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BSN 315
drugs commonly misued
| Question | Answer |
|---|---|
| Benzodiazepines | sedative-hypnotic drug CNS depressants because of calming effect |
| Benzodiazepines | lorazepam, clonazepam, diazepam, and alprazolam, all of which are prescribed with caution for patients with anxiety |
| Nonbenzodiazepines | “Z-drugs” These include sleeping agents such as eszopiclone, zaleplon, and zolpidem |
| At which percent blood alcohol content (BAC) would a person’s driving-related skills become dangerously impaired? 0.16% to 0.30% 0.31% to 0.45% 0.00% to 0.05% 0.06% to 0.15% | 0.16% to 0.30% 0.16% to 0.30% BAC represents severe impairment, where all driving-related skills become dangerously impaired. |
| Classic signs of stimulant toxicity include the following: | Diaphoresis Hypertension Hyperthermia Tachycardia Severe agitation (so much that they patient poses a danger to self or others) Psychosis Increased troponin, liver transaminase |
| Benzodiazepine Toxicity | CNS depression Respiratory depression Stupor Comatose Long-term consequences of benzodiazepine toxicity include respiratory depression, coma, or death. |
| Opioid Toxicity | Depressed mental status Decreased respiratory rate Decreased tidal volume Decreased bowel sounds Miotic (constricted) pupils Long-term consequences of opioid toxicity include seizure, coma, hypoxia, or death. |
| Fentanyl | associated with an acute amnestic syndrome in overdose |
| Meperidine | seizure, serotonin toxicity (in combination with other agents) |
| Oxycodone | possible QT interval prolongation |
| How would the nurse document assessment findings of confusion, difficulty arousing, and vomiting in a patient who consumed opioid drugs? Side effects Adverse effects Life-threatening complications Toxicity | all Side effects of taking opioid drugs |
| teaching nurse provide to a pt who has a hx of misusing benzodiazepines? Benzodiazepines are not addicting, so they are safe to take for the long term. Mixing benzodiazepines and alcohol can result in respiratory depression. Adverse effects of benzodia | Mixing benzodiazepines and alcohol can result in respiratory depression. |
| Which side effects of alcohol would the nurse teach the patient about? Select all that apply. Hypertension Increased respirations Decrease of peripheral blood flow Lowering of inhibitions Gait impairment | Lowering of inhibitions Gait impairment |
| Which assessment finding would the nurse anticipate for a pt who has a blood alcohol content of 0.10%? Relaxed but able to talk clearly Emotionally erratic w no coordination Unable to respond and possibly comatose Impaired judgment w poor coordination | Impaired judgment with poor coordination The finding of impaired judgment with poor coordination is in keeping with a blood alcohol content of 0.10%, which is just above the legal limit indicating drunkenness. |
| For which desired effects does a person misuse a Z-drug? Select all that apply. Induce a sense of calm Achieve muscle relaxation Decrease anxiety Facilitate sedation Incite euphoria | Eszopiclone zaleplon zolpidem |
| The nurse is caring for a patient who has misused substances and whose temperature is 95°F. Which substance does the nurse anticipate the patient has consumed? Alcohol Methamphetamine Oxycodone Alprazolam | Alcohol An adverse effect of misuse of alcohol can be dangerously low body temperature. |
| Nurse receives report and will be caring for a patient who has stimulant toxicity. Which assessment findings would the nurse anticipate? Select all that apply. Diaphoresis Hypotension Hyperthermia Tachycardia Extreme agitation Psychosis | Diaphoresis Hyperthermia Tachycardia Extreme agitation Psychosis |
| nurse is caring for a patient who has been diagnosed with oxycodone overdose. In addition to expected assessment findings, for which additional sign of toxicity would the nurse monitor? Amnesia Serotonin toxicity Seizure Prolonged QT interval | Prolonged QT interval |
| Disulfiram (alcohol) | Causes unpleasant side effects for an individual when alcohol is consumed |
| Naltrexone (alcohol) | Blocks the pleasurable effects of alcohol and reduces the desire to drink |
| Acamprosate (alcohol) | Reduces some of the unpleasant feelings (e.g., agitation, depression, feelings of foreboding) resulting from alcohol discontinuation or withdrawal |
| Methadone (opioid) | A synthetic opioid agonist that eliminates withdrawal symptoms and relieves drug cravings by acting on opioid receptors in the brain |
