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Nervous system Meds
| Question | Answer |
|---|---|
| What is a naturally occuring adrenergic? | Dopamine |
| Salmeterol is given by what route? | Inhalation |
| alpha- and beta-adrenergic agonist would include? | Epinephrine |
| When the medication causes vasoconstriction, limiting the blood flow to the area. | Extravasation |
| What is a contraindication for propranolol? | Asthma |
| What medication can be used for long-term to treat insomnia? | Eszopiclone |
| Thalamus (midbrain) controls? | Sensations of temp., pain, and touch |
| Hypothalmus (midbrain) controls? | body temp., H2O balance, and appetite |
| Lymbic (midbrane) controls? | neuro transmitters, emotions, nervous system |
| Forebrain controls? | sensory/motor, communication/speech |
| Hindbrain controls? | Balance, posture, function, voluntary movement, and RAS (sleep/wake) |
| Sympathetic nervous system SNS? | Fight or Flight |
| Parasympathetic nervous system PNS? | Rest and Digest |
| Sedation is? | Loss of awareness and reaction to environmental stimuli |
| Hypnosis is? | Extreme sedation resulting in CNS depression and sleep |
| Benzodiazepines (Anxiolytic) | Used frequently, not much sedation, less likely to cause sedation, Do NOT drink alcohol(treats anxiety, alcohol withdraw, hyperexcitability/agitation, pre-op tension and anxiety relief) |
| Benzo's peak in? | 30 minutes to 2 hours |
| Benzo's are the? | "Prams and Lams" (Xanax, Alprazolam) |
| Benzo's are contraindicated in? | Psychosis, acute narrow angle glaucoma, shock, coma, pregnancy, and hepatic/renal impairment |
| Benzo's can cause what adverse effects? | sedation, drowziness, blurred vision, headaches, amnesia, and confusion |
| Barbiturates (Anxiolytic, Anticonvulsant) | Not used much, not as safe, higher risk of sedation, adverse effects and dependance, Do NOT drink alcohol(treats anxiety when sedation is needed, pre-anesthesia, seizures, and acute manic reactions) |
| Barbiturates peak in? | 20 to 60 minutes |
| Barbiturates are the? | "Barbitals" (Amobarbital) |
| Barbiturates are contraindicated in? | Hx of previous addiction, hepatic/renal impairment, pregnancy, acute/chronic pain, severe respiratory depression |
| Barbiturates can cause what adverse reactions? | CNS depression, drowsiness, somnolence, lethargy, ataxia, vertigo, thinking abnormalities, paradoxical excitment, and hallucinations |
| Tricyclic Antidepressants | Relief of S/S of depression, treats enuresis in children over 6, being investigated to treat pain |
| Tricyclic Antidepressants peak in? | 2 to 4 hours |
| Tricyclic Antidepressants are the? | "ines" ( Amitriptyline) |
| Tricyclic antidepressants are contraindicated in? | recent MI, myelography in the last 48hrs, MAOI's, and pregnancy |
| Tricyclic antidepressants can cause what adverse effects? | Sedation, sleep disturbance, fatigue, hallucinations, visual disturbances, ataxia, tremors, etc.... BLACK BOX WARNING(suicidality) |
| Monoamine Oxidase Inhibitors (Anitdepressant) | Rarely used, many negative interactions, treats depression in pts who don't get relief from other medications (Isocarboxazid, Phenelzine) |
| MAOI's peak in? | 2 to 3 hours |
| MAOI's are contraindicated in? | Pheochromocytoma, CV disease, HTN, renal/hepatic impairment, myelography in the last 48hrs, and psychiatric pts |
| MAOI's can cause what adverse reactions? | dizziness, excitement, nervousness, hyperreflexia, liver toxicity, and fatal HTN crisis, BLACK BOX WARNING(suicidality) |
| MAOI required diet? | NO tyramine: aged cheese, overripe fruits, alcohol, spoiled, fermented, soybeans, pickled, smoked, certain sauces, and processed meats (not following the diet will lead to a hypertensive crisis) |
| Selective Serotonin Reuptake Inhibitors (SSRIs) (Antidepressant) | NEW, most used, Safer, increases serotonin, treats depression, OCD, panic attacks, bulimia, PMDD, PTSD, social phobias, and anxiety disorders (do NOT use with MAOI's) |
| SSRI's take how long to work? | 2 to 4 weeks |
| SSRI examples | Citalopram (Celexa), Escitalopram (Lexapro), Fluoxetine (Prozac), Paroxetine (Paxil), Sertaline (Zoloft) |
| SSRI's are contraindicated in? | hepatic/renal impairment, severely depressed or suicidal pts, and pregnancy |
| SSRI's can cause what adverse effects? | headache, drowsiness, dizziness, insomnia, anxiety, agitation, GI side effects, and dry mouth |
