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Nurs 1446 A Meds > Week 1 > Flashcards

Week 1 Flashcards

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1
Q

Fluoxetine

Class, Use, SE, Contradictions

A

SSRI

Depression:

Line treatment for major depressive disorder.

Anxiety Disorders:
generalized anxiety disorder (GAD), panic disorder,
social anxiety disorder, obsessive-compulsive disorder (OCD).
(PTSD)

SE:
Libido decrease
Akathisia
SUICIDE
GI upset (5-HT) Receptors are in the gut
Bone loss
Photosensitivty
Apathy
SEROTONIN SYNDROME

Medications potentially Serotonin Syndrome

TCA, Bupriprion, Migrane Meds, Lithium, OTC cough syrup, Antiemetics, Pain Meds, Venalfaxine / Trazodone, MAOI, LSD, L-tryptophan, St. Johns Wort, Ginseng

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2
Q

Citalopram

Class, Use, SE, Contradictions

A

SSRI

Depression:

Line treatment for major depressive disorder.

Anxiety Disorders:
generalized anxiety disorder (GAD), panic disorder,
social anxiety disorder, obsessive-compulsive disorder (OCD).
(PTSD)

SE:
Libido decrease
Akathisia
SUICIDE
GI upset (5-HT) Receptors are in the gut
Bone loss
Photosensitivty
Apathy
SEROTONIN SYNDROME

Medications potentially Serotonin Syndrome

TCA, Bupriprion, Migrane Meds, Lithium, OTC cough syrup, Antiemetics, Pain Meds, Venalfaxine / Trazodone, MAOI, LSD, L-tryptophan, St. Johns Wort, Ginseng

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3
Q

Excitalopram

Class, Use, SE, Contradictions

A

SSRI

Depression:

Line treatment for major depressive disorder.

Anxiety Disorders:
generalized anxiety disorder (GAD), panic disorder,
social anxiety disorder, obsessive-compulsive disorder (OCD).
(PTSD)

SE:
Libido decrease
Akathisia
SUICIDE
GI upset (5-HT) Receptors are in the gut
Bone loss
Photosensitivty
Apathy
SEROTONIN SYNDROME

Medications potentially Serotonin Syndrome

TCA, Bupriprion, Migrane Meds, Lithium, OTC cough syrup, Antiemetics, Pain Meds, Venalfaxine / Trazodone, MAOI, LSD, L-tryptophan, St. Johns Wort, Ginseng

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4
Q

Fluvoxamine

Class, use, SE, Contradictions

A

SSRI

Depression:

Line treatment for major depressive disorder.

Anxiety Disorders:
generalized anxiety disorder (GAD), panic disorder,
social anxiety disorder, obsessive-compulsive disorder (OCD).
(PTSD)

SE:
Libido decrease
Akathisia
SUICIDE
GI upset (5-HT) Receptors are in the gut
Bone loss
Photosensitivty
Apathy
SEROTONIN SYNDROME

Medications potentially Serotonin Syndrome

TCA, Bupriprion, Migrane Meds, Lithium, OTC cough syrup, Antiemetics, Pain Meds, Venalfaxine / Trazodone, MAOI, LSD, L-tryptophan, St. Johns Wort, Ginseng

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5
Q

Paroxetine

Class, use, SE, Contradictions

A

SSRI

Depression:

Line treatment for major depressive disorder.

Anxiety Disorders:
generalized anxiety disorder (GAD), panic disorder,
social anxiety disorder, obsessive-compulsive disorder (OCD).
(PTSD)

SE:
Libido decrease
Akathisia
SUICIDE
GI upset (5-HT) Receptors are in the gut
Bone loss
Photosensitivty
Apathy
SEROTONIN SYNDROME

Medications potentially Serotonin Syndrome

TCA, Bupriprion, Migrane Meds, Lithium, OTC cough syrup, Antiemetics, Pain Meds, Venalfaxine / Trazodone, MAOI, LSD, L-tryptophan, St. Johns Wort, Ginseng

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6
Q

Sertraline

Class, use, SE, Contradictions

A

SSRI

Depression:

Line treatment for major depressive disorder.

