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Neuro/Pain/Mental
Kee Pharmacology
| Question | Answer |
|---|---|
| The peripheral nervous system (PNS) | located outside of the brain and spinal cord, is made up of two divisions: the autonomic and the somatic. |
| The autonomic nervous system (ANS) | also called the visceral system, innervates (acts on) smooth muscles and glands. Its functions include control and regulation of the heart, respiratory system, gastrointestinal (GI) tract, bladder, eyes, and glands. |
| the somatic nervous system | is a voluntary system that innervates skeletal muscles over which there is control. |
| The afferent neurons | send impulses to the CNS, where they are interpreted. |
| The efferent neurons | receive the impulses (information) from the brain and transmit those impulses through the spinal cord to the effector organ cells. |
| The efferent pathways in the ANS | are divided into two branches: the sympathetic and the parasympathetic nerves. |
| The sympathetic nervous system | is also called the adrenergic system because at one time it was believed that adrenaline was the neurotransmitter that innervated smooth muscle. |
| The parasympathetic nervous system | is called the cholinergic system because the neurotransmitter at the end of the neuron that innervates the muscle is acetylcholine. |
| The cholinergic receptors at organ cells are | either nicotinic or muscarinic, meaning that they are stimulated by the alkaloids nicotine and muscarine |
| The four main receptors are | alpha1, alpha2, beta1, and beta2, |
| Drugs that stimulate the sympathetic nervous system are called adrenergics, adrenergic agonists, sympathomimetics, or adrenomimetics because | they mimic the sympathetic neurotransmitters |
| Adrenergics act on one or more adrenergic receptor sites located in the cells of muscles, such as | the heart, bronchiole walls, gastrointestinal (GI) tract, urinary bladder, and ciliary muscle of the eye. |
| The alpha-adrenergic receptors are located | in the vascular tissues (vessels) of muscles. |
| When the alpha1 receptor is stimulated | the arterioles and venules constrict, increasing peripheral resistance and blood return to the heart. |
| Alpha1 Physical Responses | Increases force of heart contraction; vasoconstriction increases blood pressure; mydriasis (dilation of pupils) occurs; decreases secretion in salivary glands; increases urinary bladder relaxation and urinary sphincter contraction |
| Alpha2 Physical Response | Inhibits release of norepinephrine; dilates blood vessels; produces hypotension; decreases gastrointestinal motility and tone |
| Beta1 Physical Response | Increases heart rate and force of contraction; increases renin secretion, which increases blood pressure |
| Beta2 Physical Response | Dilates bronchioles; promotes gastrointestinal and uterine relaxation; promotes increase in blood sugar through glycogenolysis in liver; increases blood flow in skeletal muscles |
| The beta1 | These receptors are located primarily in the heart. |
| The beta2 | These receptors are found mostly in the smooth muscles of the lung, the arterioles of skeletal muscles, and the uterine muscle. |
| Transmitters are inactivated by | (1) reuptake of the transmitter back into the neuron (nerve cell terminal), (2) enzymatic transformation or degradation, and (3) diffusion away from the receptor. |
| The two enzymes that inactivate the metabolism of norepinephrine are | (1) monoamine oxidase (MAO), which is inside the neuron; and (2) catechol-O-methyltransferase (COMT), which is outside the neuron. |
| Drugs can stop the termination of the neurotransmitter by | either (1) inhibiting the norepinephrine reuptake, which prolongs the action of the transmitter or (2) inhibiting the degradation of norepinephrine by enzyme action. |
| The sympathomimetic drugs that stimulate adrenergic receptors are classified into three categories according to their effects on organ cells | (1) direct-acting sympathomimetics, which directly stimulate the adrenergic receptor (e.g., epinephrine or norepinephrine); (2) indirect-acting sympathomimetics, which stimulate the release of norepinephrine from the terminal nerve endings; and (3) mixed- |
| Catecholamines | the chemical structures of a substance (either endogenous or synthetic) that can produce a sympathomimetic response. |
| nonselective | (excites all receptors approximately equally). |
| Epinephrine | can be administered subcutaneously, intravenously, topically, or by inhalation, intracardiac, and instillation methods. It should not be given orally, because it is rapidly metabolized in the GI tract and liver resulting in unstable serum levels. The perc |
| Pain | is the fifth vital sign and an unpleasant sensory and emotional experience related to tissue injury |
| Types of Pain Scales | FLACC, FACES and 0-10 |
| Meaning of terms on FLACC scale | Face Legs Activity Cry Consolability |
| Aspirin side /adverse effects | tinnitus, GI distress, hepatotoxic, salicylate poisoning, and do not give to children with flu like s/sx. |
| Causes of gout | Build up of purines in the system that crystallize in joints. Purine foods include salmon, sardines, liver etc. |
| Common gout medications | Colchicine and Allopurinol (zyloprim) |
| Actions of Allopurinol | decrease uric acid production |
| Action of Colchicine | inhibits leukocytes. |
| Maximum APAP in one day dosage | 4 g |
| Side effects of opioid analgesics | orthostatic hypotension, constipation, addiction, respiratory depression |
| Route of administration for opioid analgesics | PO, IM, IV, Patch, SL |
| PCA stands for | Patient Controlled Analgesic |
| Major types of opioid analgesics | Morphine, Codeine, Meperidine, Dilaudid, Vicodin, Percocet, Fentanyl |
| Indications and route for using a narcotic agonist-antagonist | less abuse potential, for moderate to severe pain, given IM , IV |
| These are antidotes for opiate over dose, they reverse the effects of the opioids and the patient’s pain will abruptly return | opioid antagonists |
| Name of opioid overdose antidote | narcan |
| Treatment for opioid addiction | Methadone or Orlaam (levomethadyl acetate) given once a day , opioids with less addictive properties and do not give the euphoria that IV opiates do |
| 3 types of headaches and description | migraine (severe,one side of head) , cluster headache (starts during sleep, sharp steady eye pain, tearing, flushing congestion) and tension headaches (stress , dull band of pain around entire head) |
| Class of drugs used to treat migraines | triptans |
| Actions of Triptan medications | causes vasoconstriction of cranial arteries , treats migraines or cluster headaches |
| Actions of CNS stimulant drugs | causes increase in stimulation of postsynaptic neurons |
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fineva6782
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