NRSG 220 midterm (ch46-50, ch 52, ch 66, ch 14-15, ch 59-
60) Questions With Complete Solutions
what are the considerations for alpha1 agonists phenylephrine
(5)
- examine IV sites frequently
- advise pt to remove contact lenses
- dark eye protection after ophthalmic administration
- avoid caffeine (with all adrengic agonists)
- contact HCP if palpations of jittery/nervousness
what is an example of muscarinic antagonists
belladonna
What is belladonna?
Muscarinic Antagonist
Natural source of alkaloids with anticholinergic activity
what are the uses for muscarinic antagonists (9)
- GI disorders such as irritable bowel syndrome
- ophthalmic procedures
- cardiac rhythm disorders
- chemotherapy induced diarrhea
- adjuncts to anesthesia
--> decrease secretions
- asthma and COPD
--> bronchodilation effects
- antidotes for poisoning or overdose
,- urge incontinence (overactive bladder) : watch with BPH
(Benign Prostatic Hyperplasia)
- parkinson disease
what are the muscarinic antagonists relatively high incidence of
adverse effects (7)
- urinary retention
- xerostomia (dry mouth)
- tachycardia
- CNS stimulation
- dry eyes
- photophobia
- urinary retention in BPH (Benign Prostatic Hyperplasia)
What are the symptoms of Anticholinergic Syndrome overdose
- dry mouth >> difficulty swallowing
- visual changes >> blurred vision, photophobia
- agitation and hallucinations
what is the specific antidote and when is administration given
for Anticholinergic Syndrome
- physostigmine
- generally only administered to patients showing severe
symptoms
what are nicotinic antagonists: neuromuscular blockers
drugs that act on the motor end plate of muscle s
what are the mechanisms of nicotinic antagonists:
neuromuscular blockers
,- causes relaese of Ach (acetylcholine) to travel to receptors on
skeletal muscle --> leading to muscle concentration
- induces a continuous depolarized state where calcium doesnt
return to storage depots, resulting in sustained muscle
contraction
what is the purpose of nicotinic antagonists: neuromuscular
blockers
used to induce a paralyzed condition necessary for certain
surgical procedures
what are the types of nicotinic antagonists: neuromuscular
blockers
depolarizing - succinylcholine
nondepolarizing- tubocararine
what is the action for depolarizing - succinylcholine
- triggers continuous muscle depolarization
- watch for contraction as a sign of success
- restlessness indicates no success
what is the action of nondepolarizing- tubocararine
- blocks acetylcholine receptors
- used for surgical paralysis
what are the therapeutic effects and uses succinylcholine (6)
- surgical anesthesia
- Pseudocholinesterase
- relaxes abdominal muscles, or for relaxation prior to intubation
- induces relaxation in less than 1 min
, - muscle strength returns quickly after discontinuation of the
drug
- patient can still feel pain and is aware of their surroundings-->
benzos and opioids
what are the adverse effects of succinylcholine
- complete paralysis of diaphragm/ intercostal muscles - watch
for respiratory paralysis
- tachycardia
- hypotension
- urinary retention
what are the serious adverse effects of succinylcholine
- malignant hyperthermia - muscle rigid, skin hot
- resp depression
- apnea
dyshythmias
black box warning for succinylcholine
- children with congenital musculoskeletal disease at greater risk
cardiac arrest
- no way to predict which patients at risk
what is a type of tubocurarine
nondepolarizing neuromuscular blocker (NDNB)
What is the prototype of tubocurarine
Tubocurarine is the prototype.
what is the class size for tubocurarine
60) Questions With Complete Solutions
what are the considerations for alpha1 agonists phenylephrine
(5)
- examine IV sites frequently
- advise pt to remove contact lenses
- dark eye protection after ophthalmic administration
- avoid caffeine (with all adrengic agonists)
- contact HCP if palpations of jittery/nervousness
what is an example of muscarinic antagonists
belladonna
What is belladonna?
Muscarinic Antagonist
Natural source of alkaloids with anticholinergic activity
what are the uses for muscarinic antagonists (9)
- GI disorders such as irritable bowel syndrome
- ophthalmic procedures
- cardiac rhythm disorders
- chemotherapy induced diarrhea
- adjuncts to anesthesia
--> decrease secretions
- asthma and COPD
--> bronchodilation effects
- antidotes for poisoning or overdose
,- urge incontinence (overactive bladder) : watch with BPH
(Benign Prostatic Hyperplasia)
- parkinson disease
what are the muscarinic antagonists relatively high incidence of
adverse effects (7)
- urinary retention
- xerostomia (dry mouth)
- tachycardia
- CNS stimulation
- dry eyes
- photophobia
- urinary retention in BPH (Benign Prostatic Hyperplasia)
What are the symptoms of Anticholinergic Syndrome overdose
- dry mouth >> difficulty swallowing
- visual changes >> blurred vision, photophobia
- agitation and hallucinations
what is the specific antidote and when is administration given
for Anticholinergic Syndrome
- physostigmine
- generally only administered to patients showing severe
symptoms
what are nicotinic antagonists: neuromuscular blockers
drugs that act on the motor end plate of muscle s
what are the mechanisms of nicotinic antagonists:
neuromuscular blockers
,- causes relaese of Ach (acetylcholine) to travel to receptors on
skeletal muscle --> leading to muscle concentration
- induces a continuous depolarized state where calcium doesnt
return to storage depots, resulting in sustained muscle
contraction
what is the purpose of nicotinic antagonists: neuromuscular
blockers
used to induce a paralyzed condition necessary for certain
surgical procedures
what are the types of nicotinic antagonists: neuromuscular
blockers
depolarizing - succinylcholine
nondepolarizing- tubocararine
what is the action for depolarizing - succinylcholine
- triggers continuous muscle depolarization
- watch for contraction as a sign of success
- restlessness indicates no success
what is the action of nondepolarizing- tubocararine
- blocks acetylcholine receptors
- used for surgical paralysis
what are the therapeutic effects and uses succinylcholine (6)
- surgical anesthesia
- Pseudocholinesterase
- relaxes abdominal muscles, or for relaxation prior to intubation
- induces relaxation in less than 1 min
, - muscle strength returns quickly after discontinuation of the
drug
- patient can still feel pain and is aware of their surroundings-->
benzos and opioids
what are the adverse effects of succinylcholine
- complete paralysis of diaphragm/ intercostal muscles - watch
for respiratory paralysis
- tachycardia
- hypotension
- urinary retention
what are the serious adverse effects of succinylcholine
- malignant hyperthermia - muscle rigid, skin hot
- resp depression
- apnea
dyshythmias
black box warning for succinylcholine
- children with congenital musculoskeletal disease at greater risk
cardiac arrest
- no way to predict which patients at risk
what is a type of tubocurarine
nondepolarizing neuromuscular blocker (NDNB)
What is the prototype of tubocurarine
Tubocurarine is the prototype.
what is the class size for tubocurarine
