Pharmacology NCM 106 Module 4
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Questions and Answers

What is the primary use of anxiolytics?

  • To treat anxiety and insomnia (correct)
  • To induce sleep without effects on anxiety
  • To alleviate chronic pain
  • To enhance cognitive function

Which of the following is a characteristic of primary anxiety?

  • Secondary to psychiatric disorders
  • Treated solely with pharmacologic measures
  • Related to drug use
  • Not caused by a medical condition or drug use (correct)

Which benzodiazepine is known for its use in substance abuse withdrawal?

  • Lorazepam
  • Alprazolam
  • Chlordiazepoxide (correct)
  • Clonazepam

What non-pharmacologic measure can assist in managing anxiety?

<p>Use of relaxation techniques (D)</p> Signup and view all the answers

Which of the following is not a clinical manifestation of anxiety?

<p>Euphoria (D)</p> Signup and view all the answers

Benzodiazepines are primarily utilized for which of the following conditions?

<p>Severe or prolonged anxiety (B)</p> Signup and view all the answers

What type of anxiety is directly associated with psychiatric disorders?

<p>Secondary anxiety (A)</p> Signup and view all the answers

Which of the following components is not part of the autonomic nervous system?

<p>Neuromuscular blocking agents (B)</p> Signup and view all the answers

What is the maximum dosage of valproate per day for children aged 6-12 years?

<p>1 g (D)</p> Signup and view all the answers

Which of the following is NOT a condition for which valproate is used?

<p>Hypertension (A)</p> Signup and view all the answers

What is the therapeutic serum range for valproate?

<p>50-100 mcg/mL (D)</p> Signup and view all the answers

What should be monitored to detect early blood dyscrasias in patients taking anticonvulsants?

<p>CBC levels (C)</p> Signup and view all the answers

What is an important nursing responsibility when administering anticonvulsants?

<p>Monitor serum drug levels (B)</p> Signup and view all the answers

Which statement about the administration of the suspension form of medication is true?

<p>It must be shaken thoroughly before use. (A)</p> Signup and view all the answers

What is the initial dosing recommendation for valproate in children?

<p>10-15 mg/kg/d (C)</p> Signup and view all the answers

Why should female patients taking oral contraceptives and anticonvulsants use an additional contraceptive method?

<p>Anticonvulsants may reduce the effectiveness of oral contraceptives. (A)</p> Signup and view all the answers

What should be monitored to assess the side effects of AChE inhibitors?

<p>Vital signs periodically (A)</p> Signup and view all the answers

What technique should be taught to family members to promote patient safety?

<p>Removing obstacles from the patient's path (B)</p> Signup and view all the answers

Which of the following is a potential side effect that should be monitored in patients taking AChE inhibitors?

<p>Bradycardia (B)</p> Signup and view all the answers

Why should a family member be informed about support groups?

<p>To enhance understanding of the disease (B)</p> Signup and view all the answers

What dietary consideration should be made for a patient taking selegiline?

<p>Avoid tyramine-rich foods (A)</p> Signup and view all the answers

What aspect of patient care involves monitoring liver function tests?

<p>To detect hepatotoxicity (C)</p> Signup and view all the answers

How can selegiline alleviate symptoms of parkinsonism?

<p>By increasing dopamine levels in the brain (C)</p> Signup and view all the answers

Which of the following conditions is NOT treated with muscle relaxants?

<p>Heart failure (D)</p> Signup and view all the answers

What is a primary use of nondepolarizing muscle relaxants during surgery?

<p>Relaxation of skeletal muscle (B)</p> Signup and view all the answers

Which of the following is a common side effect of muscle relaxants?

<p>Blurred vision (B)</p> Signup and view all the answers

Which condition is specifically listed as a contraindication for muscle relaxants?

<p>Acute myocardial infarction (C)</p> Signup and view all the answers

What nursing responsibility is associated with patients taking dantrolene and carisoprodol?

<p>Monitor serum liver enzyme levels (B)</p> Signup and view all the answers

Which of the following adverse reactions may occur with muscle relaxants?

