Benzos, Opioids, and Herbals
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| Derived from active opium poppy alkaloids. Morphine sulfate serves as the standard against which other narcotics and nonnarcotic analgesics are measured. | Opioid Agonist
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| Relieve moderate to severe pain by inhibiting the release of substance P centrally and peripherally. Also inhibit the production of pain and inflammation in peripheral tissues. | Opioid Agonist
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| What type of drug is codeine? | Opioid Agonist
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| What type of drug is Fentanyl citrate (Sublimaze)? | Opioid Agonist
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| What type of drug is Hydrocodone bitartrate and acetaminophen (Vicodin)? | Opioid Agonist
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| What type of drug is Hydrocodone and phenyltoloxamine (Tussionex)? | Opioid Agonist
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| What type of drug is Hydromorphone hydrocholride (Dilaudid)? | Opioid Agonist
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| What type of drug is Levorphanon tartrate (Levo-Dromoran)? | Opioid Agonist
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| What type of drug is Meperidine hydrochloride (Demerol)? | Opioid Agonist
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| What type of drug is Methadone hydrochloride (Dolophine)? | Opioid Agonist
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| What type of drug is Morphine sulfate (Duramorph)? | Opioid Agonist
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| What type of drug is Morphine sulfate sustained-release (MS Contin)? | Opioid Agonist
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| What type of drug is Morphine sulfate intensified oral solution (Roxanol)? | Opioid Agonist
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| What type of drug is Oxycodone hydrochloride (Roxicodone)? | Opioid Agonist
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| What type of drug is Oxycodeone hydrochloride and acetaminophen (Percocoet) | Opioid Agonist
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| What type of drug is Oxycodone hydrochloride and ASA (Percodan)? | Opioid Agonist
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| What type of drug is Oxymorphone hydrochloride (Numorphan) | Opioid Agonist
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| What type of drug is Propoxyphene hydrochloride (Darvon)? | Opioid Agonist
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| What type of drug is Propoxyphene napsylate (Darvon N.)? | Opioid Agonist
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| What came on the market as a general anesthetic and is 80 to 100 times more potent than morphine? | Fentanyl Citrate (Sublimaze)
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| Absorbed from GI mucosa. Parenteral admin. produces more rapid onset of action. Display low plasma protein-binding capacity, metabolized in liver/excreted in kidneys. 7-10% of dose excreted via biliary tract in feces. Onset within 30 min parenteral admin. | Opioid Agonist
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| Bind to opiate receptor sites centrally and peripherally, activating endogenous pain relief system. Produce analgesia and cough suppression, respiratory depression, constipation. Cause vasodilation in head, face, and neck. | Opioid Agonist
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| What works in the brain for cough suppression? | Hydrocodone and codeine
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| Type of drug used to relieve pain in acute, chronic, and terminal illnesses and to reduce preanesthesia anxiety. | Opioid Agonist
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| Reduces the dyspnea of pulmonary edema and left ventricular heart failure by reducing anxiety, producing peripheral vasodilation, thus reducing cardiac workload. | Morphine
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| Decreased rate and depth of respiration as dosage is increased, N/V, constipation, urine retention (especially in males with prostatic hypertrophy), and patient intolerance are adverse drug reaction to what type of drug? | Opioid Agonist
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| Reportedly have less abuse potential than the pure narcotic products. However, some have been reported to cause dependence. | Mixed Opioid Agonist-Antagonist
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| What type of drug is Buprenophine hydrochloride (Burprenex)? | Mixed Opioid Agonist-Antagonist
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| What type of drug is Butorphanol tartrate (Stadol)? | Mixed Opioid Agonist-Antagonist
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| What type of drug is Dezocine (Dalgan)? | Mixed Opioid Agonist-Antagonist
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| What type of drug is Nalbuphine hydrochloride (Nubain) | Mixed Opioid Agonist-Antagonist
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| What type of drug is Pentazocine hydrochloride and pentazocine lactate (Talwin)? | Mixed Opioid Agonist-Antagonist
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| What type of drug is Pentazocine hydrochloride and naloxone hydrochloride (Talwin NX) | Mixed Opioid Agonist-Antagonist
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| What type of drug is Pentazocine hydrochloride and ASA (Talwin Compound)? | Mixed Opioid Agonist-Antagonist
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| What type of drug is Pentazocine hydrochloride and acetaminophen (Talacen)? | Mixed Opioid Agonist-Antagonist