| Buprenorphine (opioid) | Partial opioid antagonist that binds with opioid receptors, resulting in decreased pain and increased feelings of well-being |
| Naltrexone (opioid) | Blocks the pleasurable effects of opioids and reduces the desire to use them |
| Suboxone (opioid) | A combination of buprenorphine and naltrexone; see earlier |
| Lofexidine (to treat withdrawal symptoms) (opioid) | The only FDA-approved drug that mitigates withdrawal symptoms associated with opioid withdrawal |
| Pharmacokinetics of Disulfiram | Absorb: Rapidly absorbed from (GI) tract; peak plasma concent. after 8-10 hr (PO) Distri: 1/5 of a dose may remain in the body for a week or longer Metab: red. to diethyldithiocarbamate by the glutathione reductase system in the erythrocytes Excr: Urin |
| Pharmacodynamic of Disulfiram | Onset: 12 hours Peak: Peak plasma concentrations after 8 to 10 hours (PO) Duration: Up to 20% of this drug can stay in the body for 1 to 2 weeks after the last dose Half-life: 60 to 120 hours |
| Pharmacokinetics of Naltrexone | Absorption: Well absorbed orally; subject to significant first-pass metabolism; PO bioavailability ranges from 5% to 40% Distribution: Low plasma protein-binding (21%) Metabo: Extensively metabolized by the liver Elimin: Via the urine (and breast milk) |
| Pharmacodynamics of Naltrexone | PO Onset of action: 15 to 30 minutes Intravenous (IV) Onset of action: 1 to 2 minutes Intramuscular (IM) Onset of action: 2 to 5 minutes Subcutaneous (SQ) Onset of action: 2 to 5 minutes |
| phrase describes the purpose of disulfiram? To prod unpleasant effects if alcohol is ingested To prod satisfying effects if alcohol is ingested To prod unpleasant effects if nicotine is consumed To prod satisfying effects if nicotine is consumed | To produce unpleasant effects if alcohol is ingested |
| Naltrexone decreases the craving for alcohol by blocking which receptors? Opioid Alpha Beta Nuclear | Opioid Naltrexone works by blocking opioid receptors. |
| ER nurse notified squad is bringing in a patient who has overdosed on opioids. Which type of naltrexone would the nurse have ready? Intravenous (IV) naltrexone Intramuscular (IM) naltrexone Oral (PO) naltrexone Subcutaneous (SQ) naltrexone | Intravenous (IV) naltrexone IV naltrexone has the quickest onset of action at 1 to 2 minutes. The nurse will ensure this form of the drug is ready. |
| Abstinence from alcohol for at least ____ hours is necessary before beginning disulfiram therapy. | 24 |
| Naltrexone treatment should not be started unless the patient has been opioid-free for ______ and alcohol-free for _______ | 7 to 10 days 3 to 5 days |
| Disulfiram is contraindicated for the following patients: | those unable to abstain from alcohol ingestion Those with cardiac disease, coronary artery occlusion, or psychosis Those who have recently ingested metronidazole, alcohol, or alcohol-containing medications |
| Naltrexone is contraindicated for the following patients: | Those with a known drug allergy to any component of the medication Those with hepatitis or other severe liver dysfunction |
| Interactions of Disulfiram | St. John’s wort Phenytoin and Other Metabolism-Slowing Drugs Oral anticoagulants isoniazid |
| Disulfiram Side Effects | drinking as little as 7 mL of alcohol can cause “mild” acetaldehyde syndrome, may last from 30 min-hr. Symptoms include nausea, copious vomiting, flushing, palpitations, headache, sweating, thirst, chest pain, weakness, blurred vision, and hypotension. |
| Disulfiram adverse Effects | Fully developed acetaldehyde syndrome, which can be life threatening, can result from consuming alcohol while taking disulfiram. resp depression, cardiovascular collapse, cardiac dysrhythmias, MI, acute heart failure, and convulsions. Severe hypotension |
| naltrexone side effects | Nausea and tachycardia are the most common adverse drug effects . These symptoms are related to the reversal of the opioid effect. |
| naltrexone Adverse Effects | When dosage is excessive, it can result in hepatic injury at the cellular level. |
| Pt has naltrexone Rx, been taking it for months. Which symptom associated w naltrexone nurse advise pt to report immediately to the HCP? Jaundice Heart palpitations Sudden onset of abdominal pain Pain of 6 on a 1 to 10 scale | Jaundice is a sign of liver dysfunction; because naltrexone is extensively metabolized by the liver, symptoms of hepatic impairment of any kind should be immediately reported to the health care provider. |
