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NURS 252 (Pharmacology 2) > Psychotherapeutic Drugs > Flashcards

Psychotherapeutic Drugs Flashcards

1
Q

What are psychotherapeutic drugs?

A

Drugs used in the treatment of emotional and mental disorders

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2
Q

What are the 3 main mental health disorders?

A

Anxiety
Affective (Mood) Disorders
Psychotic disorders

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3
Q

What are the 4 types of psychotherapeutic drugs?

A

Anxiolytic drugs
Mood-stabilizing drugs
Antidepressant drugs
Antipsychotic drugs

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4
Q

What are anxiolytic drugs and name an example

A

Reduce anxiety by reducing overactivity in the CNS
Benzodiazepines

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5
Q

Name 3 benzodiazepines

A

Alprazolam
Diazepam
Lorazepam

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6
Q

What are the adverse effects of benzodiazepines?

A

Decreased CNS activity, sedation, amnesia
Hypotension
Drowsiness, loss of coordination, dizziness, headaches
Nausea, vomiting, dry mouth, constipation

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7
Q

What is the antidote for an OD on benzodiazepines?

A

Flumazenil

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8
Q

What is alprazolam(xanax)? (ID, IE, AE)

A

ID: Anxiolytic, short-term relief of symptoms, panic disorder and anxiety associated with depression
AE: Confusion, ataxia, headache
IE: Alcohol, antacids, oral contraceptives

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9
Q

What is diazepam?(ID, CI, AE, IE)

A

ID: Anxiety, alcohol withdrawal, status epilepticus, preop sedation, adjunctly for muscle spasms
CI: Hepatic dysfunction
AE: Headache, confusion, slurred speech
IE: Alcohol, oral contraceptives

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10
Q

What is lorazepam(ativan)?(ID, routes)

A

Intermediate-acting
IV or IM
Acutely agitated pts, continuous infusion for agitated patients undergoing mechanical ventilation
Treatment or prevention of alcohol withdrawal

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11
Q

What are mood-stabilizing drugs?

A

Drugs used to treat bipolar disorder

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12
Q

Name 2 mood-stabilizing drugs

A

Lithium carbonate
Lithium citrate

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13
Q

What is a consideration for lithium drug treatment?

A

It has a narrow therapeutic range so it needs blood monitoring
Keeping sodium levels normal helps maintain therapeutic lithium levels

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14
Q

What are the adverse effects of lithium?

A

Cardiac dysrhythmia, drowsiness, slurred speech, epilepsy-type seizures, chore athetotic movements, ataxia, hypotension
Hypothyroidism

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15
Q

Name 2 first generation antidepressants

A

Tricyclics and MAOIs

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16
Q

Name 2 second generation antidepressants

A

SSRIs
Serotonin-norepinephrine reuptake inhibitors (SNRIs)

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17
Q

Name a tricyclic antidepressant and what is the MOA?

A

Amitriptyline
Block reuptake of neurotransmitters, causing accumulation at the nerve endings

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18
Q

What are the indications for amitriptyline?

A

Neuropathic pain, insomnia, anorexia, migraines

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19
Q

Although there is no specific antidote, what are treatments for an OD on tricyclics?

A

Activated charcoal
Speed elimination by alkalinizing urine
Manage seizures and dysrhythmias
basic life support

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20
Q

What are the contraindications and adverse effects of amitriptyline?

A

CI: pregnancy, MI
AE: dry mouth, constipation, blurred vision, urinary retention, dysrhythmias

21
Q

Name 2 nonselective and 1 selective MAOIs

A

NS: Phenelzine sulphate, tranylcypromine sulphate
S: Selegiline HCL

22
Q

What is a disadvantage for taking MAOIs?

A

There is a potential to cause a hypertensive crisis when taken with tyramine

23
Q

What food contain tyramine?

A

Aged, mature cheeses
Smoked, pickled and aged meats, fish and poultry
Yeast extracts
Red wines
Italian broad beans

24
Q

What are the indications for 2nd gen antidepressants?

A

Depression, BPD, ED, OCD, panic attacks, PTSD, Substance misuse, social anxiety disorder, premenstrual dysphoric disorder, neurologic disorder myoclonus

25
Q

What are the adverse effects of 2nd gen antidepressants?

A

Insomnia, weight gain, sexual dysfunction
Serotonin syndrome:
Increase of the effect of serotonin on CNS
s/s: delirium, tachycardia, sweating, muscle spasms, hyper reflexes, shivering, tremors

26
Q

What is bupropion HCL?

