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NUR 613 Exam 2 Questions And Correct Answers
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NUR 613 Exam 2 Questions And Correct Answers...
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NUR 613 Exam 2 Questions And Correct AnswersRisk of AEDs with pregnancy - ANSWER neural tube defects - folic acid supplements
bleeding risk - vit K after delivery
Myasthenia gravis - ANSWER destruction of nicotinic receptors - rapid muscle fatigue
autoimmune
ptosis, dysphagia, skeletal muscle weakness
what drugs are used for myasthenia gravis? - ANSWER cholinesterase inhibitors
reversible cholinesterase inhibitors - ANSWER neostigmine
irreversible cholinesterase inhibitor - ANSWER echothiophate
pesticides
how do cholinesterase inhibitors work? - ANSWER block action of AChE
ACh builds up
effects of cholinesterase inhibitors - ANSWER muscarinic stimulation - bradycardia,
bronchial constriction, increased secretions, urinary urgency, increased tone and
motility of GI, meiosis, increased near vision
NM effects - increased contractions
CNS effects - increased stimulation
can cholinesterase inhibitors cross the BBB? - ANSWER only at VERY HIGH doses
,how long is the duration of action of cholinesterase inhibitors? - ANSWER 2-4 hours
adverse effects of cholinesterase inhibitors - ANSWER muscarinic overstimulation -
muscarinic crisis
excessive NM blockade -> respiratory paralysis
cholinesterase drug interactions - ANSWER muscarinic antagonists - decrease
effectiveness
competitive NM blockers - decreases effectiveness
depolarizing NM blockers - increases effectiveness
dosing of myasthenia gravis drugs - ANSWER start low and increase slowly
take more before exertion
record when med is taken, when fatigue occurs, strength before and after drug,
muscarinic symptoms (SLUDGE)
Tensilon test - ANSWER edrophonium given
if strength increases -> myasthenic crisis -> more neostigmine
if strength decreases -> cholinergic crisis -> atropine
need environment where ventilation can be given if needed
Treatment of organophosphate poisoning/cholinergic crisis - ANSWER atropine
ventilation
, pralidoxime - if IV given over 30 mins
parkinson's disease - ANSWER neurodegenerative disease
disruption of NT in striatum
not enough dopamine, too much ACh and GABA
increased GABA levels causes motor symptoms
cardinal signs of Parkinson's - ANSWER resting tremor
rigidity
postural instability
bradykinesia
autonomic disturbances, depression, psychosis, dementia
treatment for Parkinson's includes what type of drugs? - ANSWER dopaminergic agents
- increase dopamine
anticholinergics - decrease ACh activation (benztropine)
drug for mild Parkinson's - ANSWER MAO-B inhibitors
seligiline, rasagiline
inhibit breakdown of dopamine
can also be used with levodopa during "off times"
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