Brainscape's Knowledge GenomeTM

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


See full index

NRSG 331 > Ch. 4 Pharm: Anti-Anxiety & Antidepressants > Flashcards

Ch. 4 Pharm: Anti-Anxiety & Antidepressants Flashcards

1
Q

Historical perspectives

A
  • Psychotropic drugs are meant to be an adjunct to individual or group psychotherapy
  • Meds aren’t everything, they’re a useful tool
  • As a nurse, don’t always jump to meds first
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Extra notes from class relating to mental health treatments

A
  • Electrical therapy is a thing. It works well. Safe.
  • Ice baths –> helpful for manic states
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Role of the nurse

A
  • Must understand legal ethical implications
  • Right to refuse (EXCEPT IN EMERGENCY SITUATIONS)
  • Emergency: danger to self or others.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Assessment + pharm

A
  • H&P, EKG, waist circumference
  • Cultural considerations (Table 4-1, pg 63) like Many asians are more sensitive to certain meds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Med admin + eval

A
  • Continuous monitoring. Assess. We ask the patient how the med is working for them. Wether its helping at all.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Patient education considerations

A
  • Use everyday language
  • Remember it is imperative to assess edu levle, 1st language, dev. stage, literacy
  • Always give reading info on meds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How do psychotropics work?

A
  • Affects neurotransmission
  • Antipsychotics may block receptors / leave chem out there to do its job
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Random: how is dopamine different in parkinsons & schiziophrenia

A
  • Increased: Schizophrenia
  • Decreased: Parkinsons
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Anti-Anxiety agents: Indications

A

Anxiety disorders, anxiety symptoms, acute alcohol withdrawal, skeletal muscle spasms, convulsive disorders, status epilepticus, and preoperative sedation.

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

Anti-Anxiety agents: Action

A

Depression of the CNS (CNS exception: Buspirone)

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

Anti-Anxiety agents: contra & caution

A
  • Contraindicated: In known hypersensitivity, in combo with other CNS depressants, in pregnancy and lactation, narrow angle glaucoma, shock, and coma
  • Caution: with elderly & debilitated clients, clients with renal or addiction, and those who are depressed or suicidal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Anti-Anxiety agents: Lecture notes

A
  • Benzodiazepines used a lot. Can sometimes be in higher doses. We want a chill sedation not a coma (which it can cause)
  • Deadly combos possible
  • Don’t give to pt with history of addiction. Benzos are VERY ADDICTIVE.
  • INTERACTS –> with Alcohol & Niquil
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Anti-Anxiety agents: Interactions (Increased vs Decreased)

A
  • Increased effects when taken with alcohol, barbiturates, narcotics, antipsychotics, antidepressants, antihistamines, neuromuscular blocking agents, cimetidien, disufiram, kava kava, or valerian root (& other herbal depressants)
  • Decreased effects with cigarette smoking & caffeine consumption
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Anti-Anxiety agents common meds: Clorazepate (Tranxene)

A

Long acting. Effective for anxiety disorders. Short term use only.

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

Anti-Anxiety agents common meds: Chlorodiazepoxide (Tranxene)

A

Used for alcohol withdrawal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Anti-Anxiety agents list of common ones

A
  • Diazepam (Valium)
  • Clonezepam (Klonopin)
  • Lorazepam (Ativan)
  • Alprazolam (Xanax)
17
Q

The other Anti-Anxiety agents slide: one you need to know

A
  • Buspirone (BuSpar)
  • Doesn’t addict or depress CNS.
  • Takes weeks to start working
18
Q

Anti-Anxiety agents: Monitor for

A
  • Safety!
  • Think about tolerance. Think about risk for falls related to lethargy & CNS depression.
  • Sometimes paradoxical reactions occur. Where we get the opposite effect of what the med should do.
19
Q

Antidepressants: Indications

A

Dysthmia, major depressive disorder, depression associated with organic disease, alcoholism, Schiziophrenia, intellectual disability, depressive phase of bipolar disorder, and depression paired with anxiety

