Final Medications

Question 1

SSRI medications

Answer 1

Paxil (paroxetine)

Prozac (fluoxetine)

Lexapro (esclatlopram)

Question 2

SSRI side effects

Answer 2

Initially= insomnia and anxiety 
Nausea
Diarrhea 
Sleepiness 
Emotional flattening 
Decreased libido, difficulty reaching orgasm

Question 3

SSRI indications

Answer 3

Anti- anxiety

Eating disorder

Question 4

SSRI mechanism of action

Answer 4

Increases serotonin, indirectly acts on GABA
Used 1st in chronic anxiety disorders
3-4 weeks for sx control
Best with psychotherapy

Question 5

Benzodiapene medications

Answer 5

Chloridiazepoxide (librium)

Lorazepam (ativan)

Question 6

Benzodiapenes side effects

Answer 6

Drowsiness 
Confusion 
Lethargy 
Tolerance 
Psychological/ physical dependence 
Potentiates effects of CNS depressants (ie, alcohol)
May aggravate sx of depression 
Orthostatic hypotension
Paradoxical excitement

Question 7

Benzodiapenes indications

Answer 7

Anti- anxiety

Tx of alcohol withdrawal (substitution therapy using Ativan)

Question 8

Precautions when using benzodiapenes

Answer 8

Taper gradually- withdrawal from benzos can be life threatening
Contraindications in patients that have hx of substance abuse
Use cautiously in elderly (orthostatic hypotension)

Question 9

Medication to treat opioid overdose

Answer 9

Naloxone (Narcan)

Question 10

Medication to treat opioid withdrawal

Answer 10

Methadone (dolophine) substitution - methadone is an opioid like drug
Buprenorphine

Question 11

Indications of bupropion (zyban )

Answer 11

Nicotine treatment

Question 12

bipolar disorder is characterized by ___ ___ from euphoria to ___ with intervening periods of ____. ___ or a ___ pattern may be present

Answer 12

mood swings 
depression
normalcy
delusions 
seasonal

Question 13

bipolar disorders

Answer 13

bipolar 1 
bipolar 2
cycothymic disorder 
substance/ medication induced 
bipolar d/t another medical condition

Question 14

dopamine and __ levels are excessive in ___

Answer 14

norepinephrine

mania

Question 15

in bipolar __ dopamine and ___ levels are ___

Answer 15

depression
norepinphrine
deficient

Question 16

medications that induce bipolar

Answer 16

steriods
amphetamines
antidepressents
narcotics

Question 17

a ___ episode happens for at least __ week consisting of elevated, __ or ___ mood. there is marked impairment usually requiring hospitalization that is __ attributal to substances or medical condition

Answer 17

manic 
1 
expansive
irritable 
not

Question 18

sx of mania

Answer 18

inflated self- esteem/ grandiousity
decreased need for sleep
pressured speech
flight of ideas
distractability 
increased goal directed activity 
excess participation in activites with potentially painful results 
aggitation
irritability 
aggression

Question 19

hypomanic episode

Answer 19

4 day period of elevated expansive or irritable mood 
there is a change in behavior 
observable changes in mood
no marked impairment 
not attributable to substance/ condition

Question 20

cycothymic disorder involves ___ fluctuating mood disturbance of at least 2 years. ___ periods of elevated mood and __ mood that does not meed the criteria for ___ episode or ___. the patient is never without sx for more than __ months

Answer 20

chronic 
numerous 
depression 
hypomanic 
MDD 
2

Question 21

substance/ medication induced bipolar

Answer 21

direct result of substance ingestion or withdrawl causing signifcant distress and impairment

Question 22

bipolar d/t another medical conditoin

Answer 22

direct result from another medical conditon

Question 23

bipolar in children looks like ___

Answer 23

ADHD

Question 24

restraint guidelines

Answer 24

less restrictive proven ineffective
behavior is a serious immediate danger to patient/ staff/ others
face to face evaluation at least every hour
15 minute checks for 1:1
debriefing
nurse can initiate but must be backed by dr within 1 hour

Question 25

pharm for bipolar

Answer 25

mood stabalizers - lithium anticonvolsant - tegretol - depakene - lamictil antipsychotics - zyprexa - seroquel - risperdal

Question 26

ranges for bipolar

Answer 26

1. 0- 1.5 for acute mania | maintance: 0.6- 1.2

Question 27

side effects of lithium

Answer 27

``` drowsiness, dizziness, headache dry mouth, thirst n/v hand tremors polyuria, dehydration wt gain acne lithium toxicity ```

Question 28

lithium toxicity

Answer 28

``` renal impairment diabetes insipidous hypotension arrhythmias irregular pulse ```

Question 29

NURSING ACTIONS LITHIUM TOXICITY

Answer 29

get lithium level immediately if signs of ANY toxicity

Question 30

labs for before lithium tx

Answer 30

kidney/ thyroid function ecg after 50 wt, bmi

Question 31

lab tests for maintence

Answer 31

1-2 weeks until stable monthly first 6 months check kidney function 1-2 times/ yr

Question 32

depakote side effects and lab

Answer 32

``` sedation wt gain hepatoxicity hepatitis prolonged bleeding time ``` platlet count, liver function, wt every 6 months

Question 33

lamictil side effects and lab

Answer 33

steven johnson's syndrome

Question 34

tegretol side effects and lab

Answer 34

steven johnsons aplastic anemia hyponaterima ``` initiation= cbcb, kidney thyroid function tx= cbc every 2 weeks for 2 months; kidney liver and thyroid function every 6-12 months ```

Question 35

teaching for litium

Answer 35

``` na intake exercise adequate fluid intake wt contreceptative use carry id sx of toxicity ```

Question 36

teaching for anitconvolsants

Answer 36

dont stop abruptly

Question 37

antipsychotic teachin

Answer 37

sunblock othostatic hypotension good oral care no alcohol