A

2nd gen antidepressant indication for depression and smoking cessation
AE: Dizziness, agitation, tremors, dry mouth

27
Q

What is duloxetine HCL? (ID, AE, IE, CI)

A

SNRI
ID: Depression, GAD, Pain resulting from diabetic neuropathy or fibromyalgia, chronic back pain, osteoarthritis
AE: Dizziness, drowsiness, headache, GI upset, anorexia and hepatotoxicity
IE: SSRIs, triptans and alcohol
CI: Angle-closure glaucoma, MAOIs

28
Q

What is fluoxetine? (ID, AE, CI)

A

SSRI
ID: Depression, bulimia, OCD, Panic disorder, Premenstrual dysphoric disorder
CI: MAOI
AE: anxiety, dizziness, drowsiness, insomnia

29
Q

What are antipsychotics?

A

Drugs used to treat serious mental illness:
Psychoses, autism, schizophrenia
Also used to treat extreme mania, BPD, depression resistant to other meds, certain movement disorders (Tourette’s)

30
Q

What are the 3 classes of antipsychotics?
Name the drugs we are to know in the classes

A

Conventional/1st gen: Haloperidol
2nd gen
Atypical: Clozapine, risperidone

31
Q

What is the MOA of antipsychotics?

A

Block dopamine receptors in the brain, areas associated with emotion, cognitive function and motor function

32
Q

What are the positive and negative symptoms of schizophrenia?

A

P: Hallucinations, delusions and conceptual disorganization
N: Apathy, social withdrawal, blunted affect, poverty of speech and catatonia

33
Q

T/F: Conventional (1st gen) antipsychotics are effective at treating positive and negative schizophrenia symptoms

A

F: Atypical antipsychotics are effective at treating positive and negative schizophrenia symptoms.
Conventional are less effective in managing negative symptoms

34
Q

What are the indications for antipsychotics?

A

Psychotic illness, commonly schizophrenia
Anxiety and mood disorders

35
Q

What is NMS?

A

Neuroleptic malignant syndrome
High fever, unstable BP, myoglobinemia

36
Q

What is EPS?

A

Extrapyramidal symptoms:
Involuntary muscle symptoms similar to parkinsons
Akathisia (distressing muscle restlessness)
Acute dystonia (painful muscle spasms)

37
Q

What is used to treat EPS?

A

Benztropine and trihexyphenidyl

38
Q

What are the adverse effects of antipsychotics?

A

Tardive dyskinesia (Involuntary contracts of oral and facial muscles)
Insulin resistance
Weight gain
Abnormal serum lipid levels
Cardiometabolic syndrome
Agranulocytosis (Decreased WBC)
Hemolytic anemia (Breakdown of RBCs)

39
Q

What is Haloperidol? (ID, CI, Routes)

A

1st gen antipsychotic
ID: Long-term treatment of psychosis
CI: Parkinson’s, CNS depressants
PO, IM

40
Q

What is the MOA of atypical antipsychotics?

A

Block dopamine and serotonin receptors

41
Q

What is clozapine?

A

Atypical antipsychotic
Associated with minor or no EPS
AE: Blood dyscrasias

42
Q

What is risperidone?

A

Atypical antipsychotic
ID: Schizophrenia
AE: Minimal EPS at therapeutic dosages of 1 to 6 mg/day

43
Q

What is st. john’s wort? (ID, AE, IE)

A

ID: Depression, anxiety, sleep disorders, nervousness
AE: GI upset, fatigue, dizziness, dry mouth, photosensitivity
IE: MAOIs, SSRIs, Tyramine

44
Q

What can be done to prevent the risk of suicide attempts?

A

Only dispense small amounts of medication at a time

45
Q

What is a consideration regarding antidepressants?

A

May take several weeks to see therapeutic effects

46
Q

What is a consideration regarding antidepressants for pts preparing to undergo surgery?

A

Tricyclics may need to be weaned and discontinued to avoid interactions with anesthetic drugs

47
Q

What is a consideration regarding antipsychotics?

A

Wear sunscreen because of photosensitivity

48
Q

Avoid taking antacids within __________ of antipsychotics

A

1 hour

49
Q

What are the therapeutic levels of lithium?

A

0.6 to 1.2 mmol/L

NURS 252 (Pharmacology 2) (23 decks)

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