N2370 Exam 1 Blueprint Page 1 Introduction to Pharmacology • List and define the four basic terms relating to pharmacology. • Explain what is meant by an Ideal Drug and list the three most important properties of an Ideal Drug. • Describe the therapeutic objective of drug therapy. • List and describe the four major pharmacokinetic processes of drugs. • Define the term pharmacodynamics. • Name four sources of individual variation in drug response. • List the five rights of medication administration. • Explain the benefits and limitations of the five rights of medication administration. • Describe the two major nursing roles related to drug administration. • Explain the difference between allergies and adverse effects. • List the three types of drug names and their purpose in pharmacology. • Describe the role of over-the-counter medications in patient care. • Name five general sources of pharmacology information. Pharmacology Principles • Describe the four (4) major processes that determine how well drugs pass across cell membranes. • What does hydrophilic mean and what are the implications for drugs that are hydrophilic? • What does lipophilic mean and what are the implications for drugs that are lipophilic? • What is the basic difference between molecules that have ionic versus covalent bonds? • Is it possible for a covalent bond to be polar? If so, how so? • Describe the basic structure of a cell membrane. • When does a peptide become a protein? • List the four (4) primary receptor families and give an example of each. • Which major route of drug administration has no absorption barriers? • Place in order the different routes of medication administration in order of ease of absorption. • What is bioavailability and why is it primarily about oral medications? • What is first-pass effect? • What is the role of the blood brain barrier? • Which protein is most likely to bind with a drug if protein binding is going to occur? • What are the two major organs that can determine drug concentration in blood? What are the corresponding labs that the nurse should watch when giving drugs to ensure that they can be eliminated adequately? • What is the advantage of repeated doses of medication? • What are agonists and antagonists? • Describe the difference between competitive and non-competitive antagonists. • Name and define three (3) types of drug tolerance. • What is a placebo effect? • How do drugs vary among individuals? List the ways. Stress Response • Define stress. • What is a negative feedback system? • How is a negative feedback system different from a positive feedback system? • What is homeostasis? • What is allostasis? • Describe the stages of General Adaptation Syndrome. • What is the central axis of stress response? • How can drugs effect stress? • What is the difference between epinephrine and adrenaline? • What commonly consumed substance is both lipophilic and hydrophilic? What is the significance of this? • Compare and contrast the sympathetic and parasympathetic nervous systems. N2370 Exam 1 Blueprint Page 2 Stress Response - continued • What is Psychoneuroimmunology? • Summarize the role of the immune system with regard to stress - acute and chronic. • Describe how personality can affect stress in individuals. • List four common changes due to aging that affect stress response in older people. Intro to Neuro Function and Neuropharmacology • Review the relationships between the CNS, PNS, and Sensory receptors/effector organs • Compare and contrast the structure, regulatory functions, and responses to activation of the SNS (adrenergic) and PNS (cholinergic) – identify their primary neurotransmitters • Identify the SNS receptors and where they are principally located (which organs). • List the 3 patterns and ANS innervation • Describe what dermatomes are. • What is the significance of the blood brain barrier? How is it different from normal vascular capillaries? • Describe the structure, function, and neurotransmitter of the neuromuscular junction. Why is it important to know about this? • How does a reflex arc work? How is it different from a less severe nerve impulse network? • Describe how an action potential works. What is resting potential, threshold, refractory period? • What is the difference between an axon and a dendrite? • Describe sensory, associational, and motor neurons. Which is afferent? Efferent? • Describe the functions and basic pathophysiology of astrocytes (Parkinson’s disease), oligodendrocytes (psychiatric disorders), microglia (pain and Alzheimer’s disease), ependymal (CSF formation) neuroglial cells. • What is the best way to study drugs that affect the peripheral nervous system? • List the 5 steps in synaptic transmission and then describe how drugs can modulate these. • List the 3 homeostatic objectives of the SNS. • Describe 3 ways the SNS regulates body temperature. • What are the 2 basic things the brain needs to live? Hint: the heart fights to maintain cardiac output to provide these to the brain. • Which is better in a drug, selectivity, or non-selectivity? Why? Cholinergic Drugs • Myasthenia gravis – describe how this condition evolves and how it is diagnosed o How to cholinesterase inhibitors help clients with myasthenia