Pharm week 4 ch 27, 28, 29, & 30

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Pharm week 4 ch 27, 28, 29, & 30
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2010-10-26 21:13:04
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  1. How many stages of sleep is there?
    4 phases
  2. What are the characteristics for phase 1 sleep? (6)
    • 1. begins soon as the suns sets
    • 2. pineal gland begins to produce melatonin (hormone released in the absence of light)
    • 3. muscles relax
    • 4. heart rate and breathing slow down
    • 5. body temperature drops
    • 6. the brain relaxes but is still alert
  3. What is the characetriatic for stage 2 sleep?
    layer stays still for about 10-15 minutes
  4. What are the 2 characetristics for phase 3 sleep?
    • 1. a deeper sleep
    • 2. lasts about 5-15 minutes
  5. What is phase 4 sleep also called?
    REM sleep
  6. What are the characteristics for phase 4 sleep?
    • 1. lasts a half hour or so
    • 2. REM occurs
    • 3. dreams occur
    • 4. when dreams end, starts back at phase 2 and the process over again (abotu 5 times repeated through the night)
  7. The average sleeper will sleep how long uninterrupted?
    8 hours and 15 mins
  8. What are barbiturates? (3)
    • Drugs which exert a depressant effect, often prescribed to:
    • 1. promote sleep
    • 2. prevent seizures
    • 3. induce anesthesia
  9. What does a barbiturates often end with?
    -barbital
  10. What do barbiturates interfere with?
    the sleep cycle
  11. barbiturates are quite toxic, so?
    there is a high risk of death with overdose.
  12. What are the two types of barbiturates that deal with how fast the drug works?
    • 1. short-acting
    • 2. long-acting
  13. With barbiturates, dependence is possible, and a rapid withdrawal leads to?
    seizures, death (should wean off instead)
  14. What are Benzodiazepines?
    drugs which exert a depressant effect in the CNS
  15. Benzodiazepines are often used to reduce what? and promote what?
    • reduce anxiety
    • promote sleep
    • EX: VALIUM
  16. (Benzodiazepines) little interference with REM causes what?
    little drowsiness
  17. (Benzodiazepines) little interactions with other what?
    • drugs
    • EX: WARFARIN
  18. (Benzodiazepines) can accumulate in body and cause what? leading to what?
    • serious withdrawls (taper off gradually)
    • leading to seizures
  19. (Benzodiazepines) may cause what? (4)
    • 1. excitement
    • 2. oversedation
    • 3. respitatory suppression
    • 4. decrease BP
  20. Benzodiazepine drug names end in what?
    "-am"
  21. What is the antidote/antagonist for benzodiazepines?
    flumazenol (Rumazicon)
  22. What are non-benzodiazepines?
    newer drugs to promote sleep (EX:LUNESTA, AMBIEN)
  23. Clients taking ambien may get dependent on it?
    yes (non-benzodiazpines may still cause dependence)
  24. What are 2 other names for alcohol?
    • 1. ethanol
    • 2. ETOH
  25. What are psychotropic drugs?(3)
    • agents which are used to treat emotional or psychiatric conditions such as:
    • 1. anxiety
    • 2. psychoses
    • 3. affective disorders
  26. What is another name for antianxiety agents?
    anxiolytics
  27. What are the 4 classes of antianxiety agents?
    • 1. barbiturates
    • 2. carbamates
    • 3. antihistamines
    • 4. benzodiazepines
  28. What are anxiolytics?
    drugs to treat affective disorders, usually by affecting neurotransmitter levels in the brain
  29. What are 2 facts about antidepressants?
    • 1. may take weeks to show improvement
    • 2. often interfere with libido
  30. What are the side effects of tricyclic antidepressants? (4)
    • 1. sedation
    • 2. irregular heart rate
    • 3. increased P
    • 4. anticholinergic effects (dry mouth, trouble voiding)
  31. What are tricyclic antidepressants used to treat?
    OCD
  32. What does MAO inhibitors stand for?
    monoamine oxidase inhibitors
  33. What are MAO inhibitors?
    drugs that inhibit the enzyme MAO that destroys neurotransmitters
  34. MAO inhibitors have many side effects and drug/food interactions, so?
    are not used if other options are available
  35. What kind of food should clients on MAO inhibitors avoid? (1) why? (2)
    • foods high in tyramine because it can interact and cause:
    • 1. high BP
    • 2. CVA
  36. What does SSRI stand for?
    selective serotonin reuptake inhibitors
  37. What are SSRI's?
    drugs that allow levels of seratonin to rise, thus improving depression (EX:lexapro, prozac, and paxil)
  38. What are antipsychotic agents? (3)
    • drugs that are used mainly to treat psychiatric conditions such as:
    • 1. schizophrenia
    • 2. bi-polar disorder
    • 3. psychoses
    • probably by reducing the levels or effects of dopamine on the brain.
