Psychotherapeutic Drugs Flashcards by Joshua Layton

What type of drugs treat anxiety?

Anxiolytics

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What type of drugs treat affective disorders? What conditions do they treat?

Antidepressants (depression)
Mood stabilizers (bipolar)

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What condition is a psychosis disorder? What is used to treat it?

Schizophrenia (antipsychotics)

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What are the 5 main anxiety disorders?

Panic disorder without agoraphobia
Generalized anxiety disorder
OCD
social anxiety
PTSD

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What are the Sx of a pt with a panic disorder?

Increased HR
Hyperventilation
SOB
sweating

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What is agoraphobia?

Specifically avoiding certain environments or situations due to possible anxiety attack

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What is classifies an individual with General Anxiety Disorder (GAD)?

Pt gets anxiety from regular everyday things
interferes with everyday life
last longer than 6 months

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What are the Sx of GAD?

Fatigue

Irritability

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What is Obsessive compulsive disorder? Example?

A compulsion to do something to deal with an obsession

Germaphobe
Obsession-germs
Complusion-washing hands all the time

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What is an example of a social phobia?

Public speaking

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What type of pt often experience PTSD?

Military
First responders
Police

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What can cause PTSD? What are Sx of it?

An event can cause it

Sx
Flash backs
Night terrors

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What physiological event causes anxiety? How can it be caused?

Overactive limbic system

Due to
limbic system overacting
personal insecurities
Psychological conflicts

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What are the Sx of anxiety?

Sweat palms
Trembling
Nausea
No appetite
Tachycardia
Emotional

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What part of CNS effect anxiety?

Limbic system

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What part of PNS effects anxiety?

Sympathetic system

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What is the MOA for anxiolytics?

GABA-A (increasing Cl- permeability)

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What is the Fxn of benzodiazepines?

Depress activity of brainstem and limbic system

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What are the 4 SOA for Benzodiazepines? What type of drugs are used there?

Limbic system-anxiolytics
RAS-sedative, hypnotic
Spinal cord-muscle relaxants
Cerebral cortex- anticonvulsants

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What are benzodiazepines indicated for?

Alcohol w/drawl

Conscious sedation

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What type of benzodiazepines are long acting?

Chlordiazepoxide
Clonazepam
Diazepam

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What type of long acting benzodiazepine is used for alcohol withdrawal?

Chlordiazepoxide

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What type of benzodiazepines are short acting?

Alprazolam

Lorazepam

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What is Buspirone(BuSpar)? MOA? How often is it administered? Why is it used more than benzodiazepines?

Miscellaneous anxiolytic

Blocks 5HT1a auto receptor

Administered BID (2x daily)

Less abuse potential than benzodiazepines

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What can cause increased risk of schizophrenia?

Environment=drug abuse | Genetics=both parents having schizophrenia (40x chance increase)

What do positive Sx mean?

Sx that are added to a pt

What do negative Sx mean?

Sx, attitudes and personality that is taken away from pt.

What are the positive Sx of schizophrenia?

Delusions Hallucinations Thought disorders Bizarre behavior

What type of hallucinations are seen in schizophrenic pt?

Tactile, auditory, visual

What age does schizophrenia usually develop in?

16-30yo

What percent of Americans have schizophrenia?

1.1%

What are the negative Sx of schizophrenia?

``` Flattened emotions (robotic) Emotional/social withdrawal ```

What are the cognitive Sx of schizophrenia?

Short term memory decrease Attention deficit -can’t remember or learn new things

What is the physiology of schizophrenia?

Increased 5HT and DA in the limbic and cortical pathway

What are possible neuropathways affected by schizophrenia? What do those area effect?

Mesolimbic-mood and behavior Mesocortical-pleasure and reward Nigrostristal-movement center Tuberoinfundibular-connected to hypothalamus and pituitary

What does PRL do?

Milk production Breast development Decrease GnRH Decrease libido

What is another name for DA? What does it do?

PIH | It inhibits prolactin

What types of drugs are used for schizophrenia?

5HT2a and DA2 antagonist

What are the 2 types of antipsychotics? What do they do?

Typical-DA2 antagonists (block DA2 receptors) Atypical-5HT2a antagonists(block 5HT2a receptors)

How long do antipsychotics take to onset?

2-3 weeks

What is phenothiazine drugs? What does it effect? EPS?

Typical antipsychotic Peripheral effect(highest) Less EPS

What is butyrophenons drugs? What does it effect? EPS?

Typical antipsychotic Less peripheral effect More EPS

What is Thioxanthenes drugs? What does it effect? EPS?

Typical antipsychotic Less peripheral effect More EPS

What is chlorpromazine(Thorazine)? What is it used for?

Phenothiazine Used for schizophrenia/Mental institution drug you can take home

What is thioridazine(Mellaril)? What is it used for?

Phenothiazine Used for schizophrenia/mental institution drug you can take home

What are the 2 types of phenothiazine medications you can take home?

Chlorpromazine | Thioridazine

What are the 2 effects of typical antipsychotic drugs? How long does it take to onset?

Reduce mania Reduce agitation 2-3 weeks

What type of receptors does typical antipsychotics block? What does is a ADR of that receptor being blocked?

DA2, 5HT2a and alpha receptors=orthostatic hypotension Muscarinic receptors=constipation Histamine-1 receptor= sleepiness

What does EPS stand for? What does it mean?

Extrapyramidal syndrome Movement disorder

What is dystopia?

Facial/neck spams

What is akathesia?

Severe restlessness of thighs and abs

What is Parkinsonism?

Resting tremors

What is tardive dyskinesia?

Involuntary movements of lips, jaw, tongue and extremities Usually large movements

What are the 4 different types of EPS?

Dystopia Akathesia Parkinsonism Tardive Dyskinesia

Which type of typical antipsychotics drugs cause EPS?

Butyrophenones= Haloperidol(Haldol) Thioxanthenes= Thiothixene(Navane)

What is the MOA for atypical antipsychotics?

Block 5HT2a receptors more than DA2 receptors

What are the 7 different atypical antipsychotics?

