1. Uses of epinephrine, ways given, what route is not used? It is frequently used to treat anaphylaxis (life threatening allergic

response), bronchospams, cardiogenic shock, cardiac arrest, asthma and severe hypotension.

Also used to increase cardiac output, vasoconstriction, heart rate, increase systolic pressure.

Epinephrine can be administered SubQ, IV, IM, topically, or by inhalation, intracardiac, and instillation methods. It cannot be given orally, this is because it is rapidly metabolized in the GI tract and liver which results in unstable serum levels.

2. Early Alzheimer’s drug o Acetylcholinesterase (AChE) inhibitors/ Cholinesterase inhibitors.

atropine can be used as an antidote tacrine (Cognex) donepezil (Aricept) rivastigmine (Exelon) galantamine (Razadyne)

3. How do you counteract the effects of dry mouth? Ice chips Sugarless chewing gum Hard candy

4. Can glaucoma clients be treated with atropine like drugs? No, because it will increase intraocular pressure in the eye and

cause irreversible damage. It is an anticholinergic. These dry you out (“can’t see, cant pee, cant spit, cant shit)

5. Client has Parkinson’s what would giving them anticholinergics do for them?

Inhibit the release of acetylcholine which reduces rigidity and some tremors with minimal effect of bradykinesia.

i. benztropine (Cogentin) These are anticholinergics and Parkinsons treatment drug

ii. trihexyphenidyl - HCl (Artane)iii. biperiden (Akineton)

6. Treat client with narcolepsy with modafinil what will it do for them? Increases the amount of time narcoleptic patients feel awake.

7. Best time to administer amphetamines. In the morning. This is because they cause sleeplessness and

restlessness.8. ADHD behavior

Children are less than 7 when this occurs. Most common in boys Inability to concentrate, inability to complete task,

inattentiveness, restlessness, hyperactivity, impulsivity.9. When take Ritalin?

Give before breakfast and lunch. This is because it causes insomnia, restlessness, and speeds things up.

10. treatment for mild headache? Non-opioid analgesics Perferred drugs for fever and headache: aspirin,

acetomenophine, ibuprofen.i. Aspirin (NSAID)ii. Acetomenphine* (NSAID)iii. Ibuprophen*iv. Naproxine (NSAID)

11. Know VS on infant that would show that caffeine treatment was effective.

Newborn: R: 30-55 HR: 70-190 BP: 73/55 Infant: R: 20-40 HR: 80-150 BP: 85/37 Caffeine is an analeptic and depending on the dose it stimulates

the CNS and large doses stimulates respirations. Newborns with respiratory distress might be given caffeine to increase respirations. It increases HR and BP. It is given by a NG or IV.

12. Diet concerns with Ritalin. Avoid caffeine and alcohol. Encourage patient to eat a balanced diet due to anorexic effects

can occur.13. Long term use of hypnotics may lead to…?

Therapy should be short term to prevent drug dependence and drug tolerance. Abruptly discontinuing can cause withdraw symptoms and REM rebound. Long term use can also result in depression (lethargy, sleepiness, lack of concentration, confusion, and psychological depression).

14. Lidocaine used most frequently as what type of anesthesia? Topical It is an analgesic.

15. spinal anesthesia – teaching afterward. Patient needs to stay flat after spinal injection to decrease the

likelihood of leaking spinal fluid, which will lead to a headache. Patient should also increase fluids, to decrease likelihood of leaking spinal fluid. Warn patient of possible hypotension.

Side effects: respiratory distress, headache, and hypotension.16. Side effect of Dilantin

Gingival hyperplasia Steven-Johnson’s syndrome (sloughing of the skin) Nystagmus Headache Diplopia (double-vision) Dizziness Slurred speech Decrease coordination

Alopecia (balding) Thrombocytopenia (low blood platelet count) Don’t use it in pregnancy (category X)

Suppresses NA+ influx, anticonvulsant, phenytoin. 17. How long do you take seizure medication?

Anticonvulsants are generally taken throughout a person’s lifetime. In some cases a health care provider might discontinue the drug if no seizures have occurred in the past 3-5 years.

18. status epilepticus first drug. Type of epilepsy. Diazapam (Valium) is used primarily for acute status epilepticus

as a short term effect and must be given in conjunction with or immediately before other anticonvulsants.

19. urine color with phenytoin? Harmless pinkish red, or brown.

20. Myasthenia Gravis client teaching overdose of cholinesterase inhibitor?

Teach them that cholinesterase inhibitors are absorbed best if taken before meals. Needs to be administered on time. Monitor drug effectiveness. And encourage them to wear a Med ID bracelet.

21. Would precipitate cholinergic crisis? Caused by continuous depolarization of post synaptic

membranes that create a neuromuscular blockade, or if you OD on the inhibitor.

Usually occurs within 30-60 min after taking anticholinergic medications.

22. What are s/s of cholinergic crisis? Severe muscle weakness: respiratory paralysis and arrest,

abnormal pupil constriction, excess salivation, pallor, sweating, vertigo, GI distress, bradycardia, fasciculations. Worsens after edrophonium chloride (Tensilon)

23. Antidote for crisis? Atropine

24. Treatment for acute exacerbation of MS. Tapering course of glucocorticoids (Prednisone),

adrenalcorticotropic hormone (ACTH), stimulates the adrenal cortex to secrete cortisol.

25. ACTH Adrenocorticotropic hormone side effects Raises blood sugar Suppresses inflammatory and immune responses. Prednison increase glucose, and eats away at your cartilage after

long term use.i. Nauseaii. Diarrheaiii. Abdominal distention

iv. Increased appetitev. Sweatingvi. Headachevii. Depressionviii. Flushingix. Mood changesx. Cataractsxi. Amenorrhea

26. Treated with Robaxin 0 discolor urine? Can turn urine green, brown, or black.

27. NSAIDS effects? Used as anti-inflammatory drug, inhibit biosynthesis of

prostaglandins, analgesic effect, and antipyreyic (anti fever and pain), inhibit platelet aggregation, mimic effects of corticosteroids. Inhibits COX enzymes. (COX1 –protects stomach lining, COX2- pain and inflammation).

28. Protein bound drug given already taking one that is not as highly bound what happens.

More free drug to be released in the blood because they compete for protein binding spots. Can lead to toxicity.

29. Should antipsychotics be stopped? No, they should be weaned off gradually to avoid withdraw

symptoms.30. Foods to not eat with MAOs

Anything that contains Tyramine (can lead to hypertensive crisis): cheese, yogurt, coffee, bananas, raisins, Italian green beans, liver, pickled foods, sausage, soy sauce, yeast, beer and red wines.