NRG200 Module 2 Guided Study
Use this document to guide your reading and note-taking. Answer the questions, summarize key
concepts, and ensure you understand the information by completing the exercises. This study form
serves as a structured guide for learning and reviewing key pharmacology concepts and medication
therapies.
Nervous System Overview
1. Identify and describe the main divisions of the nervous system:
● CNS (Central Nervous System): To serve as the command center of the body and is responsible
for processing and issuing commands. The brain and spinal cord make up the central nervous
system. Four lobes make up each hemisphere of the brain. They’re the frontal, temporal,
parietal, and occipital lobes.
● PNS (Peripheral Nervous System): Includes the cranial and spinal nerves and the autonomic
nervous system. Facilitating voluntary (somatic) and involuntary functions (autonomic). The
somatic nervous system controls all those voluntary movements and reflex actions and it
consists of sensory or afferent neurons that transmit the sensory information such as touch,
pain, temperature, pressure.
● ANS (Autonomic Nervous System): Includes the sympathetic and parasympathetic nervous
system. The ANS is responsible for releasing the appropriate neurotransmitter in response to
stress or danger. It also releases neurotransmitters that maintain regulatory functions of the
body, such as digestion, elimination, and reproduction. The ANS will regulate on its own without
having a conscious effort.
o Sympathetic: The sympathetic nervous system protects the body in times of danger and
stress. Fight or flight response. Pupils will be dilated and a release of adrenaline.
o Parasympathetic: The parasympathetic system maintains the regulatory tasks of the
body. Rest and digest response. Promotes relaxation and energy conservation, slows the
heart, lowers blood pressure, increases digestion, and constricts the pupils.
2. List and describe the major neurotransmitters and their functions:
● Acetylcholine: Muscle movement, memory, learning, attention, autonomic functions
● Dopamine: Pleasure, motor control (low in Parkinson’s), regulates movement and control
● Serotonin: Mood regulation, sleep, appetite
The information contained within this document is the property of Unitek Learning Education Group, Corp. Any use,
sharing, distribution or sale of this document or the information contained within is strictly prohibited and is subject
to disciplinary action, up to and including termination from the College.
● GABA: Inhibitory neurotransmitter, reduces neuronal excitability, plays a role in brain
development and learning processes
● Glutamate: Excitatory neurotransmitter, learning and memory, excessive glutamate activity can
lead to excitotoxicity and neuronal damage
● Norepinephrine: Fight or flight response, alertness
Medication Therapy – Fill in the blanks below, noting the page numbers and course resource you
consulted to find them.
1. Medication Therapy for Anxiety Disorders
● Example: Diazepam
● Mechanism of Action: Acts in the limbic system and reticular formation to potentiate the effects
of GABA, an inhibitory neurotransmitter; may act in spinal cord and supraspinal sites to produce
muscle relaxation.
● Common Side Effects: Mild drowsiness, depression, lethargy, apathy, fatigue, restlessness,
bradycardia, tachycardia, constipation, diarrhea, incontinence, urinary retention, changes in
libido, drug dependence with withdrawal syndrome.
Karch’s Focus on Nursing Pharmacology 9th Edition. Pg 348
2. Medication Therapy for Depression
● Example: Imipramine
● Mechanism of Action: Inhibits presynaptic reuptake of norepinephrine and serotonin;
anticholinergic at CNS and peripheral receptors; sedating
● Common Side Effects: Sedation, anticholinergic effects, confusion, anxiety, orthostatic
hypotension, dry mouth, constipation, urinary retention, rash, bone marrow depression, suicidal
ideation/behaviors.
Karch’s Focus on Nursing Pharmacology 9th Edition. Pg 363
3. Medication Therapy for Bipolar Disorder
● Example: Lithium
The information contained within this document is the property of Unitek Learning Education Group, Corp. Any use,
sharing, distribution or sale of this document or the information contained within is strictly prohibited and is subject
to disciplinary action, up to and including termination from the College.
● Mechanism of Action: Alters sodium transport in nerve and muscle cells; inhibits the release of
norepinephrine and dopamine (but not serotonin) from stimulated neurons; increases the
intraneuronal stores of norepinephrine and dopamine slightly; and decreases the intraneuronal
content of second messengers
● Common Side Effects: CNS problems, including lethargy, slurred speech, muscle weakness, and
fine tremor; polyuria, gastric toxicity, nausea, vomiting, diarrhea, renal toxicity.
Karch’s Focus on Nursing Pharmacology 9th Edition. Pg 388
4. Medication Therapy for Schizophrenia
● Example: Clozapine
● Mechanism of Action: Blocks dopamine and serotonin receptors; depresses the RAS;
anticholinergic, antihistaminic, alpha-adrenergic blocking
● Common Side Effects: Drowsiness, sedation, seizures, dizziness, syncope, headache, tachycardia,
nausea, vomiting, fever, neuroleptic malignant syndrome, neutropenia orthostatic hypotension,
seizures, myocarditis, cardiomyopathy.
