Term
|
Definition
| A compulsive, uncontrollable craving for and dependence on a substance to such a degree that cessation causes severe emotional, mental, or physiologic reactions |
|
|
Term
|
Definition
| Subjective need for substance after decreased use or abstinence |
|
|
Term
|
Definition
| Reliance on a substance that has reached a sufficiently high level so that its absence will cause an impairment in function |
|
|
Term
|
Definition
| Overindulgence in and dependence on a substance that has a negative impact on psychologic, physiologic, and social functioning of an individual |
|
|
Term
|
Definition
| Indiscriminate use of a drug for purposes other than those for which it is intended |
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|
Term
|
Definition
| Return to substance use during abstinence |
|
|
Term
|
Definition
| Decreased effect of a substance that results from repeated exposure. |
|
|
Term
| What are the addictive states? |
|
Definition
-Intoxication
-Detoxification
-Withdrawal syndrome
-Cessation and maintaining abstinence |
|
|
Term
|
Definition
| A state of being influenced or affected by a drug or other toxic substance |
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|
Term
|
Definition
| Involves treating an intoxicated client to diminish or remove drugs or their effects from their body |
|
|
Term
| What is withdrawal syndrome? |
|
Definition
| A group of s/s that occurs in a physically dependent person when drug use is stopped |
|
|
Term
| When is addictive treatment NOT a priority? |
|
Definition
|
|
Term
| What should you do when addict is getting surgical treatment? |
|
Definition
-Normal amounts of drugs may not be enough
-Anesthetic agents may have prolonged effect due to liver damage
-Increased doses of pain medication may be required with opiate addiction
-Increased risk for bleeding and post op complications and infection
-Withdrawal symptoms from CNS may be delayed for 5 days because of anesthetic and pain meds |
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|
Term
| What is a serious concern among nurses? |
|
Definition
|
|
Term
| What is mandatory reporting? |
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Definition
| House Bill 315 : Employers of RNs who suspected or observed a nurse of working impaired/or have diverted medications, to notify the Georgia Board of Nursing Board. |
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Term
| What are the contributing factors to nurse impairment? |
|
Definition
-chronic fatigue
-stress
- illness
-responsbility for clients responses to illness/dying
-professional dissatisfaction
-access to drugs
-martial and child issues,
-downszing |
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|
Term
| What are the characteristics of nurse impairment? |
|
Definition
| Changes in personality, behavior, job performance, and attendance. |
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Term
| What is the management of nurse impairment? |
|
Definition
Largely dependent on state policies.
-Employment termination
-Rehabilitaion of nurses |
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|
Term
|
Definition
-Nicotine
-Cocaine/amphetamines
-Benzphetamine
-Dextroaphetamine
-Methamphetamine
-Methylphenidate (Ritalin)
-Pemoline
-Phenmetrazine
-Caffiene |
|
|
Term
| What are the nicotine replacement agents? |
|
Definition
-Gum
-Losenges
-Patch
-Nasal Spray
-Inhaler |
|
|
Term
| What are the s/e of nicotine? |
|
Definition
-Increased arousal/alertness
-Performance enhancement
-Increase HR, output and BP
-cutaneous vasoconstriction
-fine tremor
-decreased appetite
-antidiueretic effect
-increased gastric mobility |
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|
Term
| What are the s/e of other stimulants? |
|
Definition
-Eupohria
-grandiosity
-mood swings
-hyperactivity
-hyperalertness
-restlesness
-anorexia
-insomnia
-hypertension
-tachy
-vasoconstriction
-tremor
-dysrhythmia
-seizures
-sexual arousal
-dilated pupils
-diaphoresis |
|
|
Term
| What is the safe amount of caffeine per day? adults |
|
Definition
|
|
Term
| What is the safe amount of caffeine per day? chillens? |
|
