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Nervous system Meds

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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