Karch’s Focus on Nursing Pharmacology 9th Edition. Pg 384
5. Medication Therapy for Glaucoma
● Example: Carbachol (Miostat)
● Mechanism of Action: Act at cholinergic receptors in the peripheral nervous system to mimic the
effects of ACh and parasympathetic stimulation.
● Common Side Effects: Bradycardia, flushing, sweating, nausea, vomiting, blurred vision,
headache
Karch’s Focus on Nursing Pharmacology 9th Edition. Pg 552
6. Medication Therapy for Muscle Spasms
● Example: Cyclobenzaprine
● Mechanism of Action: Gamma-aminobutyric acid analogue, exact mechanism of action is not
understood; inhibits monosynaptic and polysynaptic spinal reflexes; CNS depressant
The information contained within this document is the property of Unitek Learning Education Group, Corp. Any use,
sharing, distribution or sale of this document or the information contained within is strictly prohibited and is subject
to disciplinary action, up to and including termination from the College.
● Common Side Effects: Transient drowsiness, dizziness, weakness, fatigue, constipation,
headache, insomnia, hypotension, nausea, urinary retention.
Karch’s Focus on Nursing Pharmacology 9th Edition. Pg 438
7. Medication Therapy for Seizure Disorders
● Example: Phenytoin
● Mechanism of Action: Stabilizes neuronal membranes and prevents hyperexcitability caused by
excessive stimulation; limits the spread of seizure activity from an active focus; has cardiac
antiarrhythmic effects similar to those of lidocaine.
● Common Side Effects: Ataxia, dysarthria, slurred speech, mental confusion, dizziness, fatigue,
tremor, headache, dermatitis, Stevens-Johnson syndrome, nausea, gingival hyperplasia, liver
damage.
Karch’s Focus on Nursing Pharmacology 9th Edition. Pg 403
8. Medication Therapy That Supports Anesthesia
● Example: Methohexital
● Mechanism of Action: Depress the CNS to produce hypnosis and anesthesia without analgesia
● Common Side Effects: Emergence delirium, headache, restlessness, anxiety, CV depression,
respiratory depression, apnea, salivation, hiccups, skin rashes.
Karch’s Focus on Nursing Pharmacology 9th Edition. Pg 476
9. Medication Therapy for ADHD and Narcolepsy
● Example: Methylphenidate
● Mechanism of Action: Mild cortical stimulant with CNS actions similar to those of
amphetamines.
● Common Side Effects: Hypersensitivity, nervousness, insomnia, dry mouth, increased heart rate
and blood pressure, loss of appetite, nausea, growth impairment, priapism, and abdominal pain.
Karch’s Focus on Nursing Pharmacology 9th Edition. Pg 392
10. Medication Therapy for Parkinson’s Disease
The information contained within this document is the property of Unitek Learning Education Group, Corp. Any use,
sharing, distribution or sale of this document or the information contained within is strictly prohibited and is subject
to disciplinary action, up to and including termination from the College.
● Example: Benztropine
● Mechanism of Action: Acts as an anticholinergic, principally in the CNS, returning balance to the
basal ganglia and reducing the severity of rigidity, akinesia, and tremors; peripheral
anticholinergic effects help to reduce drooling and other secondary effects of parkinsonism.
● Common Side Effects: Disorientation, confusion, memory loss, nervousness, light-headedness,
dizziness, depression, blurred vision, mydriasis, dry mouth, constipation, urinary retention,
urinary hesitation, flushing, decreased sweating.
Karch’s Focus on Nursing Pharmacology 9th Edition. Pg 428
11. Medication Therapy for Alzheimer’s Disease
● Example: Donepezil
● Mechanism of Action: Reversible cholinesterase inhibitor that causes elevated ACh levels in the
cortex, which slows the neuronal degradation of Alzheimer’s disease.
● Common Side Effects: Insomnia, fatigue, nausea, vomiting, diarrhea, dyspepsia, abdominal pain,
muscle cramps.
Karch’s Focus on Nursing Pharmacology 9th Edition. Pg 562
12. Medication Therapy for Multiple Sclerosis
● Example: Baclofen
● Mechanism of Action: Gamma-aminobutyric acid analogue, exact mechanism of action is not
understood; inhibits monosynaptic and polysynaptic spinal reflexes; CNS depressant
● Common Side Effects: Transient drowsiness, dizziness, weakness, fatigue, constipation,
headache, insomnia, hypotension, nausea, urinary retention.
Karch’s Focus on Nursing Pharmacology 9th Edition. Pg 437
13. Medication Therapy for Migraine Headaches
● Example: Ergotamine
● Mechanism of Action: Constricts cranial blood vessels, decreases pulsation of cranial arteries,
and decreases hyperperfusion of the basilar artery vascular bed.
The information contained within this document is the property of Unitek Learning Education Group, Corp. Any use,
sharing, distribution or sale of this document or the information contained within is strictly prohibited and is subject
to disciplinary action, up to and including termination from the College.
