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Pharm II - Week 2
Lifestyle drugs and drugs of abuse
| Question | Answer |
|---|---|
| True or false: when a pt. is given antabuse, the drug will deactivate the alcohol in the person's body, providing a reversal effect | False. While antabuse interferes with alcohol metabolism, it DOES NOT deactivate alcohol |
| Nicotine acts on ______ receptors of the autonomic ________ | Nicotinic; ganglia |
| True or false: nicotine acts on ganglia of both sympathetic and parasympathetic NS | True; hence nonselective |
| How is nicotine absorbed? | Through alveoli to blood, mouth to blood, skin |
| True or false: nicotine has very small therapeutic use | True due to nonselectivity |
| Nicotine is a liver enzyme inducer. Explain what this means | Nicotine will help metabolize other drugs. |
| True or false: one can easily distinguish the effects of nicotine from the additives in cigarettes | False. Can be difficult to discern |
| Nicotine is a _____ stimulant. Most deaths are a result of this type of stimulation. | Cardiac |
| Explain respiratory effects of nicotine | Bronchoconstriction, plugging of alveoli, destruction of alveolar septa |
| Explain GI effects of nicotine | Increased peristalsis. Can develop tolerance to GI effects over time |
| Nicotine withdrawal occurs in ____ (time). The effects of withdrawl include (list three) | 24 hours. Effects: irritability, difficulty concentrating, increased appetite |
| True or false: one will experience withdrawal effects from nicotine only when taking a significant dose | False. Withdrawl regardless of dose taken |
| Nicotine is listed as a category ______ | X, D |
| To quit smoking you can use nicotine products and what else? | Antidepressants such as Welbutrin and Zyban |
| Side effects of smoking cessation include... | Adverse effects of nicotine replacement products include increased heart rate, increased blood pressure, increased blood sugar, increased respiration, reduced appetite, and cardiac arrhythmias |
| True or false: The US discourages use of electronic cigarettes | False. US has made no statement |
| True or false: electronic cigarettes still contain nicotine | True |
| When CNS is stimulated, you have these respiratory, cardiac, and GI effects | Increased breathing, tachycardia/arhythmias/HTN, increased motility |
| List some CNS stimulant drugs | Amphetamines, cocaine, caffeine |
| Absorption of CNS stimulant drugs is great through which route? | PO |
| True or false: caffeine and cocaine have little protein binding | True |
| The distribution of amphetamine inside the body is great | True |
| Where are CNS + drugs excreted? | Kidneys, some sweat and stool |
| What are the cardiovascular effects of CNS stimulants? | Heart rate and blood pressure increase; CVA/stroke, MI, hypertensive episode could occur |
| True or false: in children (under 15), amphetamines or other CNS + drugs can cause opposite systemic effects | True. |
| CNS stimulants are contraindicated in pts. with... | HTN, glaucoma, depression |
| Methamphetamines release ____ more dopamine than is released naturally by the body | 6x |
| True or false: according to the video in lecture, people using meth can have increased tolerance to dopamine, and eventually their bodies cannot uptake dopamine at all, resulting in loss of pleasure | True |
| CNS depressants: list the categories | Barbiturates, benzodiazepines, opiates, alcohol, methaqualone |
| What are the drugs associated with each CNS depressant category? | Barbiturates (thiobariturate), benzodiazepines (Valium, Xanax, Versed, Ativan), opiates (heroin, methadone, narcotic analgesics), methaqualone (quaaludes) |
| Methaqualone toxicity may display ____ and ______ | Restlessness, hypertonia |
| What are the effects of CNS depressants? | Depression of respiratory, heart, GI, cognition/judgment |
| Benzodiazepines are used PRN for ______ and ______. Can have _____ effects. | anxiety; pre-procedure sedation; amnesiac |
| How does alcohol fit the criteria of an ideal drug? | Effective, reversible, predictable effects, easy to administer, inexpensive, chemically stable, distinct name |
| In what ways does alcohol NOT fit the criteria of an ideal drug? | Not selective, not safe, lots of drug and food interaction |
| How can you easily reverse the effects of alcohol? | Hydration |
| Alcohol enhances _______ and easily moves through the blood-brain barrier | GABA |
| Alcohol is absorbed mostly in ______, followed by 20% in stomach, and 10-15% _______ | Intestine; buccal/sublingual |
| True or false: alcohol is not protein bound | True |
| True or false: alcohol is metabolized ONLY in the liver | False. While liver is primary place for metabolism, can be metabolized in stomach too |
| Accumulation of alcohol in body can initially affect what part of the brain? | Frontal lobe (cognition and judgment) |
| Serious signs of alcohol toxicity begin at which part of the brain? Then how does it progress? | Parietal (impaired movement), occipital (vision), diencephalon (stupor), medulla (respiratory) |
| True or false: alcohol is initially a stimulant | True. Over time and increased dosage cause it to be a depressant |
| Alcohol metabolism depends on what factors? | Ability to synthesize liver enzymes (women have less), tolerance and dependence on alcohol |
| Psychedelics are schedule _____ drugs, which include LSD and _____ | I; MDMA, mescaline and psilocybin |
| LSD and MDMA are both taken through _____ route. Which drug has more rapid effects? | PO; MDMA |
