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Neuro, Skeletal Muscle, Parkinson, Seizures

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Question
Answer
Provide intermediate to prolonged muscle relaxation or paralysis, such as required for intubation and ventilation during surgeries.   Neuromuscular Blocking Agent  
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What type of drug is Atracurium besylate?   Neuromuscular Blocking Agents  
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What type of drug is Pancuronium bromide?   Neuromuscular Blocking Agents  
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What type of drug is Succinylcholine chloride?   Neuromuscular Blocking Agents  
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What type of drug is Tubocurarine chloride?   Neuromuscular Blocking Agents  
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Vecuronium bromide?   Neuromuscular Blocking Agents  
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Absorbed poorly from GI tract and given IV. Act on motor end plate. Large portion excreted unchanged in urine.   Neuromuscular Blocking Agents  
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Compete with ACH at cholinergic receptor sites of skeletal muscle. Blocks transmitter action of ACH, preventing skeletal muscle from depolarizing.   Neuromuscular Blocking Agents  
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Muscle weakness progresses quickly to flaccid paralysis. Does not cross blood-brain barrier, so patients know what is happening to them, but can't communicate feelings.   Neuromuscular Blocking Agents  
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Used during surgery to decrease amount of anesthesia necessary. Used to paralyze patients who require ventilation and fight the EET.   Neuromuscular Blocking Agents  
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Adverse reactions to this type of drug includes apnea, histamine release, bronchospasm, arrhythmias, and hypotension.   Neuromuscular Blocking Agents  
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Many have additive effect. Acetylcholinesterases are used as antidotes to these drugs. Most effects can be reversed with neostigmine.   Neuromuscular Blocking Agents  
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Specific drug similar to Curare. Causes full paralysis.   Pancuronium bromide  
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Specific drug responsible for malignant hyperthermia   Succinylcholine chloride  
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Used to relieve acute muscle spasms associated with trauma, inflammation, anxiety, and pain.   Centrally Acting Skeletal Muscle Relaxant  
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Used to treat spasticity in MS and spinal cord injuries. Given PO and SubQ pump   Baclofen  
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Baclofen is what type of drug?   Centrally Acting Skeletal Muscle Relaxant  
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Used for Tx of acute painful musculoskeletal disorders. Not for ling-term Tx as it can cause dependence.   Carisoprodol  
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Carisoprodol is what type of drug?   Centrally Acting Skeletal Muscle Relaxant  
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Used to treat spasticity of back and bladder   Diazepam  
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What type of drug is Diazepam?   Centrally Acting Skeletal Muscle Relaxant. It is also a Benzodiazapine.  
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What type of drug is Cyclobenzaprine?   Centrally Acting Skeletal Muscle Relaxant  
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What type of drug is Metaxalone?   Centrally Acting Skeletal Muscle Relaxant  
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What type of drug is Methocarbamol?   Centrally Acting Skeletal Muscle Relaxant  
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What type of drug is Orphendadrine citrate?   Centrally Acting Skeletal Muscle Relaxant  
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What type of drug is Tizanidine?   Centrally Acting Skeletal Muscle Relaxant  
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Not well understood. Absorbed from GI, widely distributed throughout body, metabolized in liver, excreted in kidneys.   Centrally Acting Skeletal Muscle Relaxant  
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Exact action unknown. Usually attributed to depression of CNS but may involve blockage of nerve impulses that cause increased muscle tone and contraction.   Centrally Acting Skeletal Muscle Relaxant  
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Known as CNS depressants. Muscle relaxation may be related to their sedative effects.   Centrally Acting Skeletal Muscle Relaxant  
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Used as adjuncts to rest and physical therapy in treating acute musculoskeletal conditions.   Centrally Acting Skeletal Muscle Relaxant  
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Ineffective in treating muscle hyperactivity secondary to chronic neurological disorders such as cerebral palsy.   Centrally Acting Skeletal Muscle Relaxant  
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Interact with all other CNS depressants (alcohol, antianxiety agents, antidepressants, antihistamines) causing an additive effect.   Centrally Acting Skeletal Muscle Relaxant  
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Adverse reactions include drowsiness, dizziness, N/V, respiratory depression, hypotension, and flaccid paralysis.   Centrally Acting Skeletal Muscle Relaxant  
