NRSG 2350 FINAL EXAM ACTUAL QUESTIONS AND
SOLUTIONS GRADED A+
✔✔Donepezil (Aricept) - ✔✔cholinesterase inhibitor
Treatment of mild-moderate Alzheimer's Disease
Reversible cholinesterase inhibitor that cause rise in ACh levels in cortex > slow
neuronal degradation of AD
AE: insomnia, rash, NVD, dyspepsia, ab pain, cramps
TAKE WITH FOOD
✔✔Memantine (Namenda) - ✔✔NMDA receptor antagonist
Alzheimer's Disease
Blocks receptor sites in brain
Slows buildup of plaque
Slows effects of disease
✔✔Acetaminophen (Tylenol) - ✔✔Mild to moderate pain relief
Fever reduction
LACKS anti-inflammatory effect
DOES NOT CAUSE BLEEDING OR GI PROBLEMS
CAN CAUSE HEPATOTOXICITY
Antidote: Acetylcysteine (Acetadote)
✔✔Opioids - ✔✔Morphine
Fentanyl
Dilaudid (Hydromorophone)
Oxycodone
Demerol
Methadone (Dolophine)
Codeine
Hydrocodone
✔✔Morphine - ✔✔Relief of moderate to severe or acute chronic pain, pre-op med
Agonist at specific opioid receptors in CNS to produce analgesic, euphoria, sedation
ORAL, PR, SQ, IM, IV
, AE: Dizzy, sedation, NV, constipation, respiratory depression, apnea, cardiac arrest
✔✔Fentanyl - ✔✔Analgesic before, during, after surgery, chronic pain, breakthrough
pain
Binds to opioid receptors
Increases dopamine in CNS: produces analgesia, relaxation, euphoria
IM, IV Lollipops, lozenges, nasal spray, transdermal
AE: same as morphine
✔✔Dilaudid (hydromorphone) - ✔✔Relief of acute pain, chronic/severe pain, cough
Binds to opioid receptors to cause analgesia
Directly acts on cough center in medulla: depresses cough reflex
Directly acts on brain stem: depresses respiratory reflex
PO, SQ, IV, PR
Caution with anti-hypertensives may cause postural hypotension
✔✔Oxycodone - ✔✔Relief of moderate to severe pain in adults
Binds to opioid receptors & alters perception of painful stimuli
Produces CNS depression for decreased pain
PO
AE: same as morphine
✔✔Demerol - ✔✔Moderate to severe pain
Anesthesia adjunct
Binds to opioid receptors + alters perception of painful stimuli to decrease pain
PO, IM, SQ, IV
Caution in renal failure Toxic seizures
✔✔Methadone (Dolophine) - ✔✔Moderate to severe/chronic pain
Effects slower than other opioids
Used in detoxification of narcotic addicted individuals
Replaces opioids in system with milder effects: blocks the high you get from codeine,
heroin, morphine, oxy
SOLUTIONS GRADED A+
✔✔Donepezil (Aricept) - ✔✔cholinesterase inhibitor
Treatment of mild-moderate Alzheimer's Disease
Reversible cholinesterase inhibitor that cause rise in ACh levels in cortex > slow
neuronal degradation of AD
AE: insomnia, rash, NVD, dyspepsia, ab pain, cramps
TAKE WITH FOOD
✔✔Memantine (Namenda) - ✔✔NMDA receptor antagonist
Alzheimer's Disease
Blocks receptor sites in brain
Slows buildup of plaque
Slows effects of disease
✔✔Acetaminophen (Tylenol) - ✔✔Mild to moderate pain relief
Fever reduction
LACKS anti-inflammatory effect
DOES NOT CAUSE BLEEDING OR GI PROBLEMS
CAN CAUSE HEPATOTOXICITY
Antidote: Acetylcysteine (Acetadote)
✔✔Opioids - ✔✔Morphine
Fentanyl
Dilaudid (Hydromorophone)
Oxycodone
Demerol
Methadone (Dolophine)
Codeine
Hydrocodone
✔✔Morphine - ✔✔Relief of moderate to severe or acute chronic pain, pre-op med
Agonist at specific opioid receptors in CNS to produce analgesic, euphoria, sedation
ORAL, PR, SQ, IM, IV
, AE: Dizzy, sedation, NV, constipation, respiratory depression, apnea, cardiac arrest
✔✔Fentanyl - ✔✔Analgesic before, during, after surgery, chronic pain, breakthrough
pain
Binds to opioid receptors
Increases dopamine in CNS: produces analgesia, relaxation, euphoria
IM, IV Lollipops, lozenges, nasal spray, transdermal
AE: same as morphine
✔✔Dilaudid (hydromorphone) - ✔✔Relief of acute pain, chronic/severe pain, cough
Binds to opioid receptors to cause analgesia
Directly acts on cough center in medulla: depresses cough reflex
Directly acts on brain stem: depresses respiratory reflex
PO, SQ, IV, PR
Caution with anti-hypertensives may cause postural hypotension
✔✔Oxycodone - ✔✔Relief of moderate to severe pain in adults
Binds to opioid receptors & alters perception of painful stimuli
Produces CNS depression for decreased pain
PO
AE: same as morphine
✔✔Demerol - ✔✔Moderate to severe pain
Anesthesia adjunct
Binds to opioid receptors + alters perception of painful stimuli to decrease pain
PO, IM, SQ, IV
Caution in renal failure Toxic seizures
✔✔Methadone (Dolophine) - ✔✔Moderate to severe/chronic pain
Effects slower than other opioids
Used in detoxification of narcotic addicted individuals
Replaces opioids in system with milder effects: blocks the high you get from codeine,
heroin, morphine, oxy
