introduction to clinical pharmacology 10th edition by visovsky
pharm ch 10-14
Study
What is a cell receptor?
A protein molecule that substances can bind to.
Which neurotransmitter has an inhibitory action within the CNS?
Gamma-aminobutyric acid (GABA)
What are some examples of excitatory neurotransmitters?
Acetylcholine, epinephrine, norepinephrine
What are some examples of inhibitory neurotransmitters?
Dopamine, certain types of serotonin, GABA
How do dopamine agonists work in Parkinson's disease?
They increase dopamine levels to reduce muscle rigidity and tremors
What is the mechanism of action of tolcapone (Tasmar) in Parkinson's disease?
It suppresses the enzyme that breaks down naturally occurring dopamine
What is the role of acetylcholine in gait and balance?
It is involved in the balance between acetylcholine and dopamine
What is the main symptom of Parkinson's disease?
Muscle rigidity and tremors
What is the function of dopamine in the brain?
It is involved in movement and coordination
What is the role of beta amyloid plaques in Parkinson's disease?
There is no direct role of beta amyloid plaques in Parkinson's disease
What is the primary action of GABA in the CNS?
It has an inhibitory action
What is the primary action of acetylcholine in the CNS?
It can be both excitatory and inhibitory
What is the primary action of dopamine in the CNS?
It can be both excitatory and inhibitory
What is the primary action of epinephrine in the CNS?
It is an excitatory neurotransmitter
What is the primary action of norepinephrine in the CNS?
It is an excitatory neurotransmitter
What is the primary action of serotonin in the CNS?
It can be both excitatory and inhibitory
What is the primary action of tolcapone (Tasmar) in the CNS?
It suppresses the breakdown of dopamine
What is the primary action of dopamine agonists in the CNS?
They increase dopamine levels
What is the primary action of dopamine antagonists in the CNS?
They decrease dopamine levels
What is the primary action of acetylcholinesterase inhibitors in the CNS?
They increase acetylcholine levels
What is the most common adverse reaction to carbidopa/levodopa?
Dyskinesia, involuntary muscle movements.
,How long does dyskinesia typically occur in patients on carbidopa/levodopa
therapy?
Longer than 3 years.
What is the most important precaution to teach a patient and family about timing
for taking an oral dopamine agonist?
Take the drug 30 to 60 minutes before meals on an empty stomach.
What adverse effect can occur when a patient takes both a dopamine agonist and
an antihypertensive?
Severe hypotension.
What signs/symptoms would you expect a patient with Parkinson's disease to
present with if they are not adhering to a tyramine-restricted diet while taking a
monoamine oxidase type B inhibitor?
Hypertension.
Which drug should a patient with Alzheimer's disease who is taking donepezil
(Aricept) stop taking?
Dextromethorphan.
What adverse effect can occur when dextromethorphan is taken with donepezil?
Torsade de pointe, a form of ventricular dysrhythmia.
What is the purpose of a tyramine-restricted diet for a patient taking a monoamine
oxidase type B inhibitor?
To avoid a severe hypertensive crisis.
What is the purpose of a dopamine agonist?
To increase dopamine levels.
What is the purpose of an antihypertensive drug?
To lower blood pressure.
What is the purpose of donepezil (Aricept) for a patient with Alzheimer's disease?
To improve cognitive function.
What is the purpose of aspirin?
To reduce pain, inflammation, and fever.
What is the purpose of buspirone?
To treat anxiety disorders.
What is the purpose of vitamin C?
To support immune function and promote collagen synthesis.
What is the purpose of dextromethorphan?
To suppress cough.
What is the purpose of a monoamine oxidase type B inhibitor?
To increase dopamine levels and improve symptoms of Parkinson's disease.
What is the purpose of a tyramine-rich food?
To potentially precipitate a severe hypertensive crisis.
What is the purpose of a dopamine antagonist?
To block dopamine receptors and decrease dopamine levels.
What is the purpose of a hypertensive crisis?
To cause a sudden and severe increase in blood pressure.
