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From Flashcardlet > (2) Exam 2- (Psych) Psychopharmacology > Flashcards

(2) Exam 2- (Psych) Psychopharmacology Flashcards

0
Q

Psychopharmacology

What do Tricyclics do to provide therapeutic effect

A

Blocks the reuptake of norepinephrine and serotonin

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1
Q

Psychopharmacology

Three classes of anti-depressed

A

Tricyclics
SSRIs
MAO

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2
Q

Psychopharmacology

What do SSRIs do to provide therapeutic effect

A

Blocks reuptake of serotonin

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3
Q

Psychopharmacology

What do MAO’s do to provide therapeutic effect

A

Inhibition of the MAO enzyme

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4
Q

Psychopharmacology

Tricyclics should not be used with MAOIs because it can cause

A

Hypertensive crisis

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5
Q

Psychopharmacology

After trycyclic is discharged, how long is needed before MAOIs can be taken

A

1 to 3 weeks

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6
Q

Psychopharmacology

SSRIs should not be taken with MAOIs because it can cause

A

Antihypertensive crisis

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7
Q

Psychopharmacology

After an MAOI is discharged, how long is needed before starting an SSRI

A

Two weeks

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8
Q

Psychopharmacology

After SSRI is discharged, how long is needed before starting an MAOI

A

Five weeks

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9
Q

Psychopharmacology

Example trycyclic drug

A

Amitriptyline (Elavil)

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10
Q

Psychopharmacology

What are the side effects of taking tricyclics

A

Dry mouth

Orthostatic hypertension

tachycardia

Sedation

Blurred vision

Constipation

Urinary retention

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11
Q

Psychopharmacology

Example SSRIs

A

Prozac

Celexa

Zoloft

Paxil

Lexapro

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12
Q

Psychopharmacology

What are the side effects of SSRIs

A

Dry mouth

Sexual dysfunction

Nausea

Insomnia

Headache

Anxiety

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13
Q

Psychopharmacology

What are adverse reactions for SSRIs

A

Serotonin syndrome

Allergic reaction/rash

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14
Q

Psychopharmacology

When teaching about serotonin syndrome, instruct the patient not to take OTC herbal medications such as

A

St. John’s Wart

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15
Q

Psychopharmacology

Example MAOI drugs

A

Parnate

Nardil

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16
Q

Psychopharmacology

What are the side effects of MAOIs

A

Hypertensive crisis (severe hypertension)

Tachycardia

Dry mouth

Orthostatic hypotension

Insomnia

Fluid retention

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17
Q

Psychopharmacology

How long does it take for therapeutic effect to occur in tricyclics and SSRIs

A

2 to 4 weeks

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18
Q

Psychopharmacology

What other possible health risks do you want to watch for or teach your client about involving safety or tricyclics

A

Medication may reduce seizure threshold and effectiveness of antihypertensives

Avoid alcohol

Carefully evaluate suicide risk

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19
Q

Psychopharmacology

When are tricyclics administered

A

Bedtime

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20
Q

Psychopharmacology

What can cause hypertensive crisis

A

Concurrent use of tricyclics with MAOIs

Side effect of MAOIs

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21
Q

Psychopharmacology

What are the side effects of MAOIs hypertensive crisis

A

Severe hypertension

Occipital headache

Neck Stiffness

Constricting chest pain

22
Q

Psychopharmacology

What is the first choice agent for MAOIs hypertensive crisis

A

Sodium nitroprusside

23
Q

Psychopharmacology

What is the maximum amount of time that sodium nitroprusside can be administered by IV infusion

A

10 minutes

24
Q

Psychopharmacology

When the patient is taking MAOIs, what is the nurses first action if palpations or frequent headaches occur

A

Discontinue the medication and notify the physician

25
Q

Psychopharmacology

With what medication would you want to instruct the client to avoid caffeine or over-the-counter prescriptions such as weight producing pills or medications for hayfever and colds

