Partial preview of the text
Download N303 - Unit 3 Study Guide - Manually Made Test Guide Review 2026 A+ and more Quizzes Nursing in PDF only on Docsity!
Muscarinic Receptors - /V-MI (neural) M2 (cardiac) M3 (glandular/smooth muscle) Nicontinic Receptors - /V-N] or NM - neuromuscular junction N2 or NN - autonomic ganglia, CNS and adrenal medulla Alpha and Beta Adrenergic Agonists - /¥-Stimulate SNS - increase HR, constrict blood vessels, dilate bronchitis, increase RR, eye pressure, dilates pupils, glycogenesis Tx of hypotension, cardiogenic shock, bronchospasm, asthma AE - dyspnea, hypokalemia Dopamine - VV-TV infusion Tx of hemodynamic imbalances, HF, shock Vesicant Fpinephrine - VV-IV, IM, nebulized Vasoconstrictor; do not use for fingers, toes, GU (as anesthetic) For cardiac arrest, hypotension post shock, anaphylaxis, local anesthetic Norepinephrine - /V-IV infusion Reverses hypotension (for emergencies, short term) Leaves extremities necrotic Pseudoephedrine - ¥¥-Oral BTC decongestant Meth precursor Not for those with HTN, heart disease Phenylephrine - V ¥-Vasoconstriction, minimal effect as decongestant Vesicant IV Clonidine - /V-For HTN Off label for opioid withdrawal, ADHD, cancer pain, migraines more CNS effects like drowsiness Can cause severe hypotension, HF Phenylephrine and Chlonidine - /V-Increased CNS activation, EKG, BP changes Do NOT stop taking suddenly - experience rebound HTN Albuterol - VV-Inhalation for bronchospasm Isoproternol - / V-TV infusion for shock, arrhythmias, hyperkalemia Terbutaline - / V-asthmas, bronchospasm, premature labor AE for albuterol, isoproternol, terbutaline - / V-Restlessness, anxiety, tachycardia, angina, palpitations, tremors, hypokalemia Adrenergic Antagonists - VV-Will reduce HR, myocardial contractility, CO Cardioselective beta blockers (B1) - / V-Metroprolol, atenolol Protect the hings Nonselective beta blockers (B1, B2) - ¥V-Propranolol, timolol, carvedilol, labetolol Cause lung problems Bethanechol - VV-Similar to acetylcholine, reacts directly Increase bladder tone, urinary excretion, GIT excretion Effects longer lasting, not destroyed by acetylcholinesterase AE; abd pain, salivation, NV, bradycardia, hypotension, dehydration Varencline - ¥V-Replacement for smoking cessation Start before quitting, stop by 12wk AE; nausea, mania, hallucinations, aggression, panic, psychosis Neostigmine - VV-Prevents Ach breakdown Reverse toxicity of NM junction blockers, tx of MG AE; Bradycardia, cardiac arrest, dysphasia, bronchial secretions Donepezil - /V-Cholinergic agonist Crosses BBB to increase ACh concentration Very long half life - 70hr! AE; insomnia, fatigue, rash, dyspepsia, muscle cramps, syncope Atropine, Glycorrolate, Ipratropium - / ¥-Competitively block ACh receptors Atropine - / V-Decreased secretions during procedures - prior to intubation Tx for bradycardia in ACLS, bladder relaxation Antidote for cholinergic drugs Scopolamine - /¥-Motion sickness patch, reduces GI secretions Ipratropium - ¥ V-Asthma, bronchospasm, rhinitis Combo with albuterol - DuoNeb Ocular medications - /V-May need to be administered in specific order Remove contacts! Administering ocular meds - /V-Administer into conjunctival sac, close and apply pressure for 30-60s Do not rub eye If client blinks, repeat procedure Wait 5+ min btwn types of drops Timolol - /V-Glaucoma Decrease IOP by decreasing aqueous production Systemic effects of beta blockade on heart, lungs Bradycardia, bronchospasm, hypotension Do NOT take excess, monitor for bradycardia Contraindicated with HR, bradycardia Brimonidine - /V-Glaucoma Decreases production and increase outflow of aqueous humor Cause stinging, dilated pupils, blurred vision, red eyes Overuse causes rebound congestion Azelastine - //-Intranasal antihistamine for allergic rhinitis Improves