What is the purpose of a severe bradycardia?
To cause an abnormally slow heart rate.
What is the purpose of bone marrow failure?
, To cause a decrease in the production of blood cells.
What is the purpose of edema of the lower extremities?
To cause swelling in the legs and feet.
What is the purpose of a long Q-T syndrome?
To cause an abnormal heart rhythm that can be life-threatening.
What is tachycardia?
Abnormally fast heart rate.
What can cause tachycardia?
Interaction with certain factors.
What is the best action when admitting a new patient with Alzheimer's who is
prescribed both memantine and rivastigmine?
Give both drugs as prescribed.
Why is it safe to give both memantine and rivastigmine to a patient with
Alzheimer's?
They have different actions and can be used together.
Where should the family member apply the rivastigmine patches to avoid the
patient removing them?
On the upper or lower back.
What is the recommended area to apply the rivastigmine patches?
Upper or lower back.
How should the patient receive a 14-mg dose of memantine extended release (XR)
when only 7-mg and 28-mg capsules are available?
Give the patient one 28-mg capsule every other day.
What is the suggested action for opening extended release capsules?
Not recommended, but can be done for some drugs like memantine.
What can be done if it is not possible to divide the contents of a capsule
accurately?
Give two capsules to equal the prescribed dose.
Can a 28-mg capsule be cut in half?
Yes, it can be cut in half.
What should be done after cutting a 28-mg capsule in half?
Give one of the halves to the patient.
Can a 28-mg capsule be opened?
Yes, it can be opened.
What should be done after opening a 28-mg capsule?
Empty the contents into a drug cup, divide it in half, and give one half to the patient.
What is the most important nursing action to perform when assessing a patient
before starting the first dose of a newly prescribed antiepileptic drug?
Ask the patient about all other prescribed or over-the-counter drugs he or she takes
daily.
Why is intravenous (IV) administration preferred over intramuscular (IM) injection
for phenytoin?
Giving phenytoin IM is very irritating to tissue.
What is the best route for administering phenytoin?
The best routes are oral and intravenous.
pharm ch 10-14
Study
What is a cell receptor?
A protein molecule that substances can bind to.
Which neurotransmitter has an inhibitory action within the CNS?
Gamma-aminobutyric acid (GABA)
What are some examples of excitatory neurotransmitters?
Acetylcholine, epinephrine, norepinephrine
What are some examples of inhibitory neurotransmitters?
Dopamine, certain types of serotonin, GABA
How do dopamine agonists work in Parkinson's disease?
They increase dopamine levels to reduce muscle rigidity and tremors
What is the mechanism of action of tolcapone (Tasmar) in Parkinson's disease?
It suppresses the enzyme that breaks down naturally occurring dopamine
What is the role of acetylcholine in gait and balance?
It is involved in the balance between acetylcholine and dopamine
What is the main symptom of Parkinson's disease?
Muscle rigidity and tremors
What is the function of dopamine in the brain?
It is involved in movement and coordination
What is the role of beta amyloid plaques in Parkinson's disease?
There is no direct role of beta amyloid plaques in Parkinson's disease
What is the primary action of GABA in the CNS?
It has an inhibitory action
What is the primary action of acetylcholine in the CNS?
It can be both excitatory and inhibitory
What is the primary action of dopamine in the CNS?
It can be both excitatory and inhibitory
What is the primary action of epinephrine in the CNS?
It is an excitatory neurotransmitter
What is the primary action of norepinephrine in the CNS?
It is an excitatory neurotransmitter
What is the primary action of serotonin in the CNS?
It can be both excitatory and inhibitory
What is the primary action of tolcapone (Tasmar) in the CNS?
It suppresses the breakdown of dopamine
What is the primary action of dopamine agonists in the CNS?
They increase dopamine levels
What is the primary action of dopamine antagonists in the CNS?
They decrease dopamine levels
What is the primary action of acetylcholinesterase inhibitors in the CNS?
They increase acetylcholine levels
What is the most common adverse reaction to carbidopa/levodopa?
