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Pharmacology I CNM

Nursing 2002 I CNM 2010 Saturday Class Exam III

QuestionAnswer
Anxiety A state of "apprehension, tension, or uneasiness that stems from the anticipation of danger, the source of which is largely unknown or unrecognized"
Neural Systems: Limbic is located in? Middle Brain
Neural Systems: Limbic - Responsible for? Emotional expression, Learning, Memory, and Euphoria
Neural Systems: Limbic - Signals routed from limbic system to _____________? Hypothalamus
Neural Systems: Limbic - Connection = ________? Emotional States
Neural Systems: Limbic - Connection = Emotional State such as? Anxiety, Anger, Aggression, Remorse, Depression, Sexual Drive
Neural Systems: Reticular formation is what? Network of Neurons along entire length of brainstem
Neural Systems: Reticular formation also connects to what? Hypothalamus
Neural Systems: Reticular formation stimulation causes what? Heightened alertness and arousal
Neural Systems: Reticular formation Inhibition causes what? General drowsiness & sleep induction
True or False: Anxiety is the most common mental disturbance? True
Symptoms of Anxiety are similar to? Fear & mimic ANS response
What are the primary categories of anxiety? Generalized Anxiety and Panic Disorder
What are other anxiety disorders? Phobias, Obsessive compulsive disorder (OCD) and Post Traumatic Stress Syndrome (PTSD)
What are some general information regarding anxiety discussed in class? 19 million Americans affacted each year and coexists with other disorders
Anxiolytic Drugs Short term anxiety
Mood stabilizer Drugs Long Term anxiety
Anxiolytic Drugs: Benzodiazepines is Schedule? IV
Anxiolytic Drugs: Benzodiazepines is used how often? Is most widely used anxiolytic drug
Anxiolytic Drugs: Benzodiazepines in low vs high dose? In low dose, reduce anxiety and higher dose causes hypnotic action
Anxiolytic Drugs: Benzodiazepines have how many derivitives? About 20 available
Anxiolytic Drugs: Benzodiazepines is also used as what? Anticonvulsants and antihypertensives
Anxiolytic Drugs: Benzodiazepines has an antidote called? Flumazenil (Romazican) IVP
Anxiolytic Drugs: Benzodiazepines prototype discussed in class? Diazepam (Valium)
Anxiolytic Drugs: Benzodiazepines prototype [Diazepam (Valium)] discuss the DYNAMICS, Kinetics, Therapeutics, Adverse Effects and Side Effects of the drug? Dynamics: Increased actions of GABA, Depression of Limbic system, Relaxation of skeletal muscles, Delays stage 4 & REM sleep
Anxiolytic Drugs: Benzodiazepines prototype [Diazepam (Valium)] discuss the Dynamics, KINETICS, Therapeutics, Adverse Effects and Side Effects of the drug? Kinetics: Absorbed rapidly from the GI tract; Onset, peak, duration = varies; Widely PB (98%); Metabolized in theliver; Excreted in urine
Anxiolytic Drugs: Benzodiazepines prototype [Diazepam (Valium)] discuss the Dynamics, Kinetics, THERAPEUTICS, Adverse Effects and Side Effects of the drug? Therapeutics: Anxiety control, Preoperative sedation, Skeletal muscle relaxant, Status epilepticus, Alcohol withdrawl
Anxiolytic Drugs: Benzodiazepines prototype [Diazepam (Valium)] discuss the Dynamics, Kinetics, Therapeutics, ADVERSIE EFFECTS and Side Effects of the drug? Adverse Effects: ECG changes, Tachycardia, Dependence w/long term use
Anxiolytic Drugs: Benzodiazepines prototype [Diazepam (Valium)] discuss the Dynamics, Kinetics, Therapeutics, Adverse Effects and SIDE EFFECTS of the drug? Side Effects: Drowsiness, dizziness, snycope, orthostatic hypotenison, blurred vision, confusion, vomiting.