gravis? What is the basic mechanism of action of pyridostigmine or neostigmine? • Urinary retention – describe how this condition evolves o Describe how the muscarinic agonist bethanechol is used to treat this condition. What is the mechanism of action? • Overactive bladder - describe how this condition evolves o Describe how the anticholinergic agent oxybutynin is used to treat this condition. What is the mechanism of action? • Benign Prostatic Hypertrophy – How does this condition develop? What is the most common symptom? How does Tamsulosin work to reduce the symptoms? • Compare and contrast succinylcholine and pancuronium. Describe why two neuromuscular blockade agents are used during intubation and mechanical ventilation. How does succinylcholine work? What are the contraindications? How does pancuronium work? Why is it given with succinylcholine? • Describe the mechanism of action and uses for atropine. What are the therapeutic uses for it? • What is mydriasis? • List the 7 basic classes of cholinergic symptoms. • What is the difference between reversible and irreversible cholinesterase inhibitors? What is a substance we commonly ingest with this substance in it? • Compare/contrast nicotinic and muscarinic receptors N2370 Exam 1 Blueprint Page 3 Adrenergic Drugs • Identify the organs innervated by the 4 basic adrenergic receptors (a1, a2, b1, b2) • Describe the effect of each organ when each receptor is activated. What happens when they are blocked? Why might drug specificity be important? • Show how these actions correlate to the actions of the SNS or PNS. Note the neurotransmitter that typically stimulates the receptor. • Identify the receptors that are activated by the 3 basic catecholamines (epinephrine, norepinephrine, and dopamine). How is dopamine different? What is meant by a dose-dependent reaction? • What is necrosis with extravasation? What causes it and how it is treated? How can it be avoided? Or stopped? • Describe the mechanism of action, therapeutic uses, administration route, and important adverse effects of: o Dopamine o Epinephrine o Tamsulosin o Phentolamine o Propranolol o Metoprolol o Clonidine • List the 7 basic types of anticholinergic effects. Show how this relates to SNS or PNS – note the neurotransmitter that typically activates this. • What is first dose-effect? • What are indirect-acting adrenergic agents? How do they work? Motor Function Disorders • Describe the pathophysiology, clinical manifestations, and treatment for Parkinson’s Disease. • Draw the mind map in the lecture slides and be sure to understand the process. • Describe the mechanism of action, therapeutic uses, administration route, important adverse effects, and nursing assessment implications of: o Levodopa ▪ Drug interactions o Carbidopa o Carbidopa/levodopa – why given as a combination drug? o Benztropine • Describe the pathophysiology, clinical manifestations, and treatment for Multiple Sclerosis. o List the 4 types. Focus on the most common and the kind emerges over time. o Describe the mechanism of action, therapeutic uses, administration route, important adverse effects, and nursing assessment implications of Interferon beta Memory & Cognition Disorders • What is delirium? What is dementia? • Compare and contrast delirium and dementia. • If you had a patient with altered mental status, how would you determine if they have delirium or dementia? • How does delirium develop? What is the acronym for the precipitating factors? How does a nurse manage a patient with delirium? • Describe the pathophysiology and clinical manifestations of Alzheimer’s Disease. • Describe the mechanism of action of Donepezil and Memantine – in your own words that you easily understand. • Draw a mind map from the slides provided for this lecture and be able to understand all of the parts of it. N2370 Exam 1 Blueprint Page 4 CVA, Seizures, Muscle Spasms Seizures • Compare and contrast 6 types of seizures. • Describe the basic pathophysiology of seizures. • What is the process for diagnosing seizures? • Describe the mechanism of action, therapeutic uses, administration route, important adverse effects, and nursing assessment implications of: o Phenobarbital o Phenytoin o Gabapentin o Oxcarbazepine o Lorazepam o Diazepam o Dantrolene o Baclofen • What are the signs of phenytoin toxicity? • What should a nurse do when a seizure is observed? Spasticity and Spasms • What is the difference between a muscle spasm and spasticity? What is the treatment for both? • What are flexor and extensor spasms? • What is rhabdomyolysis? What causes it? • Describe malignant hyperthermia – how it occurs – and which drug is used to reverse it and how it works. (Hint: There is a short animation that shows you this in the Learning Modules.) CVA - Stroke • What are the signs of a stroke? What is the difference between a cerebral vascular accident and a stroke? • Compare and contrast the signs and symptoms of a left-sided stroke with a right-sided stroke. • What is a TIA? • What are the 3 types of strokes? • Which type(s) can be treated with alteplase? What is that drug’s mechanism of action, therapeutic uses, adverse effects, and advantages? • Which type(s) should never be treated with alteplase? Why?