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| Pharmacokinetics closely resemble those of morphine. Metabolized in the liver and excreted in the kidneys. Onset, peak, and duration vary between these drugs. | Mixed Opioid Agonist-Antagonist
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| Only Mixed Opioid Agonist-Antagonists that may only be administered in oral form is ________. | Pentazocine
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| What type of drug occupies same opiate receptor sites as the narcotic agonists, nut have no antitussive effects. Produce fewer GI effects. Exact mechanism of action has not been established. | Mixed Opioid Agonist-Antagonist
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| Prescribed for the relief of moderate to severe pain, obstetrical analgesia, preop meds. Have lower risk of drug dependence and less likely to cause respiratory depression. | Mixed Opioid Agonist-Antagonist
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| Increased CNS depression and additive resp. depression can result of pt taking other CNS depressant, such as barbituates or alcohol. | Mixed Opioid Agonist-Antagonist
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| N/V, light-headedness, sedation, euphoria, confusion and disorientation in elderly are side effects of this type of drug. Resp. may be depressed with initial dose, but does not worsen with additional doses. | Mixed Opioid Agonist-Antagonist
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| Have an affinity for the opiate receptors but do not stimulate them. Instead, these drugs attach to the receptors and prevent narcotic drugs from producing their effects. | Opioid Antagonist
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| Can be used to treat narcotic overdose or to keep detoxified patients drug-free and prevent further abuse. | Opioid Antagonist
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| What type of drug is Naloxone hydrochloride (Narcan)? | Opioid Antagonist
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| What type of drug is Naltrexone hydrochloride (Trexan)? | Opioid Antagonist
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| What form(s) may Naloxone be administered? | IV or IM
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| What form(s) may Naltrexone be administered? | Tablet or Liquid
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| Competitively inhibit the effects of narcotic agonists by occupying the opiate receptor site and blocking further narcotic binding at the site. | Opioid Antagonist
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| What is the DOC for respiratory depression? Short acting and repetitive doses may be needed. | Naloxzone hydrochloride (Narcan)
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| N/V, tachycardia, and HTN are adverse effects to what type of drugs? | Opioid Antagonist
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| Product derived from cayenne chili peppers and pepper spray. Applied topically for pain relief associated with arthritis, diabetic neuropathy, shingles, and amputation. | Capsaicin (Zostric)
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| Analgesic effects attributed to depletion of Substance P in nerve endings. Available in gels, creams, or lotions. Most effective applied 3-4 times/day. Adverse reactions include stinging and itching. | Capsaicin (Zostric)
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| Supplement derived from animal cartilage or manufactured synthetically. Used to treat arthritis. | Chondroitin sulfate (CS)
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| Thought to delay breakdown of joint cartilage, to stimulate the synthesis of new cartilage and to promote shock absorbing quality of catilage by retaining water. Daily doses based on client's weight. | Chondroitin sulfate (CS)
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| Herbal medicine used in the treatment of migraine. May be effective in reducing the incidence and severity of migraines. Thought to inhibit platelet aggregation, prostagladin synthesis, and release of inflammatory mediators such as histamine. | Feverfew
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| More studies needed. Commercial preparations are not standardized. Take with food. Adverse reactions include hypersensitivity reactions. Risk of increased bleeding in patients taking antiplatelet or anticoagulant medications. | Feverfew
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| Synthetic substance taken for arthritis. Essential structural component of joint connective tissue. Thought to reduce cartilage breakdown and improve cartilage production when taken as a supplement. | Glucosamine
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| Studies regarding effectiveness differ. May cause GI upset, drowsiness, headache, and rash. | Glucosamine
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| __________ meds are not regulated by the FDA. | Herbal
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| _____________ and ___________ may be used alone, but are more effective when taken together. Studies are questionable. Physicians may encourage patients to take these herbs for 3 months, then decide if symptoms are improved. | Glucosamine and Chondroitin
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| What type of drug is Enflurne (Ethrane)? | Inhalation Anesthetic
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| What type of drug is Halothane (Fluothane)? | Inhalation Anesthetic
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| What type of drug is Isoflurane (Forane)? | Inhalation Anesthetic