Anxiolytic Drugs: Benzodiazepines Nursing Process steps - ASSESSMENT, Nursing Diagnosis, Planning, Intervention, Client Teaching, Evaluation? ASSESSMENT: Suicidal ideation, Anxiety reation history, Support system, Drug History
Anxiolytic Drugs: Benzodiazepines Nursing Process steps - Assessment, NURSING DIAGNOSIS, Planning, Intervention, Client Teaching, Evaluation. NURSING DIAGNOSIS: Anxiety, Impaired physical mobility, Ineffective Coping, Fatigue
Anxiolytic Drugs: Benzodiazepines Nursing Process steps - Assessment, Nursing Diagnosis, PLANNING, Intervention, Client Teaching, Evaluation. PLANNING: Clients anxiety/stress levels will be reduced
Anxiolytic Drugs: Benzodiazepines Nursing Process steps - Assessment, Nursing Diagnosis, Planning, INTERVENTION, Client Teaching, Evaluation. INTERVENTION: Inject slowly IV, Use Z-track method of IM, Geriatric consideration, Monitor VS (especially BP), Do not mix with other drugs
Anxiolytic Drugs: Benzodiazepines Nursing Process steps - Assessment, Nursing Diagnosis, Planning, Intervention, CLIENT TEACHING, Evaluation. CLIENT TEACHING: Sedation & driving etc, Other CNS depressants, Relaxation techniques, Do not stop drug abruptly, Orthostatic hyptension risk
Anxiolytic Drugs: Benzodiazepines Nursing Process steps - Assessment, Nursing Diagnosis, Planning, Intervention, Client Teaching, EVALUATION. EVALUATION: Could not see in lecture...sorry
Insomnia is defined as? "Inability to fall asleep or remain asleep"
What is the percent of our time sleeping or trying to sleep? 33%
Explain the sleep function theories Body repair, Evolution as protective mechanism, Deals with 'electrical' charging and discharging of brain
True or False: One-third of the world's population has trouble sleeping sometimes during a year. True
Insomnia are more common in ______than ______ women than men
What is common about clients >65 years old? Sleep less than any age group
Sleep wake cycle is synchronized to? Bodily functions
Impaired sleep wake cycle requires what type of intervention? Pharmacologic and non pharmacologic interventions
Increased levels of what neurotransmitter initiate various process of sleep? Serotonin
What are the four types of Insomnia discussed in class? Short term insomnia, Long term insomnia, Rebound Insomnia, Insomnia & Insulin Resistance
What are the five stages of Sleep NREM stage 1, NREM stage 2, NREM stage 3, NREM stage 4, REM sleep
Describe NREM stage 1 of sleep Onset of sleep, Drowsiness for 1-7 minutes, Easily awakened,4-5% of total sleep time.
Describe NREM stage 2 of sleep Can still be easily awakened, 45-55% of total sleep time
Describe NREM stage 3 of sleep Move into and out of deeper sleep, Heart rate & BP fall, GI activity rises, 4-6% of total sleep time
Describe NREM stage 4 of sleep Deepest stage of sleep, 12-15% of total sleep time, This is where nightmares and sleep walking occur (in children only), Heart rate & blood pressure remain low; GI activity remain high
Describe REM stage of sleep Rapid eye movement and loss of muscle tone. Dreaming takes place during this phase of sleep
Sedative Hypnotic Drugs: Barbiturates are schedule? II
Sedative Hypnotic Drugs: Barbiturates were drug of choice for insomnia and anxiety until what drug came along? Benzodiazepines
Sedative Hypnotic Drugs: Barbiturates are rarely, if ever used for insomnia and has significant side effects? TRUE or FALSE True
Sedative Hypnotic Drugs: Barbiturates withdrawal extremely severe and overdose has profound respiratory depression, hypotension and shock? True or False True
Sedative Hypnotic Drugs: Barbiturates Depress _________ function at all levels? CNS
Sedative Hypnotic Drugs: Barbiturates doses are? Low, moderate and high
Sedative Hypnotic Drugs: Barbiturates has tolerance to all but respiratory depression? True or False True
Sedative Hypnotic Drugs: Barbiturates Classifiction (4)? Long Acting - Phenobarbital (1912) and Mephobarbital; Intermediate Acting - Amobarbital (Amytal) and Butabarbital (Butisol); Short Acting - Secobarbital (Secondal) and Pentobarbital (Nembutal); Ultra Short Acting - Thiopental Sodium (Pentothal)
