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Behavioral Health > Exam #1 Varcolis Ch. 11, 15 ATI 11-13, 21 And 22 Pharm Pgs. 51-66 > Flashcards

Exam #1 Varcolis Ch. 11, 15 ATI 11-13, 21 And 22 Pharm Pgs. 51-66 Flashcards

1
Q

Causes of depression

A

Triggers
Genetics
Biochemical
Learned helplessness
Cultural

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2
Q

Major Depressive Disorder

A

Episodic 2-3 months
suicidal thoughts
-constant state of being unhappy
-psychomotor retardation (slow moving)
-appetite changes
-can’t focus
-sleep disturbance
-energy decreased
-They can’t function in certain areas of life

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3
Q

Persistent depressive disorder

A

Starts at adolescents
Hard to distinguish
Daytime fatigue
Irritable
Able to function but not optimal
Eating excessively or not enough
Pessimistic thinking
Low self-esteem

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4
Q

Assessment for Depression

A

Hypothyroidism and vitamin D deficiency can both mimic depression
Cognition and thought content- what is their concentration like?
Suicide and homicide assessment
Previous episodes of depression and coping skills
Ask “what does depression mean to you?”

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5
Q

Depression outcomes

A

Safety should always be priority
Example outcomes
-patient will name 2 persons of support when suicidal
-patient will gain 5 lbs
-patient will sleep 6-8 hours per night

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6
Q

Implementation

A

Therapeutic silence
Offering self
Precautionary measures for suicide
Ask patient what is their plan if suicidal
Have a one to one sitter- should not be alone, no harmful items when suicidal
Safety contract- ask for a promise to not overdose

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7
Q

Interdisciplinary treatments

A

Milieu therapy
Psychotherapy
Mindfulness based cognitive therapy
Group therapy

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8
Q

Antidepressant drugs

A

SSRIs
SNRIs
Trazadone
TCAs
MAOIs
Bupropion

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9
Q

SSRIs

A

Citalopram
Escitalopram
Fluoxetine
Paroxetine
Sertraline

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10
Q

SSRIs Uses

A

Depression with anxiety
Panic disorder
PTSD
OCD
Bulimia

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11
Q

SSRIs side effects

A

Sleep disturbance
Sexual dysfunction
Tension headaches
Reduced appetite
Hyponatremia
Rash/SJS

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12
Q

SSRIs Adverse Effects

A

Serotonin Syndrome
Shivering
Hyperreflexia
Increased temperature
Vital sign instability: Increase BP
Encephalopathy
Restlessness
Sweating
Abdominal pain
Increased bleeding tendencies

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13
Q

SSRIs contraindications

A

Ulcer
GI bleeding

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14
Q

SNRIs

A

Venlafaxine
Desvenlafaxine
Duloxetine
Levomilnacipran

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15
Q

SNRIs Uses

A

Major depressive disorder
Anxiety disorder

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16
Q

SNRIs Adverse effects

A

Serotonin syndrome
Hyponatremia

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17
Q

Trazadone uses

A

Adjunct therapy for depression
Insomnia

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18
Q

Tricyclics (TCAs)

A

Amitriptyline
Doxepin
Impipramine
Nortriptyline

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19
Q

Tricyclics (TCAs)

A

Anticholinergic side effects
Dry mouth
Blurred vision
Tachycardia
Constipation
Urinary retention
Esophageal reflux
Photophobia
Sexual dysfunction

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20
Q

Tricyclics (TCAs) Adverse effects

A

Orthostatic hypotension
Dysrhythmias
Myocardial infarction
Heart block

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21
Q

TCAs Contraindications

A

Recent MI
Narrow angle glaucoma
Benign prostatic
Hypertrophy
Seizures
Pregnancy

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22
Q

Monoamine oxidase inhibitors (MAOIs)

A

Phenelzine
Tranylcypromine
Isocarboxazid
Selegiline

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23
Q

MAOIs adverse effects

A

Hypertensive crisis
Severe HA or blurry vision
Chest pain, tachycardia
SOB
Diaphoresis, anxiety
Mental status change
Confusion
N/V

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24
Q

MAOIs foods to avoid

A

Avocados, figs
Fermented, smoked, cured meats, and fish
Bologna, pepperoni, salami
Almost all cheeses
Yeast extract
Some beers
Protein supplements
Shrimp paste, soy sauce

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25
Q

MAOIs contraindications

A

Cardiovascular disease
HTN, CHF
Liver disease
Recurrent headaches
Recent surgery

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26
Q

Bupropion

A

Depression
Smoking cessation
Prevention of seasonal pattern depression
Weight loss

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27
Q

Bupropion Adverse effects

A

Appetite suppression
Seizures

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28
Q

Ketamine Uses

A

Anesthetic: can be given to aggressive pts
Postpartum depression
Takes away suicidal ideation

29
Q

Ketamine side effects

A

Increased BP, HR
Dissociation (high out of body experience)

30
Q

Light therapy

A

For mild depression

31
Q

St. John’s Wort

A

Interact with all antidepressants
- potentially fatal serotonin syndrome can result if combined with SSRIs

32
Q

Electroconvulsive therapy Uses

A

Major depressive disorder
Schizophrenia
Acute Mania

33
Q

Electroconvulsive therapy

A

A last resort
Inducing seizures

34
Q

ECT medications

A

Atropine: decrease secretions so they don’t aspirate
Propofol: puts them to sleep
Succinylcholine: stops jerking movement

35
Q

Anxiety

A

A feeling of uneasiness, uncertainty, or dread
Results from a real or perceived threat
Source of threat is unknown or unrecognized.

