Test 3 Assignments (8-11)

What is Acetylcholine?

The neurotransmitter of the Cholinergic system.

function of muscarinic receptors

Located on parasympathetic target tissues (e.g., intestines, bladder, bronchial tree); actions include slowing HR, relaxing vessels, increasing GI secretions/motility, pupil constriction, and accommodation.

function of Nn (nerve) receptors

Located on ganglia in the CNS; involved in functions like speech, thought, movement, and memory.

function of Nm (muscle) receptors

Located on skeletal muscles; responsible for neuromuscular movement.

how does Acetylcholine removal take place?

Broken down by acetylcholinesterase into choline and acetic acid.

what are Cholinergic agonists? How are they recognized?

Bind directly to muscarinic receptors; recognized by "-chol".

what are Cholinesterase inhibitors? How are they recognized?

Inhibit acetylcholinesterase to increase ACh; recognized by "-stigmine."

Examples of Infectious threats

Examples include anthrax, smallpox, plague; protection includes antibiotics, vaccines, PPE.

examples of Chemical threats

Examples include nerve gas, cyanide; protection includes chemical antidotes and PPE.

what is a Cholinergic crisis?

Medical emergency caused by overstimulation of ACh system.

Causes of cholinergic crisis

Overdose on ACh inhibitors, nerve gas, organophosphate insecticides.

Signs of cholinergic crisis

Hypersalivation, small pupils, twitching, sweating, weakness, dyspnea.

Treatment for cholinergic crisis

Atropine (antidote).

Radiation protection

Avoid exposure, decontaminate, take potassium iodide (KI), monitor symptoms.

What is Glaucoma?

Eye disease with increased IOP and vision loss; treated with antiglaucoma drugs if IOP > 21 mmHg.

what is an Eye cataract?

Cloudy eye lens; treated by surgery with artificial lens replacement.

function of Mydriatic drugs?

Dilate pupils for retinal exam (e.g., phenylephrine).

function of Cycloplegic drugs?

Dilate pupils and paralyze lens (e.g., atropine).

function of Miotic drugs?

Cause pupil constriction and improve aqueous humor outflow.

what are Hallucinations?

False sensory perception.

what are Delusions?

False beliefs.

Positive symptoms of psychosis

Added symptoms such as hallucinations.

Negative symptoms of psychosis

Lost symptoms such as hygiene and withdrawal.

what is Dopamine involved in?

The neurotransmitter involved in psychosis.

function of Phenothiazines? Serious side effects?

Block dopamine/serotonin; risk of EPS, NMS, suicide.

Common side effects of phenothiazines

Sedation, dry mouth; monitor for side effects and educate patient.

What are the severe side effects associated with nonphenothiazines (haloperidol)?

Similar to phenothiazines; risk of EPS, NMS, respiratory depression.

Side effects of haloperidol

Tremor, EPS, hypotension; monitor compliance and educate.

MOA of Atypical antipsychotics

Block D2 and serotonin receptors; treat positive and negative symptoms.

what is ADHD?

Disorder with poor attention, hyperactivity, and behavioral issues.

examples of CNS stimulants for ADHD

Methylphenidate, amphetamine, dexmethylphenidate, lisdexamfetamine.

Side effects of CNS stimulants

Insomnia, anorexia, weight loss, dependence; monitor growth, sleep, abuse risk.

examples of Non-stimulant drugs for ADHD?

Atomoxetine, clonidine, guanfacine.

what is Bipolar disorder?

A mood disorder with alternating depression and mania.

what are Mood stabilizers? MOA?

Stabilize mood swings by affecting sodium transport and neurotransmitter levels.

Examples of mood stabilizers

Lithium, valproate, carbamazepine, lamotrigine.

Side effects of lithium

Tremor, polyuria, hypothyroidism, toxicity (narrow therapeutic index).

Serum lithium levels

0.6-1.2 mEq/L therapeutic range

What are Seizures?

Disturbances in brain electrical activity affecting consciousness/movement/sensation.

Types of seizures

Partial (simple/complex), generalized (absence, atonic, tonic-clonic, febrile, myoclonic, status epilepticus)

Main causes of seizures

Fevers, infection, trauma, tumors, metabolic disorders, idiopathic (most common)

How do Barbiturates control seizures?

Enhance GABA action to suppress neuronal activity.

Side effects of barbiturates

Drowsiness, ataxia, respiratory depression, coma/death

how do Benzodiazepines control seizures?

Bind GABA receptors, increase chloride influx, suppressing abnormal activity.

Side effects of benzodiazepines

Sedation, dependence, memory impairment, agranulocytosis

how do GABA-enhancing drugs like gabapentin work?

Increase GABA activity to calm neurons and reduce seizures.

Side effects of GABA enhancers

Drowsiness, fatigue, vision loss, withdrawal seizures

how do Hydantoins like phenytoin work?

Delay depolarization by stabilizing sodium channels, suppressing excitability.

Side effects of hydantoins

Gingival hyperplasia, drowsiness, SJS, cardiac issues

how do Dibenzazepines (e.g., carbamazepine) work?

Desensitize sodium channels, prevent rapid neuron firing.

