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NSG 470 > Psych Drugs Exam 3 > Flashcards

Psych Drugs Exam 3 Flashcards

(93 cards)

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1
Q

Benzo MOA

A

-Used for anxiety disorders
-Enhances GABA producing inhibitory effects
-GABA receptor agonist

-Rapid relief of anxiety

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2
Q

Benzo SE

A

-CNS depression
-Anterograde amnesia

-Acute toxicity: Lethargy, confusion , resp depression, cardiac or resp arrest
-Paradoxical response: Anxiety, restlessness, insomnia, excitation, rage

-Withdrawal: Anxiety, insomnia, diaphoresis, tremors lightheadedness

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3
Q

Benzo contra-indications

A

-Schedule IV controlled substance, risk of dependence: preferred in the short term
-Contraindicated in pt with sleep apnea, resp depression, glaucoma

-Caution in pt with liver disease, mental illness and substance use disorder
-Interacts with CNS depressants: alc, opiods –> resp depression

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4
Q

What do you take benzos for

A

-Generalized anxiety disorder
-Panic disorder
-Seizure disorder
-Insomnia
-Muscle spasms
-Alc withdrawal
-Anesthesia induction
-Amnesic before surgery

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5
Q

Alprazolam (XANAX)

A

Benzo

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6
Q

Diazepam (Valium)

A

Benzo

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7
Q

Lorazepam (Ativan)

A

Benzo

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8
Q

Clonazepam (Klonpin)

A

Benzo

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9
Q

SSRI

A

-Inhibits serotonin reuptake, making its effects more pronounced
-More serotonin in the receptor the greater the effect

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10
Q

SSRI SE

A

-Take in morning for minimizing sleep disturbances
-Sexual dysfunction (Decreased libido)
-CNS stimulation (Anxiety, insomnia, agitation weight loss (early) and gain (late)
-Rash
-Hyponatremia
-Sleepiness
-Faintness, lightheadedness
-GI bleeding
-Brixism
-Alopecia
SEROTONIN SYNDROME (2-72 hr after initial treatment)

-Withdrawal: headache,N+V visual disturbances, anxiety, dizziness tremors

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11
Q

SSRI contraindications

A

-Pregnancy (birth defects, newborn pulmonary htn)
-Contraindicated with MAOIs and TCA, St john wort, tramdol –> setatonin syndrome
-Caution with liver, renal, cardiac dysfunction, seizures, diaberes, ulcers, GI bleeding, Alc

-Can caused prolonged QT interval in cardiac pt
-Caused increased risk for bleeding in antiplt therapy
-Lithium and TCA can increase in level

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12
Q

What is SSRI for

A

-MDD
-GAD, Panic disorders
-OCD
-PTSD
-Social anxiety
-Bulimia nervosa
-Premenstrual dysphoric disorders

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13
Q

Fluoxetine (Prozac)

A

SSRI
-Specifically: Panic, OCD

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14
Q

Paroxetine (Paxil)

A

SSRI

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15
Q

Citalopram (Celexa)

A

SSRI

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16
Q

Sertraline (Zoloft)

A

SSRI
-Specifically: Panic, ocd, SAD, PTSD

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17
Q

Escitalopram (Lexapro)

A

SSRI
-Specifically: GAD, OCD

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18
Q

Fluvoxamine (Luvox)

A

SSRI
-Specifically: SAD, OCD

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19
Q

SNRI(SSNRI) MOA

A

Inhibits the reuptake of Norepi and serotonin, leading to greater effects
-More time in the receptor more effect

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20
Q

SNRI(SSNRI) SE

A

Nausea
Vomiting
Diarrhea,
Dry mouth, yawning
Anxiety
Tremors
Tachycardia
Vision changes
Diaphoresis
Suicidal ideation
HTN
Chest Pain
Weight changes
Rash
Ecchymosis

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21
Q

SNRI(SSNRI) contraindications

A

-Hypersensitivity to serotonin drugs, use with MAOI drugs

-Risk of serotonin syndrome
-Dont drink alc with it

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22
Q

SNRI (SSNRI) Interactions

A

-Antiplt therapy can increase risk of bleeding
-Lithium and TCA levels can increase with use

-Use with other serotonin drugs, (MAOI), lithium, St john wort –> serotonin syndrome

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23
Q

SNRI (SSNRI) notes

A
  • Dont take with alc
    -Take with food and water
    -Dont stop suddenly, withdrawal
    -May affect glycemic control
    -May cause neonatal substances
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24
Q

Venlafaxine

A

-Effexor (Brand name)
-SSNRI (SNRI)