Definition
|
|
Term
| What are the complications from drug abuse? |
|
Definition
| Wernicke's encephalopathy and Krosakoff's Psychosis |
|
|
Term
| What is Wernicke's encephalopathy |
|
Definition
| Thiamine (vitamin B-1) deficiency causes inflammation, hemorrhage, and degeneration of brain. |
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|
Term
| What is Korsakoff's psychosis? |
|
Definition
| late neuropsychiatric manifestation with short term memory loss, confabulation, and inability to learn. |
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|
Term
| What is the treatment for drug abuse? |
|
Definition
-Drug therapy for alcohol withdrawal
-Rehabilitation and sustained abstinence for everything |
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|
Term
| What does C.O.P.E.S. stand for in alocholism? |
|
Definition
C - Coping mechanisms
O - Orient to community resources
P - Plan may include antabuse
E - Encourage vitamin B, folic aicd
S - Seizures |
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|
Term
|
Definition
| Used for alcohol and narcotic dependence |
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|
Term
| What does B.E.A.T. stand for with Revia? |
|
Definition
B - Bleeding disorder, hepatic or renal impairment - Use w/ caution
E - Educate to avoid alcohol containing products
A - Addiction to alcohol or narcotics is the use
T - Take tablet w/ full glass of water or food |
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|
Term
| What is antabuse used for? |
|
Definition
| Treatment of alcoholism. Disulfram rxn |
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|
Term
| What is B.A.R.F. with antabuse? |
|
Definition
B - bracelet should be worn (UE; N/V, weakness, sweating, liver toxicity)
A - acetaldehyde syndrome may occur. Watch for: respiratory arrest, cardiovascular depression, seizures, death
R - Remind client to avoid products containing alcohol
F - follow up w/ 12 step program |
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|
Term
| What is Zolpidem Tartrate? |
|
Definition
| AMBIEN! A Sedative Hypnotic |
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|
Term
| What teaching should be involved with Zolpidem (Ambien)? |
|
Definition
| Take just prior to going to bed as forgetfulness for events has been reported. 5mg dose for women; 10 mg dose for men. |
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|
Term
| What does A.M.B.I.E.N. stand for w/ Zolpidem? |
|
Definition
A Anxiolytic & hypnotic effects
M Morning drowsiness or hangover (modulates GABA
receptors to cause suppression of neurons)
B Beware of drug/drug effects w/Rifampin; Blurred vision
common side effect; Avoid tasks requiring driving
I Insomnia treatment
E Effects REM sleep pattern by suppressing it
N Non barbiturate; Not for long term use |
|
|
Term
| What are the pharmacokinetics of opiods? |
|
Definition
| The have the ability to activate the brain reward system, reinforcing their additive effect. They are taken orally, sniffed, smoked, injected sub q or intravenously. IV takes effects in seconds. |
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|
Term
| What are the primary effects of opiods? |
|
Definition
Analgesia
Drowsiness
Slurred speech
Detachment from the environment
IV - rush of feelings in the lower abdomen, warm skin flushing, and euphoria |
|
|
Term
| What is the antedote for opiod overdose? |
|
Definition
|
|
Term
| What are the symptoms of overdose? |
|
Definition
-pinpoint pupils
-clammy skin
-respiration depression
-coma
-death |
|
|
Term
| What are the symptoms of opiod withdrawal? |
|
Definition
| Craving, abd cramps, diarrhea, n/v |
|
|
Term
| What is used to treat the withdrawal symptoms of opiods? |
|
Definition
Methadone (Dolophine)
Clonidine (Catapres) |
|
|
Term
| What is an opiod antagonist? |
|
Definition
| Naltrexone (Trexan/ReVia) |
|
|
Term
| What is the antidote for benzodiazepines? |
|
Definition
|
|
Term
| What are the opioid drugs of abuse? |
|
Definition
-Heroin
- Morphine
- Opium
- Codeine
-Fentanyl ( Sublimaze)
-Meperidine (Demerol)
-Hydromorphone (Dilaudid)
-Propoxyphene (Darvon)
-Oxycodone (OxyContin, Percocet)