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| What type of drug is Methoxyflurane (Penthrane)? | Inhalation Anesthetic
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| What type of drug is Nitrous Oxide? | Inhalation Anesthetic
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| Absorbed at varying rates dependent on their solubility in blood. Distributed rapidly to organs with high blood flow. Metabolized by liver and excreted by kidneys. | Inhalation Anesthetic
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| Onset varies greatly on therapeutic and patient factors. Duration of action determined by rate at which it leaves the brain. All cross blood-brain barrier. | Inhalation Anesthetic
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| Generally depress the CNS. Some paradoxically increase the potential for seizure activity. | Inhalation Anesthetic
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| Interfere with nerve impulse transmission, relax skeletal and uterine smooth muscle, reduce arterial BP, and decrease respirations. | Inhalation Anesthetic
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| Used for surgery because they provide more precise and rapid control of depth of anesthesia than injection anesthetics. | Inhalation Anesthetic
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| Enflurane and isoflurane are commonly used with __________. | Nitrous Oxide
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| Enhance depressant effects of CNS, cardiac, and respiratory agents. | Inhalation Anesthetic
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| Most common adverse reaction to this type of drug is exaggerated patient response to a normal dose. Obtaining a detailed medical history from each patient is essential in the prevention of this reaction. | Inhalation Anesthetic
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| Even smaller than normal doses can result in hypotension, prolonged resp. depression, and prolonged recovery for elderly or debilitated patients. | Inhalation Anesthetic
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| Malignant hyperthermia may occur in genetically suseptible patients, and is treated with. | Dantrolene
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| Used to promote rapid induction of anesthesia or to supplement inhalation anesthetics. Used in situations requiring a short duration of anesthesia. | Injection Anesthetic
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| What four drugs are used solely as injectable anesthetics? | Propofol
Ketamine Hydrochloride
Ethmidate
Droperidol
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| What type of drug is Alfentanil (Alfenta)? | Injection Anesthetic
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| What type of drug is Diazepam (Valium)? | Injection Anesthetic and Benzodiazapine
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| What type of drug is Fentanyl citrate (Sublimaze)? | Injection Anesthetic
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| What type of drug is Lorazepam (Ativan)? | Injection Anesthetic and Benzodiazapine
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| What type of drug is Meperidine hydrochloride (Demerol)? | Injection Anesthetic and Opioid Agonist
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| What type of drug is Mehohexital sodium (Brevatil)? | Injection Anesthetic
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| What type of drug is Midazolam hydrochloride (Versed)? | Injection Anesthetic
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| What type of drug is Morphine sulfate? | Injection Anesthetic and Opioid Agonist
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| What type of drug is Sufentanil citrate (Sufenta)? | Injection Anesthetic
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| What type of drug is Thiamylal sodium (Surital)? | Injection Anesthetic
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| What type of drug is Thiopental sodium (Pentothol sodium)? | Injection Anesthetic
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| All have a rapid onset (15 sec to a few min) and are short-acting, except for diazepam which is long- acting. All bypass mechanisms which reduce bioavailablity and distribute rapidly to the CNS. | Injection Anesthetic
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| Mechanisms of action of these drugs differ, because they come from different classes. | Injection Anesthetic
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| Because these drugs have a short duration of action, they are used in short surgical procedures. | Injection Anesthetic
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| Interact with many other drugs and require the nurse to monitor vital signs, airway, and LOC. | Injection Anesthetic
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| Adverse reactions are usually extensions of their therapeutic effects. Muscle rigidity and spasms, N/V, shivering. | Injection Anesthetic
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| What type of drug is Bupivacaine hydrochloride (Marcaine)? | Local Anesthetic
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| What type of drug is Chloroprocaine hydrochloride (Nesacaine)? | Local Anesthetic
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| What type of drug is Etidocaine hydrochloride (Duranest)? | Local Anesthetic
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| What type of drug is Lidocaine hydrochloride (Xylocaine)? | Local Anesthetic
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| Produce few significant interactions. More may occur when vasoconstrictors are used with this type of drug. | Local Anesthetic