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25
Desvenlafaxine
(Pristiq) -SSNRI (SNRI) -May cause GI bleed, increased cholesterol levels
26
Duloxetine
Cymbalta (Brand name) -SSNRI (SNRI) -May cause hypoglycemia, orthostatic hypotension within the first week of use -Pt with liver disease or drink excessive alc shouldnt use
27
Bupropion (Wellbutrin, Zyban): MOA
-Inhibit dopamine reuptake (Supposedly)
28
Atypical antidepressants: SE
Headache -Dry mouth -GI distress -Tachycardia -Nausea -Restlessness -Insomnia -Loss of appetite, weight loss -Seizures -HTN
29
Atypical antidepressants: Contraindications
MAOI, Seizures, eating disorders
30
Atypical antidepressants: Interactions
MAOI: Toxicity, need to wait 2 weeks after stopping to avoid -Suicidal ideation in children, adolescence that have depression or other psyche disorders
31
Bupropion (Wellbutrin, Zyban)
-Inhibits dopamine reuptake -Atypical antidepressant -Also used for smoking cessation
32
Trazodone
-Desyrel (Brand name) -Inhibits reuptake of NE and Serotonin -Need to report flu like S+S
33
Mirtazapine
-Remeron (Brand name) -Atypical antidepressant -Increases release of NE and serotonin -Used for sleep in low doses -Need to report flu like S+S
34
TCA MOA
-Inhibit reuptake of Serotonin and NE intensifying effects
35
TCA; SE
-Orthostatic hypotension -Sedation -Decreased seizure threshold -Diaphoresis -Anticholinergic effects -Toxicity: cholinergic blockage, cardi tox, dysrhythmias
36
Contraindicatons TCA
-Preg -Suicide risk pt, Risk of toxicity -Seizures
37
Caution TCA
-CAD, diabetes, liver, kidney or resp disorders -Urinary retention or obstruction -Angle closure glaucoma -BPH -Hyperthyroidism
38
Interactions TCA
MAOI or St. John wort (serotonin syndrome) -Antihistamines or other anticholinergics have additive effects
39
TCA Purpose
-Depression -Anxiety -Insomnia -Neuropathic pain -Fibromyalgia
40
MAOI: MOA
Blocks MAO in the brain which increases serotonin, dopamine, and NE available -May take 1-3 weeks to begin producing effects, up to 2-3 weeks for the full effect
41
Amitriptyline
-Elavil (Brand name) -TCA
42
Imipramine
-Tofranil (Brand name) -TCA
43
Doxepin
-Sinequan (Brand name) -TCA
44
Nortriptyline
-Aventyl, pamelor -TCA
45
MAOI SE
CNS stimulation -Orthostatic hypotension -HTN crisis when taken with tyramine -Local rash -Suicidal ideation
46
MAOI contraindications
-Preg -SSRI -Pheochromocytoma, HF, RF, CVD, Cerebral vascular disease
47
MAOI Cautions
-Diabetes (Hides hypoglycemia) -Seizure -TCA _foods with tyramine
48
MAOI interactions
-Tyramine: foods containing it can cause a HTN crisis
49
Antidote for a MAOI HTN crisis
-Phentolamine (regitine), or nifedipine (procardia)
50
Mood stabilizer MOA
-Serotonin receptor blockade and other neurochemical changes in brain -May slow neuronal atrophy and promote neuronal growth
51
Mood stabilizer SE
-GI distress -Fine hand tremors -Polyuria -Weight gain -Renal tox -Goiter, hypothyroidism - Bradydysrhythmia -Hypotension -Electrolyte/ fluid imbalance
52
Mood stabilizer, Lithium: Mild toxicity SE
-<1.5 mEq/L -Diarrhea, nausea, vomiting , thirst, fine hand tremors, muscle weakness, slurred speech, polyuria
53
Mood stabilizer, Lithium: Moderate Toxicity SE
-1.5-2 -GI distress, mental confusion, poor coordination, coarse tremors
54
Mood stabilizer, Lithium: Severe toxicity SE
-(2-2.5) -Extreme polyuria of dilute urine , tinnitus, blurry vision, ataxia, seizures, severe hypotension, coma, resp complications -Death -Symptoms to coma and death with >2.5
55
Contraindications Mood stabilizer
-Pregnancy, breast feeding
56
Cautions Mood stabilizer
-Renal dysfunction, heart disease, dehydration , sodium depletions
57
Mood stabilizer interactions
-NSAIDS -> Increased lithium excretion -Increased lithium excretion -> Renal toxicity; use with anticholinergics -Renal toxicity -> Urinary retention, polyuria, abdominal discomfort
58
Mood stabilizer Purpose
