Chapter 4- Psychopharm

Question 1

tolerance

Answer 1

over time, may need increased dosage to achieve same effect

Question 2

dependence

Answer 2

physical or psychological
with stopping, withdrawal symptoms

Question 3

anxiolytics

Answer 3

Benzodiazepines
buspirone

Question 4

Benzodiazepines

Answer 4

decreases the CNS (limbic and reticular system)
antidote: flumazenil
also can be used for: ETOH withdrawal, seizures, spasms, sedation
SE: have GABA potentiation, may have paradoxical effect
do not give to elderly/parkinson

Question 5

common benzos

Answer 5

clonazepam
lorazepam
alprazolam
diazepam

Question 6

buspirone

Answer 6

BuSpar
does not depress CNS
no risk of abuse
has a delayed action (takes 3-4 weeks to reach full effect)

Question 7

antidepressants

Answer 7

MAOIs
Tricyclics
SSRIs
SNRIs
atypical antidepressants

Question 8

MAOIs

Answer 8

inhibit MAO enzyme that inactivates neurotransmitters
increases risk for suicide initially
avoid tyramine and OTC cold meds

Question 9

commons MAOIs

Answer 9

selegiline
isocarboxazid
phenelzine

Question 10

Tricyclics

Answer 10

block reuptake of norepi and serotonin
SE: anticholinergic, orthostatic hypotension
toxicity causes cardiac arrhythmias

Question 11

common tricyclics

Answer 11

nortriptyline
amitriptyline
desipramine
doxepin

Question 12

anticholinergic effects

Answer 12

dry mouth
blurred vision
photophobia
constipation
tachycardia
urinary retention

Question 13

SSRIs

Answer 13

block the reuptake of serotonin
SE: dry mouth, sexual dysfunction, hyponatremia
toxicity= serotonin syndrome

Question 14

common SSRIs

Answer 14

fluoxetine
sertraline
citalopram
escitalopram

Question 15

fluoxetine

Answer 15

Prozac

Question 16

sertraline

Answer 16

Zoloft

Question 17

citalopram

Answer 17

Celexa

Question 18

escitalopram

Answer 18

Lexapro

Question 19

serotonin syndrome

Answer 19

toxicity of SSRIs
diarrhea
hyperreflexia
fever
spasms + seizure
dilated pupils
shivering
tachycardia
HTN

Question 20

SNRIs

Answer 20

similar SE of SSRIs

Question 21

common SNRIs

Answer 21

venlafaxine
duloxetine
desvenlafaxine

Question 22

atypical antidepressants

Answer 22

bupropion- for withdrawal
trazodone- helps w insomnia
mirtazapine- increases appetite

Question 23

Mood Stabilizers

Answer 23

treat bipolar disorder
increase suicide risk
Lithium
Anticonvulsants
Antipsychotics

Question 24

lithium

Answer 24

narrow therapeutic range (0.6-1.2)
SE: weight gain, hypotension
antidote: mannitol
Educate: maintain adequate fluid intake, ensure sodium intake is stable. will need to draw blood 12 hrs after last dose

Question 25

trough level

Answer 25

lowest concentration of med draw blood for lithium 12 hrs after last dose

Question 26

sodium and fluid impact on lithium

Answer 26

increased sodium=decreased effect of lithium if dehydrated=increased effect of lithium

Question 27

Anticonvulsants

Answer 27

inhibits glutamate, causes suppresssion of CNS excitation SE: hyponatremia, steven johnson syndrome can cause birth defects, will need pregnancy test in women

Question 28

common anticonvulsants

Answer 28

clonazepam carbamazepine valproate topiramte

Question 29

Antipsychotics

Answer 29

"neuroleptics" "major tranquilizers" treat schizophrenia, adjunct med for depression, can be used as an antiemetic for Tourettes Typical vs Atypical

Question 30

Antipsychotic side effects

Answer 30

EPS + neuroleptic malignant syndrome w typicals. temperature regulation issues anticholinergic decreased libido amenorrhea weight gain prolonged QT diabetes photosensitivity

Question 31

Extrapyramidal symptoms

Answer 31

acute dystonias akinesia akathisia oculogyric crisis tardive dyskinesias

Question 32

antidote for EPS from antipsychotics

Answer 32

benztropine

Question 33

Antipsychotic contraindications

Answer 33

elderly Parkinson's glaucoma seizures CNS depression

Question 34

positive schizophrenia symptoms

Answer 34

hallcuinations, delusions, disorganized thoughts

Question 35

negative schizophrenia symptoms

Answer 35

blunted affect, alogia

Question 36

Typical antipsychotics

Answer 36

treat positive symptoms only meds: haloperidol, loxapine, phenothiazines

Question 37

Atypical antipsychotics

Answer 37

treat positive AND negative symptoms low potential for EPS meds: clozapine, risperidone, quetiapine

Question 38

clozapine major SE

Answer 38

agranulocytosis

Question 39

ADHD medications

Answer 39

Amphetamines atomoxetine- inhibits reuptake of norepi bupropion- blocks uptake of serotonin, dopamine, norepi

Question 40

Amphetamines

Answer 40

CNS stimulants increase neurotransmitters SE: anorexia, overstimulation, palpitations, tachycardia, insomnia, restlessness Educate: dont give w/in 6hrs of bedtime, do not consume caffeine, monitor blood sugar

Question 41

common amphetamines

Answer 41

methylphenidate dexmethylphenidate dextroamphetamine lisdexamfetamine

Question 42

Amphetamine contraindications

Answer 42

hypertension hyperthyroidism glaucoma MAOIs