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Psychopharm Flashcards

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1
Q

What foods are high in serotonin

A 
turkey 
tomatoes 
sunflower seeds 
avocados 
pineapples
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2
Q

When giving SSRI’s what bad reaction shoudl we monitor fo r

A

serotonin syndrom

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3
Q

What are the mani’s of serotonin syndrome

A 
altered LOC
sweating  
fever
Tachycardia 
HTN 
hyperreflexia 
Diarrhea
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4
Q

Treatment for serotonin syn

A

Stop medication
Provide IV fluids
Cooling blankets
Antipyretics

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5
Q

What things increase risk of serotonin syn

A

MAOIs
TCA’s
St. Johns wort

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6
Q

What is a consideration for someone taking MAOIs and is starting SSRI’s or bupropion

A

discon the MAOI’s 14 days prior to starting the SSRI’s or bupropion

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7
Q

What medication do SSRI’s increase

A

warfarin

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8
Q

What medications increase SSRI levels

A

TCA’s

lithium

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9
Q

Do NSAIDS and anticoag’s taken with SSRI’s increasse risk fo bleeding

A

yes

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10
Q

What are TCA’s

A

tricyclic antidepressents

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11
Q

What do TCA’s do

A

inhbiit reuptake of serotonin and norepinephrine

sometimes blocks histamine and acetylcholine

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12
Q

What are some common side effects of TCA’s

A 
anticholinergic effects like 
dry mouth
photophobia 
blurred vision 
constipation
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13
Q

What are some serious side effects of TCA’s

A

cardia toxicity

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14
Q

What are some examples of TCA’s

A

amitriptyline

Amoxapine

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15
Q

What is a consideration with MAOI’s and TCA’s

A

severe HTN is a risk so dont take together

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16
Q

What medications are contraindicated with TCA’s

A 
antihistamines 
opioids
benzodiazepines
alc
MAOI's
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17
Q

What problems does TCA’s and opioids benzodiazepines alc cause

A

increased CNS depression

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18
Q

What do MAOI’s do

A

MAOIs increases the availability of norepinephrine dopamine, and serotonin

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19
Q

What foods should you avoid with MAOI’s and why

A 
aged cheese 
red wine 
soy sauce 
salami 
bananas 
sauerkraut
bec they have tyramine or tryptophan
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20
Q

What are some common side effects of MAOI’s

A 
anticholinergic effects like 
dry mouth
photophobia 
blurred vision 
constipation 
anx 
orthostatic hypotension
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21
Q