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Similar to centrally acting skeletal muscles, but has different mechanism of action. Dantrolene sodium is the only drug in this class.   Peripherally Acting Skeletal Muscle Relaxant  
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Dantrolene sodium is what type of drug?   Peripherally Acting Skeletal Muscle Relaxant  
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Poorly absorbed from GI tract. Metabolized significantly in the liver to compounds less active than parent drug. Half-life of 9 hours.   Peripherally Acting Skeletal Muscle Relaxant  
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Peripherally Acting Skeletal Muscle Relaxants have a half-life of how long?   9 hours  
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Acts directly on muscle contractile mechanism as opposed to affecting reflex pathways in CNS.   Peripherally Acting Skeletal Muscle Relaxant  
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Helps to manage all types of muscle spasticity, but most effective when lesion is cerebral.   Peripherally Acting Skeletal Muscle Relaxant  
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May be useful in patients with MS, cerebral palsy, spinal cord injury or CVA.   Peripherally Acting Skeletal Muscle Relaxant  
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Type of drug used to treat and prevent malignant hyperthermia.   Peripherally Acting Skeletal Muscle Relaxant  
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Combined with CNS depressants, can lead to sedation, motor skill impairment, respiratory depression.   Peripherally Acting Skeletal Muscle Relaxant  
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Adverse drug reactions include muscle weakness, depress liver function, cause idiosyncratic hepatitis, and hepatotoxicity.   Peripherally Acting Skeletal Muscle Relaxant  
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Antagonize functions controlled primarily by the PNS. Only anticholinergic drugs which are centrally acting and cross blood brain barrier are effective in treating Parkinson's.   Anticholinergic Agent  
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May be classified as synthetic tertiary amines, phenothiazine derivatives, or antihistamines.   Anticholinergic Agent  
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What type of drug is Benztropine mesylate?   Anticholinergic Agent  
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What type of drug is Biperiden Hcl?   Anticholinergic Agent  
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What type of drug is Procyclidine Hcl?   Anticholinergic Agent  
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What type of drug is Trihexyphenidyl Hcl?   Anticholinergic Agent  
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What type of drug is Ethrpropazine?   Anticholinergic Agent  
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What type of drug is Diphenhydramine Hcl?   Anticholinergic Agent  
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What type of drug is Orphenadrine citrate?   Anticholinergic Agent  
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Well absorbed from GI tract and cross blood brain barrier to site of action in CNS. Metabolized in liver and excreted in urine as metabolites and unchanged drug. Onset of action occurs in 1 hour with peak in 2 hours.   Anticholinergic Agent  
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Counteract cholinergic activity in the brain that is thought to be present in Parkinson's.   Anticholinergic Agent  
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These drugs may inhibit cerebral motor centers and suppress cholinergic activity and the characteristic tremors of Parkinson's.   Anticholinergic Agent  
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Most commonly used in early stages of Parkinson's when symptoms are mild. May be given with Levodopa during later stages to relieve symptoms.   Anticholinergic Agent  
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Abrupt withdrawal can cause confusion, exhaustion, and exacerbation of symptoms.   Anticholinergic Agent  
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Adverse drug reactions include confusion, restlessness, blurred vision, tachycardia, N/V, urinary retention, decreased sweating.   Anticholinergic Agent  
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Drug class contains chemically unrelated drugs.   Dopaminergic Agent  
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What type of drug is Carbidopa-levodopa   Dopaminergic Agent  
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What type of drug is Amantadine Hcl?   Dopaminergic Agent  
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What type of drug is Bromocriptine mesylate?   Dopaminergic Agent  
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What type of drug is Pergolide mesylate?   Dopaminergic Agent  
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What type of drug is Selegiline?   Dopaminergic Agent  
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What type of drug is Pramipexole?   Dopaminergic Agent  
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What type of drug is Ropinirole?   Dopaminergic Agent  
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What type of drug is Tolcapone?   Dopaminergic Agent  
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Certain dopaminergic agent that is unobtainable by itself in the US   Carbidopa-levodopa  
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MADB inhibitor. Limits breakdown of dopamine. Avoid foods high in tyramine. Many drug/drug and drug/food interactions.   Selegiline  
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Dopamine receptor agonist. Also used for RLS.   Pramipexole and Ropinirole  