-Methadone (Dolophine) |
|
|
Term
| What are the drug intrxns w/ opiods? |
|
Definition
-CNS Depressants
alcohol
general anesthetics
sedatives/hypnotics
phenothiazines
antiemetics
-Mixed agonist/antagonist opiods |
|
|
Term
| What is used to treat opiod toxicity? |
|
Definition
| Opiod antagonist: Naloxone (narcan) |
|
|
Term
| What is used to treat withdrawal/dt from opioids |
|
Definition
| Opiod substitution: Methadone (Dolophine), Buprenorphine (Subutex), Cloidine (Catapres) |
|
|
Term
| What is used as maintenance therapy in opioid addiction? |
|
Definition
Opiod Agonist: Methadone (Dolophine)
Opiod Antagonist: Neltrexone (ReVia)
Mixed: Buprenorphine (Subutex) |
|
|
Term
| What inhalants are abused? |
|
Definition
-Volatile solvents
-Aerosols
-Anesthetic agents
-Nitrites
-Bath salts |
|
|
Term
| What do CNS sitmulants do? |
|
Definition
| Raise level of norepinephrine, serotonin, and dopamine |
|
|
Term
| What are the 3 categories of CNS stimulants? |
|
Definition
-Amphetamines
-Analeptics, caffine
-Anorexiants |
|
|
Term
| What are the medically approved uses for CNS stimulants? |
|
Definition
Attention deficit/hyperactivity disorder (ADHD)
Narcolepsy
Reversal of respiratory distress |
|
|
Term
| Which CNS stimulant treats ADHD? |
|
Definition
| -Amphetamines like ritalin, |
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|
Term
| Which CNS stimulant treats narcolepsy? |
|
Definition
| -Amphetamines like Methyphendiate and modafinil (Provigil) |
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|
Term
| Which CNS stimulant treats respiratory distress? |
|
Definition
| An analeptic like doxapram (Dopram) |
|
|
Term
| What is the pathophysiology of ADHD? |
|
Definition
Disregulation of transmitters
Serotonin, norepinephrine, dopamine |
|
|
Term
| What is the epidemiology of ADHD? |
|
Definition
Usually occurs in children before age 7
More common in boys |
|
|
Term
| What are the characteristics/symptoms of ADHD? |
|
Definition
| Inattentiveness, inability to concentrate, restlessness, hyperactivity, inability to complete tasks, impulsivity |
|
|
Term
| What are the characteristics of narcolepsy? |
|
Definition
Recurrent attacks of drowsiness and sleep during daytime
Unable to control sleep
Falling asleep while
Driving
Talking
Eating
Standing |
|
|
Term
| What are Adderall/Dextroamphetamine (Dexedrine)? |
|
Definition
|
|
Term
| What is the drug action of Adderall/Dextroamphetamine (Dexedrine)? |
|
Definition
| Stimulate release of norepinephrine & dopamine. |
|
|
Term
| What is Adderall/Dextroamphetamine (Dexedrine) used for? |
|
Definition
-Increase wakefulness in narcolepsy.
-Increase attention span, cognition.
-Decrease hyperactivity, impulsiveness, restlessness of ADHD. |
|
|
Term
| What are the side effects of Adderall/Dextroamphetamine (Dexedrine)? |
|
Definition
Tachycardia, palpitations, dysrhythmias, hypertension
Sleeplessness, restlessness
Irritability
Anorexia, dry mouth, weight loss, diarrhea, constipation
Impotence |
|
|
Term
| What are the amphetamine like drugs used to treat ADHD? |
|
Definition
Methylphenidate (Ritalin)
-Available in may forms!
Methamphetamine (Desoxyn) |
|
|
Term
| What are the amphetamine like drugs used to treat narcolepsy? |
|
Definition
Modafinil (Provigil)
Pemoline (Cylert) |
|
|
Term
| What is the drug action of Methylphenidate (Ritalin)? |
|
Definition
| Acts on cerebral cortex, reticular activity system |
|
|
Term
| What is Methylphenidate (Ritalin) used for? |
|
Definition
| ADHD, fatigue, narcolepsy |
|
|
Term
| What does Methylphenidate (Ritalin) interact with? |
|
Definition
Caffeine may increase effects
Decreased effects of decongestants, antihypertensives, barbiturates
May alter insulin effects |
|
|
Term
| What are the s/e of Methylphenidate (Ritalin)? |
|
Definition
Tachycardia, palpitations, dizziness, hypertension
Sleeplessness, restlessness, nervousness, tremors, irritability
Increased hyperactivity
Anorexia, dry mouth, vomiting, diarrhea, weight loss
Thrombocytopenia |
|
|
Term
| What are the nursing interventions r/t Methylphenidate (Ritalin)? |
|
Definition
-Give b4 breakfast and lunch
-Report irregular heartbeat.