<p>Angioedema (A)</p> Signup and view all the answers

How should patients be instructed to discontinue muscle relaxants?

<p>Reduce dosage progressively over a week (D)</p> Signup and view all the answers

Which of the following is an important precaution patients should take when using muscle relaxants?

<p>Avoid driving or operating machinery (A)</p> Signup and view all the answers

Which muscle relaxant is identified as depolarizing?

<p>Succinylcholine (B)</p> Signup and view all the answers

Which type of pain is associated with pressure on nerves and blockage to blood supply?

<p>Cancer pain (B)</p> Signup and view all the answers

What are nonopioid analgesics primarily used to treat?

<p>Mild to moderate pain (A)</p> Signup and view all the answers

Which of the following is NOT a characteristic of opioids when used for pain control?

<p>Should cause significant respiratory depression (A)</p> Signup and view all the answers

Which type of pain stems from skeletal muscles, ligaments, and joints?

<p>Somatic pain (C)</p> Signup and view all the answers

Which type of analgesic is usually effective for dull, throbbing pain such as headaches?

<p>Nonopioid analgesics (C)</p> Signup and view all the answers

What is a common method of administration for opioids?

<p>PCA (Patient Controlled Analgesia) (C)</p> Signup and view all the answers

Which of the following is a property of nonopioids compared to opioids?

<p>They also have an antipyretic effect (C)</p> Signup and view all the answers

What type of pain arises from smooth muscle and organs?

<p>Visceral pain (A)</p> Signup and view all the answers

What is the suggested safe adult dosage of acetaminophen per day?

<p>2000 mg/d (C)</p> Signup and view all the answers

What should a parent do if a child has ingested a large or unknown amount of acetaminophen?

<p>Call poison control center immediately (B)</p> Signup and view all the answers

What is considered a normal serum acetaminophen level?

<p>5 to 20 mcg/mL (B)</p> Signup and view all the answers

Which of the following is NOT an effect of µ receptor activation by opioid analgesics?

<p>Increased alertness (D)</p> Signup and view all the answers

How does codeine primarily differ from morphine?

<p>Codeine is less potent than morphine (A)</p> Signup and view all the answers

What is the antidote for acetaminophen overdose?

<p>Acetylcysteine (Mucomyst) (B)</p> Signup and view all the answers

Which receptor activation is primarily responsible for the analgesic effect of opioids?

<p>Mu (µ) receptors (C)</p> Signup and view all the answers

What is a potential consequence of overdosing on acetaminophen?

<p>Severe liver damage (C)</p> Signup and view all the answers

Flashcards

Anxiolytics

Drugs used to treat anxiety and insomnia.

Benzodiazepines

A type of anxiolytic used for severe or prolonged anxiety, also used as anticonvulsants and sedatives.

Primary Anxiety

Anxiety not caused by a medical condition or drug use.

Secondary Anxiety

Anxiety caused by selected drug use, medical or psychiatric disorders.

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Clinical Anxiety Symptoms

Symptoms like dyspnea, chest pain, palpitations, dizziness, sweating, trembling, and fear of losing control.

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Non-Pharmacological measures

Methods to treat anxiety that do not involve medication.

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Relaxation Techniques

Techniques used to reduce stress and anxiety.

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Psychotherapy

Mental health treatment focused on psychological problems.

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Valproate therapeutic range (mcg/mL)

50-100 mcg/mL for therapeutic serum levels

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Valproate use in children

Used to treat different types of seizures (psychomotor, myoclonic, absence, tonic-clonic) in children aged 6-12

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Valproate dose calculation

10-15 mg/kg/day in divided doses, increasing 5-10 mg/kg/week until seizures are controlled; maximum 60 mg/kg/day

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Valproate indication

Medication used to treat epilepsy and other conditions like bipolar disorder and migraine

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Serum drug levels monitoring

Monitoring the concentration level of anticonvulsant drugs in the blood

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Anticonvulsant adverse effects

May lead to anorexia, nausea, vomiting. Monitor blood cell counts for blood dyscrasias.