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These two drugs are newer drugs that directly stimulate dopamine receptors in the brain. Approved for both beginning and advanced stages. May be combined with levodopa and other drugs in advanced stages.   Pramipexole and Ropinirole  
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First drug in new class to be known as COMT inhibitor. Acts to increase level of dopamine in the brain. Blocks enzyme COMT that normally inactivates dopamine and levodopa. Used only in combination with levodopa/carbidopa.   Tolcapone  
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Absorbed from GI tract and delivered to their site of action in the brain.   Dopaminergic Agent  
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Absorbed quickly when ingested with food and is digested by active transport.   Levodopa  
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Has no antiparkinson activity, but when combined with levodopa, blocks peripheral conversion of levodopa to dopamine and allows levodopa to cross blood brain barrier. Levodopa then converted to dopamine in then brain.   Carbidopa  
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Used to Tx people with severe parkinsonism, or those who do not respond to anticholinergic agents alone.   Dopaminergic Agent  
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Act in the brain by increasing the dopamine concentration or by enhancing neurotransmission of dopamine.   Dopaminergic Agent  
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Combined with some MAO inhibitors, hypertensive crisis may occur. May cause death if combined with meperidine by some unknown mechanism.   Dopaminergic Agent  
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Adverse reactions include GI reactions, such as N/V, anorexia. May experience hyperpyrexia with withdrawal.   Dopaminergic Agent  
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Loses effect after 3-5 years   Dopaminergic Agent  
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Although exact mechanism of action is unknown, the drugs are thought to suppress seizures by decreasing movement if ions into nerve cells (Na, Ca), altering activity of neurotransmitters (increase GABA, decrease Glutamate), or combination of both.   Anti-epileptic Drug  
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What type of drug is Phenytoin?   Hyantoin  
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Oldest and most widely used AED. Often initial DOC in adults. May also be used to Tx cardiac arrhythmias.   Phenytoin  
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What type of drug is Fosphenytoin?   Hyantoin  
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Prodrug formulation that is rapidly hydrolyzed to phenytoin after IV or IM injection. Can be used in status epilepticus.   Fosphenytoin  
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Absorbed slowly, rapidly distributed. Metabolized by liver enzymes and excreted as metabolites in urine.   Hyantoin  
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Act to stabilize nerve cells against hyperexcitability.   Hyantoin  
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Specific drug that alters ion movement across cell membranes in the motor cortex.   Phenytoin  
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Used in Tx of tonic-clonic seizures, prevention and treatment of seizures occurring during or after neurosurgery   Hyantoin  
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This class interacts with many drugs, including cimetidine, theophylline, quinidine, oral anticoagulants.   Hyantoin  
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Adverse reactions include drowsiness, irritability, HA, N/V, depressed atrial and ventricular conduction.   Hyantoin  
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Toxic doses may cause paradoxical seizures and ventricular fibrillation, gingival hyperplasia.   Hyantoin  
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Drugs in this class may be used for their anticonvulsant activity. Use has declined with advent of other AEDs which cause less sedation.   Barbiturates  
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Specific drug used for long-term treatment of epilepsy, and acute management of status epilepticus and febrile seizures. May be used alone or with another AED.   Phenobarbital  
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What type of drug is Phenobarbital?   Barbiturate AED  
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Adverse drug reactions include dose-related CNS effects: drowsiness, lethargy, dizziness. Also, N/V, laryngospasm, respiratory depression, and hypotension secondary to decreased cardiac output.   Barbiturate AED  
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Seizures occur in chronic, recurrent pattern. Cause is mostly unknown. May result from developmental defect, birth injury, head trauma, cancer which includes the brain, CVA   Epilepsy  
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Seizures that begin in specific area of the brain. EEG used to Dx.   Partial/Focal Seizures  
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Movements are bilateral and symmetrical. No discernable point of origin in the brain   Generalized Seizures  
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Grand Mal seizure is what type of seizure?   Tonic/clonic  
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Minute periods of altered consciousness. Generally last a few seconds.   Absence seizures  
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Medical emergency. Person has tonic-clonic seizures and doesn't regain consciousness. Includes hypotension, hypoxia, and cardiac arrhythmias. High risk of brain injury and death.   Status Epilepticus  
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#1 cause of status epilepticus   Person d/c meds  