Sedative Hypnotic Drugs: Barbiturates prototype [Phenobarbital (Luminal)] discuss the DYNAMICS, Kinetics, Therapeutics, Adverse Effects and Side Effects of the drug? Dynamics: Long-acting, GABA-ergic system
Sedative Hypnotic Drugs: Barbiturates prototype [Phenobarbital (Luminal)] discuss the DYNAMICS, KINETICS, Therapeutics, Adverse Effects and Side Effects of the drug? Kinetics: IM or oral, extensive hepatic, biotransformation, enzyme induction, Metabolized in liver and exreted in urine
Sedative Hypnotic Drugs: Barbiturates prototype [Phenobarbital (Luminal)] discuss the DYNAMICS, Kinetics, THERAPEUTICS, Adverse Effects and Side Effects of the drug? Therapeutics: Preop sedation, Seizure managemnt
Sedative Hypnotic Drugs: Barbiturates prototype [Phenobarbital (Luminal)] discuss the DYNAMICS, Kinetics, Therapeutics, ADVERSE EFFECTS and Side Effects of the drug? Adverse Effects: Dependence, Respiratory depression, CNS depression, Coma-Death, NO ANTIDOTE
Sedative Hypnotic Drugs: Barbiturates prototype [Phenobarbital (Luminal)] discuss the DYNAMICS, Kinetics, Therapeutics, Adverse Effects and SIDE EFFECTS of the drug? Side Effects: Drowsiness, Vitamin deficiencies, Laryngospasms
Sedative Hypnotic Drugs: Barbiturates Nursing Process steps - ASSESSMENT, Nursing Diagnosis, Planning, Intervention, Client Teaching, Evaluation? Assessment: Baseline VS & lab tests, Drug History, Ascertain underlying problem r/t insomnia
Sedative Hypnotic Drugs: Barbiturates Nursing Process steps - Assessment, NURSING DIAGNOSIS, Planning, Intervention, Client Teaching, Evaluation Effects of the drug? Nursing Diagnosis: Sleep pattern disturbance, Anxiety, Ineffective coping, Noncompliance: Overuse, Risk for injury
Sedative Hypnotic Drugs: Barbiturates Nursing Process steps - Assessment, Nursing Diagnosis, PLANNING, Intervention, Client Teaching, Evaluation Effects of the drug? Planning: Client will remain asleep for 6-8 hrs.
Sedative Hypnotic Drugs: Barbiturates Nursing Process steps - Assessment, Nursing Diagnosis, Planning, INTERVENTION, Client Teaching, Evaluation Effects of the drug? Intervention: Monitor VS, Raise bedside rails (elderly), Observe for hangover
Sedative Hypnotic Drugs: Barbiturates Nursing Process steps - Assessment, Nursing Diagnosis, Planning, Intervention, CLIENT TEACHING, Evaluation Effects of the drug? Cleint Teaching: Nonpharmacologic methods, Avoid other CNS depressants, Urinate before sleep, Sedation precautions, Full therapeutic effect may take 2-3 weeks, Do not discontinue abruptly
Sedative Hypnotic Drugs: Barbiturates Nursing Process steps - Assessment, Nursisng Diagnosis, Planning, Intervention, Client Teaching, EVALUATION Effects of the drug? Evaluation: Evaluate client's perception of how the drug worked
Antidepressants and Mood stabiliazers are also known as? "Mood elevators" & "Mood stabilizers"
What are the three types of depression from lecture? Reactive (Exogenous), Major (Unipolar, Endogenous), Bipolar (previously called manic-depressive)
Define reactive (Exogenous) depression Usually sudden onset from precipatating event, Client knows why he/she is depressed, Often called the "the blues", Usually lasts for months, Benzadiazepine often prescribed
Define major (Unipolar, Endogenous) depression Loss of interest in work and/or home, Inability to complete both, Dysphoria, Can be either Primary or Secondary
Define bipolar affective disorder (Previously called manic-depressive) Swings between euphoria and dysphoria
Etiology of Depressions (theories) Neurotransmitter theory, Receptor theory, Biogenic Amine theory, Genetic/Endocrine theory
What are the depression treatments discussed in class? Drug therapy, ECT, Psychotherapy
Antidepressants: Name the four groups discussed in class Tricyclic antidepressants (TCAs) Prototype: Amitriptlyine(Elavil); Selective serotonin reuptake inhibitors(SSRIs) Prototype: Fluoxetine (Prozac)
Antidepressants: Name the four groups discussed in class Atypical antidepresants Prototype: Bupropian(Wellbutrin); Monamine Oxidase Inhibitors(MAOIs) Prototype: Phenizine(Nardil)
Antidepressants:
Antidepressants:
Antidepressants:
Created by: alwayslearning
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