20
Q

Antidepressants: Action

A

Increase concentration of norepenephrine, serotonin, and/or dopamine in the body either by blocking their reuptake by the neurons (tricyclics, heterocyclics, SSRIs, SNRIs) or by inhibiting the release of monoamine oxidase (MAOIs)

21
Q

Antidepressants: Contraindications & Caution

A
  • Caution in elderly. very sensitive. Have to monitor.
  • Doesn’t mean don’t give
  • Contraindicated: In known hypersensitivity, acute recovery from MI & in angle closure glaucoma, and concomitant with MAOIs
  • Caution: pts with hepatic, cardiac, or hypertrophy. Hist of seizures.
22
Q

Antidepressants: Classifications (5 of them)

A
  • MAOI’s (monoamine oxidase inhibitor). Many S/E and dietary restrictions.
  • Tricyclics antidepressants (TCAs). Work really well. Can cause Heart probs. Could be used for suicide if whole bottle is ingested.
  • Serotonin Reuptake inhibitors (SSRIs)
  • Serotonin/Norepinephrine reuptake inhibitors (SSRIs). Sometimes called S-SNRIs.
  • Heterocyclics
23
Q

Antidepressants: MAOIs extra precaution

A
  • Can’t have certain foods because the interaction can kill you if the food has tyramine in it.
  • If taking standardized test: EX –> Best thing for MAOI taking pt to eat? FRESH IS BEST. Baked chicken over aged salami meat.
24
Q

Antidepressants: MAOIs & ICAs (names of 4 MAOIs)

A
  • MAOIs: could be a kaplan question related to them.
    1. Tranylcyclopromine (Parnate)
    2. Phenelzine (Nardil)
    3. Isocarboxazid (Marplan)
  • The MAOI Selegiline (Emsam) is almost always a path. No dietary restriction cause of it.
  • TCA’s: Could be used for chronic pain + depression
25
Q

Antidepressants: List of older SSRIs that could be on Kaplan

A
  • Citalopram (Celexa)
  • Escitalopram (Lexapro)
  • Fluoxetine (Prozac)
  • Paroxetine (Paxil)
  • Sertraline (Zoloft)
  • Vilazodone (Viibryrd)
26
Q

Antidepressants: Heterocyclines (3 names + detail)

A
  1. Bupropion (Wellbutrin)
  2. Mirtazapine (remeron)
  3. Trazadone
    - Bupropion is a Great antidepressant. Also used for smoking cessation. S/Es possible.
27
Q

Antidepressants: Common S/E w/ SSRIs & Tricyclic meds (noted from deanna)

A
  • SSRIs: sexual dysfunction can cause many people to stop use.
  • Tricyclic meds: urinary retention. But can be used for Bed-wetting cessation.
28
Q

Antidepressants: Monitor for these S/E

A
  • w/ all classes: Dry mouth, sedation, nausea
  • discontinuation syndrome
  • Most common with tricyclines + heterocyclics: blurred vision, constipation, urinary retention, orth. hypotension, reduction of seizure threshold, tachycardia, arrythmias, photosensitivity, weight gain
29
Q

Antidepressants: Common S/E for SSRIs & SNRIs

A

Insomnia,
weight loss,
agitation,
headache,
sexual dysfunction,
serotonin syndrome

30
Q

Antidepressants: Common S/E for MAOIs & uncommon misc. S/E

A
  • Hypertensive crisis (can be fatal)
  • Site reactions (selegiline transdermal system)
  • Misc: Priapism, Hepatic failure
31
Q

Antidepressants: Serotonin syndrome. What is it?

A
  • When there is too much serotonin in the body. Related to antidepressants because they usually increase the freely available serotonin.
  • St. Johns. wort + SSRI could cause it because the OTC med and antidepressant both have serotonin or block its reuptake.
  • Immediately take person off serotonin related meds + get them to clear + usually they recover
32
Q

Antidepressants: S&S of serotonin syndrome

A
  • Restlessness, agitation
  • Confusion
  • Tachycardia
  • High BP
  • Dilated pupils
  • Muscle rigidity
  • Loss of muscle coordination
  • Diarrhea
  • Sweating

NRSG 331 (26 decks)

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