Unit I - Pharmacology & Cognition Flashcards
(30 cards)
1
Q
3 Types of Anti Depressants
A
- Tricyclic
- MAOI
- SSRI
2
Q
Tricyclic Anti Depressants
A
Blocks the absorption of serotonin
- Nopramin
- Elavil
- Anafranil
- Tofranil
- Anticholinergic S/S - dry mouth, urine retention, constipation, blurred vision, tachycardia, excess perspiration
- Weight gain
- Extreme caution in asthma patient, cardiovascular/GI disorders, alcoholism, shizophrenia and bipolar disorders
3
Q
MAOI
A
Increases # of neurotransmitters by inhibiting reabsorption
- Nardil
- Parnate
- Avoid tyramine in food and beverages - can cause hypertensive crisis
- Aged foods - cheese, beer, pizza, wine, salami
- Low safety margin - used for patients who don’t respond to SSRI and TCA
4
Q
Selective Serotonin Reuptake Inhibitors
A
Inhibits serotonin
- Prozac
- Paxil
- Zoloft
- Break between MAOI and SSRI
- Wait two weeks after stopping MAOI, before starting SSRI
5
Q
Atypical Anti-Depressants
A
- Wellbutrin
- Effects activity of NE and DA
- Use cautiously in patients with seizure disorders
- Lowers seizure threshold
- Effexor
- Available in immediate or XR form
6
Q
Traditional Antipsychotics
A
- Kills all dopamine overload
- Sedates patient
- Causes gynocomastia
- Avoid alcohol, drugs, caffeine, smoking
- Photosensitivity
- Anticholinergive S/S
- Haldol
- Thorazin
- Prolixin
- Navane
7
Q
Atypical Antipsychotics
A
- Current meds of choice for psychotic disorders
- Generally treat negative and positive symptoms
- Geodone
- Risperdal
- Use sunscreen, prevent photosensitivity
- Avoid extreme temp
- Itching/srash, decreased libido, dysmenorrhea, rhinitis, cough
- Abilify
- Tachycardia, fever, sedation, headache, N/V, parkinsonism
- Zypyrexa
- Oral disintegrating tablets contain aspartame
- Agranulocytosis, ambylopia, increased liver enzymes
8
Q
Clozapine
(Clazaril)
A
- No class
- Treats schizophrenia
- Used when schizo is unresponsive to standard therapy with other anti-psychotics
- Reduces suicidal behavior
- S/S - DASHN
- Drooling
- AGRANULOCYTOSIS - wipes out immune system, why you need weekly blood tests
- Sedation
- Hypotension (orthostatic)
- Not for dementia patients
9
Q
Anxiolitics
A
- Think benzo’s.
- Treats anxiety disorders
- Habit forming, OD can be fatal
- Used for short term, can be addictive
- Valium
- Xanax
- Ativan
- Kloponin
- Others - Versed, Restoril, Serax
10
Q
Mood Stabilizers
A
- Treats bipolar/unipolar disorders
- Bipolar patient with anti depressant takes a mood stabilizer at the same time to prevent manic episode
- Don’t change diet or decrease fluid intake
- No alcohol, OTC, prescription meds or herbs w.o. notifying HCP
- Lithium
- Depakote
- Carbamazepin
- Trileptal
11
Q
Anticholinergics
A
- Block acetylcholine
- Dry mouth/nose/throat, constipation, drowsiness, blurred vision, constipation, memory loss
- Given for negative effects of antipsychotics
- Cogentin
- Artane
- Benadryl
12
Q
Medication s/s r/t Antipsychotics
A
- Akathisia
- Tardive Dyskinesia
- Acute Dystonia
- Neuroleptic Malignant Syndrome
13
Q
Akathisia
A
- Restless leg syndrome
- Involuntary movement of lower legs
- Uncontrollable
- Urge/need to move legs to prevent unpleasant sensations
14
Q
Tardive Dyskinesia
A
- Caused by longterm use of neuroleptic meds (Haldol, Thorazine)
- Involuntary movements of tongue, lip, face, trunk, extremities
- Permanent, no treatment
15
Q
Acute Dystonia
A
- Sustained muscular spasms
- Abnormal postures
- Treatment - IM Anticholinergics
16
Q
NMS
A
- Idiosyncratic reaction to neuroleptic meds
- Fever, muscle rigifity, altered LOC, autonomic dysfunction
- ANS regulates unconscious body functions, including HR, temp, BP, and GI secretion
- Treatment - take pt off meds
17
Q
Disorganized Schizophrenia
A
- Thoughts, behavior, speech is inappropriate, doesn’t make sense
- Babble, socially isolated, doesn’t make sense
18
Q
Catatonic Schizophrenia
A
- Physical immobility to move or speak
- Unaware of surroundings
- So engaged in their mind, they can’t come out
- Completely unable to move or speak
- Catatonic stupor - wacy flexibility, can mold into a position and they stay there
19
Q
Residual Schizophrenia
A
- Patient does not display prominent symptoms
- Hallucinations/delusions present but s/s significantly diminished
- Patient is under control
20
Q
Paranoid Schizophrenia
A
- Loss of touch with reality
- Delusions not based on reality
- Can lead to suicidal and violent behaviors
- (tinfoil head)
21
Q
Cognition
A
Complicated process by which an individual learns, stores, retrieves, and uses information
22
Q
Negative Symptoms of Schizophrenia
A
- Inexpressive facial expressions
- Monotone, monosyllabic speech
- Few gestures
- Lack of interest in world/people
- Can’t feel pleasure
- Absent of normal emotion and social sensitivity
23
Q
Positive Symptoms of Schizophrenia
A
- Hallucinations
- Delusions
- Exaggerations and distortions of normal perceptions and thinking
24
Q
Meds to Treat Schizophrenia
A
- Traditional antipsychotic
- Atypical antipsychotic
- Intensive case management
25
Dementia
* Progressive
* Loss of cognitive function
* S/S similar to delirium
* Changes in memory, judgment
* Decreased ability to calculate numbers, abstract reasoning, problem solving
26
Common Causes of Dementia
1. Amyloid plaques and neurofibrillary tangles
2. CVA and cardiovascular problems
3. Nerve cell degeneration
27
Dementia Treatment
* Pharmacologic
* Behavior mod
* Assist with ADLS
* Safety measures
* Liquid nutrition, feeding tubes
* Frequent repositioning
* 24 hr nursing care
28
Delirum
* Temporary
* Confusion
* Radpily altering mental states
* Disorientation
* Personality changes
29
Factors That Can Cause Delirium
1. Infection
2. Meds (antihistamines, anticholinergics, benzos)
3. Anesthesia
4. Electrolyte imbalance
5. Pain
6. Sleep disturbances
7. Underlying dementia (dx or not dx'd)
30
Treatment of Delirium
1. Treat underlying cause
2. Find age related causes (UTI, med toxicity)
3. Look for alcohol/drug use in younger adult or adolescent population
4. Vitamin and nutrition
5. Seizure precautions