-Record height, weight, and growth of children.
-Avoid alcohol, caffeine.
-Use sugarless gum to relieve dry mouth.
-Do not stop abruptly; taper off to avoid withdrawal symptoms.
-Counseling must also be used. |
|
|
Term
| What is the action of anorexiants? |
|
Definition
|
|
Term
| What are anorexiants used for? |
|
Definition
|
|
Term
| What are the side effects of anorexiants? |
|
Definition
| Nervousness, restlessness, irritability, insomnia, palpitations, hypertension |
|
|
Term
|
Definition
| Dextroamphetamine (Dexadrine) |
|
|
Term
|
Definition
| Something used to stimulate the CNS |
|
|
Term
| What are some analeptics? |
|
Definition
| Caffeine (coffee, chocolate, cold medications), theophylline, NoDoz |
|
|
Term
| What is the medical use of an analeptic? |
|
Definition
| Stimulate respiration in newborns |
|
|
Term
| What are the s/e of analeptics? |
|
Definition
Restlessness, tremors, twitching
Palpitations, insomnia
Tinnitus, nausea, diarrhea
Psychologic dependence |
|
|
Term
| What is the analeptic used to stimulate the respiratory system? |
|
Definition
|
|
Term
| How long does doxapram (do pram) need to work? |
|
Definition
| 20-40 seconds. Peaking in 2 mins |
|
|
Term
| What are the side effects of Doxapram (Dopram)? |
|
Definition
| Hypertension, tachycardia, trembling, convulsions |
|
|
Term
| What are the 2 types of sleep? |
|
Definition
|
|
Term
| What happens if sleep is interrupted? |
|
Definition
| the cycle begins again with stage 1 of NREM sleep. |
|
|
Term
|
Definition
|
|
Term
| Who does insomnia effect more? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What are the nonpharmacologic treatments of insomnia? |
|
Definition
No daytime naps
Warm fluids to drink
Caffeine avoided 6 hr before bedtime
Heavy meals and exercise avoided before bedtime
Warm bath, reading, listening to music |
|
|
Term
| What are the prescription sedative-hypnotics? |
|
Definition
-Barbituates
-Benzodiazepine
-Nonbenzodiazepine |
|
|
Term
| What are the OTC sedative-hypnotics? |
|
Definition
Nytol, Tylenol PM
Diphenhydramine (Benadryl)
Melatonin |
|
|
Term
| What are the general side effects of sedative-hypnotics? |
|
Definition
Residual drowsiness (hangover)
Drug dependence
Drug tolerance
Excessive depression
Respiratory depression
Withdrawal symptoms |
|
|
Term
| What pregnancy class are barbiturates? |
|
Definition
|
|
Term
| What drug schedule are barbiturates? |
|
Definition
|
|
Term
| What are ultra-short acting barbiturates used for? |
|
Definition
| A general anesthetic. Ex: Thiopental sodium |
|
|
Term
| What are the short-acting barbiturates used for? |
|
Definition
Induce sleep
No residual drowsiness |
|
|
Term
| What is a short acting barbiturate? |
|
Definition
Pentobarbital (Nembutal)
Secobarbital (Seconal) |
|
|
Term
| Who is Secobarbital (Seconal) contraindicated in? |
|
Definition
| Resp. depression, severe hepatic disease, preg, nephrosis, hypersensitivity. |
|
|
Term
| What do intermediate acting barbituates do? |
|
Definition
Induce and sustain sleep
Residual drowsiness (hangover effect) |
|
|
Term
| What are some intermediate acting barbs? |
|
Definition
| Amobarbital (Amytal), butabarbital (Butisol) |
|
|
Term
| What are long acting barbiturates used to treat? |
|
Definition
|
|
Term
| What is an example of a long-acting barbiturate? |
|
Definition
|
|
Term
| What is the action of Secobarbital (Seconal)? |
|
Definition
|
|
Term
| What is Secobarbital (Seconal) used for? |
|
Definition
Short-acting to treat insomnia
Sedation
Preoperative medication |
|
|
Term
| What are the side effects of Secobarbital (Seconal)? |
|
Definition
| Hangover, dizziness, paradoxical excitement in older adults, respiratory distress, laryngospasm |
|
|
Term
| What does Secobarbital (Seconal) interact w/? |
|
Definition
| Decreased respirations with alcohol, CNS depressants, and MAOIs |
|
|
Term
| What are the nursing interventions associated w/ barbiturates? |
|
Definition
-Raise side rails for older adults as confusion may occur.
