Pharmacology of Amphetamines and Migraine Medications

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Questions and Answers

What is the mechanism of action of amphetamines?

  • They inhibit the release of norepinephrine and dopamine.
  • They increase the production of acetylcholine.
  • They block the reuptake of serotonin and dopamine.
  • They stimulate the release of norepinephrine and dopamine. (correct)

Which of the following medications is NOT an amphetamine?

  • Dexedrine
  • Adderall
  • Xenical (correct)
  • Ritalin

What is a potential adverse effect of amphetamine use?

  • Weight gain
  • Increased appetite
  • Decreased heart rate
  • Insomnia (correct)

What is the primary indication for the use of anorexiants?

<p>Management of obesity (D)</p> Signup and view all the answers

Which of the following is a common medication used in the treatment of migraine headaches?

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

What is an important nursing implication for patients taking amphetamine medications?

<p>Administer the last dose 4-6 hours before bedtime (D)</p> Signup and view all the answers

What is a potential adverse effect of anti-migraine medications like triptans?

<p>Vasoconstriction-related issues (B)</p> Signup and view all the answers

What is the primary mechanism of action for anti-migraine medications?

<p>Constricting blood vessels in the brain (D)</p> Signup and view all the answers

What is a common side effect associated with dopamine agonists used in treating Parkinson's disease?

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

Which nursing action is most appropriate for a patient taking levodopa/carbidopa who experiences psychosis?

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

What is a common adverse effect of MAO-B inhibitors used in the treatment of Parkinson's disease?

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

Which nursing action is most appropriate for a patient taking dopamine releasers (e.g., amantadine) who experiences constipation?

<p>Administer a high-fiber diet (D)</p> Signup and view all the answers

Which nursing action is most appropriate for a patient taking centrally acting anticholinergics (e.g., Benztropine) who experiences confusion?

<p>Avoid confronting activities requiring alertness (D)</p> Signup and view all the answers

What is a common adverse effect of centrally acting anticholinergics (e.g., Benztropine) used in the treatment of Parkinson's disease?

<p>Atropine-like effects (B)</p> Signup and view all the answers

What is the primary mechanism of action for centrally acting anticholinergics in the treatment of Parkinson's disease?

<p>Blocking acetylcholine receptors (A)</p> Signup and view all the answers

Which of the following medications is an opioid antagonist used to reverse the effects of opioid overdose?

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

Which of the following opioids is considered an agonist-antagonist opioid?

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

What is a potential therapeutic use of opioid antagonists like naltrexone?

<p>Treatment of opioid dependence by preventing euphoria (C)</p> Signup and view all the answers

Which of the following routes of administration is NOT typically used for buprenorphine?

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

What is a key nursing consideration when administering opioid medications?

<p>Monitoring for signs of respiratory depression (D)</p> Signup and view all the answers

Which of the following medications might be used to manage opioid-induced constipation in late-stage diseases?

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

Which of the following is NOT a potential therapeutic use of agonist-antagonist opioids?

<p>Reversal of opioid overdose (D)</p> Signup and view all the answers

Which route of administration is commonly used for naloxone administration?

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

What is a primary concern when prescribing beta blockers?

<p>Symptoms of bradycardia (C)</p> Signup and view all the answers

Which symptom may be masked in diabetic patients taking certain medications?

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

What should be monitored when a patient is on anticonvulsants or tricyclic antidepressants?

<p>Any unusual symptoms (B)</p> Signup and view all the answers

What is a recommended practice for patients on medications that cause anticholinergic effects?

<p>Practice good oral hygiene (D)</p> Signup and view all the answers

What is a significant risk when prescribing medications during pregnancy and lactation?

<p>Potential fetal harm (A)</p> Signup and view all the answers

Which of the following is a common reason for treatment failure in epilepsy?

<p>Non-adherence to the drug regimen (D)</p> Signup and view all the answers

What classifies a seizure as generalized onset?

<p>Starts simultaneously in both hemispheres (A)</p> Signup and view all the answers

Why is documentation of seizure symptoms critical?

<p>To assist in identifying the seizure type (D)</p> Signup and view all the answers

What type of anesthesia is particularly effective for procedures like nerve blocks?

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

Which of the following is NOT a common adverse effect associated with local anesthetics?

<p>Increased heart rate (B)</p> Signup and view all the answers

What is a common complication that can occur after spinal anesthesia?

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

Which of the following is a common treatment option for a spinal headache?

