Psychotherapeutic Drugs

Question 1

Risperidone IM injection duration

Answer 1

Approx. 2 weeks

Question 2

MAOI’s tyramine foods

Answer 2

aged mature cheeses, smoked, pickled meats, yeast extracts, red wines, italian broad beans

Question 3

Ingestion of tyramine foods with psychotherapeutics leads to:

Answer 3

hypertensive crisis, which may lead to cerebral hemorrhage, stroke, coma or death

Question 4

Involuntary muscle symptoms similar to those of PD

Answer 4

extrapyramidal symptoms

Question 5

Distressing muscle restlessness

Answer 5

Akathisia

Question 6

Painful muscle spasms

Answer 6

acute dystonia

Question 7

What medication is used to treat extrapyramidal symptoms?

Answer 7

benztropine (Cogenetin) and trihexyphenidyl (Artane)

Question 8

Drug of choice for mania

Answer 8

Lithium

Question 9

When levels of litihium exceed 1.5-2.0 mmol/
L begin to produce toxicity including GI discomfort, tremor, confusion, somnolence, seizures, and possibly death

Answer 9

Lithium toxicity

Question 10

What helps maintain therapeutic lithium levels

Answer 10

Normal sodium range

Question 11

What is the therapeutic level for lithium?

Answer 11

0.6-1.2 mmol/L

Question 12

Clozapine (Clozaril) AE:

Answer 12

blood dyscrasia- any disorder affecting the blood, lymphoid tissue, bone marrow, or blood coagulation process

Question 13

St. John’s wart interactions

Answer 13

tyramine foods, MAOIs and SSRIs

Question 14

What is somnolense?

Answer 14

sleepiness during the day

Question 15

Antidepressant onset

Answer 15

May take up to 8 weeks to see therapeutic effects

Question 16

SSRI patient teaching:

Answer 16

Fiber supplement must be taken atleast 2 hrs before or after to avoid interaction with drug absorption.

Question 17

Which drugs require a tapering dose of 2 months to discontinue

Answer 17

SSRIs

Question 18

Discontinuation syndrome

Answer 18

happens with or without tapering. Dizziness, diarrhea, movement disorders, insomnia, irritability, visual disturbances, lethargy, anorexia, and lowered mood

Question 19

A rare collection of symptoms resulting from elevated levels of neurotransmitter serotonin; may occur with use of any psychotropic drug that enhances brain serotonin activity such as antidepressants, buspirone, tramadol

Answer 19

serotonin syndrome

Question 20

A potentially hazardous adverse effect of any drug or combination drug with serotonergic activity

Answer 20

serotonin syndrome

Question 21

A patient is on clozapine (Clozaril) therapy for 2 months. What beverage(s) should the nurse instruct the patient to avoid?
a) grapefruit juice
b) apple juice
c) cola
d) caffeinated tea
e) fruit mix beverage of apple, mango, and grapefruit

Answer 21

a, e

Question 22

The nurse is administering clozapine (Clozaril.) What long term monitoring that is associated with this medication should the nurse prioritize? select all.
a) mood swings
b) agranulocytosis
c) weight gain
d) postural hypotension

Answer 22

b, c

Question 23

A patient is on selective serotonin reuptake inhibitor medication. What possible adverse effect should the nurse instruct the family to monitor as a priority?
a) visual disturbances
b) tardive dyskinesia
c) suicidal thoughts
d) bleeding tendencies

Answer 23

c) suicidal thoughts

Question 24

The caregiver of a patient who has started on antidepressant therapy asks the nurse “ how long will it take for him to feel better?” What is the best response by the nurse?
a) well, depression rarely responds to medication therapy
b) he should be feeling better in a few days
c) it make take 4-6 weeks before you see an improvement
d) you may not see any effects for several months

Answer 24

c) it may take 4-6 weeks before you see an improvement

Question 25

A patient was started on an antipsychotic drug that results in extrapyramidal effects. What clinical manifestations should the nurse monitor? select all a) tremors b) elation and a sense of well being c) painful muscle spasms d) motor restlessness e) bradycardia

Answer 25

a, c, d

Question 26

A patient has been taking antipsychotic medication for years, and his wife has noticed that he has had some new physical symptoms. She describes him as having odd facial movements, sticking out his tongue, and having movements of his arms that he cannot seem to control. The nurse suspects that the patient is exhibiting signs of which condition? a) hypomania b) serotonin syndrome c) tardive dyskinesia d) neuroleptic malignant syndrome

Answer 26

c) tardive dyskinesia

Question 27

The unpleasant state of mind in which real or imagined dangers are anticipated or exaggerated or both

Answer 27

anxiety

Question 28

A state characterized by an expansive emotional state (including symptoms of extreme excitement and elation) and hyperactivity.

