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Pharm-Unit 5-24&25
Pharmacology
| Question | Answer |
|---|---|
| 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
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