-Teach client to use nonpharmacologic methods to induce sleep.
-Instruct client to avoid alcohol and CNS depressants.
-Advise client not to drive motor vehicles or operate machinery.
-Advise client to report adverse reactions.
-Instruct client to withdraw gradually to avoid withdrawal symptoms. |
|
|
Term
| What is the drug action of Benzodiazepine hypnotics? |
|
Definition
| Interacts with neurotransmitter GABA to reduce neuron excitability |
|
|
Term
| What are Benzodiazepine hypnotics used for? |
|
Definition
-Reduce anxiety
-Treat insomnia |
|
|
Term
| What is an Benzodiazepine hypnotics? |
|
Definition
|
|
Term
| What is a NON-BENZODIAZEPINE HYPNOTIC> |
|
Definition
|
|
Term
| How does Zolpidem (Ambien) work? |
|
Definition
| Neurotransmitter inhibition |
|
|
Term
| How long should Zolpidem (Ambien) be used? |
|
Definition
| Treat short-term (less than 10 days) insomnia |
|
|
Term
| What should you avoid when taking sedative-hypnotics? |
|
Definition
|
|
Term
| What are the nursing interventions associated w/ sedative-hypnotics? |
|
Definition
First use nonpharmacologic methods.
Be attentive to safety.
Avoid alcohol, other CNS depressants.
Take 15 - 45 minutes before bedtime.
Report hangover effect.
Monitor BP, R.
Withdraw gradually. |
|
|
Term
| What is the purpose of general anesthesia? |
|
Definition
| Analgesia, muscle relaxation, loss of consciousness, amnesia |
|
|
Term
| What is the purpose of local anesthesia? |
|
Definition
Analgesia in limited area
DO NOT PUT ON PERIPHERAL DIGITS |
|
|
Term
| What are the routes of anesthetics? |
|
Definition
Inhalation
IV
Topical
Local
Spinal |
|
|
Term
| Where is the local anesthetic needed for a spinal anesthetic? |
|
Definition
| Subarachnoid space at the 3rd/4th lumbar space |
|
|
Term
| What are the side effects of spinal anesthesia? |
|
Definition
|
|
Term
| What can decrease the risk of a cerebrospinal fluid leak at the needle injection point? |
|
Definition
| Remaining flat after surgery |
|
|
Term
| What is a hypnotic anesthetic? |
|
Definition
|
|
Term
| What is a narcotic analgesic or benzodiazepine given 1 hour pre-op anesthetic? |
|
Definition
-Morphine
-Midazolam (Versed) |
|
|
Term
| What is an anticholinergic anesthetic given 1 hour pre-op? |
|
Definition
|
|
Term
| What barbiturate is given as an anesthetic? |
|
Definition
| IV Thiopental Sodium (Pentothal) |
|
|
Term
| What is a muscle relaxant/paralytic given before surgery? |
|
Definition
| Succinylcholine (Anectine) |
|
|
Term
| Why is atropine given b4 surgery? |
|
Definition
|
|
Term
| What are the side effects of anesthetics? |
|
Definition
Respiratory depression
Hypotension
Dysrhythmias
Hepatic dysfunction |
|
|
Term
| What are the nursing interventions r/t anesthetics? |
|
Definition
- Monitor LOC
- Monitor respirations, HR, BP
- Monitor urine output
- Adminster analgesics until client fully recovers |
|
|
Term
| What is R.E.G.I.O.N r/t anesthesia? |
|
Definition
R - respiratory paralysis
E - elimination
G - GI
I - Inform of procedure
O - Observe for hypotension
N - No trauma to extremities |
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|
