NR293/ NR 293 Exam 2 solution guide 2022 Distinction level approved.

NR293/ NR 293 Exam 2 solution guide 2022 Distinction level approved. Analgesics - Pain Medication - medications aimed at reducing pain without causing sedation NSAIDS - Aspirin - Ibuprofen - Celecoxib - Acetaminophen - Indomethacin - Magnesium - Naproxen Ibuprofen and Aspirin inhibit or block prostaglandins, thus reducing inflammation, pain and swelling Celecoxib anti-inflammatory drug given for osteoarthritis Cyclooxygenase 2 (Cox 2) an enzyme directly responsible for inflammation, swelling and pain. Acetaminophen (Tylenol) toxic for your liver (tyLIVER) Hydromorphone - side effects (urinary retention) - important to monitor urine output Morphine Sulfate - side effects (constipation, pruritis, hypotension) - decrease in pain level - decrease in tachycardia - absence of facial grimacing or discomfort - verbalization of pain relief Anxiety Disorder anxiety that interferes with daily life Buspirone commonly used antianxiety drug to treat Anxiety disorder Bipolar Disorder extreme mood swings, also known as manic-depression Lithium - commonly used mood stabilizer - therapeutic level = 0.8-1.2 Psychosis severe mental illness such as schizophrenia Antipsychotics used to treat refractory or recurring schizophrenia Risperidone helps to reduce paranoia and delusions Antidepressants - may take up to 4 weeks to notice therapeutic effects - prevent the absorption of serotonin in the body, thus increasing concentration in the brain, elevating mood Serotonin - acts as neurotransmitter - mostly in the brain but found in digestive system and blood platelets - mood, sexual desire, appetite, sleep, memory, temperature regulation and social behavior Serotonin Syndrome - when there is too much serotonin in the body - excessive nerve cell activity which can be fatal (agitation, confusion, increased heart rate, tremors, fever) Tricyclic Antidepressants - blocks serotonin absorption - overdose can cause cardiac dysrhythmias - toxicity occurs when mixed with alcohol Selective Serotonin Reuptake Inhibitors - blocks serotonin absorption - cannot be taken with anticoagulants because it can cause excessive bleeding - high protein bound Monoamine Oxidase Inhibitors - reduce the activity of the enzyme MAO, which results in higher levels of norepinephrine, serotonin and dopamine in the brain, enhancing mood - break down catecholamines in the CNS - taken with foods high in Tyramine can cause dangerously high blood pressure Norepinephrine influences sleep and alertness and is believed to be correlated to the fight or flight stress response Dopamine influences body movements and is also believed to be involved in motivation, reward, reinforcement and addictive behavior MAOIs: side effect - many patients experience dry mouth - antidepressants prevent acetylcholine from reaching muscarinic receptors in the salivary glands causing cotton mouth Drug/Food Interaction - MAOIs AVOID: cheese, processed meats and red wine St. John's Wort - when combined with antidepressants can cause adverse effects - duloxetine and sertraline + St. John's Wort = Serotonin Syndrome Opioids - used to relieve pain - withdrawal = runny nose, sweating, tearing hypertension, rapid heartbeat and increased respiratory rate Methadone - used to treat opiate addiction and relieve pain - blocks the receptors in the brain the are affected by opiates - effects last 24 to 36 hours Naloxone - an opioid antidote that blocks or inhibits the effects of narcotic overdose such as morphine sulfate - antagonist drug that reverses respiratory depression Benzodiazepines - relaxes muscles and relieves anxiety, insomnia, seizures and alcohol withdrawal symptoms - prescribed as anesthetic before procedures - increases neurotransmitter gamma aminobutyric acid, causing relaxation Gamma Aminobutyric Acid - low levels cause anxiety - high levels cause relaxation Smoking (Gum) - nicotine gum releases and immediate dose of nicotine - rapid chewing releases it quicker - can cause drowsiness Heroin - Naltrexone is commonly used to treat heroin addiction - decreases effect of opioid drugs - blocks euphoric effects Alcohol - alcoholics typically have vitamin B deficiency - leads to Wernicke's Encephelopathy and/or Korsakoff's Psychosis - alcoholism causes hypertension, agitation and tremors Wernicke's Encephelopathy/Korsakoff's Psychosis neurological disorders and acute brain reactions due to lack of Thiamine or Vitamin B1 Disulfiram - common treatment for chronic alcoholism - produces acute sensitivity to alcohol by causing unpleasant reactions when alcohol is consumed, such and hangover effects - educate on OTC drugs that contain alcohol to avoid adverse effects CNS part of the nervous system that consists of the brain and spinal cord Barbiturates - largely replaced with benzodiazepines due to safety - addictive - anesthesia for procedures, anticonvulsants and sedatives - antidote = activated charcoal Phenobarbital - longer half life allows for once a day dosing - interferes with REM sleep causing irritability, difficulty dealing with stress Anxiolytics relieve anxiety Flumazenil - overdose antidote for Benzodiazepines - competes with benzo receptor sites and blocks benzo effects Herbal Supplements: Benzodiazepines - avoid using the two together - grapefruit juice, st. john's word, kava act similarly to diazepam -combining the two can exacerbate relaxation and drowsiness Nonbenzodiazepine Hypnotics - used to treat insomnia - pregnancy category C - animal studies show adverse effects in fetus (not studied in humans) Zolpidem - short term (limit 7-10 days) - less grogginess in the morning - overnight or red eye flights (helps adjust to different time zones - long term use causes sleep walking and sleep driving - acts immediately and lasts 8 hours Eszoplicone approved for long term therapy, acts immediately and lasts 8 hours Remelteon - take 30 minutes before bedtime - containdicated in liver disease Muscle Relaxants - relieve pain associated with skeletal muscle spasm and spasticity in chronic disorders (MS or Cerebral Palsy) - act directly on skeletal muscles - often used in conjunction with physical therapy Cyclobenzaprine causes deep relaxation and sleepiness Dantrolene - given postoperatively - patients can experience malignant hyperthermia, a rare, genetic, life-threatening condition triggered by anestheisa - causes muscle rigidity and fever CNS Stimulants - increase physical activity, mental alertness and attention span - can cause insomnia CNS Stimulants: Respiratory Depression Syndromes cause relaxation of bronchial smooth muscle, increased respiration, dilation of pulmonary arteries Methylxanthines