Psychopharm Flashcards
(113 cards)
1
Q
2 bad things about amphetamines
A
Addictive, toxicity
2
Q
Whatbis important for the nurse to assess related to psychomedications?
A
List of the meds they are taking including prescribed OTC, herbal, and their allergies
3
Q
What is important after giving the medication?
A
Monitor side effects and adverse reactions, evaluate effectiveness
4
Q
What is some pt education you should do when giving pt drugs?
A
- Why when and how the med should be taken
- Who and when to contact with questions
- Expected side effects/adverse reactions
5
Q
What are some examples of neurotransmitters?
A
Epinephrine, dopamine, serotonin
6
Q
Whatbare antianxiety agents also called?
A
Anxiolytics (minor tranquilizers)
7
Q
What are anxiolytics used for?
A
Acute anxiety states (not long term)
Depress CNS
8
Q
All anxiolytics depress the CNS except for?
A
Buspirone!
9
Q
What is the most commonly prescribed anxiolytic class?
A
Benzodiazepines
10
Q
Can anxiolytics/CNS depressants be taken with another CNS depressant?
A
No, take them by themselves
11
Q
What to avoid when taking anxiolytics?
A
Alcohol, caffeine, opioid/cough meds, herbal depressants
12
Q
What to do if pt becomes confused while taking anxiolytics?
A
Stop the med, taper off
13
Q
Alprazolam (Xanax) class
A
Antianxiety
14
Q
Clonazepam (Klonopin) class
A
Antianxiety
15
Q
Diazepam (Valium) class
A
Antianxiety
16
Q
Lorazepam (Ativan) class
A
Antianxiety
17
Q
Oxazepam (Serax) class
A
Antianxiety
18
Q
Midazolam (Versed) class
A
Antianxiety
19
Q
SE of antianxiety meds
A
Orthostatic hypotension
drowsiness
dry mouth
paradoxical excitement (opposite of what we want)
blood dyscrasias (easy bruising, sore throat, fever)
20
Q
How long can antianxiety meds be used for?
A
About 4 months
After 4 months need to look at meds for long term use
21
Q
Is buspirone (Buspar) a benzodiazepine?
A
No
22
Q
What is one uses of benzodiazepines?
A
Depress the CNS
23
Q
Does buspirone depress the CNS?
A
No
24
Q
How long should you take buspirone?
A
7-10 days to see improvement
3-4 weeks to reach the optimal level
25
Does buspirone have addiction potential?
No
26
What to avoid when taking buspirone?
Alcohol, CNS depressants, grapefruit juice
27
Pt education for antianxiety meds
1. Do NOT stop abruptly, taper off slowly for 2-6 weeks
2. Avoid alcohol, caffeine, smoking, and other CNS depressants
3. Take with food/milk
4. Avoid herbals (kava, valerian, melatonin, chamomile)
28
Buproprion (Welbutrin) class
Atypical antidepressants
29
What do atypical antidepressants treat?
Schizophrenia or bipolar
30
Antidepressants action
Increase concentration of norepinephrine, serotonin, and dopamine by blocking reuptake, inhibit the release of monoamine oxidase (MAO)
31
What class of antidepressants have the least side effects?
SSRIs
32
What do you need to avoid when taking SSRIs?
Alcohol and other CNS depressants
33
How long does it take for SSRIs side effects to decrease?
2-4 weeks
34
What do you need to monitor for pt that are taking SSRIs?
Suicidal ideation
35
Fluoxetine (Prozac) class
SSRIs
36
Sertraline (Zoloft) class
SSRIs
37
Paroxetine (Paxil) class
SSRIs
38
Citalopram (Celexa) class
SSRIs
39
Escatilopram (Lexapro) class
SSRIs
40
What adverse reaction will occur when taking SSRI with buspirone/TCAs/st John's wort/selegiline?
Serotonin syndrome
41
Serotonin syndrome s/s
Diarrhea, restlessness, agitation, vital fluctuation
Late s/s: seizures, hyperthermia, uncontrolled shivering, myoclonus (involuntary muscle contraction throughout the body)
42
What is myoclonus?
Involuntary muscle contraction throughout body
43
What adverse reaction happens when taking SSRI with MAOIs?
Hypertensive crisis
44
Venlafaxine (Effexor) class
SNRIs
45
Duloxetine (Cymbalta) class
SNRIs
46
Desvenlafaxine (Pristiq) class
SNRIs
47
Side effects of SNRIs other than the common ones
Hypertension, suicidal ideation, SJS
48
what do TCAs do?
Block uptake of norepinephrine and serotonin in the brain, elevate mood, increase ADLs
49
Amitriptylline (Elavil) class
TCA
50
Imipramine (Tofranil) class
TCA
51
Trimipramine (Surmontil) class
TCA
52
Despiramine (Norpramin) class
TCA
53
Protriptyline (Vivactil) class
TCA
54
What are TCAs used for?
OCD, panic attacks, major depression
55
What are some side effects of TCAs?
Photosensitivity
Orthostatic hypotension
Blurred vision
Constipation
Sexual dysfunction
Suicidal ideation
Weight gain
56
What can you do if your pt is on TCAs but has been trying hard to lose weight for the last several weeks?
