Nursing Pharmacology and Anesthesia Review (Drugs, Sleep, Pain, Inflammation, Anesthesia, Postop Care)

Flashcards cover key concepts from the video notes on drug classifications, NCLEX naming conventions, sleep and CNS depressants, anesthesia, postoperative care, inflammation, gout, and pain management.

What naming convention is used on the NCLEX for drugs: brand names or generic names?

Only generic names are used; brands are not used on NCLEX questions.

Which suffixes are common for benzodiazepines?

-zepam and -zolam (e.g., temazepam, lorazepam, diazepam, midazolam).

What are the two primary vital signs you must monitor when giving CNS depressants?

Respiratory rate and blood pressure.

What is the antidote for opioid-induced respiratory depression?

Naloxone (Narcan).

What is the antidote for benzodiazepine overdose?

Flumazenil.

What is balanced anesthesia?

A combination of drugs used to achieve general anesthesia with minimal doses of any single drug, reducing side effects and speeding recovery.

How do spinal and epidural anesthesia differ?

Spinal anesthesia injects into the cerebrospinal fluid causing sensory and motor block; epidural injects into the epidural space above the dura, numbing pain while often preserving some movement.

Name three major postoperative complications related to immobility?

Deep vein thrombosis (DVT), constipation, and respiratory complications such as atelectasis or pneumonia.

What are the five cardinal signs of inflammation?

Redness, warmth (heat), edema (swelling), pain, and drainage (pus).

Which NSAID is linked to Reye syndrome in children?

Aspirin (acetylsalicylic acid).

What two COX enzymes do most NSAIDs inhibit?

COX-1 and COX-2.

Why were COX-2 inhibitors like Vioxx/Celecoxib controversial?

They were associated with increased risk of stroke and heart attack; Vioxx was withdrawn; Celecoxib has a black box warning.

What is the maximum daily dose of acetaminophen in the hospital?

4000 mg per day (4 g).

What is the antidote for acetaminophen overdose?

N-acetylcysteine (NAC), also known as Mucomyst.

What is a patient-controlled analgesia (PCA)?

A device that allows patients to self-administer preset opioid doses with a lockout mechanism to prevent overdose.

What are the two commonly used opioids in PCA as mentioned?

Morphine and hydromorphone (Dilaudid).

Why should IV push opioids be diluted and given slowly (over 4-5 minutes)?

To avoid adverse reactions such as vomiting, excessive sedation, and respiratory depression; rapid administration can cause severe adverse effects.

What is meant by drug synergism in analgesia?

Using two drugs together to produce a greater effect than the sum of their individual effects (potentiation).

What are monoclonal antibodies used as DMARDs? Give examples.

Immunomodulators used to treat inflammatory diseases; examples include infliximab and adalimumab.

What is hydroxychloroquine used for and what are key safety concerns?

An antimalarial also used off-label for inflammatory diseases (RA, lupus); potential cardiac toxicity and ocular/cranial nerve effects; monitor accordingly; not universally safe.

Name common gout treatments that reduce uric acid crystals.

Colchicine for acute gout; allopurinol to reduce uric acid production; uricosurics (e.g., probenecid) to increase uric acid excretion; avoid aspirin.

What is allopurinol's mechanism?

Xanthine oxidase inhibitor that reduces uric acid production.

What is a uricosuric and give an example?

A drug that increases uric acid excretion by the kidneys; example: probenecid.

What are the main benefits and risks of acetaminophen (Tylenol)?

Analgesic and antipyretic, safe for fever in children, but risk of liver toxicity; overdose treated with N-acetylcysteine.

What are common adverse effects of narcotics (opioids)?

Nausea/vomiting, constipation, hypotension, urinary retention, respiratory depression, sedation; tolerance, dependence, withdrawal.

What is naloxone used for vs flumazenil?

Naloxone reverses opioid effects; flumazenil reverses benzodiazepines.

What is REM rebound and how can it be prevented?

Intense nightmares or distress after stopping sedative-hypnotics; prevent by tapering dose rather than abrupt cessation.

What is the role of incentive spirometry after surgery?

Promotes deep breathing to prevent secretions from pooling and atelectasis; reduces pneumonia risk.

What are -caine endings and examples of local/topical anesthetics?

Drugs ending in -caine (e.g., lidocaine, bupivacaine) used for local or topical anesthesia; some can be used for nerve blocks or spinal/epidural.

What is the difference between spinal vs epidural anesthesia in labor?

Spinal anesthesia causes complete loss of sensation and motor; epidural reduces pain while allowing some mobility; both require monitoring and assessment of urinary output and neurologic function.

Why is early mobilization important after surgery?

Prevents DVT, reduces pneumonia risk, and improves GI motility; speeds recovery.

What role do NSAIDs play in inflammation and GI safety?

NSAIDs reduce inflammation by inhibiting COX enzymes; COX-1 inhibition can irritate gastric mucosa and cause GI bleeding; monitor for bleeding and ulcers.

What are DMARDs and give examples of monoclonal antibodies and other types?

Disease-modifying antirheumatic drugs; monoclonal antibodies (MABs) such as infliximab and adalimumab; non-MAB DMARDs include methotrexate and hydroxychloroquine.

What is the role of corticosteroids in inflammation and their side effects?

Rapidly reduce inflammation by mobilizing leukocytes to the bloodstream; may cause leukocytosis and hyperglycemia; risk infection; require tapering to avoid adrenal suppression.

What are nonnarcotic analgesics and give examples?

Analgesics that are not opioids; include acetaminophen and NSAIDs like aspirin and ibuprofen.

What must be considered when giving opioids to head-injured patients?

Avoid or carefully monitor due to potential respiratory depression and deterioration of neurologic status; monitor frequently.

What is the purpose of atropine in anesthesia?

An anticholinergic used to dry up saliva and secretions, protecting the airway during anesthesia and surgery.