| LSD activates _____ and causes alteration in ____ | Serotonin; altered thinking/perception/judgment |
| True or false: LSD has predictable effects, such as flashbacks and panic attacks | False. LSD has unpredictable effects. Although flashbacks and panic attacks are adverse effects, not everyone may experience them |
| Ectasy at high doses will cause ___ stimulation, ______, and ______ | CNS (heart); dehydration; hyperthermia |
| What is known about mescaline? | Not much, but provides milder high and is less disorienting than LSD |
| Marijuana is a schedule ___ drug and is in what drug category? | I; cannabinoid |
| How can marijuana be administered? | Smoked, eaten, drunk. Hashish is a concentrated form |
| How does marijuana work? | Activates specific cannbinoid receptors to cause CNS effects |
| List the CNS effects of marijuana (NOT at high doses) | Euphoria and sedation. Caused increased pleasure, impaired judgment, slowed reflexes/cognitive processes and learning. |
| List the CNS effects of marijuana at high doses | Hallucination, dissociative state, anxiety, paranoia |
| Marijuana, like nicotine, can travel through _______ and ______ | Placenta; breastmilk |
| Can marijuana be used as a bronchodilator? | Although can be used for bronchodilation, not advised as can have irritants that bronchoconstrict. |
| Marijuana will cause side effects such as... | Increase in green teeth plaque, decrease in sperm and testosterone levels |
| Chronic use of marijuana can lead to ______ syndrome | Amotivational |
| What are some therapeutic uses of weed? | Anti-nausea/antiemetic in cancer Tx, appetite stimulation (AIDs/cancer), glaucoma (lower intraocular pressure), decrease spasticity in MS and SC injury |
| Is marijuana legal in WA state? | Medicinal marijuana yes. But only pt. or designated provider allowed to grow it. |
| Is it legal to buy or sell marijuana in WA? | No |
| Salvia is a ____ found where? | Herb; southern climates (Mexico, central/south America) |
| Salvia activates what receptors? | Kappa opioid receptors |
| Route of administration of salvia | PO, inhaled, etc. |
| Salvia has a ____ rate of absoprtion and half-life | Fast. Seconds to minutes for absoprtion; 6-75 minutes for half life |
| True or false: In many states, including WA, there are laws against salvia. | False. 24 states have laws against it but WA not one of them |
| Important nursing implications of salvia include... | Safety (driving, swimming), potentiation with additional substances, addiction potential, respiratory concerns for asthma pt. |
| Who might use salvia more often? | People with depression or social issues. May lead to non-Tx or ineffective self-care |
| Bath salts are also known as _____, a drug similar to amphetamine | Mephedrone |
| True or false: there is national denial that women drink a significant amount of alcohol | True |
| Lifetime alcohol use by women in US is shown to be __% | 66 |
| True or false: generally, most women underreport alcohol use and identified when seek care for other medical concerns | True |
| __ times as many women in US die of substance-abuse related diseases than of breast cancer | 4 |
| Rates of alcohol dependence and abuse are higher in... | Lesbians, rural areas, older women |
| Women can achieve ___ blood alcohol levels than men after drinking same amounts of alcohol when compared to ______ | Higher; body weight |
| List three reasons why women may have higher alcohol levels when ingesting same amount as men | First-pass metabolism (women have less ETOH dehydrogenase in GI), lower total body water (less diluted alcohol), estrogen |
| What are some concerns with women drinking alcohol? | General mortality is higher at lower levels of ETOH intake due to risks of cancer, cirrhosis, injury. Cardiovascular effects include higher HDLs and chance of hemorrhagic stroke |
| Women die fmo liver disease related to alcohol at much lower levels of men. ____ drinks/week versus men's ____ drinks/week | 7; 14 |
| Women who have more than two drinks a day have 31-41% increase risk of invasive _______ | Breast cancer |
| Increase of breast cancer risk in alcoholic women may be due to increased _____storage with alcohol consumption | Estrogen |
| True or false: women taking estrogen pills have the same increased risk of breast cancer as alcoholic women | False. Recently found risk of cancer not related to the correlation between estrogen storage triggered by alcohol and cancer |
| Fetal alcohol syndrome can trigger generalized ______ of neurons. | Death |
| How does ETOH affect NS? | Blockade of NMDA (its receptors act as Ca channels, excitatory NT for glutamate in brain); and excessive activation of GABA (increase in Cl- movement, greater inhibition of postysnaptic cell, apoptosis in developing brain) |
| FAS shows what clinical manifestations in brain? | Decreased brain mass and behavioral disturbances |
| FAS has _____ effects; growth ______, CNS impairment (list three), impulsive behavior, por social relationships | Lifelong; deficiency; (IQ, memory, attention) |
| True or false: lifetime costs of someone with FAS can be up to 5 million | True |
| True or false: alcohol causes an increased rate of fertility | False. Causes 30% increase of rate of infertility |
| High alcohol intake may affect ____ disease, dysfunction of ovaries, and ______ | Tubal; endometriosis |
| High alcohol intake along with inferility/miscarriage is thought to be a ____ relationship (they affect each other) | Bi-directional |
| A nurse would recommend a women drink no more than ____ drinks/day | 1-2 |
Created by:
choel
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