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| What type of drug is Mepivacaine hydrochloride (Carbocaine, Isocaine)? | Local Anesthetic
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| What type of drug is Procaine hydrochloride (Novocaine)? | Local Anesthetic
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| What type of drug is Propoxycane hydrochloride (Ravocaine)? | Local Anesthetic
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| What type of drug is Tetracaine hydrochloride (Pontocaine)? | Local Anesthetic
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| Absorption varies widely. Distributed throughout the body. Rate and extent of absorption varies with dose, drug, and administration site. | Local Anesthetic
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| Block the transmission of impulses across the nerve cell membranes. | Local Anesthetic
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| Prevent or relieve pain from a medical procedure. Preferred to general anesthesia for surgery of elderly or debilitated patients. | Local Anesthetic
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| May be combined with a vasoconstrictor, such as epinephrine, to control local bleeding and reduce absorption from the local site. Dosages vary greatly according to the procedure that is to be performed. | Local Anesthetic
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| Adverse reactions to this type of drug usually result from overdose, hypersensitivity, or improper injection technique. Can cause both CNS and cardiovascular reactions. | Local Anesthetic
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| Applied directly to the skin or mucous membranes to prevent or relieve minor pain. | Topical Anesthetic
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| What type of drug is Benzocaine (Anbesol, Ora-Jel)? | Topical Anesthetic
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| What type of drug is Benzyl alcohol? | Topical Anesthetic
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| What type of drug is Butacaine sulfate? | Topical Anesthetic
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| What type of drug is Butaben picrate? | Topical Anesthetic
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| What type of drug is Clove oil? | Topical Anesthetic
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| What type of drug is Cocaine hydrochloride? | Topical Anesthetic
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| What type of drug is Dibucaine hydrochloride? | Topical Anesthetic
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| What type of drug is Dyclonine hydrochloride ? | Topical Anesthetic
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| What type of drug is Ethyl chloride? | Topical Anesthetic
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| What type of drug is Lidocaine? | Topical Anesthetic
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| What type of drug is Menthol? | Topical Anesthetic
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| What type of drug is Pramoxine hydrochloride? | Topical Anesthetic
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| What type of drug is Tetracaine? | Topical Anesthetic
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| These agents generally are not absorbed systemically, except for mucosal application of cocaine. Onset is rapid and produces anesthesia in minutes. | Topical Anesthetic
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| Actions of this type of drug differ according to the medication. Some block transmission of nerve impulses. | Topical Anesthetic
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| Relieve or prevent minor burn pain, itching, and irritation. May be used to anesthetize an area before an injection is given. | Topical Anesthetic
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| What drug can interact with beta-adrenergic blockers and cimetidine, increasing risk of toxicity? | Topical lidocaine
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| Reactions vary according to the class of drugs. May produce CNS and cardiovascular reactions, skin irritation, and frostbite. | Topical Anesthetic
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| When should herbals be discontinued prior to surgery? | 2-3 weeks
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| Type of psychogenic disorder: How person presents self, facial appearance; Produce mood disturbances unrelated to other physical or psychiatric disorders. May appear flat, sad; not much emotional reaction. | Affective Disorders
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| Type of psychogenic disorder: Persistent mood disturbance and presence of other s/s for 2 weeks or more. | Depression
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| Type of psychogenic disorder: Sudden onset after precipitating event. Can require Tx and last for months. Can usually tell you what precipitating factor was. | Reactive depression
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| Type of psychogenic disorder: Person demonstrates periods of euphoria, rapid speech, overactivity, flight of ideas, no need for sleep. | Mania
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| Type of psychogenic disorder: Normal response to stress and can motivate people to problem solve. Disorder is severely anxious and impairs ability to function. | Anxiety
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| What are two type of anxiety disorder? | Phobia and Non-phobia
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| OCD is included in what type of anxiety disorder? | Non-phobia