mucociliary function Bitter taste! Fluticasone/Mometasone - VV-intranasal glucocorticoid Rhinitis, chronic sinusitis Extremely potent vasoconstrictor and anti-inflammatory Topical agents - VV -Contraindicated for allergy, open areas of skin/wound Some patches contain metal Emollients - /¥-Ointments - contain most oil Creams - less oil Lotions - more water than oil, don't seal in moisture as well Apply using palm downward stroke Soak and seal method - /V-Soak in warm water, immediately apply moisturizer when wet to seal in Hydrocortisone, Behamethasone, Dexamethasone - V¥-Corticosteroids first line tx for eczema Steroids reduce itch, inflammation, dryness, prevent flares Corticosteroids cause thinning of skin!!! Tacrolimus, Pimecrolimus - ¥ /-Alternative to steroids if skin is damaged or steroids overused box warning - increased risk of skin cancer, lymphoma Crisaborole- / ¥-Targets PDE4 enzymes deep within skin For eczema, mild-moderate CHG - VV-Wipes are below jawline only Can cause burns in low birthweight neonates Some contain alcohol Todine and providone iodine - V/¥-Providone causes less toxicity/irritation Todine allergy is commo Acyclovir - VV-Genital of mucocutaneous herpes Apply at first sign of sores Local pain common - 30% ointment Clotrimazole - /¥-Vaginal yeast infection Ketoconazole - ¥ ¥-Cutaneous candidiasis, dandruff Nystatin - / V-Diaper dermatitis, candida skin infection Topical antibiotics - /V-Most skin infections use oral as first line Topical for second line Bacitracin - VV-Prevent skin/wound infections Mupirocin - V¥-Skin infections caused by staph - MRSA decolonization Imipramine - / V-Reduced reuptake of SHT, NE Depression, off label for pain, neuropathy, anxiety Takes 10-14d, max effect 4-8wk May cause sedation, works with sleep Anticholinergic effects (urine retention, constipation) Worsen psychosis symptoms, lower seizure threshold Phenelzine - /¥-Inhibit MOA, higher levels of NE, dopamine, 5HT Depression for those that cannot tolerate others Dizziness, nervousness, hyper-reflexive, tremors Takes months for peak effect SSRIs will cause serotonin syndrome! Tyramine foods, TCAs, vasopressin cause HTNsive crisis!!! Fluoxetine - ¥¥-Inhibit serotonin reuptake Depression, anxiety, off label for OCD, bulimia, PMDD, PTSD, phobias 4wk for full effect Mulch less AE than TCAs, MAOIs Rare lethal interacts - MAOTs, St John's wart, SNRIs Bleeding is with anticoags, NSAIDs Duloxetine - V ¥-Inhibits uptake of serotonin AND NE. More effective in some people Depression, anxiety, pain syndrome 4-6wk for full effect Rare, fatal interactions with MAOIs, SJW, amphetamines, fentanyl, lithium, tricyclics, triptans Bleeding risk with anticoags, NSAIDs Bupropion - /V-Inhibits reuptake of NE and dopamine Depression, smoking cessation, SSRI sexual dysfunction NO issues during pregnancy BW for CNS stimulation, neuropsychiatric effects Trazadone - V V-Blocks SHT, precursor uptake Depression AE; OH, priapism, drowsiness, fatigue, cognitive/motor impairment Haloperiod! - first gen - ¥ V-Blocks dopamine receptors, limiting brain stimuli Psychosis, schizophrenia, bipolar manic state, agitation, Tourrete's syndrome Part of B52 cocktails + diaphenhydramine + lorazepam AE; neuroleptic malignant syndrome, extrapyramidal symptoms Anticholinergic- teach to chew gum, sip water, stay cool May lower seizure threshold Neuroleptic Malignant Syndrome (NMS) - VV-High fever, HTN, muscle rigidity, arrhythmias Cool pt, give antipyretics Dantrolene can reverse rigidity Extrapyramidal symptoms - ¥¥-Similar to Parkinson's s/s, akathisia, dystonia, dyskinesia Deutrabenzaine and Valbenazine Clozapine - VV-Blocks dopamine, serotonin receptors - reduces bad side effects Psychosis, schizophrenia, combative behavior Lower risk for EPS, TD Vaproic acid, Zaonisamide - V/V-Block sodium