PSYCHOTROPIC MEDS Flashcards by Megan miller

antipsychotics: target symptoms

positive symptoms; agitation, hallucinations, delusions, combativeness/belligerent behavior, sleep disturbance, tension, paranoid behavior/disorganized thinking

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antipsychotics: symptoms less likely to respond

negative symptoms; impaired judgement, lack of insight, depression and withdrawal, poor motivation

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antipsychotics: side effects

sedation, postural hypotension, weight gain, photosensitivity, sexual dysfunction, breast swelling, anticholinergic (dry mouth, blurred vision, urinary hesitation, constipation), tardive dyskinesia, acute dystonic reactions (involuntary muscle spasms or tightening of face), neuroleptic malignant syndrome (medical emergency, fever, muscle rigidity, mental status changes)

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antipsychotics: tardive dyskinesia side effect treat

limit antipsychotic exposure, use vitamin E for prevention

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antipsychotics: extrapyramidal symptoms (parkinsonian movements) treat

Artane, Cogentin, benadryl

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antipsychotics: common atypical; clozapine

clozaril
different action
side effects–high saliva production, sedation, nausea, hypotension, dizziness, weight gain, risk of seizures; no tardive dyskinesia
need for weekly blood monitoring

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antipsychotics: common atypical; resperidone

riserdal
injectable
side effects; sedation, some headache, dry mouth, constipation, blurred vision, palpitations, no tardive dyskinesia
question of relief for positive and negativesymptoms

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antipsychotics: newer meds

apriprazole--abilify 
ziprasidone--geodon
quetiapine--seroquel 
olanzapine--zyprexa
asenapine-saphris
paliperidone palmitate--invega sustenna
paliperidone-invega
illoperidone--fanapt

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tricyclic antidepressants: side effects

autonomic, anticholinergic (dry mouth, blurred vision, constipation, urinary probs, sweating/heat sensitivity), pustural hypotension, tachycardia, change in EKG arhythmias

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tricyclic antidepressants: contraindicated for

people with heart disease, lethal in high doses so not good for suicidal pts

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tricyclic antidepressants: therapeutic effects in

2-3 weeks

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monoamine oxidase inhibitors (MAOIs): most effective for

atypical and nonendogenous depression

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monoamine oxidase inhibitors (MAOIs): side effects

hypertension with high dose or when tricyclic/stimulant also taken

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monoamine oxidase inhibitors (MAOIs): adverse drug reactions

stimulants, appetite suppressants, cold remedies, cocaine derivatives, anything that raises blood pressure

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monoamine oxidase inhibitors (MAOIs): dietary restrictions

food with high levels of tyramine; avoid beer/ale, wine, cheese, smoke/pickled fish, beef/chicken liver, summer sausage, italian beans, yeast vitamin supplements

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second generation antidepressants: benefits

reduced, different side/averse effects

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second generation antidepressants: SSRIs therapeutic efficacy similar to

TCAs (tricyclic acids)

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second generation antidepressants: SSRIs side effects are dose related

weight loss, nausea, diarrhea, nervousness (fluoxetine/prozac), insomnia, sexual dysfunction with long term use, less toxic to heart and safer in overdose than TCAs

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second generation antidepressants: SNRIS side effects dose related

dry mouth, loss of appetite, nausea, diarrhea, constipation, nervousness, insomnia, elevated blood pressure and sexual problems
less toxic and safer in overdose

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mood stabilizers: lithium

narrow therapeutic index; need blood levels/kidney/thyroid checked regularly

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mood stabilizers: lithium side effects

thyroid can enlarge and underactive (treat with thyroid replacement meds)
renal kidney impact, need to drink more water for dehydration
gastrointestinal (anorexia, cramps, nausea, vomiting)
CNS (mental dullness, decreased memory and concentration, headache, hand tremors, fatigue and lethargy, weight gain)

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mood stabilizers: lithium; don’t take

during first trimester of pregnancy

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mood stabilizers: sometimes combined

with antidepressant or antipsychotic

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mood stabilizers: therapeutic effect

2+ weeks to build dosage to therapeutic level, need LI does multiple times a day

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mood stabilizers: response rate