<p>Bed rest and analgesics (B)</p> Signup and view all the answers

What is the role of nurses in the postoperative care of patients who have received anesthesia?

<p>Monitoring vital signs and ensuring patient safety (C)</p> Signup and view all the answers

Which of the following is NOT a non-pharmacological pain management technique?

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

What is a key aspect of effective pain management?

<p>Regular reassessment of pain levels (B)</p> Signup and view all the answers

What is the primary goal of anesthetic administration?

<p>To minimize pain and discomfort (A)</p> Signup and view all the answers

Which of the following is a potential complication associated with aspirin use in children and adolescents with viral illnesses?

<p>Reye's Syndrome (D)</p> Signup and view all the answers

What is the primary pharmacological action of acetaminophen?

<p>Slowing production of prostaglandins in the central nervous system (A)</p> Signup and view all the answers

Which of these individuals should be advised to limit their daily acetaminophen intake to 2 g/day?

<p>A client consuming more than three alcoholic drinks daily (B)</p> Signup and view all the answers

What nursing action is appropriate when a client is suspected of having acetaminophen toxicity?

<p>Administering acetylcysteine as an antidote via duodenal tube (C)</p> Signup and view all the answers

Which of the following is a contraindication for the use of acetaminophen?

<p>Chronic alcohol use disorder (B)</p> Signup and view all the answers

What nursing action is appropriate when a client is taking warfarin and acetaminophen?

<p>Monitoring prothrombin time and INR levels (C)</p> Signup and view all the answers

Which of the following is a precautionary measure when administering NSAIDs?

<p>Administering with food or milk to reduce gastric discomfort (D)</p> Signup and view all the answers

When should a client discontinue aspirin before elective surgery or childbirth?

<p>One week before (D)</p> Signup and view all the answers

Flashcards

CNS Stimulants

Drugs that enhance mental alertness by releasing norepinephrine and dopamine.

Common Amphetamines

Dextroamphetamine, Adderall, and Ritalin are examples of this category.

ADHD Treatment

CNS stimulants are frequently used to treat ADHD in various age groups.

Anorexiants

Appetite-suppressing medications, typically sympathomimetic drugs.

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Common Anorexiant

Orlistat (Xenical) is a well-known medication in this category.

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Anti-Migraine Medications

Drugs like triptans that constrict blood vessels to treat migraines.

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Common Anti-Migraine Drugs

Sumatriptan, Rizatriptan, and Zolmitriptan are key medications.

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Monitor Adverse Effects

Key nursing responsibility in managing patients on CNS drugs.

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Parenteral Administration

Injection into tissues or the CNS, including methods like epidural or spinal injections.

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Local Anesthetics Uses

Medications used for minor surgeries, dental work, and chronic pain management.

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Adverse Effects of Local Anesthetics

Reactions that can occur from high doses or accidental intravascular injections.

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Spinal Headache

A common post-procedure headache from spinal anesthesia that may require rest and caffeine.

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Nursing Considerations

Essential duties involving patient assessment and monitoring throughout anesthesia phases.

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Pain Management Approaches

A combination of pharmacological and non-pharmacological methods to relieve pain.

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Pharmacological Pain Relief

Use of medications like opioids, NSAIDs, and adjuvant drugs for pain management.

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Non-Pharmacological Interventions

Methods such as massage and repositioning to help manage pain.

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Centrally Acting Anticholinergics

Medications that block muscarinic receptors to balance dopamine and acetylcholine.

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Levodopa/Carbidopa Adverse Effects

Common side effects include nausea, drowsiness, and dyskinesias.

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Dopamine Agonists Risks

Risk of sudden sleepiness and hallucinations.

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Dopamine Releasers (Amantadine)

Can cause confusion, dizziness, and dry mouth.

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COMT Inhibitors Adverse Effects

Gastrointestinal problems and potential liver failure.

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MAO-B Inhibitors Diet Warning

Avoid tyramine to prevent hypertensive crisis.

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Centrally Acting Anticholinergics in Older Adults

May cause sedation and confusion; regular eye exams recommended.

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Medication Effectiveness Evaluation

Assess recovery of muscle strength and cognitive improvement.

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Agonist-Antagonist Opioids

Opioids that activate kappa receptors while blocking mu receptors, reducing abuse potential.

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Butorphanol

Prototype medication for agonist-antagonist opioids used for pain relief.

