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NUR 340 > 346 drug class and functions > Flashcards

346 drug class and functions Flashcards

1
Q

Anxiolytic agents (anti-anxiety)

A

benzodiazepines
nonbenzodiazepine receptor agonist
melatonin receptor agonists

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2
Q

Antidepressants

A

Tricyclic antidepressants (TCAs):
Monoamine oxidase Inhibitors (MAOIs)
Selective Serotonin reuptake inhibitors (SSRIs)
Serotonin-norepinephrine reuptake inhibitors (SNRIs)
Norepinephrine and serotonin specific antidepressant (NaSSA)
Norepinephrine dopamine reuptake inhibitor (NDRI)
Serotonin antagonists and reuptake inhibitors (SARI)
Serotonin partial agonist reuptake inhibitor (SPARI)
Serotonin modulator and stimulator

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3
Q

Mood stabilizing agents

A

lithium
anticonvulsant agents

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4
Q

antipsychotic drugs

A

first generation
second generation

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5
Q

ADHD medications

A
  • Methylphenidate (Ritalin, concerta)
  • Amphetamines (Adderall, vyvanse)- Seem to reduce the reuptake of dopamine and, in high concentrations, to inhibit monoamine oxidase A (MAO-A) → norepinephrine and dopamine enhancing effects. May cause insomnia, increased BP, and HR
  • Atomoxetine (Strattera)- Nonstimulant for 6+ y.o.
  • Guanfacine (intuniv)
  • Clonidine (Kapay)
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6
Q

Alzheimers disease medications

A

cholinesterase inhibitors
glutamine-blocking agent

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7
Q

Nonbenzodiazepine receptor agonists

A

z-hypnotics
short-acting sedative hypnotic sleep agent
quick onset, take when about to sleep
helps you sleep but no “hangover” effect
take 30-40 mins before bed
get 8 hours of sleep

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8
Q

what drug class is gold standard for anxiety disorders

A

antidepressants (mostly SSRIs)

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9
Q

Tricyclic antidepressants (TCAs)

A

end in -ine
block the reuptake of norepinephrine or both norepinephrine and serotonin
not fist line anymore- more lethal in OD, causes sedation, longer to reach therapeutic goal
side effects: anticholinergic effects (drying up effects), orthostatic hypotension, confusion, drowsiness

know about BP or CNS issues before prescribing

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10
Q

monoamine oxidase inhibitors list of foods to avoid

A

Strong or aged cheeses
avocados
Cured meats (salami, beef jerky)
Smoked or processed meats
Pickled or fermented foods
Soybean products
Sauces: soy sauce, shrimp sauce, fish sauce, miso, and teriyaki sauce
Snow peas & fava beans
Beer, red wine, sherry and liqueurs
Dried or overripe fruits (eg. Raisins, prunes, bananas, & avocados)
Meat tenderizers
Old or spoiled foods

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11
Q

side effects of MAOIs

A

HTN crisis, photosensitivity, weight gain, sexual dysfunction
discontinue 10 days before surgery
monitor for urine retention

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12
Q

side effects of MAOIs

A

HTN crisis, photosensitivity, weight gain, sexual dysfunction
discontinue 10 days before surgery
monitor for urine retention

have a lot of drug to drug interactions (on powerpoint), know medication history

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13
Q

action of MAOIs

A

monoamine oxidase is involved in removing the neurotransmitters norepinephrine, serotonin and dopamine from the brain, MAOIs prevent this from happening which makes more of these neurotransmitters available

useful for those whole have tried other medications and were unsuccessful

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14
Q

serotonin syndrome

A

MAOIs + SSRIs
causes a build up of serotonin in the body
s/s: tachycardia, diaphoresis, fever leading to hypothermia, shivering, muscle rigidity, restlessness, agitation, delirium

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15
Q

Selective serotonin reuptake inhibitors (SSRI)

A

inhibit the reuptake of serotonin
serotonin hangs in the synapse longer, lets post synapse use it for longer
most commonly prescribed for depression
all have a black box warning for increased suicidal ideation

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16
Q

Normal transmission

A

enough neurotransmitters for the number of receptors

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17
Q

deficient neurotransmitters

A

less neurotransmitters than number of receptors

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18
Q

deficient receptors

A

More neurotransmitters than number of receptors

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19
Q

categories of diagnostic tests to visualize the brain

A

electrical
structural
functional

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20
Q

electrical imaging

A

records electrical signals in the brain
Electroencephalography (EEG)
shows the state a person is in
supports identification of brain abnormalities

