NURS 5220 ACTUAL LATEST EXAM
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5220 FINAL EXAM [BRAND NEW]
What are the cardiovascular effects of midazolam? - ANSWER- Minimal effects in commonly used doses, decrease in blood pressure when combined with opioids in patients with heart disease or the elderly
What are the respiratory effects of midazolam? - ANSWER- Dose-dependent respiratory depression, increased when combined with other CNS depressants, most respiratory depressing benzodiazepine
How do hypnotic doses of benzodiazepines affect sleep-related breathing disorders? - ANSWER- Worsen by adversely affecting control of upper airway muscles and decreasing ventilatory response to CO2
What are the adverse effects of midazolam? - ANSWER- Prolonged sedation, impaired cognition and psychomotor performance, unwanted amnesia, potential for delirium, increased risk of accidents and falls, dependence and withdrawal effects
What are the withdrawal effects of benzodiazepines? - ANSWER- Delirium, anxiety, panic, seizures, insomnia, muscle spasm
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What are the drug interactions of benzodiazepines? - ANSWER- Potential for cross-tolerance to nonbenzodiazepine GABA anesthetic agents, augmentation of CNS depressant effects of other sedative-hypnotic anesthetics and opioids
What is the most prescribed psychiatric medication in the US? - ANSWER- Alprazolam (Xanax)
What is the primary use of alprazolam? - ANSWER- Anxiolysis
What is the half-life of alprazolam? - ANSWER- 12-15 hours What is the effect of MAOIs on dopamine metabolism? - ANSWER- Reduces synaptic and glial metabolism of dopamine.
What are the adverse effects of MAOIs? - ANSWER- Dizziness, headache, dry mouth, nausea, weight gain, peripheral edema, orthostatic hypotension, increased risk of hypoglycemia.
What are the dietary interactions of MAOIs? - ANSWER- MAOIs inhibit the catabolism of dietary amines, leading to a severe hypertensive crisis when consuming tyramine-containing foods.
What happens when tyramine is transported into synaptic vesicles? - ANSWER- It displaces norepinephrine.
Do transdermal selegiline require dietary restrictions? - ANSWER- No, transdermal selegiline does not require dietary restrictions.
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What drug interactions should be avoided with MAOIs? - ANSWER- Avoid indirect acting sympathomimetic agents and use caution with SSRIs, tricyclic antidepressants, and stimulants.
Which opioids should be avoided in the operating room due to serotonergic toxicity? - ANSWER- Meperidine, phenylpiperidine opioids (tramadol, fentanyl, alfentanil, sufentanil, remifentanil, methadone).
What should be considered in perioperative planning for patients on MAOIs? - ANSWER- Minimal interruption of medications, as interruption can exacerbate motor symptoms and interfere with ventilation. Consider the need for gastric tube administration for longer procedures.
What is lorazepam (Ativan) utilized for? - ANSWER- Anxiety, alcohol withdrawal, sedation
What is the half-life of lorazepam? - ANSWER- 10-22 hours
What is diazepam (Valium) utilized for? - ANSWER- Oral sedation
What is the half-life of diazepam? - ANSWER- >24 hours (active metabolite)
What is the relationship between half-life and patient age for diazepam? - ANSWER- Linear relationship
Why is chronic use of diazepam not recommended in the elderly? - ANSWER- Takes longer to metabolize the drug
What is the half-life of Midazolam (Versed)? - ANSWER- 1-3 hours
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