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Seizure precautions

Protect patients at risk of seizures from potential hazards like sharp objects

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Patient compliance with medication

Encouraging patient adherence to the prescribed medication regimen

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AChE inhibitors side effects

Monitoring for side effects like bradycardia, hypotension, and behavioral changes is important.

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Parkinson's Disease Medication (Selegiline)

A medication used to reduce symptoms of Parkinson's disease by increasing its dosage.

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Selegiline Mechanism

Selegiline's mechanism for alleviating Parkinson's symptoms is not described in the provided text.

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Dietary Changes for Selegiline

Specific dietary changes for TR taking selegiline are not outlined in the text.

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Muscle Relaxants Purpose

Relieve muscle spasms and pain from injuries or chronic conditions such as multiple sclerosis (MS), stroke, or cerebral palsy.

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Health Teachings for Patients

Instruct patients and families about medication purposes and schedules, safety techniques, support groups, and rising slowly.

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Monitor Liver Function Tests

Routine liver function tests are necessary to detect possible hepatotoxicity (liver damage) from medications.

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Patient Food Tolerance

Informing patients about appropriate food choices and potential tolerances for medications.

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Succinylcholine

A short-acting muscle relaxant used for procedures like intubation and endoscopy. It works by mimicking acetylcholine, causing a rapid and brief paralysis.

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Nondepolarizing Muscle Relaxants

These medications block the action of acetylcholine at the neuromuscular junction, causing muscle relaxation used in surgeries for longer procedures.

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Pancuronium Bromide (Pavulon)

A long-acting nondepolarizing muscle relaxant used in general anesthesia for surgeries requiring prolonged muscle relaxation.

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Vecuronium (Norcuron)

A medium-duration, nondepolarizing muscle relaxant used in general anesthesia. It produces muscle relaxation that lasts for an intermediate period.

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Anticholinergic Effects

Side effects of certain drugs, like muscle relaxants, that block the action of acetylcholine, resulting in symptoms like dry mouth, blurred vision, and urinary retention.

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Adverse Reactions to Muscle Relaxants

Serious side effects of muscle relaxants, including allergic reactions, angioedema, and heart problems.

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Contraindications for Muscle Relaxants

Conditions under which muscle relaxants should not be used, including acute myocardial infarction, heart rhythm problems, and hyperthyroidism.

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Nursing Responsibilities for Muscle Relaxant Patients

Monitoring vital signs, liver enzymes, and observing for side effects is important for nurses to follow.

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Opioid Criteria for Cancer Pain

When using opioids for cancer pain, they should be oral or transdermal, long-acting, combined with adjunct therapy, and cause minimal respiratory depression.

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Pain Types: Somatic

Pain originating from skeletal muscles, ligaments, and joints.

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Pain Types: Visceral

Pain originating from smooth muscle and organs.

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Nonopioid Analgesics: Uses

Nonopioid analgesics are used for mild to moderate pain, including headaches, menstrual pain, inflammation, minor injuries, muscle aches, and mild arthritis.

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Nonopioid Analgesics: Mechanism

Nonopioid analgesics (like aspirin, acetaminophen, ibuprofen, naproxen) are less potent than opioids and work by reducing inflammation and pain.

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Pain Types: Superficial

Pain originating from surface areas such as skin and mucous membranes.

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Pain Types: Vascular

Pain originating from vascular or perivascular tissues, often associated with headaches or migraines.

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Pain Types: Cancer

Pain from pressure on nerves and organs, blockage to blood supply, or cancer spreading to bones.

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Study Notes

Pharmacology Study Notes

  • University of San Agustin: Located in Iloilo City, Philippines.

  • NCM 106: Learning module focusing on pharmacology within the nursing program.

  • Module 4: Focuses on drugs affecting the body's systems, including the central nervous system (autonomic and peripheral).

  • Module Outcomes: Students should be able to perform appropriate health education, evaluate patient compliance to medication, document patient status/response related to drug therapy and proficiently manage resources (human, physical, financial, and time) for safe medication administration. Intra-agency, inter-agency, multidisciplinary, and sectoral collaborations should be demonstrated. Responsibility to stay current with nursing pharmacology trends and exemplify love for country. Students should exhibit professionalism and planning for safe medication practices.

