Pharm week 4 ch 27, 28, 29, & 30
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. What would you like to do?
How many stages of sleep is there?
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
What is the characetriatic for stage 2 sleep?
layer stays still for about 10-15 minutes
What are the 2 characetristics for phase 3 sleep?
- 1. a deeper sleep
- 2. lasts about 5-15 minutes
What is phase 4 sleep also called?
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)
The average sleeper will sleep how long uninterrupted?
8 hours and 15 mins
What are barbiturates? (3)
- Drugs which exert a depressant effect, often prescribed to:
- 1. promote sleep
- 2. prevent seizures
- 3. induce anesthesia
What does a barbiturates often end with?
What do barbiturates interfere with?
the sleep cycle
barbiturates are quite toxic, so?
there is a high risk of death with overdose.
What are the two types of barbiturates that deal with how fast the drug works?
- 1. short-acting
- 2. long-acting
With barbiturates, dependence is possible, and a rapid withdrawal leads to?
seizures, death (should wean off instead)
What are Benzodiazepines?
drugs which exert a depressant effect in the CNS
Benzodiazepines are often used to reduce what? and promote what?
- reduce anxiety
- promote sleep
- EX: VALIUM
(Benzodiazepines) little interference with REM causes what?
(Benzodiazepines) little interactions with other what?
(Benzodiazepines) can accumulate in body and cause what? leading to what?
- serious withdrawls (taper off gradually)
- leading to seizures
(Benzodiazepines) may cause what? (4)
- 1. excitement
- 2. oversedation
- 3. respitatory suppression
- 4. decrease BP
Benzodiazepine drug names end in what?
What is the antidote/antagonist for benzodiazepines?
What are non-benzodiazepines?
newer drugs to promote sleep (EX:LUNESTA, AMBIEN)
Clients taking ambien may get dependent on it?
yes (non-benzodiazpines may still cause dependence)
What are 2 other names for alcohol?
What are psychotropic drugs?(3)
- agents which are used to treat emotional or psychiatric conditions such as:
- 1. anxiety
- 2. psychoses
- 3. affective disorders
What is another name for antianxiety agents?
What are the 4 classes of antianxiety agents?
- 1. barbiturates
- 2. carbamates
- 3. antihistamines
- 4. benzodiazepines
What are anxiolytics?
drugs to treat affective disorders, usually by affecting neurotransmitter levels in the brain
What are 2 facts about antidepressants?
- 1. may take weeks to show improvement
- 2. often interfere with libido
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)
What are tricyclic antidepressants used to treat?
What does MAO inhibitors stand for?
monoamine oxidase inhibitors
What are MAO inhibitors?
drugs that inhibit the enzyme MAO that destroys neurotransmitters
MAO inhibitors have many side effects and drug/food interactions, so?
are not used if other options are available
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
What does SSRI stand for?
selective serotonin reuptake inhibitors
What are SSRI's?
drugs that allow levels of seratonin to rise, thus improving depression (EX:lexapro, prozac, and paxil)
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.
What do antipsychotic agents usually end with?
What kind of symptoms do antipsychotic agents cause?
extrapyramidal symptoms (EPS)
What are extrapyramidal symptoms? (4)
- 1. uncontrollable, involuntary muscle jerking
- 2. spasms
- 3. uncoordinated gait (leg movements)
- 4. lip smacking, chewing movements
What is a type of extrapyramidal symptom?
tardive dyskenesia movements
When do tardive dyskenesia movements occur?
with long term use of antipsychotics. MAY BE IRREVERSIBLE
What is lithium?
drug for treating bi-polar disorders, unknown method of action
Clients on lithium need?
regular blood work to assess lithium levels
Cleints should not take lithium if?
they are pregnat or nursing
What are 2 S&S of lithium?
- 1. DOES NOT cause sedation
- 2. metallic taste
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
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
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
What are the general considerations for antianxiety agents and sedatives and hypnotics? (7)
- 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
What does A+Ox3 mean?
alert and oriented to person, place, and time
What is ADD?
does not show hyperactiivity behaviors, but causes interference with ability to focus and may benefit with medication
What is ADHD?
has problems with focusing along with hyperactivity, impulsive, constantly "wired" behavior
What do peoople with ADD and ADHD respond well to?
CNS stimulants (withdraw gradually)
What are the main side effects of CNS stimulants? (4)
- 1. slowed growth
- 2. GI upset
- 3. dry mouth
- 4. cardiac problems
What should be avoided when a person is on CNS stimulants?
Many CNS stimulants are sustained release so?
DO NOT crush
what is very helpful when a person is on CNS stimulants?
feedback from teacher
CNS stimulants are contraindicated in those with?
substance abuse history
What is alzheimer's disease?
Chronic, progressive neurological disorder
What is alzheimer's disease characterized by? (4)
- 1. decline in cognitive function
- 2. neurofibrillary tangles
- 3. plaques in brain
- 4. decrease Ach levels
IS Alzheimer's curable?
no, but there are drugs to slow its progression.
Most Alzheimer's drugs work to?
increase Ach levels in brain
In later stages, (Alzheimer's) sedative may be required to? (2)
- 1. reduce agitation
- 2. assist caregivers
What are the drugs used for musculoskeletal disorders? (3)
- 1. Neuromuscular blocking agents
- 2. Skeletal muscle relaxants
- 3. skeletal muscle sitmulants
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)
What route are neuromuscular blocking agents usually given?
What is the precaution for neuromuscular blocking agents?
may interact with certain antibiotics which enhance the effects of the blocking drug
What are skeletal muscle relaxants?
drugs which reduce skeletal muscle contraction (unknown method of action) to help with muscle spasms.
What are the 3 precautions for skeletal muscle relaxants?
- 1. may cause sedation
- 2. many interactions with other drugs
- 3. may cause hepatoxicity
What are skeletal muscle stimulants?
drugs which raise Ach levels by interfering with the enzyme that breaks down Ach.
skeletal muscle stimulants are mainly used to treat?
What causes Atropine Sulfate?
too much anticholine
What would you like to do?
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