``` Aripiprazole(Abilify) Olanzapine(Zyprexa) Quetiapine(Seroquel) Risperidone(Risperdal) Ziprasidone(Goedon) Paliperidone(Invega) Lurasidone(Latuda) ```

What is the preferred therapy for schizophrenia?

Atypical antipsychotic

What is the benefit to ADR for atypical antipsychotics?

ADR - weight gain - hyperglycemia - hyperlipidemia Benefits - less peripheral - less EPS

What are the 3 types of depression and examples?

Reactive depression -goes away without drugs Major Depressive Disorder(MDD) -d/t biochemical imbalance Bipolar Mood disorder -alternating mania and depressive moods

What is mania?

Very high highs followed by very low lows

What is the major cause of depression?

Decreases levels of NE and 5HT in brain

What are the 3 classes of antidepressants?

SSRIs Atypical SSRIs TCAs MAOIs

How do SSRIs work?

Inhibit 5HT reuptake to increase serotonin in synapse

What are the 2 different types of atypical SSRIs? What do they do?

SNRIs -inhibit 5HT/NE reuptake to increase in synapse NDRIs -inhibit NE/DA reuptake to increase in synapse

What is the MOA for antidepressants?

Blocks reuptake of neurotransmitters

Where to SSRIs work?

Limbic and cortical areas of the brain

What are the 6 typical SSRIs? What do they stimulate?

``` Citalopram(Celexa) Escitalopram(Lexapro) fluoxetine(Prozac) paroxetine(Paxil) sertraline(Zoloft) Vortioxetine(Trintellix) ``` Stimulates CNS

What are the indications for typical SSRIs?

MDD PTSD OCD Premenstrual Dysphoric disorder(extremely moody)

What is used to Tx premenstrual dysphoric disorder?

Fluoxetine(Prozac) | Sertraline(Zoloft)

What are the ADRs of typical SSRIs?

- decreased libido(sexual dysfunction) - suicidal thoughts(first 2-3 weeks) - serotonin syndrome

What is serotonin syndrome? What are the Sx?

Increased serotonin in body increases sympathetic response Sx - tachycardia - hyperthermia - muscle spasms - diaphoresis

What are the name of the 6 SNRIs that are atypical SSRIs?

``` Venlafaxine(Effexor), desvenlafaxine(Pristiq) levomilnacipran(Fetzima) duloxetine(Cymbalta) Trazodone(Desyrel) vilazodone(Vllbryd) ```

What SNRI is used to induce sleep?

Trazadone(Desyrel)

What is the NDRI that helps a pt stop smoking?

Bupropion(Wellbutrin)

What are pharmacogenomic/pharmacogenetics? What is it based on?

Using genetics to determine the best medication to give Based on pharmacodynamics and pharmacokinetics

What are the two types of TCAs? What do they do?

Tertiary amine(increase 5HT more than NE) Secondary amine(increase NE more than 5HT)

What is Nortriptyline(pamelor)?

TCA-Secondary amine

What is Amitriptyline(Elavil)?

TC-tertiary amine

What are the 4 ADR of TCAs?

Constipation Orthostatic hypotension Sleepy Alterations in EKG

What is another name for TCAs?

Tricyclics

What is the DOC for mania? What does it do?

Lithium Lowers Na+

What is the normal range of lithium levels?

0.6-1.2 mEg/L

What is the DOC for MDD? If that drug doesn’t work what medication is given?

SSRIs Then atypical SSRIs

When administering anti-anxiety medication, what should a nurse closely monitor for elderly pt?

CNS depression | Liver and kidney function

What would a nurse tell a teen pt parent about taking antidepressants?

2-3 weeks to onset | Possible suicide tendencies

Why would a nurse assist with ambulation of a older pt taking antidepressants?

ADR can cause drowsiness and postural hypotension

When going out into the sun a pt on phenothiazine should?

Wear sunscreen because phenothiazine increase photo sensitivity

What shouldn’t be taken with antipsychotics line phenothiazine?

Alcohol and CNS depressants

What are the 4 uses for benzodiazepine?

Anti anxiety Seizures Preoperative med Alcohol withdrawal

What atypical SSRI helps with sleep?

Trazadone(Desyrel)

What time should antidepressants be taken? Morning or night?

Mornings

What Tx mania and bipolar disorder?

Lithium

What loads the gun and pulls the trigger?

Genetics loads the gun and environment pulls the trigger

Psychotherapeutic Drugs Flashcards

(94 cards)