Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

behavioral health > week 4 pharm > Flashcards

week 4 pharm Flashcards

antipsychotics & mood stabilizers

1
Q

Lithium

A

*range 0.5 to 1.2 mEq/L

  • inverse relationship w sodium
  • first line of treatment for acute mania & depression
    -prevents manic & depressive episodes
  • mood stabilizer that prevents mood cycling (3-6 weeks)

*interacts w NSAIDS & diuretics & anticholinergics & antidepressants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

expected side effects of Lithium

A

sedation
acne
nausea
excessive thirst
hand tremors
weight gain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

early lithium toxicity

A

1.2 - 1.5
* hold med & call dr

n/v/d
muscle weakness
slurred speech

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

advanced lithium toxicity

A

> 1.5

-excess sweating
-vomiting
-diarrhea

EEG changes
-hand tremor
- muscle hyper-irritability
- GI upset
- confusion
-incoordination

*stupor
*blurrred vision

*affects KIDNEYS

**treated w normal saline bolus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

long term effects of Lithium

A

hypothyroidism - goiter
kidney dysfuction

weight gain
*assess levels every 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Anticonvulsants

A

1st line of treatment mood stabilizer – bipolar mania, hypomania, mixed states, cycling

*ValPROic Acid
*DivalPROex
*ValPROate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Expected side effects of valPROic Acid

A

*anticonvulsant

tremor
sedation
GI pain
hair loss
weight gain

blood dyscarias – anemia & thrombocytosis
hepatotoxicity
pancreatitis

*taken in patients w kidney dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

lithium affects ____ buut anticonvulsants affect _____

A

lithium = kidneys

anticonvulsants = liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

anticonvulsant therapeutic levels & toxicity symptoms

A

*ValPROic Acid
*DivalPROex
*ValPROate

85 - 125 ug/mL
toxic = intentional overdose
- ataxia (loss of body movement)
- confusion
- somnolence
-coma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Carbamazepine

A

anticonvulsant

treats bipolar disorder, rapid cycling, mixed states

treats & prevents acute mania

*MONITOR FOR RASHES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Adverse effects of Carbamazepine

A

*anticonvulsant = mood stabilizer
- hyponatremia & fluid overload
- decreases effectoveness of birth control
- blood dyscrasias
- hepatic disease

RASH
*fatigue & nausea
*diplopia (double vision)
*ataxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Lamotrigine treats ___ & adverse effects

A

**anticonvulsant = bipolar depression–acute &maintenance

  • monitor for FEVER = aseptic meningitis
  • lower birth control effectiveness
  • Steven Johnsons
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Anxiolytics are

A

Benzodiazepenes = Clonazepam & Lorazepam

given when concerned about heart or delirium

adjunctive agents for acute mania & psychomotor agitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

second - generation antipsychotics are best for

A

non-compliance for acute mania, bipolar depression, & their prevention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

first-generations antipsychotics

A

Chlorpromazine
Loxapine
Fluphenazine
Haloperidol

  • treat POSITIVE symptoms
  • used less = adverse effects
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

extrapyramidal symptoms of first-generation antipsychotics

A

*PSEUDOPARKINSONISM - fall risk

*ACUTE DYSTONIA - (muscle & laryngeal symptoms - concern for airway)

*AKATHISIA- (restless feet & extreme stress- suicide risk)

*TARDIVE DYSKINESIA - (face droop- irreversible)

17
Q

other side effects of 1st gen antipsychotics

A

lowered seizure threshold
orthostatic hypotension
sedation
increased prolactin = sex dysfunction, amenorrhea, galactorrhea

*high fall risk

18
Q

adverse effects of first gen antipsychotics

A

*METABOLIC SYNDROME
*prolonged QT interval
*anticholinergic toxicity
*neuroleptic malignant syndrome

19
Q

metabolic syndrome presents as..

A

weight gain, hypertension, diabetes, & dyslipidemia

20
Q

anticholinergic toxicity presents with..

A

*dry mouth
*urinary retention
anxiety, hallucinations, hyperactivity, seizures, & delirium

symptoms disappear w stop of first gens

21
Q

Neuroleptic Malignant Syndrome presents as

A

*high fever (103-105)
*muscle rigidity (monitor DVT & rhabdomyolysis)
*increased vitals
*altered mental status

22
Q

Second & Third Generation Antipsychotics

A

*CLOZAPINE - last resort
*ARIPIPRAZOLE - sedating
*RISPERIDONE - stroke risk
*LURASIDONE
*OLANZIPINE - gain weight
*QUETIAPINE - high street value & homeless

treat NEGATIVE & POSITIVE

23
Q

when using clozapine

A

*monitor for FEVER
*AGRANULOCYTOSIS - WBC’s

drooling
mycarditis
*last-resort

24
Q

Injectable Antipsychotics

A

Haldol
Aripriprazole
Risperidone
Olanzipine
Ziprasidone
*must be stable on PO verison first

25
Q

when evaluation antipsychotic medication effectiveness the nurse should ask about..

A

*have the symptoms LESSENED
*medication ADHERENT
*support system

26
Q

lithium levels during a manic episode

A

0.8 to 1.4

okay to administer next dose if patient is within the range

27
Q

a client’s lithium level is 2.1 mEq/L. Which of the following is an appropriate action by the nurse?

  1. Perform immediate gastric lavage
  2. Prepare the client for hemodialysis
  3. Administer an additional oral dose of lithium
  4. Request a stat repeat of the lab test
A
  1. Perform immediate gastric lavage
28
Q

when a client has a lithium level of 2.5 mEq/L the nurse should..

A

prepare the client for hemodialysis

29
Q

When teaching the client about ways to prevent lithium toxicity, the nurse should advise the client to do which of the following?

  1. Avoid the use of acetaminophen for headaches
  2. restrict intake of foods rich in sodium
  3. decrease fluid intake to less than 1,500 ml daily
  4. limit aerobic activity in hot water
A
  1. limit aerobic activity in hot water — avoid activities that have the potential to cause sodium & water depletion
30
Q

a nurse is caring for a client who has a new prescription for valproic acid. the nurse should instruct the client to have which of the following laboratory tests completed periodically? sap

  1. thrombocyte count
  2. glucose
  3. amylase
  4. liver function tests
  5. potassium
A
  1. thrombocyte count
  2. amylase (pancreatitis)
  3. liver function tests
31
Q

a nurse is assessing a client who recently egan taking haloperidol. which of the following findings in the priority to report to the provider?

  1. shuffling gait
  2. neck spasms
  3. drowsiness
  4. sexual dysfunction
A
  1. neck spasms

*acute dystonia=respiratory insufficiency

32
Q

a nurse is providing teaching for a client who is to begin taking risperidone. which of the following instructions should the nurse include?

  1. “add extra snacks to your diet to prevent weight loss. “
  2. “notify the provider if you have trouble sleeping.”
  3. “you may begin to have mild seizures while taking this medication.”
  4. “this medication is likely to increase your libido.”
A
  1. “notify the provider if you have trouble sleeping.”
33
Q

a nurse is following up witha client who takes chlorpromazine for treatment of schizophrenia. the nurse should expect to find the greatest improvement in which of the following manifestations? sap

  1. disorganized speech
  2. bizarre behavior
  3. impaired social interactions
  4. hallucinations
  5. decreased motivation
A
  1. disorganized speech
  2. bizarre behavior
  3. hallucinations

chlorptomazine = 1st gen = positive manifestations

behavioral health (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions