?
    • Proper gtts admin
    • ***DO NOT ABRUPTLY STOP TAKING***
    • Spread doses evenly apart to optimize the effects
    • Therapeutic effects of anti-Alzheimer's drugs may not occur for up to 6 weeks
  62. What is a special nursing implication in patients taking Bethanechol?
    Should void w/in 60min of administration
  63. What is a special nursing implication for a post-op patient with <GI peristalsis on Metoclopramide
    Watch for: ^BP, are they passing gas, COCA poop
  64. Which drugs cause interactions with Cholinergic drugs?
    • Anticholinergics, Antihistamines, sympathomimetics
    • *b/c they antagonize cholinergic drugs, resulting in <responses
  65. What are Anticholinergics? (cholinergic blocking agents)
    Drugs that block or inhibit the actions of acetylcholine (ACh) in the PSNS (parasympathetic nervous system)
  66. How do Anticholinergics effect the body?
    • Heart: Lg doses ^pulse, small doses <pulse
    • Lungs: Bronchodilation, <secretions
    • GI: Relax smooth muscle tone, <motility & peristalsis, <secretions
    • Eye: Dilate pupils (Midriasis), <accommodation
    • Glands: <salivation, <perspiration
    • CNS: <tremors & rigidity
  67. What is the Anticholinergic Atropine used for?
    • Pre-op med to <salivary secretions
    • Antispasmodic: <GI peristalsis
    • ^HR (high doses): used for SEVERE bradycardia, or heart block
  68. What is the Anticholinergic Scopolamine & Dramamine used for?
    Motion Sickness
  69. What is the Anticholinergic Hyoscyamine (Cystospaz) used for?
    • Tx of Urinary bladder spasms
    • Tx of IBS & peptic ulcers
  70. Tolterodine (Detrol), is an Anticholinergic used for what?
    • Tx for Urinary frequency (gotta go, gotta go)
    • urgency & incontinence
  71. The Anticholinergic drug Ipratropium (Atrovent) is used for what?
    • Tx of COPD, Asthma, bronchospasms:  causes bronchodilation
    • <bronchial secretions
  72. Benztropine (Cogentin), & Trihexyphenidyl (Artane) are Anticholinergics used to treat what?
    • Parkinsonism & drug induced parkinsonism
    • *<muscle rigidity & muscle tremors
  73. What medication groups do Anticholinergics interact with?
    • Antihistamines
    • Phenothiazines
    • Tricyclic Antidepressants
    • MAOIs
  74. When given with other Anticholinergic drugs what happens?
    Additive effect: ^effects of meds
  75. What are the s/e of Anticholinergics?
    • DRY DRY DRY!!!
    • Dry mouth
    • Dry eyes
    • ^intraocular pressure (IOP)
    • Visual disturbances--blurred vision
    • Midriosis (pupil dilation)
    • Constipation
    • Urinary retention
    • Ortho hypotensin
    • Tachycardia (in high doses)
  76. What are the nursing interventions for the s/e of Anticholinergics?
    • Dry mouth: good oral hygeine/hard candies
    • Dry eyes: NS eye gtts PRN
    • Tachy: Monitor pulse
    • Ortho hypotension
    • Visual disturbances: avoid driving at NOC & wear sunglasses
    • Constipation: Assess bowel fxn regularily
    • Urinary retention: Assess I&O
  77. What are the nursing implications for Anticholinergics?
    • Monitor for confusion/drowsiness (*elderly)
    • Elderly: <fluid balance=heat stroke cautions
    • Adequate fluid intake
    • Urinary hesitancy/retention
    • Constipation
    • palpitations
    • tremors
    • fever
  78. When Parkinsonism patients are taking an Anticholinergic like Cogentin what does the nurse need to watch for?
    Ensuring the med is working by noting if there is a <in tremors & salivation/drooling
  79. With the Anticholinergic drug Detrol, what is the nurse monitoring for?
    • Improved urinary patterns
    • <hypermotility
    • ^time between voids
  80. CNS stimulants like Amphetamines, caffeine, Analeptics & Anorexiants are used for what types of issues?
    • ADHD
    • Narcolepsy
    • Reversal of respiratory depression
    • Obesity
  81. CNS stimulants are in 3 categories, what are they?
    • Amphetamines
    • Anorexiants
    • Analeptics
  82. What is the possible pathophysiology of ADHD?
    A dysregulation of the transmitters serotonin, norephinephrine, & dopamine.