What is a serious side eff of MAOI’s

A

HTN crisis

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22
Q

What are some examples of MAOI’s

A

isocarboxzid
phenelzine
Tranylcypromine

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23
Q

What is a consideration with MAOI’s and antihypertensives

A

hypotension may develop

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24
Q

What should you do for MAOI and antihypertensive pats

A

monitor BP and notify MD of significant drop

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25
What analgesic may cause hyperpyrexia when given with MAOIs
meperidine
26
What food may increase the risk of HTN with MAOI's and why
caffeine and phenylethylamine | bec they cause vasoconstriction
27
What conditions is bupropion contraindicated
``` pregnancy seizure disorders MAOIs anorexia nervosa bulimia nervosa ```
28
What classes of meds are given as anti anx
benzodiazepines, barbiturates, beta-blockers
29
What are some common SE of anti anx meds
sedation confusion tolerance
30
What are some short acting benzodiasepine s
lorazepam oxazepam alprazolam
31
What are some long acting benzo's
diazapam | chlordiazepoxide
32
What are some short acting barbiturates
methohexital | thiopentone
33
What are some long acting barb's
phenobarbital | amobarbital
34
What are some common SE of mood stabilizers (antimanics)
sedation WeightG GI distress thristiness
35
What are some serious SE of mood stabilizers
hepatotoxicity
36
What are some mood stabilizers
lithium valporic acid Carbamazepine
37
How long does lithium take to start workign
5-7 day s
38
What is the care for pats takign lithium
Get lab lev after 12hours of first dose - Hold until lab levels are confirmed monitor for sign of toxiciity labs ev 2-3 days for therapeutic levels labs ev 1-3 months for maintenance level monitor sodium levels and signs of dehydration Dont skimp on dietary sodium drink 6-8 glasses of water per day use cautiously with heart and renal pats
39
What are the early signs of lithium tox (less than 1.5mEq/L)
dia N/V polyuria mus weakness
40
What are some signs of lithium tox from 1.5 to 2 mEq's
confusion tremors poor coordination
41
What are some signs of lithium tox from 2-2.5 mEq's
extreme polyuria tinnitus seizure coma death
42
What is the therapeutic level of lithium
0.5-1.5
43
What is some teaching for lithium meds
category D preg risk | so no breast feeding when taking it
44
What is a consideration for starting carbamazepine
Monitor blood levels weekly for the first 8 weeks
45
What are some CNS stimulants
amphetamine | methylphenidate
46
What are antipsychotics used to treat
``` hallucinations nightmares delusions paranoia agitation alt ment stat ```
47
What are some SE of first gen or conventional antipsychotics
extrapyrimidal effects like Dystonia- sudden mus spasms of the eyes back and neck restlessness (akathesia) parkinsons like problems liek pill rolliing tremors and shuffling gait tardive dyskinesia: involuntary movements like lip smacking chewing tongue protrusion
48
What is usu given for dystonia from antipsycho's
benadryl or benztropine
49
What is usu given for restlessness from antipsycho's
lorazepam
50
When does dystonia, akathesia, and pseudoparkinsonism from antipsycho's set in
4hrs for dystonia 4 weeks for pseudoparkisonisms 4 weeks akathesia
51
What is a common ending for 1st gen antipsychotics
azine
52
What type of med class is hadol and how strong is it
antipsychotic and its one of the strongest
53
Bec antipsychotics effect dopamine what hormone is affected and what are some conditions taht can result from this inference
prolactin doesnt get inhibited | galactorrhea and gynecomastia
54
What are some advantages of second gen antipsycho's
``` High tolerability rate Reduction of negative symptoms Lower rate of relapse Improve cognition with schizophrenia Decrease suicidal thoughts Decrease anxiety and depression less chance of ExtraPyr SE doesnt cause galactorrhea ```
55
What are some disadvantages of second gen antipsycho's
Metabolic dysregulation leading to diabetes High cholesterol and cardiac disease Hypertension Low self image
56
What might be given prophylactically with pats who are receiving second gen antipsycho's
metformin
57
Why is low self esteem a problem with 2nd gen antipsychs and what do we educate for it
weight gain is common | exercise
58
What are some common SE of second gen antipsycho's
Weight G sedation hypersalivation anticholernegic effects
59
What are some serios SE of 2nd gen antipsych
neuroleptic malignant syndrome | sudden death from QT prologation from ziprasidone quetiapine
60
What are some 2nd gen antipsych
clozapine risperidone quetiapine
61
What type of patient is clozapine helpful
suidcidal schizophrenia pats
62
What 2nd gen antipsych still has the risk of increased prolactin
risperidone | ziprasidone
63
What med is given to treat pseudoparkinsonism
amantadine
64
What med might be given to counteract the low dopamine levels from first gen antipsychs
levodopa
65
mani's of neuroleptic malignant syndrome
``` fever >103 HTN tachycardia mus rigidity elevated Creatine Kinase (CK) and WBC levels ```
66
What are the mani's of serotonin syndrom e
``` fever HTN tachycardia hyper reflexia diarrhea ```
67
What is the treatment for NMS
discon the med mon vital signs meds for fever transfer to ICU
68
What is the fisrt choice med for NMS and why
bromocryptine | bec it reduces fever and hypertonia
69
What med is given to reduce muscle breakdown in NMS pats
dantrolene
70
What is a consideration for a NMS pat that was taking decanoate
they may be in recovery for 7-10 days
71
What are the meds for tardive dyskinesia
none so far so advocate for less meds
72
What are some side effects of anticonvulsants
NV drowsiness or dizziness blood problems risk of suicide

Psych (14 decks)

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