● Common Side Effects: Numbness, tingling in the fingers and toes, muscle pain in the extremities,
pulselessness or weakness in the legs, precordial distress, tachycardia, bradycardia, nausea,
vomiting, diarrhea, severe thirst, chest pain, confusion.
Karch’s Focus on Nursing Pharmacology 9th Edition. Pg 464
III. Nursing Considerations - Fill in the blanks below, noting the page numbers and course resource you
consulted to find them.
1. List key monitoring parameters for patients receiving neurological medications:
o Dizziness, drowsiness, confusion, and impaired coordination
o Avoid driving or operating heavy machinery until aware how medication affects you
o Excessive drowsiness can indicate potential toxicity.
NRG200 Module 2 Part 5
2. Patient education topics for medication adherence and safety:
o Take medications at the right time - either before or after a meal/morning or night time
o Educate about common side effects
o Educate adherence in terms that patient will understand
NRG200 Module 2 Part 5
IV. Review Questions - Fill in the blanks below, noting the page numbers and course resource you
consulted to find them.
1. How do benzodiazepines help manage anxiety? They prevent anxiety without causing much
associated sedation. These drugs act in the limbic system and the RAS to make GABA more
The information contained within this document is the property of Unitek Learning Education Group, Corp. Any use,
sharing, distribution or sale of this document or the information contained within is strictly prohibited and is subject
to disciplinary action, up to and including termination from the College.
effective, causing interference with neuron firing. GABA stabilizes the postsynaptic cell. This
leads to an anxiolytic effect at doses lower than those required to induce sedation and hypnosis.
/ Karch’s Focus on Nursing Pharmacology 9th Edition. Pg 344
2. What is the role of SSRIs in depression treatment? SSRIs prevent the reuptake of serotonin into
the presynaptic nerve, leading to an accumulation of these biogenic amines in the synaptic cleft.
This accumulation causes increased stimulation of the postsynaptic nerve and may be
responsible for the antidepressant effect of these drugs. / Karch’s Focus on Nursing Pharmacology 9th
Edition. Pg 370
3. Why is lithium monitoring necessary for bipolar disorder management? It can accumulate and
cause severe toxicity. It can cause severe CNS, renal, and pulmonary problems that may lead to
death. / Karch’s Focus on Nursing Pharmacology 9th Edition. Pg 387
4. What are the major differences between conventional and atypical antipsychotics? The typical
antipsychotic drugs block dopamine receptors, preventing the stimulation of the postsynaptic
neurons by dopamine. Whereas atypical antipsychotics block both dopamine and serotonin
receptors. / Karch’s Focus on Nursing Pharmacology 9th Edition. Pg 378
5. How do prostaglandin analogs work in glaucoma therapy? It reduces intraocular pressure (IOP)
by increasing aqueous humor outflow through relaxation of ciliary muscle. It basically lowers IOP
indirectly through ciliary contraction. / RN Pharmacology for Nursing Edition 9.0 Pg 18
6. Why is liver function monitoring important for seizure medications? It is important because
patients with hepatic impairment are at risk for increased toxicity. / Karch’s Focus on Nursing
Pharmacology 9th Edition. Pg 378
7. What precautions should be taken with anesthetic medications? Patients receiving general or
local anesthetics should include precautions to prevent injury and skin breakdown; support and
reassurance to deal with the loss of sensation and mobility; and patient teaching regarding what
to expect, to decrease stress and anxiety. / Karch’s Focus on Nursing Pharmacology 9th Edition. Pg 486
8. How do stimulant medications improve ADHD symptoms? These drugs can calm hyperkinetic
children and help them focus on one activity for a longer period. The paradoxical effect of
calming hyperexcitability through CNS stimulation seen in ADHD isn’t completely understood./
Karch’s Focus on Nursing Pharmacology 9th Edition. Pg 390
9. What dietary considerations are important for Parkinson’s medications? Avoid eating foods that
contain tyramine (avocados, soybeans, figs, smoked meat, dried or cured fish, cheese, yeast
products, beer, chianti wine, caffeinated bevs). Continue to avoid 2 weeks after stopping
medications. / RN Pharmacology for Nursing Edition 9.0 Pg 17
10. What is the goal of Alzheimer’s medications? The goal of Alzheimer’s medications doesn’t
reverse the effects of the disease unfortunately, but studies show that they may somewhat
delay the losses seen with the disease./ Karch’s Focus on Nursing Pharmacology 9th Edition. Pg 561
The information contained within this document is the property of Unitek Learning Education Group, Corp. Any use,
sharing, distribution or sale of this document or the information contained within is strictly prohibited and is subject
to disciplinary action, up to and including termination from the College.
Additional Notes:
Notes: (use this area to take any additional notes you need to help you prepare for quizzes, exams, and
assignments).
The information contained within this document is the property of Unitek Learning Education Group, Corp. Any use,
sharing, distribution or sale of this document or the information contained within is strictly prohibited and is subject
to disciplinary action, up to and including termination from the College.
