Mental Health / Withdrawal Flashcards Preview

NUR 325 Fundamentals of Pathopharmacology > Mental Health / Withdrawal > Flashcards

Flashcards in Mental Health / Withdrawal Deck (33)
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1
Q

Medication classes of Antidepressants

A

Selective serotonin reuptake inhibitors (SSRI)

Serotonin and Norepinephrine reuptake inhibitors (SNRI)

Tricyclic antidepressants

MAO inhibitors

Benzodiazepines

2
Q

Nursing considerations of antidepressants

A

SSRI & SNRI are first line- safety risk
Asses suicide risk
After starting drug- monitor 4-8 weeks for efficacy

3
Q

MOA for SSRI

fluoxetine (Prozac)

A

inhibitors of serotonin at nerve endings

More serotonin is available at the nerve endings

4
Q

Adverse effects of SSRI

A
weight gain
GI- N/V/D, constipation, dry mouth
CNS- headache, nervousness, insomnia
Sexual dysfunction
serotonin syndrome
withdrawal syndrome
Suicidal risk
Neonatal effects if pregnant
5
Q

Serotonin syndrome

A

2-72 hours after treatment, altered mental status, increased occurrence with MAOIs and other serotonergic drugs

6
Q

withdrawal syndrome of SSRI

A

dizziness, H/A, sensory disturbances, tremor, anxiety, dysphoria

7
Q

fluoxetine (Prozac)

A

Less sever/fewer s/e
less drug/drug interactions

Avoid use with MAO inhibitors

8
Q

MAO of venlafazine (Effexor)

A

Blocks neuronal activity of serotonin and norepinephrine

9
Q

Adverse effects of venlafazine

A

nausea, headache, anorexia, insomnia, somnolence, sexual dysfunction, withdrawal syndrome, sweating, blurred vision, increased LFTs (duloxetine)

10
Q

Tricyclic Antidepressants

A

amitryptaline (Elavil)

11
Q

MAO of amitryptaline (Elavil)

A

Block reuptake of 2 monoamine transmitters, norepinephrine & serotonin (intensify the effect), making more available in the synapse

12
Q

Adverse effects of amitryptaline (Elavil)

A
sedation
orthostatic hypotension
anticholinergic effects
sexual dysfunction
cardiac toxicity
13
Q

Monoamine Oxidase Inhibitors (MAOI)

A

phenelzine (Nardil)

14
Q

MAO of phenelzine (Nardil)

A

Inhibits MAO- enzyme found in the liver, intestinal wall and terminals of neurons
MAO converts norepi, 5-HT, and dopamine to inactive product

decreased MAO increases availability of neurotransmitters at the nerve endings

15
Q

adverse effects of phenelzine (Nardil)

A

food/drug interactions
CNS stimulation
orthostatic hypotension
rapid increase in BP, stroke, coma

drug interactions!

16
Q

Atypical Antidepressants

A

buproprioin (Wellbutrin)

17
Q

MAO of buproprion (Wellbutrin)

A

is unclear

18
Q

side effects of buproprion

A

seizure, agitation, headache, dry mouth, constipation, weight loss, GI upset, dizziness, tremor

19
Q

ketamine

A

low/dose intranasal administration that can be used to treat extreme pain

can rapidly help with suicidality and other serious symptoms of depression

20
Q

Adverse effects of ketamine

A

perceptual disturbances dissociation

21
Q

MOA of trzadone (Oleptro)

A

second-line agent

blockade of 5-HT reuptake

22
Q

Benzodiazepines

A

alprazolam (Xanax)
diazepam (valium)
lorazepam (Ativan)

23
Q

MOA of
alprazolam (Xanax)
diazepam (valium)
lorazepam (Ativan)

A

Enhance inhibitory effects of GABA in the CNS

24
Q

Adverse effects of
alprazolam (Xanax)
diazepam (valium)
lorazepam (Ativan)

A

CNS depression (decreased LOC)
w/d effects
memory loss
respiratory depression

25
Q

benzo nursing considerations

A

Teratogenic- avoid while pregnant
do not mix w other medications
avoid grapefruit or fatty foods
Antidote: flumazenil (Romazicon)

26
Q

MAO of tramadol (Ultram)

A

Binds weakly to mu opioid receptors

inhibit reuptake of both norepi and serotonin

27
Q

Adverse effects of tramadol

A

drowsy, dizzy, headache, nausea, constipation, respiratory depression

rare- seizures

28
Q

MAO of gabapentin (Neurontin) & pregablin (Lyrica)

A

thought to spontaneously suppress neuronal firing

29
Q

Adverse effects of gabapentin & pregablin

A

drowsy, dizzy, visual problems

30
Q

NSAIDS

A
aspirin (ASA)
ibuprofen (Advil)
naproxen (Aleve)
ketorolac (Toradol)
celecoxib (Celebrex)
31
Q

NSAIDS MOA

A

blocks a key enzyme: COX- that is crucial to the production of prostaglandins

32
Q

Side effects of NSAIDS

A

GI upset, stomach ulcers, GI bleeding, rash, edema, kidney failure, increases in BP, inhibits platelet aggregation, SOA in asthma patients

33
Q

Side effects of Aspirin

A

toxicity- n/v

Reye’s Syndrome