  83. ADHD typically occurs in what age group?
    children, & usually starts before the age of 7
  84. What are the characteristics of ADHD?
    • Inattentiveness
    • Inability to concentrate
    • restlessness
    • Hyperactivity
    • Inability to complete tasks
    • Impulsivity
  85. What are the characteristics of Narcolepsy?
    • Recurrent attacks of drowsiness during daytime
    • Unable to control sleep
    • Falling asleep while: Driving, Eating, Standing,
    •                              Talking
  86. What are the Amphetamines, Adderall & Dexedrine used for?
    • Adderall: ADHD & Narcolepsy
    • Dexedrine: Obesity
  87. The CNS stimulants in Adderall & Dexadring from the Amphetamines category act by doing what?
    Stimulating the release of norepinephrine & dopamine.
  88. What are the actions of Amphetamines Adderall & Dexedrine?
    • Adderall & Dexedrine:
    • ^wakefulness in narcolepsy
    • Adderall:
    • <hyperactivity, impulsiveness & restlessness of ADHD 
    • Dexedrine: 
    • Tx of obesity
  89. What are the s/e of a/r of Amphetamines?
    • Tachycardia, palpitations, hypertension
    • Sleeplessness, restlessness
    • Anorexia, dry mouth, Wt loss, diarrhea, constipation
    • Impotence
  90. What are some Amphetamine-Like Drugs & what are their uses?
    • ADHD
    • Methylphenidate (Ritalin) CSS II
    • Methamphetamine (Desoxyn)

    • Narcolepsy
    • Modafinil (Provigil)
    • Pemoline (Cylert)
  91. What are the s/e of Ampthetamine-Like drugs?
    • wide range, dose related
    • **tend to speed up body systems**
  92. What are the nursing interventions for Amphetamines & Amphetamine-Like drugs?
    • Take before breakfast & lunch
    • Assess HR/rhythm
    • **Record Height, Weight, Growth of children**
    • Avoid alcohol & caffeine
    • Use sugarless gum for dry mouth
    • TAPER OFF - do not abruptly stop
  93. List a few Anorexiants.
    • Dextroamphetamine (Dexadrine)
    • Sibutramine (Meridia)
    • Orlistat (Xenical or Alli)
  94. How do Anorexiants work?
    Suppress appetite
  95. What are the s/e of Anorexiants?
    nervousness, restlessness, irritability, insomnia, palpitation, HTN
  96. What is the primary use for Analeptics?
    To stimulate respirations
  97. Name some Analeptics.
    • Caffeine (NoDoz, Coffee, Chocolate, Cold meds)
    • Theophylline
  98. What are the Analeptics CaffeineTheophylline used for?
    • Caffeine & Theophylline: Stimulate respirations in newborns
    • Theophylline: Relaxes bronchioles
  99. What are the s/e of Analeptics?
    • Restlessness, tremors, twitching, palpitations, insomnia, tinnitus, nausea, diarrhea
    • psychologica dependence
  100. The CNS Depressants: Sedatives are drugs that do what?
    Diminishes physical & mental response
  101. The CNS Depressants: Hypnotics do what?
    • Cause sleep
    • **A sedative can become a hypnotic if given in a large enough dose**
  102. How does dosing affect the effect of Sedatives & Hypnotics?
    • Low doses: Calm CNS w/o inducing sleep
    • High doses: Calm CNS to the point of causing sleep
  103. What are the categories of Sedative-Hypnotics?
    • Barbiturates
    • Benzodiazepines
    • NonBenzodiazepines
  104. What do the OTC Sedative-Hypnotics Nytol, Sleep-eze & Tylenol PM have in common?
    Diphenhydramine (Benadryl)
  105. What are the categories of Barbitruates?
    • Ultrashort-acting
    • Short-acting
    • Intermediate-acting
    • Long-acting
  106. Benzodiazepines are Antianxiety agents, name them. (pam, am or lam)
    • Short-acting
    • Alprazolam (Xanax)
    • Long-acting
    • Lorazepam (Ativan)
    • Diazepam (Valium) 
    • Chlordiazepoxide (Librium)
