PHARMACOLOGY

Question 1

This refers to the maximal therapeutic effect that can be achieved by a drug.

Answer 1

EFFICACY

Question 2

This describes the amount of drug needed to achieve that maximum effect

Drugs that have a low _______ require higher dosages to achieve efficacy

High-_____ drugs achieve efficacy at lower doses.

Answer 2

POTENCY

Question 3

This is the amount of time it takes for half of the drug to be removed from the bloodstream.

Drugs with a shorter ________ may need to be given 3 or 4 times in a day, but drugs with a longer half-life may be given once a day.

The amount of time needed for a drug to leave the body completely after it has been discontinued is about five times its ________

Answer 3

HALF-LIFE

Question 4

A medication is selected based on its effect on the client’s ___________ _________, such as delusional thinking, panic attacks, or hallucinations.

Answer 4

TARGET SYMPTOMS

Question 5

The effectiveness of the medication is evaluated in large part by its ability to ___________ the target symptom.

Answer 5

DEMINISH OR ELIMINATE

Question 6

As a rule, elderly persons require _______ dosages of a medication to produce therapeutic effects, and it may take longer for a drug to achieve its full therapeutic effect.

Answer 6

LOWER

Question 7

Psychotropic medications are often __________ __________ rather than abruptly discontinued.

Answer 7

DECREASED GRADUALLY

Question 8

Problems when Psychotropic medications are abruptly discontinued.

1. _____________ (temporary return of symptoms)
2. ______________ of the original symptoms
3. ____________ (new symptoms resulting from discontinuation of the drug)

Answer 8

1. Rebound (temporary return of symptoms)
2. Recurrence of the original symptoms
3. Withdrawal (new symptoms resulting from discontinuation of the drug)

Question 9

______________ care is essential to ensure compliance with the medication regimen, to make needed adjustments in dosage, and to manage side effects.

Answer 9

FOLLOW-UP

Question 10

These are also known as NEUROLEPTICS / MAJOR TRANQUILIZERS

These are used to treat symptoms of psychosis, such as delusions and hallucinations.

They work by blocking the receptors of the neurotransmitter Dopamine.

Answer 10

ANTIPSYCHOTIC DRUGS

Question 11

Antipsychotic drugs are Indicated to Schizophrenia and Other Psychosis

Desired effect: __________ of SYMPTOMS

Best taken_________meals

Answer 11

1. CONTROL OF SYMPTOMS.
2. BEST TAKEN WITH MEAL

Question 12

Antipsychotic drugs that blocks all three dopamine receptors (D2, D3, D4)

DRUGS END WITH “ZINE” & “DOL”

HELPS DIMINISH POSITIVE SYMPTOMS

Answer 12

TYPICAL DRUGS / FIRST GENERATION ANTIPSYCHOTICS

Question 13

WEAK BLOCKERS OF D2 RECEPTORS

DRUGS END WITH “PINE” & “DONE”

HELPS DIMINISH POSITIVE AND NEGATIVE SYMPTOMS

Answer 13

ATYPICAL DRUG/ SECOND GENERATION ANTIPSYCHOTICS

Question 14

SIDE EFFECTS OF ANTIPSYCHOTIC MEDICATION

1. B_________ _____N
2. D____ ________H
3. P________Y
4. O_____C H_______N
5. E____ P_______ S____
6. A____________S
7. N__________ M_________ S________

Answer 14

1. BLURRED VISION
2. DRY MOUTH
3. PHOTOSENSITIVITY
4. ORTHOSTATIC HYPOTENSION
5. EXTRA PYRAMIDAL SYMPTOMS
6. AGRANULOCYTOSIS
7. NEUROLEPTIC MALIGNANT SYNDROME

Question 15

EXTRA PYRAMIDAL SYMPTOMS

A_____
P_____
A_____
T_____

Answer 15

AKATHISIA
PSEUDOPARKINSOSISM
ACUTE DYSTONIA
TARDIVE DYSKINESIA

Question 16

RESTLESS LEG SYNDROME
“ANT’S IN THE PANTS”

Answer 16

AKATHISIA

Question 17

pill-rolling tremors
mask-like face
cog-wheel rigidity
propulsive gait

Answer 17

PSEUDOPARKINSONISM

Question 18

Defect in muscle tone

Answer 18

ACUTE DYSTONIA

Question 19

ACUTE DYSTONIA
Defect in muscle tone

T______- CERVICAL SCOLIOSIS
O______- TRUNK RIGIDITY
O_______-EYE BALL (UPWARD MOVEMENT)
L________- MUSCULAR CONTRACTION OF THE VOCAL CORDS

Answer 19

TORTICOLLIS

OPISTHOTONUS

OCULOGYRIC CRISIS

LARYNGOSPASM

Question 20

Tongue-thrusting and protrusion
lip-smacking,
blinking, grimacing and other excessive, unnecessary facial movements

Answer 20

TARDIVE DISKINESIA

Question 21

NURSING ACTION?

