NU 381 Pharmacology Exam 2 Study Guide Flashcards

Comprehensive vocabulary flashcards covering medications, drug classes, toxicities, memory tricks, and nursing priority concepts for NU 381 Pharmacology Exam 2.

Baclofen

A centrally acting skeletal muscle relaxant and antispastic indicated for spasticity associated with conditions such as multiple sclerosis or spinal cord injury. It acts at the spinal cord to decrease muscle spasms and rigidity. Abrupt withdrawal can cause hallucinations, seizures, confusion, and rebound spasticity.

Phenytoin

An anticonvulsant that stabilizes neuronal membranes to control seizure disorders. Common total serum reference range is $10\text{--}20\,\text{mcg/mL}$. Adverse effects include gingival hyperplasia and rash; toxicity produces nystagmus, ataxia, slurred speech, and increased CNS depression.

Corticosteroids

Glucocorticoid anti-inflammatory and immunosuppressant drugs (e.g., prednisone, methylprednisolone, dexamethasone) used for inflammatory, allergic, and autoimmune disorders. Side effects include hyperglycemia, fluid retention, and weight gain. Major dangers include infection, GI ulcer/bleeding, osteoporosis, and adrenal crisis if abruptly stopped after long-term use.

Opioids

Analgesic medications (e.g., morphine, fentanyl, hydromorphone, oxycodone) given for moderate-to-severe pain that bind CNS opioid receptors. Major immediate dangers are respiratory depression and profound sedation. Reversed by naloxone.

Levodopa/Carbidopa

An antiparkinson dopaminergic combination used for symptomatic treatment of Parkinson disease. Levodopa converts to dopamine in the brain, while carbidopa prevents peripheral levodopa breakdown. High-protein meals can interfere with absorption.

Timolol (ophthalmic)

A nonselective ophthalmic beta blocker that decreases aqueous humor production to lower intraocular pressure in glaucoma. Gently pressing the inner canthus/nasolacrimal duct reduces systemic absorption. Systemic absorption carries bronchoconstriction risks, making asthma a major concern.

Lithium

A mood stabilizer with a narrow therapeutic index (maintenance range about $0.6\text{--}1.2\,\text{mEq/L}$) used for bipolar disorder. Toxicity signs include coarse tremor, ataxia, confusion, and severe GI symptoms. Risk of toxicity increases with dehydration, sodium depletion, or NSAID use.

MAOIs

Monoamine oxidase inhibitor antidepressants (e.g., phenelzine, tranylcypromine). Ingesting tyramine-rich aged, fermented, or cured foods while on MAOIs can precipitate a dangerous hypertensive crisis (severe headache, elevated BP, chest pain).

Diazepam

A benzodiazepine that enhances inhibitory GABA activity in the CNS to treat anxiety, acute seizures, muscle spasms, and alcohol withdrawal. Major risks include respiratory/CNS depression, dependence, and withdrawal. Reversed by flumazenil.

Buspirone

A nonbenzodiazepine anxiolytic for generalized anxiety disorder that modulates serotonin receptors without immediate sedation. It requires scheduled daily administration and takes several weeks for full therapeutic benefit, so it is not a PRN rescue drug.

Tramadol

An analgesic for moderate pain with weak opioid receptor activity and serotonin/norepinephrine reuptake inhibition. Two major adverse dangers are seizures and serotonin syndrome.

Naproxen

An NSAID that inhibits prostaglandin synthesis to manage pain, fever, and inflammation. Major risks follow the G-K-C pattern: GI ulcer/bleeding, Kidney injury, and Cardiovascular thrombotic risk. It can also increase lithium levels.

Valproate

An anticonvulsant and mood stabilizer used for seizure disorders, bipolar disorder, and migraine prevention. Key toxicities to monitor include hepatotoxicity, pancreatitis, and thrombocytopenia, as well as significant fetal risk in pregnancy.

Alprazolam

A benzodiazepine indicated for anxiety and panic disorders that enhances GABA-mediated CNS inhibition. Abrupt discontinuation after prolonged regular use can cause withdrawal seizures.

Benzodiazepines

A class of CNS depressant anxiolytics/sedatives that enhance GABA activity. Combining benzodiazepines with opioids and alcohol creates a severe/fatal risk for CNS and respiratory depression. Reversal agent is flumazenil.

Risperidone

An atypical antipsychotic acting via dopamine and serotonin antagonism for schizophrenia, bipolar disorder, and autism irritability. Key risks include metabolic changes, elevated prolactin, extrapyramidal symptoms, and Neuroleptic Malignant Syndrome (NMS).

NSAIDs

Nonsteroidal anti-inflammatory drugs that reduce prostaglandin production to decrease pain, inflammation, and fever. Primary clinical concerns include GI bleeding/ulcers, renal impairment, fluid retention, hypertension, and cardiovascular risk.

Cannabis

A psychoactive cannabinoid that acts on cannabinoid receptors and alters CNS function. Common side effects include impaired memory, judgment, coordination, and reaction time. Driving safety and avoiding combination with other CNS depressants are primary teaching points.

Dantrolene

A direct-acting skeletal muscle relaxant that reduces calcium release from muscle cells. It is the key treatment for malignant hyperthermia. Ongoing therapy carries a major risk of hepatotoxicity.

Oxcarbazepine

An anticonvulsant that stabilizes neuronal electrical activity through sodium-channel blockade. A primary major adverse effect is hyponatremia, requiring serum sodium monitoring.

Sumatriptan

A triptan / serotonin receptor agonist used for acute migraine attacks by producing cranial vasoconstriction. It is contraindicated in patients with coronary artery disease and uncontrolled hypertension due to vasoconstrictive cardiovascular risks.

Serotonin Syndrome

A life-threatening condition caused by excess serotonergic activity. Key presentation includes mental status agitation, autonomic dysfunction (fever, sweating, diarrhea, tachycardia), and neuromuscular hyperactivity (hyperreflexia, clonus, tremor).

Neuroleptic Malignant Syndrome (NMS)

An emergency reaction associated with antipsychotic drugs (e.g., risperidone) characterized by high fever, severe lead-pipe rigidity, altered mental status, and autonomic instability.

Malignant Hyperthermia

A perioperative emergency triggered by anesthesia, presenting with severe muscle rigidity, rapidly rising end-tidal $\text{CO}_2$, tachycardia, and severe hyperthermia. Treated urgently with dantrolene.

SSRIs

Selective serotonin reuptake inhibitor antidepressants (e.g., fluoxetine, sertraline, escitalopram) that inhibit serotonin reuptake. Full therapeutic benefits require several weeks. Combining SSRIs with MAOIs or tramadol poses a high risk of serotonin syndrome.

Narrow Therapeutic Window

A property of drugs (e.g., lithium) where effective therapeutic levels and toxic concentrations are very close, requiring serum drug level monitoring, organ function evaluation, and clinical assessment.

Flumazenil

The specific reversal agent for benzodiazepines. It must be used cautiously because it can precipitate withdrawal seizures in patients with physical dependence.

Naloxone

The opioid antagonist used to reverse opioid-induced respiratory depression. Continuous monitoring is essential post-administration because respiratory depression can recur as naloxone wears off.

Medication Error Priority Sequence

The essential sequence of nursing steps following a drug administration error: Assess the patient first to ensure safety, provide necessary supportive care, notify the healthcare provider, and then file an incident report per facility policy.