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Flashcards in Psychopharm Deck (72)
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1

Mental Health disorder symptoms are thought to occur because of...

changes in levels of neurotransmitters

2

The aim of medical treatment is to...

restore levels of neurotransmitters to a level at which patient no longer experiences symptoms

3

Antidepressants action

elevate serotonin and/or norepinephrine

4

Antidepressants indications

-depression
-anxiety disorders
-OCD
-PTSD
-Panic disorder

5

SSRI's

Selective Serotonin Re-uptake Inhibitors

fluoxetine
paroxetine
fluvoxamine
citalopram
sertraline
escitalopram vilazodone

6

SSRI Side Effects

-mild overall side effect profile

-may report GI symptoms

-change in appetite/weight loss

-HA

-sexual dysfunction

-may give person enough energy to act on thought os suicide

7

Serious Side Effects of SSRIs

Serotonergic Syndrome

8

Serotonergic Syndrome

-caused by mixing MAOIs and SSRIs

-overdose of SSRIs

-Taking two antidepressants at once

9

Symptoms of Serotonergic Syndrome

-agitation
-sweating
-fever
-rigidity
-tachycardia
-hypotension
-hyperreflexia
-extreme conditions=coma/death

10

SNRIs

-venlafaxine
-desvenlafaxine
-duloxetine

11

Other commonly used Antidepressants

-bupropion (Wellbutrin)

-mirtazapine (Remeron)

-desyrel (Trazodone)

12

Tricyclic antidepressants

(TCA)

increase levels of serotonin and norepinephrine

13

TCAs

amitriptyline (Elavil)

imipramine (Tofranil)

doxepin (Sinequan)

desipramine (Norpramin)

nortriptyline (Pamelor)

14

Main Side effects of TCAs

*Anticholinergic

-blurred vision
-dry mouth
-urinary hesitancy or retention
-constipation

15

Other side effects of TCAs

-orthostatic hypotension
-EKG changes due to cardiotoxicity
-sedation: due to blocking histamine
-memory and concentration disturbances
-HA
-fatigue
-impotence

**There is increased risk of fatal overdose with TCAs

16

MAOIs

Monoamine Oxidase Inhibitors

-inhibit the breakdown of monoamines, specifically Serotonin and Norepinephrine by inhibiting the catabolic enzyme

-also inhibits the metabolism of Tyramine (potent vasopressor

-foods containing Tyramine may stimulate hypertensive events, possibly hypertensive crisis

17

MAOI names

-isocarboxazid
-phenelzine
-tranylcypromine

18

Restricted Foods

-aged cheeses
-aged and cured meats
-dried or pickled fish
-liver
-bananas
-broad bean pods
-sauerkraut
-soy sauce and other soy condiments
-draft beer
-vitamins with Brewer's yeast

19

Consume in Moderation

-red or white wine
-bottled or canned beer
-chocolate
-yogurt

20

Antipsychotics indication

treatment of acute and chronic psychosis

21

Antipsychotics action

dopamine antagonist

-blocks dopamine

22

Commonly Used Antipsychotics Atypicals

-clozapine
-risperidone
-olanzapine
-quetiapine
-ziprasidone
-aripiprazole
-lurasidone

23

Atypical/SGA: Clozaril

-most effective for + and - sx's

-first a typical--very effective but some serious adverse rxns

-bone marrow suppression--can cause leukopenia--need weekly CBC with Diff q week for 1st 6 months--then q2wks

-increased risk of Szs

24

Interdisciplinary collaboration

-clozapine monitoring

-physician enrolls patient in registry, orders lab work (weekly WBC/ANC)

-nurse faxes lab work to pharmacy/physician as needed, monitors for symptoms of immunosuppression and delivers med

-pharmacist does not dispense med until new lab values are rec'd

25

SE for Clozaril & Zyprexa

-sedation
-constipation
-orthostasis
-low EPS

26

Zyprexa may cause...

appetite increase and is contraindicated with DM

27

Risperdal

-sedation
-orthostasis
-moderate EPS
-anticholinergic--low
-can cause elevated Prolactin levels

28

Seroquel

-orthostasis
-somnolence
-wt gain

29

Geodon

nausea
-somnolence

30

Abilify

nausea
-HA
-somnolence/insomnia