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Flashcards in Meds Deck (63):
1

If we administer Naloxone for an overdose, what do we monitor?

Monitor for resp. depression

2

Benzos not indicated for?

Chronic pain syndrome

3

Early signs of w/d with heroin?

Restlessness
Irritability
Piloerection (goosebumps)
Tremor
Loss of appetite

4

What time do we administer Donepezil?

Bedtime

5

Most common SE of Buspirone?

Drowsiness

6

What takes Methadone?

People coming off opioids

7

What tests do we do on pts. taking Valproic Acid?

Liver function and hematology

8

Can we give both Valproic acid and Lithium?

Yes

9

What is a drug for w/d from alcohol?

Chlordiazepoxide

Benzos! main point

10

Most common side effect of benzos?

Sedation
Dizzy
Drowsy

11

Benzos cause CNS depression or excitation?

Depression

12

Buspirone causes dizziness, nausea, headache, light-headedness, and agitation. Does this medication interfere with activites?

No, because it DOES NOT cause sedation!

13

SSRI: Paroxetine--CNS depression or excitation?

Excitation/Stimulation--> Insomnia

14

Is there weight gain or loss with SSRIs?

Weight gain

20 lbs+ possible with long term use

15

When does serotonin syndrome ususally being?

2-72 hours after initiation of treatment of SSRI

-Agitation
-Anxiety
-Confusion
-Disorientation
-Difficulty concentrating
-Diaphoresis
-Fever
-Hallucincations
-Hyperreflexia
-Incoordination
-Tremors

16

Bruxism is an adverse effect of SSRI. How can we treat--like with what med?

Low dose Buspirone

17

Why do we uses SSRIs cautiously in clients who have bipolar disorder?

Due to risk of mania

18

When should SSRI Paroxetine be administered?

In the morning; can take with food

19

What are 3 big AE of TCA?

Orthostatic hypotension
Anticholinergic effects
Sedation

20

When should TCA be administered?

Bedtime (remember it causes sedation)

21

How many weeks worth of meds can we give if client takes TCA?

Give no more than 1 week supply of med to clients who are acutely ill due to the high risk of lethality with overdose

22

TCA are contraindicated in clients with ___

Seizure disorders

23

SSRIs can cause sexual dysfunction. What med can we give to help with this?

Bupropian

24

When do we give SSRI?

In the morning

25

What 2 SSRIs increase risk of birth defects?

Fluoxetine and paroxetine

Use other SSRIs in pregnancy

26

Is it ok to take St. Johns Wort with SSRI?

No

also don't take with warfarin, TCA, lithium, and NSAIDs, and anticoagulatnts

27

MAOI: CNS depression or stimualation?

Stimulation

28

MAOI causes CNS stimulation. What are some other adverse effects besides stimulation (3)?

-Orthostatic hypotension
-Hypertensive crisis
-Local rash associated with transdermal prep

29

MAOI: If client is experiencing a hypertensive crisis (headache, nausea, increased HR and BP), what medication can we give?

Phentolamine
Nifedipine

30

Why is bupropion contraindicated in clients who have anorexia nervosa or bulimia nervosa?

It causes weight loss due to suppression of appetite--those patients don't need weight loss

31

What "other atypical antidepressant" has therapeutic effects that may occur sooner, and with less sexual dysfunction like SSRIs?

Mirtazapine

32

What may be a serious adverse effect of the "other atypical antidepressant" Trazodone?

Priapism

33

What is an indication of toxicity for TCAs?

Cardiac dysrhythmias

34

When do we give TCA?

Bedtime due to risk of sedation and orthostatic hypotension

35

When do we give SSRI?

Morning; take with food to minimize GI problems

36

What list of foods should we give to clients taking MAOIs?

List of foods to avoid aka Tyramines

37

Ok to take Bupropion with MAOIs?

No

38

Do we give lithium with meals? milk?

Yes, to both to minimize GI distress

39

What level of lithium:

N.D.V
Thirst
Polyuria
Muscle weakness
Fine hand tremor
Slurred speech

Less than 1.5

40

What level of lithium:

Mental confusion
Poor coordination
Coarse tremor
Onging GI distress--NVD

1.5-2

41

What level of lithium:

Extreme polyuria of dilute urine
Tinnitus
Blurred vision
Ataxia
Seizures
Severe hypotension leading to coma, and possibly death from resp. complications

Greater than 2-2.5

42

What level of lithium:

Rapid progression of manifestations leading to coma and death

Greater than 2.5

43

Lithium is teratogenic, especially in 1st trimester. Is it ok to give when breastfeeding?

NO-discourage this!!

44

Lithium and pain: should we use NSAIDs or aspirin?

Aspirin

45

How often to we give lithium?

2-3 times daily--take with food to decrease GI distress

46

When do we administer carbamazepine?

At bedtime

47

Who is carabamazepine contrainindicated in?

Clients who have bone marrow suppression or bleeding disorders

48

Who is valproic acid contraindicated in?

Clients with liver disorders

49

First generation anti-psychotics (conventional)

Treat positive, negative, or both?

Mainly positive symptoms of schizo

50

Second generation antipsychitcis (atypical)

Treat positive, negative, or both?

Both positive and negative symptoms of schizo

51

Which has fewer EPS: First or second gen?

Second gen (atypical)

52

Which has fewer anticholinergics: First or sec gen?

Second gen (atypical)

*with the exception of clozapine

53

What are a few examples of first gen antipsychotics (conventional)

Chlorpromazine
Haloperidol
Thioridazine


Many more*

54

What are some complications of first. yen antipsychotics (11)?

1. Agranulocytosis
2. Anti-cholinergic effects
3. EPS
4. Neuroendocrine effects (gynecomastia, galactorrhea, menstrual irregularities)
5. NMS
6. Orthostatic hypotension
7. Sedation
8. Seizures
9. Severe dysrhythmias
10. Sexual dysfunction
11. Skin effects

55

First gens antipsychotics: If client begins to experience EPS acute dystonia, what med can we give?

Anticholinergic agents like BENTROPINE (Cogentin) or Diphenhydramine

56

Conventional: If client begins to experience Parkinsonism, what meds can we give?

Benztropine
Diphenhydramine
Amantadine

57

How is akathisia managed?

BB
Benzo
Anticholinergic meds

58

What are signs of NMS?

-Sudden high fever
-BP fluctuations
-Dysrhythmias
-Muscle rigidity
-Changes in LOC
-Coma

59

NMS: What drugs can we give to help this?

1. Antipyretics
2. Dantrolene and bromocriptine (to induce muscle relaxation)

60

When should 1st gens be administered?

Bedtime

61

What are examples of 2nd gen antipsychotics?

Risperidone
Clozapine (agranulocytosis)
Olanzapine
Quetiapine

*many more

62

What are some adverse effects of 2nd gen antipsychotics?

Remember Knappier said 1st gens have more EPS but 2nd gens affect metabolic stuff

-New onset of diabetes
-Weight gain
-Hypercholesterolemia
-Orthostatic hypotension
-Anticholinergic effects
-Agitation, dizzy, sedation, sleep disruption
-Mild EPS, such as tremor

63

Can we give Risperidone for dementia clients?

No