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| Type of psychogenic disorder: Result in inappropriate or abnormal behavior and/or thinking. S/S include dissociative thought patterns, hallucinations, and delusions. | Psychoses
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| Type of psychogenic disorder: Person displays overt psychotic s/s for 6 months or more. | Schizophrenia
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| Introduced as sedatives in the early 1900s. Classified as long, immediate, short, and ultra-short acting. Short acting may be used for sedation and sleep. Classified as schedule II d/t potential side effects and abuse. Used only for short-term Tx. | Barbiturate
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| Pentobarbital sodium (Nembutal) is an example of what type of drug? | Barbiturate
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| Produce daytime and preanesthetic sedation, skeletal muscle relaxation, relief of anxiety and tension, and anticonvulsant activity. | Benzodiazapine
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| What type of drug is Alprazolam (Xanax)? | Benzodiazapine
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| What type of drug is Chlordiazepoxide hydrochloride (Librium)? | Benzodiazapine
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| What type of drug is clonazepam (Klonopin)? | Benzodiazapine
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| What type of drug is Clorazepate dipotassium (Tranxene)? | Benzodiazapine
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| What type of drug is Estezolam (ProSam)? | Benzodiazapine
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| What type of drug is Oxazepam (Serax)? | Benzodiazapine
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| What type of drug is Flurazepam hydrochloride (Dalamane)? | Benzodiazapine
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| What type of drug is Quazepam (Doral)? | Benzodiazapine
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| What type of drug is Temazepam (Restoril)? | Benzodiazapine
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| What type of drug is Triazolam (Halcion)? | Benzodiazapine
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| Flurazepam hydrochoride, Quazepam, Temazepam, and Triazolam are all particularly utized as what? | Sleeping pills
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| What drug is particularly used for alcohol withdrawal, anxiety, and seizures? | Chloridiazepoxide hydrochloride (Librium)
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| Prototype drug. Longer-acting. Not used much anymore. | Diazepam (Valium)
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| Metabolized in the liver and excreted primarily in the urine. Widely distributed to body tissues, cross the placenta and blood brain barrier (lipid soluble). | Benzodiazapine
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| Duration of action is enhanced by their distribution and potential for redistribution, but they can readily bind to plasma proteins. Most are given orally, however, a few can be administered parenterally. | Benzodiazapine
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| Onset of action is usually rapid (under 30 min), except flurazepam and lorazepam which may take up to 1-2 hours in some cases. Peak concentration varies with each drug. | Benzodiazapine
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| What specific drug peaks in 1-3 hours with a duration of action up to 18 hours. Use in elderly patients exhibits a prolonged half-life. | Flurazepam
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| Believed to act in the cerebral cortex and limbic, thalamic, and hypothalmic levels of the CNS. Bind to receptor sites that enhance the inhibitory effects of GABA to relieve anxiety, tension, and nervousness to produce sleep. | Benzodiazapine
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| Clinical use produces a net increase in total sleep time and produces a deep, refreshing sleep. | Benzodiazapine
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| Major inhibitory transmitter in the brain and spinal cord | GABA
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| In low doses, flurazepam decreases stages _____ and _____ NREM sleep, but doesn't diminish REM sleep. | 3 and 4
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| What specific benzodiazapine can be deadly in those with Chronic Lung Disease? What can it cause? | Flurazepam hydrochloride (Dalmene)
Respiratory Acidosis
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| Clinically indicated for relaxing the patient during the day or before surgery, or for treatment of insomnia, anxiety, panic attacks, prevention of agitation and delirium tremens in acute alcohol withdrawal. | Benzodiazapine
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| Except for CNS depressants, there are few drug interactions. No food/drug interactions are identified. | Benzodiazapine
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| Abuse of these drugs can lead to overdose, but with less frequency of the barbiturates. | Benzodiazapine
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| Are generally preferred to the barbiturates, because they have fewer side effects and lower potential for abuse. | Benzodiazapine
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| Often given concurrently with antidepressants, antipsychotics, and mood stabilizers to treat anxiety symptoms associated with depression, acute psychosis, and mania. Schedule IV drugs are not indicated for long-term use. | Benzodiazapine