Side effects of dibenzazepines

Dizziness, ataxia, blurred vision, SJS, aplastic anemia

MOA for Phenytoin-related drugs

Desensitize sodium channels, reducing abnormal electrical activity spread.

Side effects of phenytoin-related drugs

Rash, blood disorders, nystagmus, cardiac issues, hirsutism

MOA for Succinimides like ethosuximide

Block low-threshold calcium channels, preventing seizures.

Side effects of succinimides

GI upset, dizziness, suicidal behavior, agranulocytosis

Difference between acute and chronic pain

Acute is short-term from injury; chronic lasts longer and persists beyond healing.

What is Neuropathic pain

Pain from nerve damage or irritation.

what are the Endogenous opioids

Endorphins, enkephalins, dynorphins

MOA for Strong opioid agonists? Exs?

Activate mu receptors to relieve severe pain (e.g., morphine, fentanyl)

Side effects of strong opioids

Sedation, constipation, respiratory depression, dependence

what are Weak opioids? Exs?

Less potent, used for moderate pain (e.g., codeine, tramadol)

MOA for Mixed opioid agonists

Stimulate some receptors, block others (e.g., buprenorphine)

MOA for Opioid antagonists; ex?

Block mu/kappa receptors, reversing overdose (e.g., naloxone)

Nursing intervention for opioid-induced constipation

Administer peripherally acting opioid antagonists like naloxegol.

Common non-opioid analgesics and side effects for each (3)

Aspirin (bleeding), NSAIDs (GI issues), acetaminophen (liver damage)

what are Adjuvant analgesics? Ex?

Non-analgesic drugs with pain-relieving properties (e.g., antidepressants, anticonvulsants)

Difference between tension headache and migraine

Tension = steady pain; migraine = throbbing, often with aura

how do Triptans help migraines? What are they?

Serotonin agonists that cause vasoconstriction

how do Ergot alkaloids help migraines?

Vasoconstrict brain vessels by activating multiple receptors

how do CGRP blockers help migraines?

Block calcitonin gene-related peptide to reduce inflammation and dilation

how do NSAIDs help migraines?

Reduce prostaglandin production and inflammation

Drugs used for migraine prevention (4)

Beta-blockers, antiseizure meds, calcium channel blockers, antidepressants

how do Beta-blockers like atenolol prevent migraines?

Reduce HR and stabilize blood flow

how do Calcium channel blockers like nifedipine help migraines?

Cause vasodilation and blood flow stabilization

how does Amitriptyline help migraines?

Modifies neurotransmitters and stabilizes mood

what is Lidocaine?

Local anesthetic blocking nerve impulses

what is Propofol?

IV anesthetic for induction/maintenance; fast acting

what is Midazolam (Versed)?

Benzodiazepine for preoperative sedation and amnesia

what is Ketamine? (Therapeutic effect)

Produces dissociative anesthesia; used in sedation and pain

What causes Parkinson's disease?

Death of neurons that produce dopamine in the brain.

What are symptoms of Parkinson's disease?

Resting tremor, muscle rigidity, bradykinesia, postural instability, flat affect.

How do levodopa, carbidopa, and entacapone help Parkinson's?

Restore dopamine levels to reduce tremors and rigidity.

What are side effects of levodopa and related drugs?

Nausea, vomiting, orthostatic hypotension, psychosis, dyskinesia.

How do centrally acting anticholinergics help Parkinson's?

Block excess ACh to restore dopamine balance and reduce tremors.

What are side effects of anticholinergics for Parkinson's?

Dry mouth, sedation, blurred vision, hallucinations, dizziness.

How do dopamine agonists help in Parkinson's disease?

Directly stimulate dopamine receptors to reduce symptoms.

Side effects of dopamine agonists?

Nausea, hallucinations, drowsiness, dizziness, impulse control problems.

How do COMT inhibitors like selegiline help Parkinson's?

Prevent dopamine breakdown, prolong effects of levodopa.

Side effects of COMT inhibitors?

Mental confusion, nausea, hallucinations, liver damage.

How do MAO-B inhibitors help Parkinson's disease?

Block dopamine breakdown in nerve terminals to boost dopamine levels.

Side effects of MAO-B inhibitors?

Drowsiness, insomnia, blurred vision, hypertensive crisis, serotonin syndrome.

What causes Alzheimer's disease?

Amyloid plaques and neurofibrillary tangles leading to neuron loss.

Symptoms of Alzheimer's disease?

Memory loss, confusion, aggression, impaired judgment, anxiety, hallucinations.

How do cholinesterase inhibitors help Alzheimer's?

Increase acetylcholine by inhibiting acetylcholinesterase.

Side effects of cholinesterase inhibitors?

Nausea, vomiting, diarrhea, weight loss.

How do NMDA receptor blockers help Alzheimer's?

Block excessive glutamate activation that can cause neuron damage.

Side effects of memantine (NMDA blocker)?

Headache, dizziness, GI upset, bradycardia, hepatotoxicity.

How do anti-amyloid drugs help Alzheimer's?

Monoclonal antibodies reduce amyloid plaques and slow decline.

Side effects of anti-amyloid drugs?

Brain swelling, seizures, infusion reactions, headache.

What is Multiple Sclerosis (MS)?

Autoimmune disease causing CNS inflammation and myelin loss.