  • Central Nervous System (CNS): Drug categories include anxiolytics, hypnotics, antidepressants, psychotherapeutic agents, antiepileptic agents, antiparkinsonism agents, muscle relaxants, narcotics, and anti-migraine drugs, as well as general and local anesthetics and neuromuscular blocking agents.

  • Anxiolytics/Hypnotics: Primarily for anxiety and insomnia; examples include benzodiazepines (lorazepam, alprazolam). Side effects include drowsiness, dizziness, and confusion. Nursing responsibilities include monitoring for side effects, recognizing tolerance/dependence, and lower dosing for older adults, children, and debilitated persons. Health teachings include slow transitions from sitting/standing, avoiding driving/machinery, and not combining with alcohol or CNS depressants.

  • Sedative-Hypnotics (Barbiturates & Nonbenzodiazepines): For sleep disorders. Short-acting, intermediate-acting, and ultra-short acting forms exist; examples include Zolpidem (Ambien). Side effects include drowsiness, dizziness, and confusion. Nursing responsibilities include vital sign monitoring (blood pressure, pulse), bed alarms for vulnerable patients, and evaluating for respiratory depression.

  • Antidepressants: Used for depressive episodes, characterized by mood changes and loss of interest in normal activities; contributing factors include genetics, social/environmental factors, and biological conditions. Types include Tricyclic antidepressants (TCAs) and Selective Serotonin Reuptake Inhibitors (SSRIs). Symptoms include loss of interest/pleasure, depressed mood, weight changes, and sleep/appetite disturbances. Nursing responsibilities include monitoring vital signs, especially blood pressure and pulse, to watch for orthostatic hypotension. Encouraging family support is critical. Health teaching should center on gradual changes in position, avoiding risky activities, and recognizing when to seek medical advice.

  • Mood Stabilizers: Used to treat bipolar affective disorder, including lithium, carbamazepine, valproic acid, and lamotrigine. Side effects include tremors, drowsiness, nausea, and other issues. Nursing responsibilities include monitoring therapeutic serum levels and advising patients about their importance. Health teaching should focus on taking the medication as prescribed, avoiding risky activities (especially when initially starting the dose), hydration, and fluid intake.

  • Antipsychotics: Used to treat psychotic symptoms; there are typical and atypical antipsychotics. Side effects include movement disorders, weight gain, and other issues. Nursing responsibilities include vital sign monitoring, frequent observation, and prompt reporting to the physician about any changes. Health teachings can include ensuring adherence to the prescribed dosing regimen and reporting any side effects. The patient should be discouraged from stopping the medication without physician authorization.

  • Antiepileptic Agents: Various medications used to control seizures; examples include phenytoin, ethosuximide, carbamazepine, and valproate. Side effects and nursing responsibilities are specific to each agent, and include close monitoring vital signs and labwork. Health teaching is focused on compliance with the treatment plan, adhering to the dose administration schedule, and reporting any unusual symptoms.

  • Muscle Relaxants: Several types are categorized as centrally and peripherally acting. Centrally acting types depress neuronal activity to relieve spasms. Peripherally acting types are adjuncts to anesthesia. Includes side effects like drowsiness, dizziness, nausea and vomiting. Nursing responsibilities include monitoring vital signs and assessing for adverse neurological symptoms, while health teaching will include patient safety measures, especially regarding driving/machinery operation and adherence to the treatment schedule.

  • Anti-migraine Medications: For treating acute migraine attacks. Triptans (e.g., sumatriptan) are more effective than ergot alkaloids for migraine relief. Side effects and nursing responsibilities should be carefully weighed, and health teachings might include reporting any side effects immediately.

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This quiz covers key concepts from Module 4 of the NCM 106 pharmacology learning module at the University of San Agustin. Focused on drugs affecting the central nervous system, it assesses knowledge of safe medication practices, patient compliance, and pharmacology trends. Prepare to demonstrate your understanding of CNS medications and their implications for nursing care.

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