70-90% with typical bipolar respond, most effective at preventing mania not depression

mood stabilizers: anticonvulsants to stabilize mood; carbamazepine

tegretol avoid during pregnancy, may depress bone marrow function (blood count monitoring) patient needs to report signs of infection or bleeding ASAP

mood stabilizers: anticonvulsants to stabilize mood; valproic acid

depakote more effective for rapid cycling and mixed bipolar avoid during pregnancy

anxiety medications: panic disorder with or without agoraphobia

TCAs, MAOIs, SSRIs, alprazolam/xanax

anxiety medications: OCD

TCAs (clomipramine/Afafranil), MAOIs, SSRIs (fluvoxamine/Luvox, sertraline/Zoloft)

anxiety medications: specific phobias and social phobia

``` beta blockers (propanolol) to treat somatic symptoms of stage fright paxil for social phobia ```

anxiety medications: GAD, benzos; side effects

impaired muscle coordination, impairment of short term memory

anxiety medications: GAD, benzos; can also be used for detox of

alcohol or other depressants to prevent seizures

anxiety medications: GAD, benzos; safer and more effective than

barbiturates

anxiety medications: GAD, benzos; treatment issues

chronic use vs PRN, relapse vs withdrawal after meds discontinued, abuse liability, hard to discontinue, over use; drug most often used in overdose

anxiety medications: GAD, barbiturates

high abuse potential/safety problem, hard to separate anxiolytic and sedative doses, dangerout when used with alcohol

anxiety medications: GAD, barbiturates formerly used

methaqualone (quaaludes), hydroxyzine (atarax, vistaril), meprobamate (Milltown)

anxiety medications: GAD; antipsychotics

no more effective than benzos, more side effects, combo with anxiolytic in psychotic patient with high anxiety

anxiety medications: GAD, can use buspirone/buspar but

takes 2-6 weeks to relieve symptoms and not as good a PRN option

meds for sleep (hypnotics): benzos have less probabilty to tolerance

to hypnotic effects than with barbiturates

hyperactivity in kids: psychostimulants are standard: side effects

insomnia, decreased appetite, stomachace, headaches, jitteriness

hyperactivity in kids: meds; methylphenidate

ritalin and concerta

hyperactivity in kids: meds; amphetamine

adderall

hyperactivity in kids: meds; pemoline

cylert

hyperactivity in kids: meds; lisdezamfetamine

vyvanse

hyperactivity in kids: meds; other options; aripiprazole, ziprasidone, guanfacine, cloridine

ability, geodon, intuniv, kaprav

autism spectrum; not approved by FDA but use

SSRIs, TCAs, psychoactive antipsychotics, stimulants, antianxiety meds

``` Thorazine/chlorpromazine Stelazine/trifluoperazine Mellaril/thioridazine Prolixin/fluohenazine (prolixin D injectable) Navene/thiothixene Haldol/haloperidol ```

Typical antipsychotics

Clozapine/clozaril Reperidone/risperdal (available as injectable) ``` Apriprazole/abilify Ziprasidone/geodon Quetiapine/seroqeul Olanzapine/zyprexa Asenapine/saphris Paliperidone palmitate/inveva sustenna Paliperidone/invega Illoperidone/fanapt ```

Atypical antipsychotics

``` Imipramine/tofranil Amitriptyline/elavil Nortriptyline/aventyl, pamelor, norpress Desipramine/norpramin, pertofrane Doxepin/adapin, deptran, sinequan ```

Tricyclic antidepressants

Phenelzine/Nardill Tranylcypromine/parnate Isocarboxazid/marplan

MAOIs (Minoan is oxidase inhibitors) antidepressant

``` Amoxapine/asendin Trazadone/desyrel Maprotiline/ludiomil Bupropin/Wellbutrin Venlaxafine/Effexor Nafazadone/serzone ```

Second generation antidepressants

Fluoxetine/Prozac Sertraline/Zoloft Paroxetine/Paxil Vilazodone/vilbryd

SSRIs

Duloxetine/cymbalta | Desvenlafaxine/pristiq

SNRIs

Lithium

Mood stabilizer

``` Carbamazepine/tegretol Valproic acid/depakote Gabapentin/neurontin Lamotrigine/lamictal Toprimate/topomax ```

Anticonvulsants to stabilize mood

Panic disorder with or without agoraphobia

TCAs, SSRIs, MAOIs, Xanax/alprazolam

OCD

TCA MAOI SSRI (Luvox/fluvoxamine, sertraline/Zoloft)

``` Beta blockers (propranolol) Paxil ```

Somatic symptoms of stage fright | Social phobia

Diazepam/Valium Chlordiazepam/Librium Lorazepam/Ativan Clorazepate/tranxene

Benzos

Amobarbital Secobarbital Penobarbital

Barbiturates

Benzos Flurazepam/dalmare Triazolam/halcion Temazepam/restoril Barbiturates-chloral hydrate Trazadone/desyrel Eszopicione/lunesta Zolpidem/ambien Zaleplon/sonata Ramelteon/rozerem

Sleep aids/hypnotics

Donepezil/aricept | Mamantine/name day

Dementia meds

PSYCHOTROPIC MEDS Flashcards

(62 cards)