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Pharmacology - Spring 2024 > Ch. 16 - Emotional, Mood, and Behavioral Disorders > Flashcards

Ch. 16 - Emotional, Mood, and Behavioral Disorders Flashcards

1
Q

To be diagnosed with bipolar disorder, what must happen?

A

Manic symptoms must persist for at least 1 week

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1
Q

A depressed affect that lasts for a minimum of two weeks and is present for most of the day, every day, or almost everyday in addition to 5 other symptoms

A

Major depressive disorder

Difficulty sleeping or sleeping too much
Extremely tired; without energy
Abnormal eating patterns
Vague physical symptoms
Obsession with death
Avoidance of psychosocial and interpersonal interactions
Lack of interest in personal appearance or sex
Delusions or hallucinations
Inability to concentrate or make decisions
Feelings of despair, guilt, misery; lack of self-worth

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2
Q

Intense mood changes associated with hormonal changes after giving birth

A

Postpartum depression

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2
Q
A
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3
Q

Enhanced release of melatonin due to lower natural light levels

A

Seasonal Affective Disorder (SAD)

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4
Q

Intense mood shifts; unusual behaviors

A

Psychotic depression

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5
Q

Severe depressive illness generally requires what?

A

Interpersonal and cognitive-behavioral
Psychodynamic therapies

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6
Q

Focus on the patient’s disturbed personal relationships that both cause and exacerbate the depression

A

Interpersonal therapies

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7
Q

Helps patients change the negative styles of thought and behavior often associated with their depression

A

Cognitive behavioral therapy

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8
Q

Focus on resolving the patient’s internal conflicts

A

Psychodynamic therapies

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9
Q

For patients with serious and life-threatening mood disorders who are unresponsive to pharmacotherapy and psychotherapy

A

Electroconvulsive therapy (ECT)

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10
Q

Inhibit the reuptake of neurotransmitters (norepinephrine and serotonin) into the presynaptic nerve terminals

A

TCAs & SNRIs

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11
Q

Inhibit MAO enzyme activity inside the presynaptic nerve terminals

A

MAOIs

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12
Q

Have an effect of enhanced catecholamine release

A

MAOIs

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13
Q

Block the reuptake of serotonin into presynaptic nerve terminals

A

SSRIs

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14
Q

Enzymes that terminate the action of norepinephrine

A

MAO & COMT

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15
Q

Classes of Antidepressant Drugs

A

SSRIs
SNRIs and other atypical antidepressants
TCAs
MAOIs

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16
Q

Ex. citalopram (Celexa)
fluoxetine (Prozac)
paroxitine (Paxil)

A

Selective Serotonin Reuptake Inhibitors (SSRI)

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17
Q

Ex. Bupropion (Wellbutrin)
duloxetine (Cymbalta)
venlafaxine (Effexor)

A

Atypical antidepressants, including serotonin-norepinephrine reuptake inhibitors (SNRI)

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18
Q

Ex. amitriptyline (Elavil)
imipramine (Tofranil)

A

Tricyclic antidepressants (TCA)

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19
Q

Ex. phenelzine (Nardil)

A

Monoamine Oxidase Inhibitors (MAOI)

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20
Q

Characterized by episodes of depression alternating with episodes of mania

A

Bipolar disorder (manic-depression)

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21
Q

Lack of energy
sleep disturbances
abnormal eating patterns
Feelings of despair
guilt
hopelessness

A

Depressive symptoms

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22
Q

Inflated self-esteem or grandiosity
Decreased need for sleep
Increased talkativeness
Flight of ideas; subjective feeling that thoughts are racing
Distractibility
Increased goal-directed activity
Excessive involvement in pleasurable activities that have high potential for painful consequences

A

manic symptoms

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23
Q

Work by moderating extreme shifts in emotions between mania and depression.

A

mood stabilizers

24
Q

Why should Bipolar disorder never be treated with antidepressants alone?

A

it will cause the patient to have manic cycles

25
Q

Mood Stabilizer main drug

A

lithium (Eskalith)

26
Q

lithium (Eskalith) MOA

A

affects sodium transport across cell membranes

27
Q

Acts like sodium in the body: so adverse effects are similar to those of hyponatremia

A

lithium (Eskalith)

28
Q

Why does lithium (Eskalith) require frequent blood draws

A

To check serum levels b/c lithium (Eskalith) has a narrow therapeutic range

29
Q

How often do you check serum levels for the patient taking lithium (Eskalith)?