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21
Q

structural imaging techniques

A

provides gross anatomical detail of brain structure
can reveal schizophrenia and cognitive disorders
CT and MRI

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22
Q

CT (structural)

A

can show larger mass or bleed, lesions, infarcts
urgent (2-5 mins)

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23
Q

MRI (structural)

A

can show: edema, trauma, ischemia, neoplasm
longer study (30-60 mins)

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24
Q

Functional imaging studies

A

physiological activity in the brain
can detect physiological and biochemical changes in living tissue (schizophrenia, mood disorders, adult ADHD)

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25
Q

fMRI

A

brain activity through blood O2

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26
Q

Pet scan

A

injected tracer shows activity of the brain and 3D brain imaging

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27
Q

SPECT scan

A

like a PET but shows activity of the brain and brain layers

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28
Q

acetylcholine

A

role in learning, memory, regulates mood: mania and sexual aggression, stimulates parasympathetic nervous system

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29
Q

too much acetylcholine

A

depression

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30
Q

too little acetylcholine

A

dementia, alzheimer’s disease, huntington’s disease, parkinson’s

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31
Q

Dopamine

A

involved in fine muscle movement, integration of emotions and thoughts, and decision making

32
Q

too much dopamine

A

schizophrenia

33
Q

too little dopamine

A

ADHD, depression, muscular rigidity and tremors found in parkinson’s disease

34
Q

serotonin

A

hunger, sleep regulation, mood, and pain perception, hormonal activity, aggression and sexual behavior

35
Q

too much serotonin

A

anxiety

36
Q

too little serotonin

A

depression, OCD

37
Q

GABA

A

plays a role in inhibition, reduces aggression, excitation and anxiety, anticonvulsant properties, pain perception

38
Q

too much GABA

A

plays a role in inhibition, reduces aggression, excitation and anxiety, anticonvulsant properties, pain perception

39
Q

too much GABA

A

reduces anxiety

40
Q

too little GABA

A

anxiety, schizophrenia, mania, huntington’s disease

41
Q

Norepinephrine

A

level in brain affects mood, attention and arousal, stimulates sympathetic branch of ANS (fight or flight) in response to stress

42
Q

too much norepinephrine

A

mania, anxiety, schizophrenia

43
Q

too little norepinephrine

A

depression

44
Q

too much adrenaline

A

anxiety

45
Q

too little epinephrine

A

depression

46
Q

agonists

A

work with
Mimic the effects of neurotransmitters naturally found in the brain
Bind to and stimulate the neurotransmitter

47
Q

antagonist

A

works against
block neurotransmitter from binding to its receptor
obstruct the neurotransmitter

48
Q

neurotransmitters that are affect with depression

A

serotonin and norepinephrine

49
Q

side effects for SSRIs

A

apathy, low libido, nausea and vomiting, painful menstruation, sexual dysfunction, insomnia, rash, taste changes, dry mouth, dizziness, weight loss/gain

50
Q

Serotonin-norepinephrine reuptake inhibitors SNRIs

A

inhibits the reuptake of serotonin AND norepinephrine
newer drug class
little more expensive

51
Q

Serotonin-norepinephrine reuptake inhibitors SNRIs drugs

A

Venlafaxine (effexor)
Desvenlafaxine (Pristiq)
Duloxetine (cymbalta)- Also works on nerve pain, limits pain signals that ascend up to the brain
Levomilnacipran (fetzima)- This med has a greater effect on norepinephrine reuptake than any of the other SNRIs available for treating depression

52
Q

Norepinephrine and serotonin specific antidepressant (NaSSA)

A

work on norepinephrine and serotonin
boost mood and help keep people calm, commonly used for anxiety (If SSRI doesn’t work)
Mirtazapine (Remeron)

53
Q

Norepinephrine dopamine reuptake inhibitor (NDRI)

A

Bupropion (Wellbutrin- antidepressant) (Zyban- smoking)- Can also be used for smoking cessation
Can not abruptly stop taking = seizure risk
May cause appetite suppression

54
Q

Serotonin partial agonist reuptake inhibitor (SPARI)

A

Enhances serotonin by inhibiting the transporter and by stimulation serotonin (dual action- stimulate AND enhance serotonin)
Side effects: diarrhea, nausea, vomiting, insomnia

55
Q

Serotonin antagonists and reuptake inhibitors (SARI)