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Opioid Antagonists

Drugs that block opioid receptors to reverse effects like respiratory depression.

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Naloxone

Prototype opioid antagonist used to reverse the effects of opioid overdose.

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Therapeutic Uses of Opioids

Used for pain relief, sedation, cough suppression, and more.

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Routes of Administration for Naloxone

Can be given IV, IM, or subcutaneously for quick action in emergencies.

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Opioid-Induced Constipation

A side effect of opioids, managed by medicines like Methylnaltrexone.

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Reye’s Syndrome

A rare complication from aspirin use in children with viral illnesses.

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Aspirin Toxicity

Progressive symptoms from mild salicylism to severe outcomes like acidosis and coma.

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Acetaminophen Action

Slows the production of prostaglandins in the central nervous system.

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Acetaminophen Limits

Maximum intake is 4 g/day, lower for undernourished and heavy drinkers.

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Acetaminophen Toxicity

Can cause liver damage, starting with nausea and abdominal discomfort.

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Acetylcysteine

An antidote for acetaminophen toxicity given via duodenal tube.

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NSAID Administration

Take NSAIDs with food to reduce gastric upset; stop aspirin before surgery.

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Warfarin Interaction

Alcohol increases liver damage risk and affects warfarin metabolism.

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Beta Blockers Symptoms

Monitor for bradycardia and hypotension in patients.

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Hypoglycemia Awareness

Diabetics may not notice low blood sugar symptoms when on certain drugs.

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Anticonvulsant Monitoring

Report unusual symptoms like GI distress or CNS signs.

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Pregnancy Medication Guidelines

Many drugs pose risks during pregnancy and lactation.

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Chronic Conditions and Medications

Avoid medications in patients with liver, renal, or cardiac issues.

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Seizure Classifications

Seizures can be generalized, focal, or unknown origin.

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Seizure Documentation

Document symptoms and events before, during, and after seizures.

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Medication Noncompliance

Non-adherence to medication is a key reason for epilepsy treatment failure.

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Study Notes

Overview of Epilepsy and Seizures

  • Epilepsy is a chronic neurological condition characterized by recurrent, unprovoked seizures resulting from uncontrolled electrical activity within the brain.
  • Seizures can lead to periods of convulsive behavior, significant muscle contractions, and loss of consciousness.
  • The terms seizure and convulsion are often used interchangeably but aren't synonymous with epilepsy.

Status Epilepticus

  • A critical condition of continuous seizure activity with no interim recovery.
  • It can result in permanent brain damage or death.
  • It's considered a medical emergency requiring immediate intervention.

Antiepileptic Drugs (AEDs)

  • Primary objectives are to control or prevent seizures and minimize adverse effects and toxicity from medication.
  • Therapy is typically long-term, often lifelong, and may involve single or combination drugs, with single-drug therapy usually being the initial approach.

Mechanism of Action

  • These medications work by reducing the ability of neurons to stimulate and suppress the transmission of electrical impulses between nerves, and slow down nerve impulse conduction.

Indications and Usage

  • These medications are used for the prevention and control of seizures.
  • It's used as maintenance therapy for chronic seizures.
  • Used for emergency treatment of convulsions and status epilepticus.

Common AEDs and Their Characteristics

  • Barbiturates: Phenobarbital and Primidone.
    • Used to control seizures.
    • Common side effect includes sedation.
    • Blood levels must be monitored to stay within the therapeutic range.
  • Hydantoins: Phenytoin (Dilantin).
    • First-line drug for many years.
    • Adverse effects include gum hyperplasia, acne, hair growth, and bone loss.
    • Administered via slow IV with numerous incompatibilities .
    • Fosphenytoin (Cerebyx) is an injectable prodrug, less irritating than phenytoin.
  • Iminostilbenes: Carbamazepine (Tegretol).
    • Common for controlling seizures but has interactions inducing hepatic enzymes, leading to varied reactions.
  • Miscellaneous AEDs: Gabapentin (Neurontin) and Lamotrigine (Lamictal).
    • Gabapentin (Neurontin): Analog of GABA, used for partial seizures and neuropathy.Generally well-tolerated with possible CNS and GI symptoms.
    • Lamotrigine (Lamictal): Used for various seizure types, including those in Lennox-Gastaut syndrome; can cause eye problems.
  • Other AEDs: Levetiracetam (Keppra), Pregabalin (Lyrica), Topiramate (Topamax), Valproic Acid.

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