36
Q

Fear

A

Reaction to a specific danger
You see the threat

37
Q

Normal anxiety

A

Can motivate you to do things

38
Q

Acute anxiety

A

Example: anxious right before getting surgery

39
Q

Pathological anxiety

A

Emotional response that is out of proportion to the threat
Emotional response can continue even after the threat is resolved.

40
Q

Levels of anxiety

A

Mild
Moderate
Severe
Panic

41
Q

Mild anxiety

A

Ability to learn: good
Physical characteristics
-restless
-mild irritability
-nail biting/finger tapping
-shaking their leg

42
Q

Moderate

A

Ability to learn: altered but still possible
Physical characteristics
-tension
-pounding heart
-increased. Respiratory rate and heart rate
-somatic symptoms: using the restroom a lot
-voice tremors

43
Q

Severe anxiety

A

Overly focused
Scattered details
Ability to learn: unable
Physical characteristics:
-automatic behavior
-severe somatic symptoms (chest pain)
-hyperventilation
-sense of dread

44
Q

Panic anxiety

A

Ability to learn: unable
Characteristics:
-erratic and impulsive behavior (ex: may take off all their clothes)
-hallucinations
-pass out
-dissociate
-freeze

45
Q

Panic disorders

A

Recurrent and unexpected panic attacks
monitor for suicide, don’t leave pt alone

Benzodiazepines: help during panic attacks
Anticipatory anxiety: worry a panic attack is going to happen
Symptoms: Nausea, hot flashes

46
Q

Panic attack

A

Can last between 1-30 min
Sudden onset of fear or apprehension
not always in response to an acute stressor

47
Q

Social anxiety disorder

A

Provoked by exposure to a social situation or a performance situation
Fear is being evaluated or rejected: embarrassment or humiliation

48
Q

Agoraphobia

A

Fear of being in places where help might not be available
escape might be difficult or embarrasing
Ex: a grocery store, a park, fear of crowd

Treatment therapy: SSRIs

49
Q

Generalized anxiety disorder

A

Excessive anxiety and worry about a number or events and activities
Constant “what ifs”

Treatment: combo of meds and therapy

50
Q

OCD

A

Obsessions: uncontrollable, recurring thoughts
Compulsions: ritualistic behaviors
Ex: washing hands 3 times

important to allow them to carry out their rituals, never interrupt

51
Q

Body dysmorphic disorder

A

Imagined “defective body part”
Ex: constantly looking at themselves in the mirror, grooming themselves

52
Q

Hoarding disorder

A

Excessive collecting of items
Persistent difficulty in parting with possessions

53
Q

Acceptance and commitment therapy

A

Part of psychotherapy
Commit to changing their behavior

54
Q

Meditation

A
55
Q

Mindfulness

A

Focusing on different parts of the body

Ex: yoga

56
Q

Behavioral therapy

A

Aversion therapy: focuses on pain, given an undesirable stimulus ex: the pedophile example
Flooding: throwing someone in a situation with the considered threat
Systematic desensitization
Exposure and response prevention
Modeling: holding a cricket to show there is no harm
Thought stopping

57
Q

Relaxation training

A

Deep breathing
Guided imagery
Progressive relaxation
Autogenic training
Self-hypnosis
Biofeedback-assisted relaxation

58
Q

Antidepressants

A

SSRIs
SNRIs
- Long term treatments
-start with low doses
-prioritize suicide risk

59
Q

Benzodiazepines

A

Lorazepam
Clonazepam
Alprazolam

60
Q

Benzodiazepines uses

A

Short term treatment
Tolerance develops
Withdrawal symptoms
Addiction
— sedation
—used for the treatment of relief of anxiety and reduce seizures

61
Q

Benzodiazepines side effects

A

Amnesia: memory loss
— avoid driving
— impaired judgment

Long term use can lead to dementia and respiratory depression

62
Q

Benzodiazepines antidote

A

Flumazenil

63
Q

Antihistamines

A

Diphenhydramine
Hydroxyzine

64
Q

Antihistamine uses

A

Short term use only
Good for those with substance use disorder
Sedating: therefore helping with anxiety and tension

65
Q

Buspirone

A

Non-additive
Long term treatment
2-4 weeks to be effective
Only for long term treatment of anxiety
Can cause orthostatic hypotension, lightheadedness, and dizziness

66
Q

Kava kava

A

Elevates mood and feeling of relaxation
Used for the treatment of anxiety and insomnia

67
Q

Valerian

A

Best for sleep
Treatment of anxiety and relieve insomnia

68
Q

Lavender oil

A

most effective
Boost mood and treat sleep

69
Q

St. John’s wort

A

Treatment of depression, anxiety and insomnia

Behavioral Health (8 decks)

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