NUR 2474 Pharmacology Exam 1 Actual Questions & Answers 2023/2024

dopaminergic agent - Answer levodopa/carbidopa anticholinergic agent - Answer benzotrophine cholinesterase inhibitor - Answer donepezil Immunomodulators - Answer interferon beta traditional anti epileptic drugs - Answer phenytoin, carbamazepine, valproic acid atypical anti epileptic drugs - Answer oxcarbazepine lamotrigdine barbiturates - Answer Phenobarbital muscle spams drugs - Answer baclofen dantrolene 1st generation antipsychotics - Answer low potency: chlorpromazine high potency: haloperidol 2nd generation antipsychotic - Answer clozapine risperdone olanzapine SSRIs - Answer fluoxetine sertraline paroxetine SNRI - Answer venlafaxine duloxetine TCA - Answer amitriptyline MAOI - Answer phenelzine atypical antidepressant - Answer Bupropion, trazodone OTC herbal for depression - Answer ST. Johns Wort mood stabilizer - Answer lithium benzodiazepines - Answer lorazepam, diazepam alprazolam benzodiazepine like drugs - Answer zolpidem insomnia drugs used - Answer trazodone doxepin OTC drug for insomnia - Answer melatonin Atypical Anxiolytic - Answer Buspirone amphetamines - Answer amphetamine, lisdexamfetamine methamphetamine methylxanthines - Answer methylphenidate when should we complete blood testing with use of lithium? - Answer early in therapy- every 2-3 days, until a therapeutic dose has been established, then long term-every 3 to 6 months therapeutic level of lithium - Answer 0.8-1.4 mEq/L toxic level of lithium - Answer greater than 1.5 mEq/L when can we start to see side effects of lithium? - Answer when the drug is at a therapeutic level. they are expected. what are the side effects of lithium (therapeutic level)? - Answer GI effects, tremors, polyuria, renal toxicity, goiter, hypothyroidism, teratogenesis. what will happen to side effects when one has a toxic level of lithium? - Answer the effects will be much worse and possibly life threatening i.e. tremor that becomes larger with muscle incoordination what medications can we use to treat the cyclic effects of bipolar (mood-depression- psychosis)? - Answer mood stabilizer (lithium)= control mood antidepressant (SSRI,TCA,MAOI)= control depression antipsychotic (Ist/2nd generation)= control the psychosis how does a benzodiazepine help with ETOH withdrawal? - Answer it will decrease the withdrawal manifestations and intensity, while making one sleepy and having CNS depression. plus, it is easy to give IM and will work quickly. what is a popular benzodiazepine that is used to treat anxiety? - Answer alprazolam (think A-anxiety) how does alprazolam work to reduce anxiety? - Answer it inhibits GABA in the CNS, depressing the CNS. what are the side effects of alprazolam use? - Answer a. CNS depression, anterograde amnesia (patient cannot remember much), sleep driving (not safe), paradoxical effects (still anxious, stays up, rowdy), respiratory depression. what drugs does alprazolam interact with? - Answer CNS depressant medications (additive effects), ETOH what are various treatments and drugs used to treat anxiety patients? - Answer benzo's (pam/lam), atypical anxiolytic buspirone, SSRIs paroxetine/fluoxetine, TCAs, MAOIs, trazodone. explain what a sedative hypnotic does - Answer cause the patient to have sedation, sleepiness, CNS depression, anterograde amnesia (patient cannot remember much), sleep driving (not safe),respiratory depression what things should we teach the patient using a drug to treat anxiety? - Answer drug should be tapered only by the HCP, not patient no ETOH use what withdrawal effects may look like what does anxiety medication PO withdraw look like? - Answer drowsiness, lethargy, confusion what does anxiety medication IV withdraw look like? - Answer hypotension, respiratory arrest, cardiac arrest. explain what methylphenidate does - Answer increases attention and focus in children (NOTHING DEALING W/ BEHAVIORS) other effects of methylphenidate use in children - Answer decreased appetite insomnia if given late in the day what things should we always do when giving methylphenidate to a child with ADHD? - Answer ALWAYS: give the drug in the morning, after breakfast, and give the last dose before 4pm, or else the child will not sleep at night which 3 drugs are controlled substances and highly abused? - Answer amphetamines, barbiturates, methylphenidate what is the purpose of drug treatment