A

Every 4-5 days, after any change of dose, or initiation of therapy

30
Q

Therapeutic concentrations of lithium (Eskalith)

A

range from 0.6 to 1.5 mEq/L

31
Q

Persistent GI upset (nausea, vomiting, abdominal pain), increased urination, and confusion

A

Early signs of lithium toxicity

32
Q

Nystagmus, convulsions, ataxia, coma

A

Late signs of lithium toxicity

33
Q

Drugs for the treatment of bipolar disorder

A

antiseizure drugs:
atypical antipsychotic drugs

34
Q

Valproic acid (Depakene, Depakote)
cabamazapine (Tegretol)
lamotrigine (Lamictal)

A

antiseizure drugs used for treatment of bipolar disorder

35
Q

heart block
aplastic anemia
respiratory depression
SJS
toxic epidermal necrolysis
coma
death (overdose)
liver failure
pancreatitis
exfoliative dermatitis

A

serious adverse effects of antiseizure drugs

36
Q

Dizziness
ataxia
somnolence
headache
nausea
diplopia
blurred vision
sedation
drowsiness
nausea
vomiting
prolonged bleeding time

A

side effects of antiseizure drugs

37
Q

Risperidone (Risperdal)
aripiprazole (Abilify)
Seroquel
Zyprexa

A

Atypical antipsychotics used for bipolar disorder

38
Q

tachycardia
parkinsonism
transient fever
akathisia
insomnia
sedation
dizziness
nausea
vomiting
constipation

A

Side effects of atypical antipsychotics used for treatment of bipolar disorder

39
Q

agranulocytosis
increased risk of death in older adults with demential-related psychosis
neuroleptic malignant syndrome (rare)

A

Serious adverse effects of atypical antipsychotics used for the treatment of bipolar disorder

40
Q

Neurodevelopmental/Behavioral disorder

A

ADHD

41
Q

Easy distractibility
Failure to receive or follow instructions
Inability to focus on one task at a time
Difficulty remembering
Frequent loss or misplacement of personal items
Excessive talking; interrupting
Inability to sit still
Impulsiveness
Sleep disturbance

A

Symptoms of ADHD/Developmentally inappropriate behaviors

42
Q

Methylphenidate (Ritalin, Concerta, Daytrana, Metadate, Methylin)
Adderall
Vyvanse

A

CNS Stimulants

43
Q

CNS stimulants MOA

A

heightens awareness, increases focus

44
Q

insomnia
nervousness
anorexia
weight loss
irritability
palpitations

A

Side effects of CNS stimulants

45
Q

Psychological dependence
circulatory collapse
sudden death (reported in children with structural cardiac abnormalities)

A

Serious adverse effects of CNS stimulants

46
Q

To reduce the risk of dependence and evaluate need, the nurse should educate their patient to do what when taking CNS stimulants.

A

take drug-free “holidays”

47
Q

Similar efficacy to stimulants with reduced risk of dependence.

A

Non-stimulants for ADHD treatment

48
Q

Can be used as monotherapy or adjuvant

A

Non-stimulants for ADHD treatment

49
Q

atomoxetine (Strattera)
clonidine
guanfacine (Intuniv)

A

Non-stimulants for ADHD treatment

50
Q

headache
insomnia
decreased appetite
dry mouth
vomiting
upper abdominal pain
severe liver injury

A

Adverse effects of Nonstimulants for the treatment of ADHD

51
Q

Black Box Warning for atomoxetine (Strattera)

A

suicidal ideation

52
Q

Nervousness
Anxiety
GI Upset
Fatigue

A

side effects for only SSRIs

53
Q

Increased BP & HR
Sweating
Agitation
Tremor
Vomiting
Increased Appetite

A

side effects for only SNRIs

54
Q

Sedation
Mydriasis - dilation of the eye

A

Side effects for only TCAs

55
Q

Dry mouth
Sexual Dysfunction

A

Side effects for:
SSRIs
SNRIs
TCAs
MAOIs

56
Q

Headache
Somnolence

A

Side effects for:
SSRIs
SNRIs

57
Q

Urinary retention

A

Side effects for:
TCAs
MAOIs

58
Q

Nausea
Insomnia

A

Side effects for:
SSRIs
SNRIs
MAOIs

59
Q

Dizziness

A

Side effects for:
SSRIs
SNRIs
TCAs

60
Q

Constipation
Blurred Vision
Drowsiness
Orthostatic hypotension

A

Side effects for:
SNRIs
TCAs
MAOIs

Pharmacology - Spring 2024 (8 decks)

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