EPS
1. AKATHISIA
2.PSEUDOPARKINSOSISM
3. ACUTE DYSTONIA
4. TARDIVE DYSKINESIA

Answer 21

Report at once

1)Lowering the dosage of the antipsychotic
2) Changing to a different antipsychotic
3) Administering anticholinergic medication

Question 22

NEUROLEPTIC MALIGNANT SYNDROME TRIAD

R______
H______
U______

Treatment:
Immediate discontinuance of all antipsychotic

Answer 22

RIGIDITY

HIGH FEVER

UNSTABLE BLOOD PRESSURE

Question 23

Common indication: Anxiety disorders
Desired Effect: Decreased anxiety, adequate sleep

Answer 23

MINOR TRANQUILIZERS/ ANXIOLYTICS

Question 24

Examples:

Diazepam (Valium)

Oxazepam (Serax)

Chlordiazepoxide (Librium)

Chlorazepate Dipotassium (Tranxene)

Alprazolam (Xanax)

Answer 24

MINOR TRANQUILIZERS/ ANXIOLYTICS

Question 25

MINOR TRANQUILIZERS/ ANXIOLYTICS Nursing Implications: Best taken ____________ meals Advise to avoid d______ Avoid a______l and c_________e-containing foods Administer it _________ with any drug

Answer 25

BEST TAKEN AFTER MEALS AVOID DRIVING AVOID ALCOHOL AND CAFFEINE-CONTAINING FOODS ADMINISTER SEPARATELY WITH OTHER DRUGS

Question 26

Desired effects: increased appetite, adequate sleep

Answer 26

ANTIDEPRESSANTS

Question 27

Examples: Imipramine (Tofranil) Amitriptyline (Elavil)

Answer 27

TRYCICLIC ANTIDEPRESSANTS

Question 28

Tricyclic Antidepressants Nursing Implications: Best given______ meals Effectivity: after ________________(INITIAL) _________(OPTIMUM) Check the ___, it causes ____tension Check the h_______E, it causes cardiac a_________s

Answer 28

BEST GIVEN AFTER MEALS EFFECTIVITY INITIAL: AFTER 2-3 WEEKS OPTIMUM: AFTER 4-6 WEEKS CHECK BP, IT CAUSE HYPOTENSION CHECK HEART RATE, IT CAN CAUSE ARRYTHMIAS

Question 29

Indication: refractory depression

Answer 29

MAO INHIBITORS

Question 30

Examples: * Tranylcypromine (PA____________) * Phenelzine (NA_____________) * Isocarboxazid (MA__________)

Answer 30

MAO INHIBITORS PARANTE NARDIL MARPLAN

Question 31

MAO INHIBITORS Nursing Implications: Best taken _____ meals Report headache; it indicates _____________ _____________ Avoid __________ containing foods like: * Avocado * Banana * Cheddar and aged cheese * Soysauce * Preserved foods Effectivity: _____ weeks Monitor the _____ There should be at least a ___-week interval when shifting from one anti-depressant to another

Answer 31

BEST TAKEN AFTER MEALS HEADACHE INDICATES HYPERTENSIVE CRISIS AVOID TYRAMINE FOODS AFFECTIVITY IS AFTER 2-3 WEEKS MONITOR BP INTERVAL OF AT LEAST 2 WEEKS when shifting from one anti-depressant to another

Question 32

Examples: Fluoxetine (Prozac) Celatopram (Celexa) Sertraline (Zoloft) Paroxetine (Paxil) Fluvoxamine (Luvox)

Answer 32

SELECTIVE SEROTONIN REUPTAKE INHIBITORS

Question 33

SELECTIVE SEROTONIN REUPTAKE INHIBITORS Nursing Implications: Avoid the use of: d_______m A_______l Tryptophan Monitor P__, P_ Never give to _____________ / lactating mothers.

Answer 33

AVOID THE USE OF DIAZEPAM ALCOHOL MONITOR PTT &PT NEVER GIVE TO PREGNANT WOMEN

Question 34

Examples: Lithium Citrate (Cibalith) Lithium Carbonate (Eskalith, Lithane, Lithobid)

Answer 34

ANTI-MANIC AGENT

Question 35

ANTI-MANIC AGENT Nursing implications: Best taken _____ meals Never give to pregnant mothers

Answer 35

TAKEN AFTER MEALS

Question 36

ANTI-MANIC AGENT Nursing implications: Increase intake of: __________ (3 L /day) __________ (3 gm/day)

Answer 36

WATER (3 L /day) SODIUM (3 gm/day)

Question 37

ANTI-MANIC AGENT Nursing implications: Avoid activities that increase _____________

Answer 37

PERSPIRATION

Question 38

ANTI-MANIC AGENT Nursing implications: Effectivity: ____ ____ DAYS

Answer 38

10-14 days

Question 39

ANTI-MANIC AGENT Nursing implications: Antipsychotic is administered during the first 2 weeks Therapeutic level: _____________ meq/L IDEAL LEVEL:____ EXACT LEVEL:_____

Answer 39

Therapeutic level: 0.5 - 1.5 meq/L IDEAL LEVEL: 0.7-1.2 meq/L EXACT LEVEL: 1 meq/L

Question 40

ANTI-MANIC AGENT Toxic Effect: These include: Severe d_____ V________g D___________s M________e w_______s Lack of c________n

Answer 40

Toxic Effect Severe diarrhea Vomiting Drowsiness Muscle weakness Lack of coordination