Nervous System and Anxiety Medications

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Questions and Answers

Which of the following medications is classified as an opioid pain medication?

Celecoxib – Celebrex

Ibuprofen

Fentanyl - Sublimaze (correct)

Naproxen

What is a common side effect associated with opioid pain medications?

Increased GI peristalsis

Enhanced alertness

Elevated blood pressure

Decreased urinary output (correct)

Which medication is used as an antidote for opioid overdose?

Hydromorphone

Aspirin

Naloxone (correct)

Celecoxib

What condition is NOT an indication for the use of anti-inflammatory medications?

Severe trauma pain Signup and view all the answers

Which of the following NSAIDs specifically inhibits COX-2 enzymes?

Celecoxib Signup and view all the answers

What role does the peripheral nervous system (PNS) play in the nervous system?

It carries motor nerves away from the central nervous system. Signup and view all the answers

Which neurotransmitter is primarily affected by benzodiazepines?

GABA Signup and view all the answers

Which of the following is NOT an indication for benzodiazepine use?

Chronic pain management Signup and view all the answers

What is a key characteristic of benzodiazepines in treating anxiety?

They can be used without sedation. Signup and view all the answers

What effect does the abrupt discontinuation of benzodiazepines after prolonged use have?

It may increase anxiety levels. Signup and view all the answers

How do benzodiazepines mainly reduce anxiety?

By facilitating GABA binding. Signup and view all the answers

What precaution should be taken when administering benzodiazepines to a patient?

Alcohol should be avoided. Signup and view all the answers

Which of the following medications is classified as a benzodiazepine?

Alprazolam Signup and view all the answers

What is the primary role of COX-2 in relation to anti-inflammatory drugs?

It is specifically induced by inflammatory stimuli. Signup and view all the answers

Which of the following is NOT a consideration for NSAIDs?

They have a specific antidote available. Signup and view all the answers

What is one of the mechanisms through which acetaminophen reduces fever?

It acts directly on the thermoregulatory cells in the hypothalamus. Signup and view all the answers

Which of the following conditions is acetaminophen indicated for?

Moderate pain from menstrual cramps. Signup and view all the answers

What is the primary mechanism of action for lidocaine as a local anesthetic?

Temporarily halting production and conduction of nerve impulses Signup and view all the answers

What should be monitored for a patient taking acetaminophen?

Signs of diaphoresis, tachycardia, and malaise. Signup and view all the answers

What effect might an overdose of acetaminophen have on the liver?

It may result in liver damage. Signup and view all the answers

Which of the following is NOT a consideration for administering lidocaine as a local anesthetic?

Expect a feeling of euphoria Signup and view all the answers

What are mu receptors primarily responsible for in relation to pain management?

Analgesia and respiratory depression Signup and view all the answers

Which medication acts as the antidote for an acetaminophen overdose?

N-acetylcysteine (Mucomyst). Signup and view all the answers

What is a common undesirable effect of using NSAIDs?

Increased gastrointestinal distress. Signup and view all the answers

Flumazenil is used primarily to reverse which effect?

Sedation induced by benzodiazepines Signup and view all the answers

What is the relationship between lidocaine and ventricular arrhythmias?

Lidocaine is used to treat ventricular tachycardia and fibrillation Signup and view all the answers

Which of the following describes a common misconception about pain management?

Pain only affects the physical body Signup and view all the answers

How do opioid agonists primarily alleviate pain?

By inhibiting pain transmission through specific receptors Signup and view all the answers

Which of the following effects is associated with kappa receptors?

Pupil constriction and some degree of sedation Signup and view all the answers

Study Notes

Nervous System

Controls body functions.
Composed of the CNS and PNS.
PNS includes sensory receptors that send information to the CNS and motor nerves that carry information away.
Operates through electrical impulses and chemical messengers for transmitting information in response to stimuli.
Drug therapy often targets receptor sites and neurotransmitter release, uptake, and breakdown.

Anxiety

Feeling of tension, nervousness, apprehension, or fear with unpleasant reactions to stimuli.
Benzodiazepines reduce anxiety by inducing calm, drowsiness, and sleep.
Benzodiazepines facilitate GABA (gamma-aminobutyric acid) binding at GABA receptors in the CNS.

Anxiety Medications

Benzodiazepines are used to prevent anxiety without sedation.
Indicated for anxiety disorders, alcohol withdrawal, hyperexcitability/agitation, seizure disorders, insomnia, and pre-operative anxiety relief.
Common Benzodiazepines:
- Alprazolam (Xanax)
- Diazepam (Valium)
- Lorazepam (Ativan)
Drugs in this class often end in "lam" or "pam."