A

MAOIs

26
Q

Psychopharmacology

What foods would you want to instruct the client to avoid when taking MAOIs

A

Foods that require bacteria or molds for preparation or those that contain tyramine

27
Q

Psychopharmacology

What are foods containing tyramine

A

Cheese (especially aged)

Beer, red wine

caffeine- coffee, tea, chocolate

Bananas

Sausage, baloney, pepperoni, salami

Beef, chicken, liver

Canned goods

28
Q

Psychopharmacology

What is the treatment for serotonin syndrome

A

Stop taking the SSRIs and give PRN meds to treat other symptoms while half-life decreases

29
Q

Psychopharmacology

What are the three classes of mood stabilizers

A

Lithium

Anticonvulsants

Neuroleptics

30
Q

Psychopharmacology

What mood stabilizer is the only one classified as a true antimanic medication

A

Lithium

31
Q

Psychopharmacology

What is the therapeutic drug serum level for lithium

A

0.6-1.2 mEq/L

32
Q

Psychopharmacology

What are the two most common side effects for lithium

A

Polyuria and polydipsia

33
Q

Psychopharmacology

What are the common signs and symptoms of lithium toxicity

A

Ataxia, blurred vision, severe diarrhea, N&V, fever, polyuria, polydipsia, and tinnitus

34
Q

Psychopharmacology

When taking lithium, when does the nurse especially monitor the suicidal client

A

During improved mood and increased energy levels

35
Q

Psychopharmacology

What is not administered while the client is taking lithium

A

Diuretics

36
Q

Psychopharmacology

What should a client on lithium be instructed to avoid

A

Alcohol

37
Q

Psychopharmacology

When lithium dose is missed, the client may take the missed dose within how many hours

A

Within two hours of the schedule time

38
Q

Psychopharmacology

If a clients lithium dose is missed two hours past the scheduled time, what action should be taken

A

Take the next dose at the scheduled time

39
Q

Psychopharmacology

What should the client be instructed to do if polyuria, prolonged vomiting, diarrhea, and fever or lack of coordination and confusion occurs

A

Notify the physician

40
Q

Psychopharmacology

Diet and fluid intake for clients taking lithium

A

6 to 8 glasses of water a day

Avoid excess amounts of coffee, tea, or cola

3 g of salt

41
Q

Psychopharmacology

Why is the client taking lithium instructed to avoid excess amounts of coffee, tea, or cola

A

They have a diuretic effect

42
Q

Psychopharmacology

At what serum blood level must the patient be monitored for lithium toxicity

A

1.8 or higher

43
Q

Psychopharmacology

What are the main side effects of tegretol

A

Dizziness

Ataxia

Agranulocytosis

44
Q

Psychopharmacology

When taking Tegretol, what is done if agranulocytosis develops

A

Meds are stopped

45
Q

Psychopharmacology

What are early signs and symptoms of agranulocytosis

A

Sore throat, sudden fever or signs and symptoms feeling like a cold or flu

46
Q

Psychopharmacology

What is agranulocytosis

A

A sudden severe decrease in white blood cell count especially neutrophils

47
Q

Psychopharmacology

What medications can cause agranulocytosis

A

Tegretol and Depakote

48
Q

Psychopharmacology

Due to agranulocytosis, at what WBC and neutrophils count is medicine stopped and the HCP is contacted

A

WBC <3000

Neutrophils <1500

49
Q

Psychopharmacology

When taking Tegretol, what functions need to be monitored

A

Hepatic and renal function

50
Q

Psychopharmacology

What are the side effects of Depakote

A

G.I. distress

hepatotoxicity

Trimmers

Sedation

Headache

Dizziness

51
Q

Psychopharmacology

What are the nursing implications for Depakote

A

Maintain serum levels

Monitor blood levels

Administer with food

52
Q

Psychopharmacology

What are the therapeutic serum level’s for Depakote

A

50 - 125

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