| Other antidepressants | Treat depression when other medications do not work, Desvenlafaxine (Pristiq), Duloxetine (Cymbalta), Venlafaxine (Effexor) |
| Which other antidepressant can also be used to stop smoking? | Bupropion (Wellbutrin) |
| What type of antipsychotic are newer? | Atypical: they have fewer side effects, block dopamine and serotonin |
| What are the adverse effects of antipsychotic meds? | sedation, weakness, tremor, drowsiness, extrapyrmidal side effects, pseudoparkinsonism, dystonia, akathisia, tardive dyskinesia, neuroleptic malignant syndrome. Do NOT take with alcohol. |
| Therapeutic Lithium level? | 0.6 to 1.2 |
| Lithium treats? | bipolar disorder and mania. Do not use with thiazide diuretics. |
| CNS stimulants treat? | ADD, ADHD, and narcolepsy |
| Which CNS stimulant can treat bindge eating? | Lisdexamfetamine (Vyvance) |
| What does Dilantin treat? | seizures (anticonvulsants) |
| What does Levodopa treat? | Parkinson's disease (Dopamine replacement therapy) |
| Narcotic agonists | Controlled substances, addictive, Act at specific opiod receptor site in the CNS, Produce analgesia, sedation, and a sense of well-being, can cross the placenta, slows everything down, Nurse needs to encourage fluids and mobility |
| Which narcotic agonist has antitussive properties? | Codiene and fentanyl |
| Narcotic antagonists | Naloxone (Narcan), Has no effect on its own, reverses the effects of opiates, pt feels better but still needs to seek treatment for overdose (ER). |
| Adrenergic agonists | AKA sympathomimetic (fight or flight) treatment varies from opthalmic to systemically treating shock, can be used for pts of all ages |
| Are adrenergic agonists alpha or beta? | Either or both |
| What actions can adrenergic agonists have? | Vasocontriction, increased BP, HR and urinary output, dilation (relaxation) of smooth muscle, glycogenolysis (breaks down blood sugar to give more energy), concurrent use of Beta blockers can inhibit therapeutic effect |
| Dopamine | #1 for treating shock, given by IV, Increases renal blood flow to profuse and save the kidneys |
| Alpha specific adrenergic agonists | (heart) Treats essential HTN, orthostatic hypotension, and cold and allergies. Phenylephrine treats shock |
| Beta specific adrenergic agonists | (Beta2=lungs) Treats bronchospasm. Isoproterenol has an immediate action and is used in emergent situations |
| Adrenergic blocking agents | Sympatholytic(blocks the effects of the SNS), allows the provider to select a drug that will give the desired therapeutic effects, use caution in pts with diabetes and respiratory disease |
| Nonselective adrenergic blocking agents | Not specific, treats HTN, lowers BP and HR, Not for long term for anxiety, can cause delayed response to hypoglycemia. Labetalol treats HTN alone or in combination with other meds |
| Nonselective alpha adrenergic blocking agents | Only 1 available, Phentolamine treats extravasation |
| Alpha selective adrenergic blocking agents | Treats HTN and often for BPH because of the relaxing effects on the bladder and prostate (doxazosin) |
| Nonselective beta adrenergic blocking agents | Treats HTN, angina, migraines, and reinfarction. Widely used, AKA "beta-blockers" |
| Beta1-selective adrenergic blocking agents ("lols") | Affect the heart and NOT the lungs, perferred for pts who smoke or have asthma. Treats HTN, angina, and some cardiac arrhythmias |
| Cholinergic agonists | Parasympathomimetic, mimic the action of acetylcholine, not limited to a specific site, systemic effects (GI increases, vasodilation (flushing, hypotension)) |
| Direct acting cholinergic agonists | Increase the tone of the detrusor muscle of the bladder and relax the bladder sphincter |
| Indirect acting cholinergic agonists | treats Myasthenia gravis and alzheimer's disease, increases secretions |
| What is the most common indirect acting cholinergic agonist for treating alzheimer's? | Donepezil |
| Anticholinergic agents | Parasypatholytic, block acetylcholine, increases HR, decreases GI, bladder tone and function and secretions, dilates pupils, causes a loss of eye accomodation (cycloplegia) |
| Atropine | Anticholinergic, injection or tablet, presurgical, increase HR, parasympatholytic |
| Anticholinergic agents adverse effects | Can't Pee, See, or Spit |
Created by:
Valkyrie90
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