Considerations for Anti-anxiety Medications

Avoid abrupt discontinuation after prolonged use.
Do not administer to patients with renal or hepatic dysfunction, history of drug abuse, or low blood pressure.
Monitor for drowsiness, dizziness, and decreased blood pressure.
Enhance the action of GABA (inhibitory transmitter).
Teach patients to rise slowly from a supine position.
Avoid alcohol.
Flumazenil is a benzodiazepine antagonist that can reverse sedation.

Local Anesthetics

Lidocaine is a local anesthetic used to prevent pain for a specified time frame.
Acts as a powerful nerve block, temporarily interrupting nerve impulse production and conduction.
Typically applied directly to the painful area.

Lidocaine: Pain Medication/Anesthetic/Anti-arrhythmic

As an anesthetic, it acts on the CNS to produce sedation and sleep before procedures.
As a local anesthetic, it inhibits nerve impulses from sensory nerves.
Indications: Pain management for dental procedures and minor surgeries.
Monitor vital signs and protect the numbed area from injury.
As an anti-arrhythmic, it treats ventricular arrhythmias like ventricular tachycardia and fibrillation.
Monitor EKG (electrocardiogram) and vital signs.
Do not mix with amphotericin B or cefazolin.

Pain

Sensory and emotional experience associated with potential tissue damage.
Difficult for patients to cope with.
Pain medications work in the CNS (brain and spinal cord) to alter pain impulse processing from peripheral nerves.

Pain Medications: Opioid Agonists

Inhibit pain transmission by mimicking the body's natural pain control mechanisms.
Increase the pain threshold.
Act on mu and kappa opioid receptors.
Mu receptors are primarily responsible for pain blocking, respiratory depression, euphoria, decreased GI activity, pupil constriction, and physical dependence.
Kappa receptors are associated with some analgesia, pupil constriction, sedation, and dysphoria.
Indicated for moderate to severe pain and pre-operative medication.

Opioid Pain Medications

Codeine
Fentanyl (Sublimaze)
Hydromorphone (Dilaudid)
Morphine (MS Contin)
Oxycodone (Oxycontin, Roxicondone)
Methadone (Dolophine)

Pain Medication Considerations: The 6 Ds

Depressed respirations
Dizziness
Drowsiness
Decreased GI peristalsis and urine output
Decreased blood pressure
Drug dependence
Naloxone (Narcan) is an opioid antagonist that can rapidly reverse opioid overdose.

Anti-inflammatory Medications

Inhibit prostaglandin synthesis by inhibiting the enzyme cyclooxygenase.
Result in analgesic, anti-inflammatory, and antipyretic (fever-reducing) activities.
Indicated to reduce fever, inflammation, and pain associated with musculoskeletal disorders (rheumatoid arthritis, osteoarthritis), and mild to moderate pain.

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

Cox-1:
- Acetylsalicylic acid (Aspirin)
- Ibuprofen (Motrin, Advil)
- Diclofenac (Voltaren)
- Meloxicam (Mobic)
- Naproxen (Aleve)
Cox-2:
- Celecoxib (Celebrex)

Mechanism of Action for Cox-1 and Cox-2

Cyclooxygenases (COX-1 and COX-2) are enzymes that convert arachidonic acid into prostaglandins and other lipid mediators.
COX-2 is induced by inflammatory stimuli and is considered a suitable target for anti-inflammatory drugs.

Indications for Cox-1 and Cox-2

NSAIDs reduce prostaglandin production, which promotes inflammation, pain, and fever.

Considerations for NSAIDs:

Avoid alcohol.
Monitor for:
- Birth defects
- Bone marrow depression
- Increased GI distress
- Renal toxicity
- Tinnitus
- Hepatotoxicity
Take with food.
Discontinue 5-7 days before surgery.
No specific antidote for NSAIDs.

Acetaminophen (Tylenol)

Nonopioid analgesic/antipyretic
A selective COX-2 inhibitor
Mechanism of action:
- Relieves pain by raising the body's pain threshold.
- Reduces fever by eliminating excess heat through the hypothalamus.
- Blocks pain receptors in the brain.

Acetaminophen Indications

Relieve mild to moderate pain:
- Headaches
- Muscle aches
- Menstrual cramps
- Colds/sore throats
- Toothaches
- Backaches
- Vaccination reactions
Reduce fever

Acetaminophen Nursing Considerations

Monitor for diaphoresis (sweating), tachycardia (rapid heart rate), and malaise (general discomfort).
Recommend one glass of water with each dose.
Muco-myst (acetylcysteine) is the antidote for overdose.
Errors in dosing can cause liver damage.
Use cautiously in patients with renal disease, alcohol abuse, or hepatic disease.

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Description

This quiz covers the fundamentals of the nervous system, its functions, and the role of anxiety medications, specifically benzodiazepines. It explores how the central and peripheral nervous systems communicate through electrical impulses and the effects of drugs on these processes. Test your knowledge on anxiety symptoms and treatment options.