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Pharm-Unit 5-24&25

Pharmacology

QuestionAnswer
What are the adverse reactions for dopaminergic drugs nervousness,anxiety,HA,blurred vision, arrhthymias
Dopaminergic drugs increase levels of______ in _____? Increase levels of Dopamine in substantia nigra
Dopaminergic drugs directly ______ ______ _______ stimulate dopamine receptors
Dopaminergic drugs help restore? balance between inhibitory and stimulation neurons
Levodopa does not cross the blood brain barrier. T/F False, levodopa does cross the blood brain barrier. Dopaminergic drugs do not cross the blood brain barrier.
Contraindications for Dopaminergic Drugs Angle Closure glaucoma and GI obstruction
Cautions for dopaminergic drugs Cardiovascular disease, bronchial asthma, peptic ulcer, UT obstruction
Dopaminergic drug-drugs MAOIs,Vitamin B6, Phenytoin
Dopaminergic drugs and MAOIs cause? risk of hypertension, so stop 14 days prior to use(MAOIs)
Dopaminergic drugs and Vitamin B6 cause? decrease effectiveness of levodopa
Dopaminergic drugs and phenytoin cause? decrease effectiveness of levodopa
precursor of dopamine levodopa
Levodopa is converted into? dopamine
Levodopa is usually given with _____ as ____ carbidopa as Sinemet
Carbidopa reduces amount of _____ ____ to do what? Reduces amount of levodopa needed to reach therapeutic level in brain
With less levodopa, what happens? there are reduced side effects
Adverse reactions of Levodopa adentitious movements, hand tremors, anorexia, dry mouth, dysphagia, urinary retention, cardiac irregularities
Nursing considerations for Levodopa are? observe for balance(decline levels of dopamine), assess use of vitamin B6(increase dominance of cholinergic neurons), watch EKG changes(prolonged QT), empty bladder before taking drug, if constipation, implement bowel program
types of dopaminergic drugs parlodel, symmetrol, Requip, Dermax, Mirapex
Anticholinergic drugs block ______ in _____ block action of ACh in CNS
Anticholinergic drugs help normalize ___________ ACh-dopamine imbalance
Anticholinergic drugs are used for? -treat parkinsonism -relief of extrapyramidal symptoms
Contraindications for anticholingeric drugs -narrow angle glaucoma -GI obstruction -GU obstruction -prostatic hypertrophy
Cautions for anticholinergic drugs -dysrhythmias -hypertension -hypotension -hepatic dysfunction -pregnancy -lactation
Adverse reactions for anticholinergic drugs disorientation, confusion, agitation, delirium, NV, paralytic ileus
Drug-Drug for Anticholinergic Drugs Tricyclic antidepressants and phenothiazines
Example of a Anticholinergic Drug Biperiden(Akineton)
Nursing Considerations for Anticholinergic Drugs -Assess for tachycardia and dysrhythmias -watch for constipation and paralytic ileus -sugarless candy or lozenges if dry mouth
Most skeletal muscle relaxants work in? Most work in brain and spinal cord
Skeletal muscle relaxants interfere with? Interfere with cycle of muscle spasm/pain and with reflex arc in upper level CNS that cause spasm
Skeletal muscle relaxants ___ or ___ spasm. lyse or destroy spasm(spasmolytics)
Skeletal muscle relaxants that enter muscle fibers directly are? Botulinum toxins and Dantrolene
Muscle spasm is often from? injury to musculoskeletal system
Muscle spasm caused by? flood sensory impulses coming to spinal cord from injured area
Muscle spasticity is a result of? damage to neurons within CNS
Muscle spasticity may result from? increase in excitatory influences within CNS or a decrease in inhibitory influences within CNS
Centrally acting skeletal muscle relaxants action exact mechanism of action unknown
Centrally acting skeletal muscle relaxants contraindication rheumatic disorders
Caution- Centrally actng skeletal muscle realaxants -epilepsy(seizures worsen) -cardiac dysfunction(decreased muscle function) -muscle weakness conditions
Adverse reactions of Centrally Acting Skeletal Muscle Relaxants drowsiness,fatigue,weakness, hypotension, confusion, HA,N, dry mouth
Drug to drug for Centrally Acting Skeletal Muscle Relaxants CNS depressants
Example of a Centrally Acting Skeletal Muscle Relaxant Baciofen(Lioresal)
Indication of Lioresal alleviation of signs and symptoms of spasticity, may be used in spinal cord injuries or spinal cord diseases
Lioresal metabolized? not metabolized
Nursing Considerations for Lioresal -Warn about driving, operating equipment -no alcohol use -warn about CNS depressants -taper drug over 1-2weeks (to prevent psychoses)
Direct Acting Skeletal Muscle Relaxants interfere with? release of calcium from muscle tubules
D.A.S.M.R.- Interfere with release of calcium from muscle tubules prevents? prevents fibers from contracting
D.A.S.M.R.- Interfere with release of calcium from muscle tubules don't interfere with? Don't interfere with neuromuscular transmission
Direct acting skeletal muscle relaxants treat ____ directly affecting what? treat spasticity directly affecting peripheral muscle contraction
Direct acting skeletal muscle relaxants manage? associated with? Manage spasticity associated with neuromuscular disease
Contraindications for Direct acting skeletal muscle relaxants spasticity related to locomotion, hepatic disease, lactation
Adverse reactions of Direct acting skeletal muscle relaxants fatigue,weakness,confusion,GI irritation, enuresis(bed wetting), urinary frequency and urgency
Drug-Drug for Direct acting skeletal muscle relaxants Estrogen(risk of liver toxicity), neuromuscular junction blockers(added effect)
Example of Direct acting skeletal muscle relaxants Dantrium
Nursing Implications for Direct acting skeletal muscle relaxants Assess for muscle weakness, respiratory depression, liver damage(NV,anorexia, fatigue), extravasation(alkaline solution), diarrhea(lower dose)
Created by: mhruska on 2010-09-27



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