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NR565 Week 4 Study Guide Week 4 is the midterm (no quiz) and includes all material from Weeks 1-4; Be sure to also review the Weeks 1, 2 & 3 study guides to prepare for the exam $13.49   Add to cart

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NR565 Week 4 Study Guide Week 4 is the midterm (no quiz) and includes all material from Weeks 1-4; Be sure to also review the Weeks 1, 2 & 3 study guides to prepare for the exam

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NR565 Week 4 Study Guide Week 4 is the midterm (no quiz) and includes all material from Weeks 1-4; Be sure to also review the Weeks 1, 2 & 3 study guides to prepare for the exam Many questions will are written to assess your clinical application of the material from the textbook, in real-world ...

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  • March 31, 2022
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  • 2022/2023
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NR565 Week 4 Study Guide
Week 4 is the midterm (no quiz) and includes all material
from Weeks 1-4; Be sure to also review the Weeks 1, 2 &
3 study guides to prepare for the exam
Many questions will are written to assess your clinical
application of the material from the textbook, in real-world
scenarios
Chapter 15: Drugs Affecting the Central Nervous System
Anorexiants: Precautions and contraindications
Examples; phentermine, benzphetamine, diethylproprion,
phendiametrazine and lorcaserin.
Anorexiants are sympathomimetic amines and are thought to exert their action by
stimulation of satiety centers in the hypothalamus and limbic region. They act
through noradrenergic, dopaminergic, or serotonergic pathways. Lorcaserin
promotes satiety by selectively activating 5-HT2C receptors in the hypothalamus.
Thought to stimulate the release of norepinephrine and/or dopamine from
storage sites in nerve terminals in the lateral hypothalamic feeding center,
thereby producing a decrease in appetite
ADRs- CNS overstimulation, agitation, confusion, insomnia, dizziness, HTN,
headache, palpiatiations, arrhythmias, dry mouth, n/v. Sudden withdrawal in
patients who have a long history of use may cause withdrawal symptoms.
Increases glucose uptake from skeletal muscles and must be used cautiously in
diabetics- altered insulin or oral hypoglycemic dosage requirements . Carry a
high risk of tolerance and dependence. Use with caution in patients with ahistory
of alcohol or drug dependence. Use for a max period of 6 months.

Lorcaserin is a serotonergic drug and may develop serotonin syndrome if taken
with other serotonergic drugs.

Drug interactions- do not use with SSRIs, careful use with serotonergic meds due
to risk for serotonin syndrome, avoid MAOIs = result in hypertensive crisis,
careful use with adrenergic blockers, insulin sulfonylureas, and phenothiazines =
lithium toxicity, ovoid orlistat = decrease levels of levothyroxine and increases
warfarin in the body.

, Anticonvulsants: Hydantoins, iminostilbenes, succinimides
Mode of Action:
Essentially, anti-seizure drugs act by stimulating an influx of chloride ions; usually
this is associated with the neurotransmitter gamma-aminobutyric acid delaying
an influx of sodium and delaying an influx of calcium.

 Hydantoins; phenytoin, ethotoin, fosphenytoin – first
line tx for tonic-clonic and complex seizures and are least
sedating drugs for seizure tx. Hydantoins inhibit and stabilize
electrical discharges in the motor cortex of the brain by affecting the influx of
sodium ions into the neuron during depolarization and repolarization,
slowing the propagation and spread of abnormal discharges. They also affect
the brainstem's contribution to grand mal seizures and have antiarrhymic
properties.



 Metabolism and excretion Metabolism of hydantoins
takes place in the liver; excretion, via the kidneys. Plasma half-lives range from 6 to
24 hours.

Precautions and Contraindications
Hydantoins are contraindicated under conditions of hypersensitivity. Phenytoin-
induced hepatitis is a common hypersensitivity reaction. Other
hypersensitivity reactions include fever, rash, arthralgias, and
lymphadenopathy. Phenytoin may cause severe cardiovascular events and
death has resulted from too-rapid IV administration. Phenytoin has a Black-
Box Warning that IV administration should not exceed 50 mg/minute in
adults and 1 to 3 mg/kg/minute in pediatric patients owing to risk of
cardiovascular reactions associated with a too rapid rate of administration.
Phenytoin is contraindicated in sinus bradycardia, sinoatrial block, second-
and third-degree atrioventricular block, and Stokes–Adams syndrome. It
should be used cautiously in patients with hepatic or renal disease. Ethotoin is
contraindicated in the presence of hepatic or hematological disorders.

Black box warning for IV administrations – do not give too fast or can
cause cardiovascular reactions.

 MOAs, indications
 Absolute contraindications - bradycardian sinoatrial block,
second and third degree atrioventricular block and stokes-adams
syndrome.

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