NUR2474 Pharmacology for Professional Nursing (NUR2474) - Test #1 – Review Rasmussen College (NUR2474 Section CPPC2A0Z Pharmacology for Professional Nursing (11 Weeks) - Residential and Online - 2021 Spring Quarter)

NUR2474 Pharmacology for Professional Nursing (NUR2474) - Test #1 – Review Rasmussen College (NUR2474 Section CPPC2A0Z Pharmacology for Professional Nursing (11 Weeks) - Residential and Online - 2021 Spring Quarter) 1. Lithium levels, use, side effects o Lithium is a MOOD STABILIZER o Levels: ▪ 0.4 to 1 mEq/L. o Action: ▪ Prevents/decreases incidence of acute manic episodes - May inhibit MOA = Increase activity of brain o Use: ▪ Treat Bipolar Disorder o Side Effects: ▪ Nausea, , Abdominal bloating, Anorexia, Fatigue, and Memory impairment, Polyuria (frequently urinating), Tremor, Hypothyroidism o Teratogenic ▪ Def: Can disturb the development of the embryo/fetus and produce malformation o 1-3 weeks for full effect 2. Benzodiazepines uses, actions, antidote, side effects o Suffix: -PAM, -LAM o Fast Acting o Short term use o Can cause dependency o Uses: ▪ Anxiety, Insomnia, and Seizure disorders, Muscle spasms, and Withdrawal from alcohol o Actions: ▪ Binds to GABA receptors to enhance the action of GABA - GABA is a neurotransmitter that slows/calms the speed of brain activity o Antidote: ▪ Flumazenil - Administered IV o Side Effects: ▪ Sedation, Low respiration rate, Low blood pressure, Low heart rate, and Amnesia 3. Medications for anxiety, sleep and concentration o Anxiety: ▪ Selective Serotonin Reuptake Inhibitor (SSRI’s) - Suffix: -TINE, -LINE, -PRAM - 4 weeks for full effect - Works slow - Do not take with St. Johns Wort - Action: o Inhibits the reuptake of serotonin back into the neuron leading to more serotonin floating around in the brain = Improve mood - Use: o Anxiety, Depression, PTSD, OCD - Side Effects: o Weight gain. Insomnia, and Sexual dysfunction - Drug used: Paroxetine o Dosage: ▪ 20 to 50 mg/day - Drug used: Venlafaxine (SNRI) o Dosage: ▪ 37.5 mg once a day o Routes: ▪ Standard tablets (generic only) ▪ Nonbenzodiazepine-Nonbarbiturates - Drug used: Buspirone (Atypical) o 1-2 weeks for full effect – Works slow o Short term use o Does not cause sedation or dependency o Take with food if GI upset o Side Effects: ▪ Dizziness, Nausea, Headache o Use: ▪ Anxiety, PTSD, OCD, and Panic ▪ Benzodiazepines - Suffix: -PAM, -LAM - Works immediately - Drug used: Diazepam - Uses: o Anxiety, Insomnia, and Seizure disorders, Muscle spasms, and Withdrawal from alcohol - Actions: o Binds to GABA receptors to enhance the action of GABA ▪ GABA is a neurotransmitter that slows/calms the speed of brain activity o Sleep: - Side Effects: o Sedation, Low respiration rate, Low blood pressure, Low heart rate, and Amnesia ▪ Benzodiazepines - (See Anxiety) ▪ Antidepressants - Takes 2-4 weeks to take full effect - Risk for suicide - Medications: o SSRI’s ▪ Action: Improves mood ▪ Risk: Serotonin Syndrome = Agitation, Hallucinations, Fever, Tremors, and Sweating ▪ Side Effects: Weight gain. Insomnia, and Sexual dysfunction ▪ Suffix: -TINE, -LINE, -PRAM o SNRI’s ▪ Action: Inhibits the reuptake of serotonin and norepinephrine into the neuron.. leading to more floating around the brain ▪ Side Effects: Loss of appetite, Insomnia, and Sexual dysfunction o TCA’s ▪ Action: Inhibits serotonin reuptake, norepinephrine, and alpha receptors ▪ Use: Depression, Anxiety, Insomnia, and Fibromyalgia ▪ Side Effects: Orthostatic hypotension, Sedation, anticholinergic, and Urinary retention ▪ Suffix: -TRYPTLINE, -IPRAMINE ▪ Be careful in the sun = Increase fiber and fluids o MAOI’s ▪ Action: Blocks the destruction of serotonin, norepinephrine, dopamine, and tyramine.. leading to increase of serotonin, norepinephrine, dopamine, and tyramine ▪ Use: Depression and Panic disorder ▪ Side Effects: Agitation, Anxiety, Low blood pressure, Hypertensive crisis, ▪ Do not eat tyramine foods o Atypicals ▪ Buproprion (Wellbutrin) o Concentration: ▪ For Depression and Smoking cessation ▪ Trazadone ▪ For Depression (high dose) and Insomnia ▪ Stimulants (see #4 for more info) - Adderall (dextroamphetamine) - Ritalin & Concerta (methylphenidate) 4. Stimulants, examples, education * Stimulants Examples: o Amphetamines: for attention deficit and hyperactive disorder ▪ Adderall (dextroamphetamine) ▪ Action: • CNS & respiratory stimulation • Increased motor activity • Mental alertness • Increased attention span in ADHD ▪ Use: • ADHD ▪ Ritalin & Concerta (methylphenidate) ▪ Action: • Produce CNS and respiratory stimulation with weak sympathomimetic activity ▪ Use: • Increases attention span in ADHD • Increase motor activity, mental alertness, and diminished fatigue in narcoleptic patients. o Anorexiants: for obesity ▪ Didrex (benzphetamine) ▪ Phentride (phentermine) o Analeptics: to prevent narcolepsy due to sleep apnea & hypoventilation ▪ Caffiene ▪ Dopram (doxapram) ▪ Dexidrine (dextroamphetamine) ▪ CPAP machine o Result of Stimulants ▪ Trigger release of dopamine & norepinephrine ▪ Increase level of alertness ▪ Addictive rush ▪ Euphoria ▪ Alertness ▪ Loss of appetite ▪ Weight loss ▪ Sleeplessness ▪ Tremors ▪ Restlessness ▪ Irritability ▪ Increased heart rate ▪ Palpitations ▪ Hypertension o Stimulants (therapeutic class) ▪ Timing: AM keeps you awake ▪ HR goes up, avoid stress, caffeine, etc ▪ Abuse is common ▪ Most are controlled substances—need new Rx o Education: ▪ Warn patients against habitual caffeine use ▪ Cardiovascular responses to caffeine (palpitations, rapid pulse, dizziness) ▪ Overdose can cause convulsions Stimulant therapy: amphetamine (like drugs) - example: methylphenidate o Side effects ▪ Insomnia ▪ Weight loss ▪ Dysrhythmias ▪ Hallucinations ▪ Withdrawal ▪ ***Do Not Stop Abruptly o Interventions ▪ Do not take after 4pm ▪ Monitor weight/diet ▪ Encourage small frequent meals ▪ Monitor heart rhythm ▪ Encourage pt to report hallucinations ▪ Headache and nausea are caused by withdrawal o Interactions ▪ Caffeine ▪ MAOIs ▪ Hydantoins ▪ Warfarin o Administration concerns ▪ Avoid in pt with history of abuse ▪ Controlled substance requires new prescription from MD