psychotherapeutics

Question 1

Sedatives & Hypnotics (Barbiturates)

Example

Answer 1

Phenobarbital

Question 2

Sedatives & Hypnotics (Barbiturates)

Action

Answer 2

Depresses sensory cortex, alters cerebella functions

Question 3

Sedatives & Hypnotics (Barbiturates)

Contraindications

Answer 3

Pt with hypersensitivity to phenobarbital

dyspnea or airway compromised

Question 4

Sedatives & Hypnotics (Barbiturates)

Adverse effects

Answer 4

hypoventilation
Somnolence (sleepy)
Nausea
Bradycaria

Question 5

Anti Anxiety  (Benzo and non Benzo)
Example

Answer 5

Diazepam (Benzo) (Acute)

Hydroxyzine (non benzo) (chronic)

Question 6

Sedatives & Hypnotics (Barbiturates)

use

Answer 6

Sedative

manage seizures

Question 7

Anti Anxiety  (Benzo and non Benzo)
use

Answer 7

Manage anxiety

Question 8

Anti Anxiety  (Benzo and non Benzo)
Action

Answer 8

Most depress cns

Benzo: binds to benzodiazopam receptors in gaba receptors

Non Benzo: act on the brains dopamine and serotonin receptors

Question 9

Anti Anxiety  (Benzo and non Benzo)
Contraindications

Answer 9

Pt w/cns depression or pt w/ severe pain
Glaucoma
Pregnancy D
Impaired liver or kidney
Alcohol dependency
Tricyclic antidepressant

Question 10

Anti Anxiety  (Benzo and non Benzo) 
Patient Management

Answer 10

Have pt lie down for 30 minutes after taking

use caution with older patients

Question 11

Anti Depressant

TCA

Answer 11

Tricyclic Antidepressants

Question 12

TCA Action

Answer 12

increases level of serotonins by inhibiting the reuptake and block the action of acetylcholine

Question 13

TCA

Adverse reactions

Answer 13

dry mouth, 
blurred vission 
hypotension
urine retention 
constipation 
orthostatic hypotension

Question 14

TCA Contraindication

Answer 14

hypersnsitivity to TCA

within 14 days of maoi

Following MI

Question 15

TCA Example

Answer 15

Amitriptyline

Question 16

Anti Depressant MAOI

Answer 16

Monoamine Oxidase Inhibitors ( old version of anti depressants)

Question 17

MAOI Action

Answer 17

inhibits the activity of monoamine oxidase resulting in

increased endogenous neurohormones

Question 18

MAOI adverse reactions

Answer 18

Food interactions, 
Vertigo
Nausea
Constipation
Dry Mouth
Headache
Over activity (hyper)

Question 19

MAOI Contraindications

Answer 19

CVA disease
Hypertension
CHF
Elderly

Question 20

MAOI Example

Answer 20

Nardil

Question 21

Antidepressant SSRI

Answer 21

Selective serotonin reuptake inhibitors (common)

Question 22

SSRI action

Answer 22

increase serotonin by inhibiting neuronal uptake to cns

Question 23

SSRI Adverse reactions

Answer 23

Nausea, Vomiting
Sexual dysfunction
Insomnia

Question 24

SSRI Contraindication

Answer 24

Fluoxetine is less effective in pt who smokes

Question 25

SSRI Examples

Answer 25

Fluoxetine (prozac) | sertraline (zoloft)

Question 26

Anti depressant | SNRI

Answer 26

Serotonin-norepinephrine reuptake inhibitor (similar to adrenalin)

Question 27

Antipsychotic | Action

Answer 27

Block dopamine receptors

Question 28

Most antipsychotics exept for haloperidol are what?

Answer 28

phenothiazine

Question 29

What medication is a butyrophenone?

Answer 29

Haloperidol

Question 30

Second generation like Olanzapine, Clozapine, Quetiapine and risperidone have what?

Answer 30

Fewer adverse reactions

Question 31

Antipsychotic use

Answer 31

Treatment in acute and chronic psychosis

Question 32

The use of Chlorpromazine is also used to treat what?

Answer 32

Intractable hiccups

Question 33

Clozapine is limited to what illness?

Answer 33

Schizophrenia

Question 34

Anti Psychotic Adverse effects

Answer 34

``` Dry Mouth Hypotension sedation photophobia/sensitivity headache Extrapyramidal -parkinsons like sympyoms Akathisia Acute Dystonia acute Tardive Dyskinesia ```

Question 35

What is akathisia?

Answer 35

Extreme restlessness

Question 36

What is dystonia?

Answer 36

Facial grimacing and twisting of the neck

Question 37

What is Tardive dyskinesia

Answer 37

Irreversible involuntary dyskinetic movements, rhythmic movements of the tongue and mouth

Question 38

Neuroleptic malignant syndrome is mainly seen with what medication?

Answer 38

Haloperidol | Requires intensive symptomatic treatment

Question 39

Antipsychotic contraindications

Answer 39

Severely depressed | Hypotension

Question 40

Antipsychotic patient management

Answer 40

Assess deviation from normal poor eye contact Monotone

Question 41

Antipsychotic examples

Answer 41

Prochlorperazine | Haloperidol

Question 42

CNS Stimulants | Sub class

Answer 42

Amphetamines and anorexiants

Question 43

CNS Stimulant action

Answer 43

Produce CNS stimulation by increasing levels of neurotransmitters in the CNS Produce CNS and respiratory stimulation, dilated pupils, increased motor activity and mental alertness, and a diminished sense of fatigue. In children with ADHD these agents decrease restlessness and increase attention span

Question 44

CNS Stimulant use

Answer 44

The treatment of narcolepsy and as adjunctive treatment in the management of attention deficit hyperactivity disorder (ADHD).

Question 45

CNS Stimulant Adverse reactions

Answer 45

``` Headache, dizziness, apprehension Over stimulation of the CNS Insomnia, tachycardia, blurred vision, blurred vision ```

Question 46

CNS Stimulant Contraindication

Answer 46

``` Moderate to severe, Hypertension, stroke Glaucoma Hypersensitivity to Amphetamines: Risk of physical dependence ```

Question 47

CNS Patient management

Answer 47

Take the drug in the morning 30-45 minutes before breakfast and before lunch. Insomnia and anorexia usually disappear during continued therapy. May be given on only school days. Do NOT increase the dose or take the drug more frequently. Decrease coffee or caffeine.

Question 48

CNS stimulant examples

Answer 48

Methylphenidate HCL: Concerta (amphetamine) Dextroamphetamine: Adderall (amphetamine) Phentermine: Ionamin (anorexiant )