Answer 28

mania

Question 29

A group of psychotropic drugs prescribed to alleviate anxiety

Answer 29

benzodiazepines

Question 30

Emotional disorders characterized by changes in mood

Answer 30

affective disorders

Question 31

A major psychological disorder, characterized by episodes of mania or hypomania, cycling with depression

Answer 31

bipolar affective disorder

Question 32

Patients taking MAOIs need to be taught to avoid foods containing which substance?

Answer 32

tyramine

Question 33

An older class of antidepressant drugs

Answer 33

tricyclics

Question 34

An abnormal emotional state characterized by exaggerated feelings of sadness, melancholy, and worthlessness out of proportion to reality.

Answer 34

depression

Question 35

A long acting benzodiazepine

Answer 35

diazepam (Valium)

Question 36

The most widely used tricyclic antidepressant

Answer 36

amitriptyline (Elavil)

Question 37

An atypical antipsychotic drug used to treat anxiety

Answer 37

risperidone (Risperdal)

Question 38

A nonbenzodiazepine drug used to treat anxiety

Answer 38

buspirone

Question 39

Term for symptoms or adverse effects that often occur with antipsychotic medications

Answer 39

extrapyramidal

Question 40

Medication used to treat mania

Answer 40

lithium

Question 41

A type of serious medical illness that can take several different forms and is associated with being truly out of touch with reality

Answer 41

psychosis

Question 42

Anxiolytic drugs

Answer 42

benzodiazepines and buspirone

Question 43

Drugs that reduce anxiety by reducing overactivity in the CNS

Answer 43

anxiolytic drugs

Question 44

The nurse is caring for a patient experiencing ethanol withdrawal. The nurse expects to administer which medication or medication class as treatment for this condition? a) lithium (Carbolith) b) benzodiazepines c) buspirone d) antidepressants

Answer 44

b) benzodiazepines

Question 45

The nurse is teaching a patient receiving MAOIs. What food product should the nurse teach the patient to avoid? a) orange juice b) milk c) shrimp d) swiss cheese

Answer 45

d) swiss cheese (tyramine food)

Question 46

The nurse calls a patient to schedule a follow up visit after the patient has been treated for depression for 4 weeks. What concern will the nurse assess for during the conversation with the patient? a) weakness b) hallucinations c) suicidal ideation d) difficulty with urination

Answer 46

c) suicidal ideation

Question 47

The nurse is caring for a patient who has been taking clozapine (Clozaril) for 2 months. Which laboratory test(s) should be performed regularly while the patient is on this medication? a) platelet count b) WBC count c) liver function studies d) kidney function studies

Answer 47

b) WBC count

Question 48

The nurse is giving medications to a patient. Which drug class, when administered with lithium, increases the potential for lithium toxicity? a) thiazides b) levofloxacin c) calcium citrate d) beta blockers

Answer 48

thiazides

Question 49

A patient who has been taking lithium for 6 months has had severe vomiting and diarrhea from a GI flu. The nurse will assess for which potential problem at this time? a) anxiety b) chest pain c) agitation d) dehydration

Answer 49

d) dehydration

Question 49

The nurse is teaching a patient about treatment with an SSRI antidepressant. Which teaching considerations are appropriate? select all. a) the patient should be told which foods contain tyramine and instructed to avoid these foods b) the patient should be instructed to use caution when standing up from a sitting position c) the patient should not take any products that contain the natural health product St. John's wort d) This medication should not be stopped abruptly e) drug levels may become toxic if dehydration occurs f) the patient should be told to check with the health care provider before taking any OTC medications

Answer 49

b, c, d, f

Question 50

A 22 yr old patient who has been taking lithium for 3 months has had severe vomiting and diarrhea from a GI flu. What is the nurse's priority assessment at this time?

Answer 50

Priority assessment is to look for dehydration and changes in mental status. Fluid loss lead to dehydration, dangerous for patients taking lithium because dehydration and sodium imbalances lead to lithium toxicity.

Question 51

A 68 yr old patient has been taking SSRI antidepressant for 5 weeks. His wife calls and expresses concern because he has started to give away some of his keepsakes. What is the nurses priority action.

Answer 51

Priority is to watch for suicidal idealation which may increase during the weeks after antidepressant therapy has started. Nurse should instruct the wife to bring her husband in asap for exam and don't leave him alone