Educate them so they know they will not be able to lose weight while taking TCAs
We can ask the doctor for another antidepressant if pt is really trying to lose weight!
57
What is the first antidepressants ever made?
MAOIs
58
What do MAOIs do?
Increase norepinephrine, epinephrine, dopamine, and serotonin
59
Tranylcypromine sulfate (Parnate) class
MAOI
60
Isocarboxazid (Marplan) class
MAOI
61
Selegiline (Emsam) class
MAOI
62
Phnelzine Sulfate (Nardil) class
MAOI
63
What do pt need to avoid while taking MAOIs?
Foods that are high in tyramine
64
Side effects of MAOIs
Orthostatic hyper!tension! Hypertensive crisis (>180/120, can lead to heart attack, stroke, and death)
Anticholinergic effects (dryyyyyy)
65
If opioid overdose happens, what can be administered?
Naloxone (Narcan)
66
what are 2 adverse reactions of antidepressants?
Serotonin syndrome
Neuroleptic malignant syndrome
67
Common side effects of antidepressants
Dry mouth, sedation, nausea, sexual dysfunction
68
Neuroleptic malignant syndrome s/s
Seizure, altered mental status, muscle rigidity, sudden high fever, bp fluctuations, high hr, dysrhythmias, rhabdomyolysis, acute renal failure, resp failure, coma
69
What to do when neuroleptic malignant syndrome occur?
Stop the antipsychotic!
Hydration, hypothermic blankets, antipyretics
Benzodiazepines, muscle relaxants
70
What do bipolar mania have?
Cycles of low (depression) and high (manic)
71
Lithium carbonate class
Mood stabilizers
72
What is lithium's narrow therapeutic range?
0.6-1.2
73
What electrolyte does your body need while taking lithium?
Sodium!
74
What happens when your sodium is low while taking lithium?
Higher risk for lithium toxicity
75
What drug to avoid while taking lithium?
NSAIDs (ibuprofen, neproxen, aspirin) b/c lithium toxicity
76
Carbamazepine (Tegretol) class
Mood stabilizer
77
Divalproex (Depakote) class
Mood stabilizer
78
Lamotrigine (Lamictal)
Mood stabilizer
79
Ziprasidone (Geodon) class
Mood stabilizer
80
Aripiprazole (Abilify) class
Mood stabilizer
81
Side effects of mood stabilizers
Drowsiness, dizziness, nausea, vomiting, headache, dry mouth, weight loss/gain
82
What are antipsychotic agents also called?
Neuroleptics
83
A bad adverse reaction with certain antipsychotics
Agranulocytosis
84
What are some s/s of DRESS?
Rash, fever, swollen lymph nodes
85
Hormonal side effects of antipsychotics
Galactorrhea (having milk while not pregnant)
Amenoria (no periods)
Gynecomastia (male breast dev)
86
Olanzapine (Zyprexa) class
Antipsychotics
87
Quetiapine (Seroquel) class
Antipsychotics
88
Risperidone (Risperdal) class
Antipsychotics
89
Haloperidol (Haldol) class
Antipsychotics
90
Side effects of antipsychotics
Constipation, NVD, dry mouth, insomnia, sedation, sexual dysfunction, weight gain
91
Whatbisnextra pyramids symptoms (EPS)?
A side effect of antipsychotics
92
What symptoms do EPS include?
Pseudoparkinsonism (drooling, tremors, shuffling gait)
Tardive dyskinesia (ex: involuntarily chewing motion)
Dystonia（uncontrolled muscle contraction）
Akinesia（loss of ability to move muscles）
Akathisia（muscle restlessness）
93
What can the nurse do when EPS occurs?
Can change meds or treat EPS
94
What can you use to block pseudoparkinsonism and dystonia?
Use benztropine (Cogentin) to block the cholinergic activity.
Oral: onset 2-3 days
IM/IV: onset within minutes
95
What are sedative hypnotics used for?
Short term management of anxiety and insomnia
96
What does sedative hypnotics do?
Depress CNS
May produce tolerance or dependence except for Ramelteon (Rozerem) (not a controlled substance)
97
Contraindications of sedative hypnotics
Severe hepatic/cardiac/renal/resp disease or insufficiency
Children and older adults
98
What to avoid when taking sedative hypnotics?
Alcohol and other CNS depressants
99
What to do after giving ot sedative hypnotics?
Continuously monitor for abnormal thinking and behavior changes
Always look for black box warning
100
Butabarbital (Butisol) class
Sedative hypnotics
101
Phenobarbital (Sezaby) class
Sedative hypnotics
102
Temazepam (Restoril) class
Sedative hypnotics
103
Eszopiclone (Lunesta) class
Sedative hypnotics
104
Zolpidem (Ambien) class
Sedative hypnotics
105
What schedule of controlled substance is amphetamine?
2
106
What is the FDA approval video game for ADHD?
EndeavorRx
107
Amphetamine (Adderall) class
ADHD agents
108
Methylphenidate (Ritalin) class
ADHD agents
109
Atomoxetine (Strattera) class
ADHD agents
110
Lisdexamfetamine (Vyvanse) class
ADHD agents
111
When should pt take ADHD agents?
At night b/c they are sedative
112
When taking lithium, what needs to be done once a month?
Report for blood tests
113
Gabapentin (Neurontin) class
Mood stabilizer