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Type of drug that has chemical structure similar to tricyclic antidepressants.   Iminostilbene  
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What type of drug is Carbamazepine?   Iminostilbene  
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Effective for partial, generalized, and mixed seizure types. Also produce sedative, anticholinergic, antidepressant effects. Also used in Tx of bipolar disorder.   Carbamazepine  
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What type of drug is Oxcarbazepine?   Iminostilbene  
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Specific drug approved for monotherapy and use with other AEDs for treatment of partial seizures.   Oxcarbazepine  
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Decreases the steady state of other drugs   Iminostilbene  
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Usually tolerable if drug Tx begins slowly and increased to therapeutic level. Can produce effects similar to the tricyclic antidepressants, including HF, hypotension, syncope, arrhythmias, and MI   Iminostilbene  
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Specific drug indicated for status epilepticus only. High serum concentrations are needed to control seizures and has addictive potential. Provides short-term effects of less than an hour. May need repeated doses.   Diazepam  
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Specific drug used to terminate acute convulsive seizures. DOC for status epilepticus because its effects last longer than valium.   Lorazepam  
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Specific drug may be recommended for long-term use. Used to treat absence, atypical absence, atonic, and myoclonic seizures. Used alone or with other AEDs.   Clonazepam  
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Specific drug used as adjunct therapy of partial seizures only. Long-term use. May be used alone or with other AEDs.   Clorazepam dipotassium  
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Additive effect with other CNS depressants. Adverse reaction usually neurologic, and are dose-related including: drowsiness, confusion, weakness, and HA   Benzodiazepine AED  
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Used to treat absence (petit mal) seizures.   Succinimide  
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What type of drug is Ethosuximide?   Succinimide  
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DOC for treatment of absence seizures. May be used with other AEDs for treatment of mixed types of seizures.   Ethosuximide  
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Inhibit metabolism of hydantoin convulsants   Succinimide  
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Adverse drug reactions include N/V, weight loss, cramping, lethargy, drowsiness, irritability, confusion, and rarely psychosis and suicidal ideation   Succinimide  
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Pt should alert dentist if taking _________   Phenytoin  
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Should see therapeutic effects of Phenytoin in ____ to ____ days   7 to 10  
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Structurally unrelated to other anticonvulsants. Must be used cautiously with other AEDs because of possible fatal hepatotoxicity.   Valproic Acid  
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Thought to increase the effects of GABA in the brain. Prescribed for absence, myoclonic, and tonic-clonic seizures. Also used to treat manic reactions in bipolar disorder. Produce less sedation and cognitive impairment than phenytoin and phenobrabital   Valproic Acid  
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What type of drug is Valproate sodium?   Valproic Acid  
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Inhibition of platelet aggregation, which can cause prolonged bleeding times in patients receiving anticoagulants. Inhibits hepatic metabolism of phenobarbitol   Valproic Acid  
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Adverse reactions include N/V. diarrhea, constipation, sedation, drowsiness, HA, muscle weakness.   Valproic Acid  
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Fatal hepatotoxicity may develop anywhere from 3 days to 6 months after initiation of therapy. Children and patients taking other AEDs are at greater risk.   Valproic Acid  
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Prescribed more because they have less interactions with other drugs   Newer AEDs  
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used with other AEDs for treatment of adults with partial seizures. Thought to reduce the release of glutamate.   Lamotigine  
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Used for treatment of partial seizures in combination with other AEDs. Chemically unrelated to other AEDs and mechanism of action is unknown.   Levetiracetam  
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Believed to increase GABA concentrations in the brain. Used with other AEDs for clients with partial seizures.   Tiafabine  
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Broad spectrum of antiseizure activity. May act by increasing effects of GABA. Risk of kidney stones.   Topiramate  
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Used with other AEDs for treatment of partial seizures that do not respond to a single drug. Also used in treatment of chronic pain syndromes.   Gabapentin  
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Chemically a sulfonamide, so contraindicated in clients allergic to sulfa drugs. Thought to act by inhibiting the entry of Na and Ca ions into nerve cells.   Zonisamide  
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