| Which dose of naltrexone would the nurse anticipate being prescribed for a patient who had their last drink 6 days ago and is being discharged to home? 25 mg orally daily 50 mg orally daily 75 mg orally daily 100 mg orally daily | The oral dosage for PO naltrexone is 50 mg once a day; the nurse would anticipate this dosage to be prescribed. |
| nurse caring for patient w blood alcohol level of 0.45% monitors patient closely for which symptom? oliguria respiratory depression decreased bp vasoconstriction of cutaneous blood vessels | acamprosate |
| teaching plan for patient taking bupropion sr will include which statement? "weight gain is common" "increased salivation is common" "take a second dose as early in the day as possible" "take the drug at least one hour before a monomine oxidase inhibi | "Take a second dose as early in the day as possible" |
| phenobarbital is classified which schedule? sched 1 sched 2 sched 3 sched 4 | Phenobarbital is classified as a Schedule IV controlled substance |
| primary health care provider has prescribed a drug that will help reduce craving for alcohol. which drug will nurse prepare to administer? disulfiram naltrexone acamprosate chlordiazepoxide | Naltrexone works by blocking opioid receptors, reducing the pleasurable effects of alcohol and decreasing cravings. |
| nrs collects pt hx of sub abuse on admin to inpt rehab fac. pt reports increasing the drug dose to get the same effect as when they first started using. pt is experiencing which condition? tolerance addiction cross-dependence physiologic dependence | tolerance |
| patient who is a chronic smoker is being treated at rehab center. which will the nurse expect to administer to immediately stop cigarette craving in the patient nicotine inhaler nicotine lozenges nicotine nasal spray nicotine chewing gum | nicotine nasal spray. Among nicotine replacement therapies, the nasal spray delivers nicotine to the bloodstream very rapidly, closely mimicking the quick nicotine delivery of a cigarette and providing fast relief from craving |
| patient w alcoholism has tremors and elevated bp. nurse observes that pt is also agitated. which drug will nurse administer? Naltrexone disulfiram acamprosate chlordiazepoxide | Chlordiazepoxide is a benzodiazepine commonly used to manage symptoms of alcohol withdrawal, such as tremors, elevated blood pressure, and agitation. |
| which government agency is responsible for enforcing mandates of controlled substances act of 1970? | The DEA implements, regulates, and enforces the laws concerning controlled substances in the United States. |
| patient with alcohol withdrawal is given carbamezepine. which finding indicates therapeutic effect? no seizures no cravings no respiratory depression no damage to myocardium | no seizures |
| nurse caring for patient w blood alcohol level of 0.45% monitors patient closely for which symptom? oliguria respiratory depression decreased bp vasoconstriction of cutaneous blood vessels | respiratory depression |
| which statement by unlicensed assistive personnel indicates need for teaching by nurse? drug abuse can be culturally defined there is a wide variation in what is labeled abuse being physically dependent on a drug is the same as addicted | "being physically dependent on a drug is the same as addicted" |
| a pt with alcoholism is prescribed a barbiturate. nurse has advised patient to stop drinking alcohol. which risk is the nurse trying to prevent? delirium tremens trigeminal neuralgia Korsakoff's syndrom respiratory depression | respiratory depression. Both alcohol and barbiturates are central nervous system depressants, and combining them significantly increases the risk of severe respiratory depression, which can be life-threatening |
| the term freebasingcocaine indicates the use of cocaine through with route? huffing smoking bagging snorting | The term freebasing cocaine indicates the use of cocaine through smoking. Freebase cocaine is specifically prepared to be smoked, as this form allows the drug to be vaporized and inhaled, resulting in a rapid and intense high |
| which major neurotransmitters is part of the reward circuit of the brain that is related to addition? serotonin dopamine epinephrine norepinephrine | Dopamine serves as the primary neurotransmitter in the brain's reward system, specifically in the mesolimbic pathway, and is crucial for reinforcing behaviors and experiences associated with pleasure, motivation, and addiction |
Created by:
adricela55