  39. What do antipsychotic agents usually end with?
    -azine
  40. What kind of symptoms do antipsychotic agents cause?
    extrapyramidal symptoms (EPS)
  41. What are extrapyramidal symptoms? (4)
    • 1. uncontrollable, involuntary muscle jerking
    • 2. spasms
    • 3. uncoordinated gait (leg movements)
    • 4. lip smacking, chewing movements
  42. What is a type of extrapyramidal symptom?
    tardive dyskenesia movements
  43. When do tardive dyskenesia movements occur?
    with long term use of antipsychotics. MAY BE IRREVERSIBLE
  44. What is lithium?
    drug for treating bi-polar disorders, unknown method of action
  45. Clients on lithium need?
    regular blood work to assess lithium levels
  46. Cleints should not take lithium if?
    they are pregnat or nursing
  47. What are 2 S&S of lithium?
    • 1. DOES NOT cause sedation
    • 2. metallic taste
  48. What are the S&S of lithium for levels between 1.0 MEQ/L and 2.0 MEQ/L? (5)
    • 1. nausea
    • 2. vomiting
    • 3. muscle weakness
    • 4. drowsiness
    • 5. loss of coordination
  49. What are the S&S of lithium for levels between 2.0 and 3.0 MEQ/L? (12)
    • 1. agitation
    • 2. ataxia
    • 3. blurred vision
    • 4. confusion
    • 5. dizziness/vertigo
    • 6. increased loss of muscle coordination
    • 7. myoclonic twitching
    • 8. hyperreflexia
    • 9. hypertonia
    • 10.slurred speech
    • 11. tinnitus
    • 12. urinary or bowel incontinence
  50. What are the S&S for lithium levels greater than 3 MEQ/L? (6)
    • 1. arrhythmias/dysrhythmias
    • 2. coma
    • 3. hypotension
    • 4. peripheral vascular collapse
    • 5. seizures
    • 6. stupor
  51. What are the general considerations for antianxiety agents and sedatives and hypnotics? (7)
    • WATCH:
    • 1. vital signs
    • 2. levels of consciousness/sedation
    • 3. dizziness
    • 4. mood/suicide ideations
    • 5. side effects reported by patients
    • 6. stop only with physcian approval & often gradually wean off
    • 7. no alcohol, or similar drugs
  52. What does A+Ox3 mean?
    alert and oriented to person, place, and time
  53. What is ADD?
    does not show hyperactiivity behaviors, but causes interference with ability to focus and may benefit with medication
  54. What is ADHD?
    has problems with focusing along with hyperactivity, impulsive, constantly "wired" behavior
  55. What do peoople with ADD and ADHD respond well to?
    CNS stimulants (withdraw gradually)
  56. What are the main side effects of CNS stimulants? (4)
    • 1. slowed growth
    • 2. GI upset
    • 3. dry mouth
    • 4. cardiac problems
  57. What should be avoided when a person is on CNS stimulants?
    caffeine
  58. Many CNS stimulants are sustained release so?
    DO NOT crush
  59. what is very helpful when a person is on CNS stimulants?
    feedback from teacher
  60. CNS stimulants are contraindicated in those with?
    substance abuse history
  61. What is alzheimer's disease?
    Chronic, progressive neurological disorder
  62. What is alzheimer's disease characterized by? (4)
    • 1. decline in cognitive function
    • 2. neurofibrillary tangles
    • 3. plaques in brain
    • 4. decrease Ach levels
  63. IS Alzheimer's curable?
    no, but there are drugs to slow its progression.
  64. Most Alzheimer's drugs work to?
    increase Ach levels in brain
  65. In later stages, (Alzheimer's) sedative may be required to? (2)
    • 1. reduce agitation
    • 2. assist caregivers
  66. What are the drugs used for musculoskeletal disorders? (3)
    • 1. Neuromuscular blocking agents
    • 2. Skeletal muscle relaxants
    • 3. skeletal muscle sitmulants
  67. What are neuromuscular blocking agents?
    drugs which cause paralysis skeletal muscles (but not smooth or cardiac muscle) by interfering with normal Ach binding (drug blocks the receptors to Ach)
  68. What route are neuromuscular blocking agents usually given?
    IV
  69. What is the precaution for neuromuscular blocking agents?
    may interact with certain antibiotics which enhance the effects of the blocking drug
  70. What are skeletal muscle relaxants?
    drugs which reduce skeletal muscle contraction (unknown method of action) to help with muscle spasms.
  71. What are the 3 precautions for skeletal muscle relaxants?
    • 1. may cause sedation
    • 2. many interactions with other drugs
    • 3. may cause hepatoxicity
  72. What are skeletal muscle stimulants?
    drugs which raise Ach levels by interfering with the enzyme that breaks down Ach.
  73. skeletal muscle stimulants are mainly used to treat?
    myasthenia gravis
  74. What causes Atropine Sulfate?
    too much anticholine

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