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NUR 340 > 346 drug class and functions > Flashcards

346 drug class and functions Flashcards

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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
fMRI
brain activity through blood O2
26
Pet scan
injected tracer shows activity of the brain and 3D brain imaging
27
SPECT scan
like a PET but shows activity of the brain and brain layers
28
acetylcholine
role in learning, memory, regulates mood: mania and sexual aggression, stimulates parasympathetic nervous system
29
too much acetylcholine
depression
30
too little acetylcholine
dementia, alzheimer's disease, huntington’s disease, parkinson’s
31
Dopamine
involved in fine muscle movement, integration of emotions and thoughts, and decision making
32
too much dopamine
schizophrenia
33
too little dopamine
ADHD, depression, muscular rigidity and tremors found in parkinson's disease
34
serotonin
hunger, sleep regulation, mood, and pain perception, hormonal activity, aggression and sexual behavior
35
too much serotonin
anxiety
36
too little serotonin
depression, OCD
37
GABA
plays a role in inhibition, reduces aggression, excitation and anxiety, anticonvulsant properties, pain perception
38
too much GABA
plays a role in inhibition, reduces aggression, excitation and anxiety, anticonvulsant properties, pain perception
39
too much GABA
reduces anxiety
40
too little GABA
anxiety, schizophrenia, mania, huntington's disease
41
Norepinephrine
level in brain affects mood, attention and arousal, stimulates sympathetic branch of ANS (fight or flight) in response to stress
42
too much norepinephrine
mania, anxiety, schizophrenia
43
too little norepinephrine
depression
44
too much adrenaline
anxiety
45
too little epinephrine
depression
46
agonists
work with Mimic the effects of neurotransmitters naturally found in the brain Bind to and stimulate the neurotransmitter
47
antagonist
works against block neurotransmitter from binding to its receptor obstruct the neurotransmitter
48
neurotransmitters that are affect with depression
serotonin and norepinephrine
49
side effects for SSRIs
apathy, low libido, nausea and vomiting, painful menstruation, sexual dysfunction, insomnia, rash, taste changes, dry mouth, dizziness, weight loss/gain
50
Serotonin-norepinephrine reuptake inhibitors SNRIs
inhibits the reuptake of serotonin AND norepinephrine newer drug class little more expensive
51
Serotonin-norepinephrine reuptake inhibitors SNRIs drugs
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
Norepinephrine and serotonin specific antidepressant (NaSSA)
work on norepinephrine and serotonin boost mood and help keep people calm, commonly used for anxiety (If SSRI doesn't work) Mirtazapine (Remeron)
53
Norepinephrine dopamine reuptake inhibitor (NDRI)
Bupropion (Wellbutrin- antidepressant) (Zyban- smoking)- Can also be used for smoking cessation Can not abruptly stop taking = seizure risk May cause appetite suppression
54
Serotonin partial agonist reuptake inhibitor (SPARI)
Enhances serotonin by inhibiting the transporter and by stimulation serotonin (dual action- stimulate AND enhance serotonin) Side effects: diarrhea, nausea, vomiting, insomnia
55
Serotonin antagonists and reuptake inhibitors (SARI)
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
Serotonin modulator and stimulator
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
modd stabilizers
lithium anticonvulsants
58
lithium
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
side effects for mood stabilizers
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
therapeutic blood levels for lithium (NOT for THIS exam)
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
therapeutic blood levels of Divalproex (Depakote) (NOT for THIS exam)
Maintenance blood level: 50 to 100 mcg/mL
62
therapeutic blood levels for Carbamazepine (Tegretol) (NOT for THIS exam)
Maintenance blood level: 4 to 12 mcg/mL
63
lithium and sodium relationship
Lithium is a salt and competes with sodium. Our body responds to lithium in the same way it responds to sodium
64
factors that affect lithium levels
New BP medications (shift lithium levels) NSAIDs (shift lithium levels) flu → need to replenish fluids if they have diarrhea or vomiting
65
lithium toxicity
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
conventional first generation antipsychotic meds (typical)
mostly work on positive symptoms of schizophrenia- people experiencing psychosis block attachment of dopamine and reduce dopaminergic transmission
67
second generation antipsychotics (atypical or unconventional)
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
side effects of 1st generation
weight gain (slows metabolism) sedation (slows the mind) slows down the mind to allow patient to focus on what's happening
69
side effects of 2nd gen
produce fewer extrapyramidal side effects (EPS) increase risk for metabolic syndromes → diabetes! increased weight, blood sugar, and triglycerides
70
Clozapine (Clozaril) (2nd gen antipsychotics) concerns
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
ADHD medications are ___
psychostimulants
72
ADHD meds are given for
short attention span, impulsivity, overactivity
73
Cholinesterase inhibitors
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
Glutamine-blocking agent
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
Cholinesterase inhibitors side effects
anticholinergic effects- dry mouth

NUR 340 (3 decks)

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