  107. Certain long-acting Benzodiazepines are used for alcohol withdrawal, which ones are they?
    • Lorazepam (Ativan)
    • Diazepam (Valium)
    • Chlordiazepoxide (Librium)
  108. Temazepam (Restoril) is a Hypnotic that is generally used long or short term?
    short term
  109. Which Nonbenzodiazepines are used as Hypnotics for short term use of insomnia?
    • Zolpidem (Ambien)
    • Eszopiclone (Lunesta)
  110. What are the general s/e of Sedative-Hypnotics?
    • Residual drowsiness (Hang-over effect)
    • Drug dependence
    • Drug tolerance
    • Excessive depression
    • Respiratory depression
    • Withdrawal symptoms
  111. Sedative-Hypnotics like ALL CNS depressents interact with what things?
    • Alcohol
    • Other CNS depressants
  112. What are the nursing interventions for Sedative-Hypnotic drugs?
    • Attempt Non-pharm methods 1st
    • Take 15-45min before bed
    • Report hang-over effect
    • Be attentive to safety
    • Avoid alcohol & other CNS depressants
    • Monitor BP, Resp, withdrawal s/s
  113. What are the 2 classifications of Anesthetics?
    • General
    • Local
  114. What is the purpose of General Anesthesia?
    • Analgesic
    • Muscle relaxation
    • Loss of consciousness
    • Amnesia
  115. What is the purpose of Local Anesthesia?
    Analgesic in limited area
  116. Balanced Anesthesia is a combination of drugs given at varying times before, & during sx used for what purpose?
    • <Cardiovascular problems
    • <Amount of general anesthetic needed
    • <N/V
    • <Pain
  117. What are the routes used for Anesthetics?
    • Inhalation
    • IV
    • Topical
    • Local
    • Spinal
  118. With Inhalation (General) Anesthetics like gas or volatile liquid what are the a/r to watch for?
    • ***Malignant Hyperthermia***
    • Resp. depression
    • Hypotension
    • Dysrhythmias
    • Hepatic dysfunction
  119. Which Anesthetic causes LESS respiratory distress than General Anesthetics?
    Midazolam (Versed)
  120. How do Topical Anesthetics work & name a few.
    they <sensitivity of the affected area

    • Chloreseptic spray
    • Lidocaine Gell
  121. How do Local Anesthetics work & what are they used for?
    • Block pain at the site where drug is given
    • used for dental procedures & other minor Sxs
    • (Lidocaine, Novacaine)
  122. List the Spinal Anesthetic types.
    • Spinal Block
    • Epidural Block
    • Caudal Block
  123. What are the nursing interventions for Anesthetics?
    • Monitor: LOC
    •      Vitals: BP/P
    •      Resp. rate
    •      Cardiovascular status
    •      I&O
  124. What is the action of Antipsychotics?
    Block action of dopamine
  125. What are Antipsychotics used for?
    • Schizophrenia
    • Bipolar Disorder
    • Other types of psychosisis
  126. What are the two major categories of Antipsychotic drugs?
    • Typical (1st generation/older drugs)
    • Atypical (2nd gen/newer drugs)
  127. Typical Antipsychotic drugs are most effective for Positive s/s, name a few of these drugs.
    • Chlorpromazine (Thorazine)
    • Haloperidol (Haldol)

    • Rarely Used:
    • Fluphenazine (Prolixen)
  128. What are the s/e with Typical (1st Gen) Antipsychotics?
    • Drowsiness, Anticholinergic effects (dry, dry)
    • Extrapyramidal s/s (parkinson like s/s)
    •     Temors, rigidity, pill rolling, shuffling gait,
    •     restlessness (akathisia)
    • Tx: Benztropine (Cogentin)
    • Tardive Dyskinesia
    •      Tongue movements, foot tapping, shoulder
    •      shrugging
    • Tx: stop drug
    • Neuroleptic Malignant Syndrome (NMS)
    •      High fever, ^^CPK, muscle rigidity
    •      **LIFE THREATENING**
    • Tx: stop drug, call DR!
  129. What are the advantages of Atypical Antipsychotics?
    • Effective in Tx of both positive & negative s/s of Schizophrenia
    • Less likely to cause EPS or Tardive Dyskinesia
  130. Name a few Atypical Antipsychotics.
    • Clozapine (Clozaril): s/e Agranulocytosis- ^infection d/t <WBC (monitor CBC)
    • Risperidone (Risperdal)
    • Quetiapine (Seroquel)
    • Ziprasidone (Geodon)
    • Aripiprazole (Abilify)
  131. What should a nurse monitor a client for when taking 2nd Gen Atypical Antipsychotics?
    • Vitals
    • "cheeking" meds
    • Give w/food or milk
    • watch for: EPS, NMS, TD
    • Assess WBC w/Clozaril
    • **NEED TO TAPER OFF MED NOT D/C ABRUPTLY**
  132. How long could it take for Atypical Antipsychotics drugs to achieve effectiveness?
    3-6wks
  133. Anxiolytics (Antianxiety drugs) like the Benzodiazepines are used for a variety of issues, what are they?
    • Anxiolytic
    • Anticonvulsant
    • Sedative-hypnotic
    • Preoperative drug
    • Tx of Alcohol withdrawal
  134. What are the two major Mood Disorders & how are they characterized?
    • Depression: Loss of interest in normal activities, sad affect, vegetative symptoms
    • Bipolar: mood swings from mania to depression
  135. What are the major Antidepressant Agents?
    • Most Common d/t less s/e
    • SSRIs (Selective serotonin reuptake inhibitors)
    •      *Fluoxetine (Prozac), Sertraline (Zoloft)
    •      *Duloxetine (Cymbalta), Paroxetine (Paxil)
    •      *Citalopram (Celexa)
    • Serotonin/Norepinephrine reuptake inhibitors
    •      *Venlafaxine (Effexor)
    •      *Desvenlafaxine (Pristiq)
    • Atypical Antidepressants
    •      *Bupropion (Wellbutrin), Trazodone  
    • Not used much:
    • Tricyclic Antidepressants (TCAs)
    •    *Amitriptyline (Elavil), Nortriptyline (Pamelor)
    • Monoamine Oxidase Inhibitors (MAOIs)
    •   *Isocraboxide (Marplan) or Phenelzine (Nardil)
  136. SSRIs (Selective Serotonin Reuptake Inhibitors) like Fluexetine (Prozac), Sertraline (Zoloft), & Paroxetine (Paxil) are used for what?
    • Major depression, Anxiety disorders
    • OCD, Panic, Phobias
  137. What are the s/e of the SSRIs like Paxil & Prozac?
    • HA, Nervousness, Restlessness, Insomnia/drowsiness= depending on person
    • Tremors, GI distress, Sexual dysfunction, Seizures, suicidal ideation
    • *s/e often <after 2-3wks
  138. What are TCAs (Tricyclic Antidepressants) like Amitriptyline (Elavil) & Nortriptyline (Pamlor) used for?
    • Major Depression
    • Neuropathic pain
  139. What are the s/e of TCAs?
    • Big s/e:
    • Sedation
    • Anticholinergic Effects: Dizziness, blurred vision, dry mouth & eyes, urinary retention, constipation
    • Others:
    • Wt gan, GI distress, Sexual dysfunction
    • Ortho hypotension, dysrhythmias, EPS, blood dyscrasias
  140. What are Mood Stabilizer drugs used for?
    • Bipolar Disorder
    • Anticonvulsants (Tegretol, Depakote, Lamictal)
  141. Name a few Mood Stabilizer drugs.
    • Carbamazepine (Tegretol)
    • Valproic Acid (Depakote)
    • Lamotrigine (Lamictal)
    • Lithium
  142. What is the biggest concern with Lithium?
    the narrow therapeutic index
  143. What are the s/e of Lithium?
    HA, drowsiness, dizziness, hypotension, restlessness, slurred speech, dry mouth, metallic taste, tremors, muscle weakness, GI distress, edema of hands & ankles, ^urination, dysrhythmias, blood dyscrasias, nephrotoxicity
  144. What are some nursing interventions for clients on Lithium?
    • Monitor:
    • Lithium levels Q1-2 months
    • Vitals
    • Sodium levels
    • effectiveness
    • suicidal tendencies
    • urine output, rena fxn tests
    • enc. fluids
    • take w/food
  145. What is the therapeutic range for Lithium?
    • 0.5-1.5mEq/L
    • Toxic range: is >2mEq/L
  146. What should a client taking Lithium wear?
    Medic alert bracelet

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