-Bipolar disorder -Acute mania -Reduces suicide risk -Psychotic disorders -Alc use disorder -Bulimia nervosa
59
Mood stabilizer notes
Need frequent blood draws -2000-3000 ml of fluid daily -Monitor sodium and weight -Monitor lithium levels (2-3 weeks) -Treatment may include emetics, gastric lavage or hemodialysis (high levels)
60
Lithium Carbonate
-Lithane (Brand name) -Eskalith (Brand name) -Lithobid (Brand name) -Carbolith (Brand name) -Mood stabilizer
61
Anticonvulsants MOA: Valproic acid
-potentiate GABA -Gaba effects are greater
62
Anticonvulsants MOA: Carbamazepine
-Slows Na+ and Ca2+ reentry, slowing nerve conduction
63
Anticonvulsants MOA: Lamotrigine
-Inhibits glutamate -(glutamate is responsible for excitation)
64
Valprotic acid: SE
-GI distress -Pancreatitis -Hepatotoxicity -Thrombocytopenia -Teratogenesis
65
Carbamazepine: SE
-Cognitive effects -Blood abnormalities (Leukopenia, anemia, thrombocytopenia) -Teratogenicity -Hypo-osmolarity -> ADH loss, fluid loss, fluid overload -Skin disorders
66
Lamotrigine SE
-Dizziness -HA -N+V -Double vision -Skin disorders
67
Anticonvulsants Contraindications
-Pregnancy -Carbamazepine, with bone marrow suppression or bleeding disorders -Valproic acid with liver disorders
68
Anticonvulsants interactions
None listed
69
Anticonvulsants purpose
-Treatment and prevention of relapse of mania and depressive episodes -Mixed mania -Rapid cycling bipolar disorders -Schizophrenia -"mood stabilizers"
70
Valproic Acid
-Depakote (Brand name) -Anticonvulsants -Inhibits gaba
71
Carbamazepine
-Tegretol (Brand name) -Equetro (Brand name) -Anticonvulsants -Slows Na and Ca reabsorption
72
Lamotrigine
Lamictal (Brand name) -Anticonvulsant - Inhibits glutamine
73
2nd gen antipsychotics MOA
Blocks receptors for serotonin and dopamine, NE and histamine
74
2nd gen antipsychotics SE
-New onset diabetes mellitus -Weight gain -Hypercholesterolemia with increased risk for heart disease -HTN -Orthostatic hypotension -Anticholinergic effects -Agitation -Dizziness -Sedation -Sleep disruption -Mild EPS (ex-tremor)
75
2nd gen antipsychotics: Contraindications
Dementia Risperidone, Preg
76
2nd gen antipsych: Cautions
-Avoid alc -CVD cerebrovascular diseases, seizures, DM
77
2nd gen antipsych: Interactions
-Immunosuppressive medications can further suppress with clozapine; -TCA can prolong QT interval and cardiac dysrhythmias -Barbs, phenytoin and fluconazole disrupt hepatic metabolism
78
2nd gen antipsych notes
Oral disinter-grating tablets are available for pt with history of cheeking or pocketing meds, or have a hard time swallowing -when you give Asenapine you cant eat 10 min before or after
79
Risperidone
-Risperdal (Brand name) -2nd gen antipsych -Available to give IM every q2-4 wk for less adherent pt
80
Olanzapine
-Zyprexa (Brand name) -2nd gen antipsych
81
Quetiapine
-Seroquel (Brand name) -2nd gen antipsych
82
Aripiprazole
- Abilify (Brand name) -2nd gen antipsych
83
Ziprasidone
-Geodon (Brand name) -2nd gen antipsych
84
Dantrolene
-Dantrium -Treats muscle rigidity -Used in Serotonin Syndrome
85
Diazepam
-Valium -Used to treat muscle rigidity -Used in Serotonin Syndrome
86
Propranolol
-Used in Serotonin Syndrome to block 5HT receptors -Beta blocker, promotes vasodilation as well
87
Phenelzine
-Nardile (Brand name) -MAOI
88
Tranylcypromine
-Parnate (Brand name) -MAOI
89
Selegiline
(Emsam) (Brand name) -MAOI -Transdermal
90
Clonazepam
-Klonopin (Brand name) Anxiolytics -Used for treatment resistant mania and psychomotor agitation
91
Lorazepam
-Ativan (Brand name -Anxiolytics -Used for treatment resistant mania and psychomotor agitation
92
Diazepam
-Valium (Brand name) -Anxiolytics -Used for treatment resistant mania and psychomotor agitation
93
Alprazolam
-Xanax (Brand name) -Anxiolytics -Used for treatment resistant mania and psychomotor agitation

NSG 470 (26 decks)

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