with Alzheimer Disease patients? - Answer there is treatment to help slow down the progression of the disease, but to not cure it how does donepezil works? - Answer it slow the progression of Alzheimers disease by causing reversible inhibition of cholinesterase and the cholinergic receptors. what should we do when discontinuing an antidepressant (or any medication)? - Answer if antidepressant is stopped cold turkey, withdrawal syndrome can occur. we must gradually taper the drug slowly and have the HCP taper it. do not let patient taper drug by themselves. what are signs and symptoms of withdrawal syndrome? - Answer HA, Nausea, visual disturbances, sweating, dizziness, tremors what is the relationship between sertraline and nursing infants? - Answer when this drug is used with a patient who is pregnant or nursing infants, the infant can have neonatal abstinence syndrome occur what should we educate pregnant or nursing moms about when using sertraline? - Answer We must educate the patient on potentially using other medications during this time period, as it can cause potential birth defects and the baby to become sick. explain the relationship between fluoxetine and alcohol abuse - Answer when this drug is used with alcohol abuse, it can interact with the medication and make the patient very sick.. what should we teach the patient regarding alcohol use - Answer the patient must avoid alcohol while taking most medications what is the first line medication used to stop a seizure? - Answer diazepam (benzo) by IM explain side effect - Answer unavoidable secondary drug effects produced at therapeutic doses. May be unwanted, but unavoidable and expected. explain adverse effect - Answer undesired and unexpected severe responses to a medication. They do have the potential to cause harm. explain allergies/anaphylaxis - Answer an immune response to a medication that causes a reaction that can be mild to life threatening. what are s/s of allergic reactions? - Answer i. itchy, rash, hives, wheezes, SOB, swelling of face, lips and throat. what should we do if we a patient actively in allergic reaction? - Answer stop the medication, call the doctor, D/C lines, check for antidotes, and give emergency care based on ABC's. what should we do before giving any medication? - Answer ask about patient allergies to medications and what happens when they take them. remember if they report they get any s/s of allergic run with medication use, we must hold med and call dr. explain intended drug effects - Answer effects that we want to see and that are therapeutic when using the drug. Ex: with an antidepressant, we want to see a mood change, because that is the intended use of the drug. explain teratogenic effect - Answer a drug induced birth defect that can cause harm to the fetus. Why we do not allow pregnant moms or those lactating to not take certain medications so they do not harm their child. explain paradoxical effect - Answer The opposite of the intended drug response. example of paradoxical response - Answer Benzo's may be used for sedation and insomnia treatment, but may instead cause them to stay up, have excitement, and to be rowdy. The opposite. explain tolerance - Answer occurs when there is a long term reduced responsiveness to a medication over time, causing the medication to not produce a therapeutic effect. Will need to increase the dose to get the same effect. Will be higher dose but the effects will be seen. will take longer to wean also explain dependence - Answer the patient gets used to the drug and cannot stop using it. When they do stop the med cold turkey they can have withdrawal symptoms. Why we have to wean and taper the drug. explain addiction - Answer occurs when the patient abuses the drug and uses it for pleasure instead as prescribed. why may we give a atypical antipsychotic medication (2nd generation)? - Answer when one cannot handle the EPS that the 1stgeneration drugs produce. which patient populations should we not use a atypical antipsychotic with? - Answer those with diabetes, those with high cholesterol what can the atypical antipsychotics cause? - Answer drug onset diabetes, drug onset high cholesterol, weight gain why should not we use an atypical antipsychotic with a patient with dementia? - Answer It will not work to control the disease and will exaggerate the psychosis. They will need a cholinesterase inhibitor