A

for anxiety and depression
Nefazodone (serzone)
Trazodone (formerly sold as desyrel) (oleptro)
- Not the first choice antidepressant treatment but - useful for insomnia
- Can cause priapism
- used for sedation in the ER (or to calm)
Brexpiprazole (Rexulti)- Can cause weight gain

56
Q

Serotonin modulator and stimulator

A

Inhibits serotonin reuptake and partially agonizing or antagonizing the 5-HT receptors
Can improve cognitive deficits in the elderly
Side effects: constipation, nausea, vomiting, hyponatremia, induction of hypomania
Vortioxetine (trintellix)

helps with mental clouding, fuzziness, difficultly with making decisions

57
Q

modd stabilizers

A

lithium
anticonvulsants

58
Q

lithium

A

gold standard
Stabilizes depression and mania (bipolar disorder)
Potential for toxic effects: tremor ataxia, confusion, convulsions, and n/v
Affects cardiac contraction → Can lead to sinus bradycardia

59
Q

side effects for mood stabilizers

A

most mood stabilizers required monitoring of blood levels and organ function
Weight gain
Somnolence
agranulocytosis- look at CBC, specifically WBC
Thrombocytopenia- same ^^
Hepatitis
Steven johnson syndrome- assess skin for rash

60
Q

therapeutic blood levels for lithium (NOT for THIS exam)

A

Therapeutic blood level: 0.8 to 1.4 mEq/L
Maintenance blood level: 0.4 to 1.3 mEq/L
Toxic blood level: 1.5 mEq/L and above

61
Q

therapeutic blood levels of Divalproex (Depakote) (NOT for THIS exam)

A

Maintenance blood level: 50 to 100 mcg/mL

62
Q

therapeutic blood levels for Carbamazepine (Tegretol) (NOT for THIS exam)

A

Maintenance blood level: 4 to 12 mcg/mL

63
Q

lithium and sodium relationship

A

Lithium is a salt and competes with sodium. Our body responds to lithium in the same way it responds to sodium

64
Q

factors that affect lithium levels

A

New BP medications (shift lithium levels)
NSAIDs (shift lithium levels)
flu → need to replenish fluids if they have diarrhea or vomiting

65
Q

lithium toxicity

A

Acute: Diarrhea, nausea, vomiting, stomach pains, dizziness, weakness, confusion, memory problems, psychosis, hand tremors, muscle twitching, ataxia (incoordination), nystagmus, seizures
Chronic: tremors, slurred speech, increased reflexes

66
Q

conventional first generation antipsychotic meds (typical)

A

mostly work on positive symptoms of schizophrenia- people experiencing psychosis
block attachment of dopamine and reduce dopaminergic transmission

67
Q

second generation antipsychotics (atypical or unconventional)

A

target positive and negative (flattening effects of schizophrenia) symptoms
often choose as the first line generation
Predominantly D2 (dopamine) and 5-HT2A (serotonin) antagonists (blockers)

68
Q

side effects of 1st generation

A

weight gain (slows metabolism)
sedation (slows the mind)

slows down the mind to allow patient to focus on what’s happening

69
Q

side effects of 2nd gen

A

produce fewer extrapyramidal side effects (EPS)
increase risk for metabolic syndromes → diabetes! increased weight, blood sugar, and triglycerides

70
Q

Clozapine (Clozaril) (2nd gen antipsychotics) concerns

A

five black box warning: agranulocytosis (look at WBC), seizures, myocarditis, “other adverse cardiovascular and respiratory effects”, “increased mortality in elderly patients with dementia related psychosis”

Patient must be a part of the clozapine REMS program - must obtain an absolute neutrophil count for patients

71
Q

ADHD medications are ___

A

psychostimulants

72
Q

ADHD meds are given for

A

short attention span, impulsivity, overactivity

73
Q

Cholinesterase inhibitors

A

slow the destruction of acetylcholine
Slow the rate of memory loss
Break down acetylcholine
by inhibiting cholinesterase, these medications increase the amount of acetylcholine in the synapse by inhibiting its breakdown

not curative medications, they are supportive and promote independence and focus (until disease progresses and they no longer work)

74
Q

Glutamine-blocking agent

A

Works by blocking the NMDA receptors in the brain which blocks the excessive activity of glutamine but still allows for the normal activation of these receptors that occurs when the brain forms a memory

not curative medications, they are supportive and promote independence and focus (until disease progresses and they no longer work)

75
Q

Cholinesterase inhibitors side effects

A

anticholinergic effects- dry mouth

NUR 340 (3 decks)

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