channels, prevent repetitive nerve firing Seizures, trigeminal neuralgia, bipolar AE: blood dycrasias Lamotrigine - / V-High risk for suicide, drowsiness, aspectic meningitis Levetracetam - /V-CNS effects, makes kids irritable Topiramate - /V-CNS, metabolic acidosis, glaucoma Pregabilin - /V-Fibromyalgia Off label for seizures Gabapentin - /¥-Neuropathic pain Off label for seizures Carbiopda + levodopa - /V-Dopamine agonist + dopamine synthesis Parkinson's Most effective, wears off within 5y On-off phenomena worsens overtime Avoid large amounts of protein Benztropine - VV-Parkinson’s, drug induced EPS, dystonia AE; toxic megacolon, paralytic ileus Baclofen - //-Interfere with reflexes that cause spasms Spasticity, MSK pain, hiccups (muscle relaxant) Intrathecal infusion pump - put into spinal cord Dantrolene - J -Enter/work on muscle directly, prevents contraction/spasticity For motor-neuron related issues (spinal cord, CP, AT.S) Hepatotoxic Ergotmine - V¥-Constrict cranial blood vessels reducing hyperperfusion For migraines Pregnancy category X Vasospasms if given with triptans, antifungals, macrolides, grapefruit juice Causes gangrene with beta-blockers!!! Ergot toxicity Ergot toxicity - /V-Muscle pain, paresthesia, peripheral ischemia, thirst, BP changes Sumatriptan - /V-Serotonin receptor agonist, causes cranial vasoconstriction For migraines Less vascular and GI effects AE; vasocontrictive, chest pressure/angina, teratogenic Do NOT give with other triptans or ergots Galcanezumab - / V-Calcitonin gene related peptide inhibitors and determining agonists Monoclonal antibody SQ monthly AE; injection site reaction, hypersensitivity 1/2 life of opioid > 1/2 of naloxone - need repeat doses Abstinence syndrome - /V-Cramping, HTN, reversal of analgesia Buprenophrine - /V-Antagonist on Kappa receptor, agonist on Mu receptor Much lower potential for abuse, less respiratory depression, less analgesic effects AE; abstinence syndrome for opioid dependent individuals Midazolam - V V-General anesthetic Non-barbiturate, short acting benzo AE; respiratory/CNS depression, vomiting, hypotension Would be given to pt having long seizure Propofol - VV-General anesthetic Global CNS depression through gaba, short acting Can only be given by APRN/MD/DO AE: lowers BP, suppresses breathing, causes loss of consciousness Ketamine - / ¥-General anesthetic NMDA receptor agonist, produces dissociative experience Risk for misuse - schedule TIT drug Anesthesia, also antidepressant, pain AE; hallucinations, dreams, confusion, psychotic episodes Do NOT use with mental illness Nitrous oxide - Y V-General anesthetic CNS depressant Dental procedures, childbirth Metabolizes very quickly AE; none; book = CV/respiratory depression Can block reuptake of O2 post op Tetracaine, lidocaine, bupivacine - /V-Local anesthetic Cause temp interruption to nerve impulses, affect permeability of nerve membrane to sodium ions AE; high dose systemic absorption cause CNS, cardiac toxicity, burning, stinging, swelling, tenderness TV infusions used as anti-arrhythmic TV regional anesthesia - Bier Block - / V-Tie tourniquet before working to prevent anesthetic getting to rest of body Depolarization - /¥-Contraction Nondepolarization - /V-Does not contract Pancuronium, rocuronium, vercuronium - ¥ /-Antagonist to Ach at junction, prevents depolarization (contraction) With anesthesia to prevent movement, facilitate intubation, during procedures, electroconvulsant therapy AE: prolonged paralysis possible, loss of movement May cause wheezing, GI dysfunction, skin breakdown, hyperkalemia, cardiac dysrhythmias NEVER give without APRN, MD Anticipate intubation, monitor potassium Succinylcholine- /V-Attach to Ach receptor on muscle cell, causing prolonged depolarizing, flaccid paralysis Anesthesia, intubation, ventilator 
