Anti-anxiety/psych

Question 1

Benzodiazepines

Answer 1

-Pam and -am. Anti anxiety, seizures, preop sedation, alcohol withdrawal

Question 2

Anti- anxiety

Answer 2

Central nervous depression agents. A- affect neurotransmitters. Uses- anxiety, manic episodes, panic attacks. Ex- Librium (chlordiazepoxide), Xanax (alprazolam), Ativan (lorazepam), vistaril (hydroxyzine), equanil. SE- sedation, confusion, hepatic dysfunction. Nx- monitor for addiction, OD, avoid alcohol, liver func. Taper off. Changes in smoking, caffeine dec effectiveness

Question 3

Lithium

Answer 3

Toxicity- early: fine motor tremors, n/v, diarrhea. Late: seizures. Serum Na within normal limits to keep therapeutic. Normal 1-1.5. Toxic >2

Question 4

Chlorpromazine (Thorazine)

Answer 4

Antipsychotic. Schizophrenia, mania, Tourette’s syndrome. SnS- ortho hypotn, extrapyramidal reactions, seizures

Question 5

Haloperidol (haldol)

Answer 5

Antipsychotic. Schizophrenia. SnS- blood dyscrasia, extrapyramidal symptoms. Oculogyric crisis- eyes locked upward, acute dystonic reaction, physician will order anticholinergic agent to correct reaction. Used for Tourette syndrome

Question 6

Thioridazine (mellaril)

Answer 6

Akasthisia- inability to sit or stand still, foot tap, pace. MD- change med or give antiparkinsonian agent

Question 7

Lorazepam

Answer 7

Anti-anxiety. Sedative-hypnotic. Abd discomfort.

Question 8

Valproic acid

Answer 8

Anticonvulsant. Bipolar disorder. Preg D. Tremors

Question 9

Clozapine

Answer 9

Antipsychotic. Preg B. Flu-like symptoms- agranulocytosis.

Question 10

Fluphenazine (prolixin)

Answer 10

Sedation common during first few weeks of therapy. Phenothiazine. Antipsychotic. Schizophrenia.

Question 11

Risperidone (risperdal)

Answer 11

Antipsychotic. Bipolar. Schizophrenia. SE-Blurry vision, extrapyramidal reactions, HA, insomnia, agitation, anxiety. Don’t drink alcohol.

Question 12

OCD

Answer 12

SSRIs (ending in -ine and -pram), TCAs (ending in -triptyline and -pramine)

Question 13

Chlordiazepoxide (Librium)

Answer 13

Anxiolytic used for outpatient detox. Antianxiety. SE- lethargy, hangover, agranulocytosis

Question 14

Buspirone

Answer 14

Antianxiety. SE- light-headedness, confusion, hypotension, palpitations

Question 15

Fluoxetine

Answer 15

SSRI antidepressant. SE- palpitation, bradycardia, n/v

Question 16

Phenelzine sulfate

Answer 16

MAOI antidepressant. Do not take if consume tyramine in the diet. Results in hypertensive crisis- dizziness, HA, nervousness. Admin nifedipine to lower BP. Don’t eat- bananas, avocado

Question 17

Imipramine

Answer 17

Tricyclic antidepressant. SE- fever, dry mouth, inc fatigue, vomiting and diarrhea, sore throat

Question 18

Hydroxyzine (vistaril)

Answer 18

Antihistamine. Anxiety, preop and postop sedation, n/v

Question 19

Antipsychotic agents

Answer 19

-azine; thiothixene; haloperidol- CI in glaucoma, hepatic/renal/cv disease or Parkinson’s disease. SE- tachycardia, seizures, urinary retention, resp dep, laryngospasm, neuromalignant syndrome, dysrhythmias. Risperidone, quetiapine, aripiprazole. Lithium. Perphenazine for schizophrenia and n/v.

Question 20

Antidepressant

Answer 20

SSRI- xetine, -pram, sertraline. MAOI- phenelzine, tranylcypromine (avoid tyramine foods pickled, aged, fermented, caffeinated> hypertensive crisis). Tricyclic-triptyline, imipramine (OD lethal)

Question 21

Methylphenidate

Answer 21

Manage ADHD, narcolepsy, and depression in elderly. SE- nervousness, palpitations, insomnia, tachycardia, wt loss, growth suppression. Do not use- glaucoma, tics, Tourette’s, agitation, anxiety, tension

Question 22

Bupropion (Wellbutrin)

Answer 22

Tx of depression and smoking cessation. SE- HA, dry mouth, n/v, photosensitivity (sunscreen). Stop smoking once med has been taken for at least a week. Don’t drink alcohol. Don’t take med if forget and close to next dose.

Question 23

Pseudoparkinsonism symptoms

Answer 23

Benztropine (cogentin) and trihexphenidyl (artane)

Question 24

Sertraline (Zoloft)

Answer 24

Antidepressant, OCD, panic disorder with or without agoraphobia, PTSD. SE- GI upset, HA, dizziness, impotence, and insomnia. Can potentiate effects of digoxin, warfarin, diazepam. Avoid alcohol. Therapeutic effect may take 4 weeks

Question 25

Disulfiram

Answer 25

Alcoholism. SE- flushing, sweating, throbbing headache, tachycardia, resp distress, n/v in presence of alcohol

Question 26

Antabuse

Answer 26

Deterrent to impulsive drinking. CI if pt drank within past 12 hrs

Question 27

Carbamazepine

Answer 27

Anticonvulsant. Tx seizures and nerve pain such as trigeminal neuralgia and diabetic neuropathy. Also tx bipolar disorder. SE- severe rash; makes birth control less effective. Don’t d/c suddenly. Monitor urinary and liver fx, CBC, platelet and reticulocyte counts. Amount of anesthetic may need to be reduced b/c client is on anticonvulsant