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| Adverse reactions include daytime sedation and hangover effect with clinically effective doses. RR depression may occur in elderly, debilitated, or clients with liver dysfunction. | Benzodiazapine
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| Physical dependence is associated with longer use and higher doses, and withdrawal symptoms may occur when the drug is stopped. | Benzodiazapine
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| Toxicity of this type of drug produces excessive sedation, RR depression, and coma. | Benzodiazapine
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| What type of drug is Buspirone (Buspar)? | Antianxiety (Non-Benzo)
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| What type of drug is Clomipramine (Anafranil)? | Antianxiety (Non-Benzo)
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| What type of drug is Hydroxyzine (Vistaril)? | Antianxiety (Non-Benzo)
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| What type of drug is Sertraline (Zoloft)? | Antianxiety (Non-Benzo)
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| What type of drug is Venlafaxine (Effexor XR) | Antianxiety (Non-Benzo)
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| Specific drug not good for acute anxiety disorders. May take up to 2-4 weeks to be effective. Pt responds better if no previous benzodiazapine use. | Buspirone (Buspar)
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| What specific drug contains antihistamine and is used a lot for post-op nausea? | Hydroxyzine (Vistaril)
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| What specif drug is a SSRI and approved for OCD and panic disorder? | Sertraline (Zoloft)
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| What specific drug is a SNRI and approved for generalized anxiety and PTSD? | Venlafaxine (Effexor XR)
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| What type of drug is Chloral hydrate (Noctec)? | Sedative-Hypnotic
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| What type of drug is Diphenhydramine (Benedryl)? | Sedative-Hypnotic
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| What type of drug is Eszopidone (Lunesta)? | Sedative-Hypnotic
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| What type of drug is Zolpidem (Ambien)? | Sedative-Hypnotic
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| To what specific Sedative-Hypnotic drug does a person develop tolerance in about 2 weeks? | Chloral hydrate (Noctec)
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| What specific Sedative-Hypnotic is an antihistamine? | Diphenhydramine (Benadryl)
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| What specific Sedative-Hypnotic is approved for long-term use? | Eszopidone (Lunesta)
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| These drugs are rapidly absorbed from the GI tract, metabolized in the liver, and excreted in the urine. Onset of action is rapid, peak in 1-2 hours, and duration 4-8 hours. | Non-Benzodiazapine Antianxiety and Sedative-Hypnotic
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| What specific drug causes less CNS sedation and may cause nervousness and excitement? | Buspirone (Buspar)
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| Mechanism of action is dependent on the actual drug class and produce sedation similar to benzodiazapines. Can produce CNS depression and depress of respiratory center leading to respiratory failure. | Non-Benzodiazapine Antianxiety and Sedative-Hypnotic
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| Agent that produces soothing, tranquil effect | Sedative
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| Agent that induces sleep | Hypnotic
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| Drug that is reversal or treatment for benzodiazapine overdose. Given IV. Onset of 2 min. Peak 6-10 min. Half-life of 60-90 min. May need repeated doses. | Flumezenil
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| Used for short-term tx of insomnia and for sedation prior to surgery, and for tx of anxiety. Offer no special benefits, and are similar to the barbiturates. | Non-Benzodiazapine Antianxiety and Sedative-Hypnotic
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| Cause additive effect when used with other CNS depressants. No food/drug interactions. DO NOT MIX CNS DEPRESSANTS!!! | Non-Benzodiazapine Antianxiety and Sedative-Hypnotic
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| Common adverse GI symptoms, including N/V & gastric irritation. Hangover effect does occur, but less common than benzos and barbiturates. High doses can result in CNS & RR depression, tolerance, dependence, and dangerous symptoms r/t abrupt withdrawal. | Non-Benzodiazapine Antianxiety and Sedative-Hypnotic
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| The sounds "EEN" and/or "OWN" can often be associated with what type of drugs? | Opioid Agonist and Mixed Opioid Agonist-Antagonist
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| The sound "CANE" can often be associated with what type of drugs? | Local and/or Topical Anesthetic
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| The sound "PAM" can often be associated with what type of drugs? | Benzodiazapine
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| The sound "FLUR" can often be associated with what types of drugs? | Inhalation Anesthetic
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| We will pass this test! | Keep Studying!
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| Keep your eyes... | ...On the prize!
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