Antidepressants, Mood Stabilizers, Antipsychotics, and Anxiolytics Flashcards
What is psychosis and its symptoms?
Losing contact with reality; being unable to tell what is real and what is not.
Symptoms Include:
Hallucinations, Delusions, Catatonia (similar to flat effect), Difficulty processing information, Incoherance
What is schizophrenia and its symptoms?
Schizophrenia is a progressive, chronic disorder where many psychosis symptoms are developed. Thought to result from an imbalance of EXCESSIVE dopamine.
Symptoms Include:
Auditory and visual (usually more audio) hallucinations
Hallucinations
Delusions
Paranoia
Incoherent speech ("word salad")
Social Withdrawal
Poor self-care
Loss of speech
What is extrapyramidal syndrome (EPS)?
EPS = Basically pseudoparkinsonism and other involuntary muscle movements
SS:
Lip smacking (involuntary)
Muscle rigidity
Stooped posture
Bradykinesia (slow movements)
Acute dystonia (Muscle spasms, usually of back and neck; CAN IMPAIR RESPIRATION)
Akasthisia (Difficulty standing still)
Tardive Dyskinesia (Lip smacking, chewing motion, marching in place and other involuntary movements)
What is the difference between typical and atypical antipsychotics?
Typical = Were created FIRST
- So they have more SE and drug interactions - Are now used less
Atypical = Were created SECOND
- So have less SE and drug interactions - Usually are FIRST LINE w/ psychosis disorders
What is Neuroleptic Malignant Syndrome (NMS)?
NMS = A FATAL condition and adverse effect of many anticonvulsants
SS Include: Coma Renal failure Muscle rigidity SUDDEN high fever Altered mental status Labile Blood Pressure (Where the blood goes really high then really low etc. continuously - basically an unregulated BP)
What are some points for Fluphenazine (Prolixin), a Phenothiazine TYPICAL Antipsychotic
Is a CNS depressant
Causes agranulocytosis
DO NOT TAKE WITH: Kava Kava (increase chance of dystonia)
Should be used with caution in pregnant/lactating women
EPS is a risk!
What are some important points with Haloperidol (Haldol), a Nonphenothiazide TYPICAL Antipsychotic?
Can cause photosensitivity
EPS and NMS is a risk!
Can cause seizures
What are some important points on Aripiprazole (Abilify), an ATYPICAL Antipsychotic?
EPS and NMS risk
DON’T TAKE W/ grapefruit juice (increases Abilify blood levels) OR St. John’s Word (Decreases Abilify blood levels)
Interferes with the 5-HT receptors (is the only medication that I need to know that does this)
What is primary vs. secondary anxiety? (Difference in how they are defined and treated)
Primary = NOT related to a medical condition
- Tx: Anxiolytics
Secondary = RELATED TO a medical condition (such as substance abuse or another psychiatric disorder)
- Tx: Anxiolytics; ONLY IF severe, untreatable, or causes disability (w/ ADLs etc.)
What are some important points about Iorazepam (Ativan)?
Is a benzodiazepine
ADDICTIVE (and pt can become tolerant)
DO NOT USE IF: Pregnant/Lactating, Smoking/Vaping
DON’T TAKE W/: Kava Kava
CNS Depressant
Don’t do activities that require ALERTNESS (includes driving)
ANTIDOTE = Flumazenil (Mazicon)
What are the different types of depression? How are each of them treated?
Reactive: SUDDEN onset after an event (ex: loss of a job, loss of a loved one etc.)
- Tx: Benzos
Major: Recurrent depressive episodes for multiple days at a time
- Tx: They’re on their own I guess (it’s probably any antidepressive)
Bipolar Affective: The depressive episode of bipolar disorder
- Tx: Depakote
What are the 2 HERBAL medications that can treat depression? What are their important points?
HERBAL MEDICATIONS: St. John’s Wort and Gingko Biloba
IMPORTANT POINT: Increases bleeding time
- So should DISCONTINUE about 1-2 weeks b4 surgery to prevent complications
What are some important points of Amitriptyline HCL (Apo-Amitriptyline/Vantarip)?
Is a tricyclic antidepressant
-triptyline is common root
Is NOT 1st line (usually a last resort med) b/c it has a bunch of drug interactions and SE
EPS risk
WASHOUT PERIOD: A 14-day period where pt is on NEITHER Tricyclics or MAOIs
- This is because Tricyclic and MAOIs CANNOT be used at the same time as it can cause a HTN Crisis
What are signs and symptoms of a hypertensive crisis?
THINK: Blood pressure is super high, so what would that look like?
Severe chest pain Diaphoresis (sweating) Anxiety Shortness of breath Tachycardia Confusion Nausea and vomiting
What are some important points with Fluoxetine (Prozac?)
Is a Selective Serotonin Reuptake Inhibitor (SSRI)
-xetine is a common root
SSRI are 1st line antidepressants
HYPONATREMIA common
- A change in mental status, urinary frequency, and seizures can be SS of hyponatremia
MOST SSRIs are CNS depressants, however Prozac is a CNS agonist
- Can cause agitation, so good for sedation type depressions