Dyskinesia, involuntary muscle movements.
,How long does dyskinesia typically occur in patients on carbidopa/levodopa
therapy?
Longer than 3 years.
What is the most important precaution to teach a patient and family about timing
for taking an oral dopamine agonist?
Take the drug 30 to 60 minutes before meals on an empty stomach.
What adverse effect can occur when a patient takes both a dopamine agonist and
an antihypertensive?
Severe hypotension.
What signs/symptoms would you expect a patient with Parkinson's disease to
present with if they are not adhering to a tyramine-restricted diet while taking a
monoamine oxidase type B inhibitor?
Hypertension.
Which drug should a patient with Alzheimer's disease who is taking donepezil
(Aricept) stop taking?
Dextromethorphan.
What adverse effect can occur when dextromethorphan is taken with donepezil?
Torsade de pointe, a form of ventricular dysrhythmia.
What is the purpose of a tyramine-restricted diet for a patient taking a monoamine
oxidase type B inhibitor?
To avoid a severe hypertensive crisis.
What is the purpose of a dopamine agonist?
To increase dopamine levels.
What is the purpose of an antihypertensive drug?
To lower blood pressure.
What is the purpose of donepezil (Aricept) for a patient with Alzheimer's disease?
To improve cognitive function.
What is the purpose of aspirin?
To reduce pain, inflammation, and fever.
What is the purpose of buspirone?
To treat anxiety disorders.
What is the purpose of vitamin C?
To support immune function and promote collagen synthesis.
What is the purpose of dextromethorphan?
To suppress cough.
What is the purpose of a monoamine oxidase type B inhibitor?
To increase dopamine levels and improve symptoms of Parkinson's disease.
What is the purpose of a tyramine-rich food?
To potentially precipitate a severe hypertensive crisis.
What is the purpose of a dopamine antagonist?
To block dopamine receptors and decrease dopamine levels.
What is the purpose of a hypertensive crisis?
To cause a sudden and severe increase in blood pressure.
What is the purpose of a severe bradycardia?
To cause an abnormally slow heart rate.
What is the purpose of bone marrow failure?
, To cause a decrease in the production of blood cells.
What is the purpose of edema of the lower extremities?
To cause swelling in the legs and feet.
What is the purpose of a long Q-T syndrome?
To cause an abnormal heart rhythm that can be life-threatening.
What is tachycardia?
Abnormally fast heart rate.
What can cause tachycardia?
Interaction with certain factors.
What is the best action when admitting a new patient with Alzheimer's who is
prescribed both memantine and rivastigmine?
Give both drugs as prescribed.
Why is it safe to give both memantine and rivastigmine to a patient with
Alzheimer's?
They have different actions and can be used together.
Where should the family member apply the rivastigmine patches to avoid the
patient removing them?
On the upper or lower back.
What is the recommended area to apply the rivastigmine patches?
Upper or lower back.
How should the patient receive a 14-mg dose of memantine extended release (XR)
when only 7-mg and 28-mg capsules are available?
Give the patient one 28-mg capsule every other day.
What is the suggested action for opening extended release capsules?
Not recommended, but can be done for some drugs like memantine.
What can be done if it is not possible to divide the contents of a capsule
accurately?
Give two capsules to equal the prescribed dose.
Can a 28-mg capsule be cut in half?
Yes, it can be cut in half.
What should be done after cutting a 28-mg capsule in half?
Give one of the halves to the patient.
Can a 28-mg capsule be opened?
Yes, it can be opened.
What should be done after opening a 28-mg capsule?
Empty the contents into a drug cup, divide it in half, and give one half to the patient.
What is the most important nursing action to perform when assessing a patient
before starting the first dose of a newly prescribed antiepileptic drug?
Ask the patient about all other prescribed or over-the-counter drugs he or she takes
daily.
Why is intravenous (IV) administration preferred over intramuscular (IM) injection
for phenytoin?
Giving phenytoin IM is very irritating to tissue.
What is the best route for administering phenytoin?
The best routes are oral and intravenous.