Anxiety Disorders:
generalized anxiety disorder (GAD), panic disorder,
social anxiety disorder, obsessive-compulsive disorder (OCD).
(PTSD)

SE:
Libido decrease
Akathisia
SUICIDE
GI upset (5-HT) Receptors are in the gut
Bone loss
Photosensitivty
Apathy
SEROTONIN SYNDROME

Medications potentially Serotonin Syndrome

TCA, Bupriprion, Migrane Meds, Lithium, OTC cough syrup, Antiemetics, Pain Meds, Venalfaxine / Trazodone, MAOI, LSD, L-tryptophan, St. Johns Wort, Ginseng

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7
Q

Paroxetine an SSRI has 2 majors issues involved with its use.

A

Snap-back effect I’d stopped abruptly

Anticholinergic (Inhibits Acetylcholine)

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8
Q

Everything goes up is a severe SE of SSRI esp when dosage is increased or take with Contradicted medications

A

Serotonin syndrome

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9
Q

Zyprexa maybe used for…

A

Treating mild symptoms of serotonin syndrome

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10
Q

Why won’t Tylenol or Motrin help the fever associated with Serotonin syndrome?

A

Elevated temperature is due to excessive muscle activity Not Hypothalamus

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11
Q

Venalfaxine & desvenalfaxine are this type of medication

Watch for HTN

A

SNRI

Serotonin & Norepinephrine Reuptake inhibitor

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12
Q

Duloxetine SNRI has this off lable use

A

GAD, Neuropathic Pain

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13
Q

Atomoxetine (this type of med) is indicated for ADHA

A

SNRI

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14
Q

Duloxetine

A

SNRI Serotonin Norepinephrine Reuptake Inhibitor

Use

Major Depressive Disorder (MDD):
Generalized Anxiety Disorder (GAD)
Panic Disorder
Fibromyalgia
Social Anxiety Disorder (SAD)
PTSD

SE
Nausea: Common when starting the medication.
Dry Mouth: A frequent side effect.
Dizziness: Often reported, especially when standing up quickly.
Insomnia or Sleep Disturbances: SNRIs can affect sleep patterns.
Sweating: Increased sweating is common.
Loss of Appetite: Some patients experience weight loss.
Sexual Dysfunction: Reduced libido, delayed ejaculation, or orgasm

SERIOUS SIDE EFFECTS

Increased Risk of Bleeding
Serotonin Syndrome
Mania , in bipolar patients

Contradictions

MAOI
HTN
Liver or Kidney disease

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15
Q

Venalfaxine & Desvenlafaxine

A

SNRI Serotonin Norepinephrine Reuptake Inhibitor

Use

Major Depressive Disorder (MDD):
Generalized Anxiety Disorder (GAD)
Panic Disorder
Fibromyalgia
Social Anxiety Disorder (SAD)
PTSD

SE
Nausea: Common when starting the medication.
Dry Mouth: A frequent side effect.
Dizziness: Often reported, especially when standing up quickly.
Insomnia or Sleep Disturbances: SNRIs can affect sleep patterns.
Sweating: Increased sweating is common.
Loss of Appetite: Some patients experience weight loss.
Sexual Dysfunction: Reduced libido, delayed ejaculation, or orgasm

SERIOUS SIDE EFFECTS

Increased Risk of Bleeding
Serotonin Syndrome
Mania , in bipolar patients

Contradictions

MAOI
HTN
Liver or Kidney disease

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16
Q

Levomilnacipran

A

SNRI Serotonin Norepinephrine Reuptake Inhibitor

Use

Major Depressive Disorder (MDD):
Generalized Anxiety Disorder (GAD)
Panic Disorder
Fibromyalgia
Social Anxiety Disorder (SAD)
PTSD

SE
Nausea: Common when starting the medication.
Dry Mouth: A frequent side effect.
Dizziness: Often reported, especially when standing up quickly.
Insomnia or Sleep Disturbances: SNRIs can affect sleep patterns.
Sweating: Increased sweating is common.
Loss of Appetite: Some patients experience weight loss.
Sexual Dysfunction: Reduced libido, delayed ejaculation, or orgasm

SERIOUS SIDE EFFECTS

Increased Risk of Bleeding
Serotonin Syndrome
Mania , in bipolar patients

Contradictions

MAOI
HTN
Liver or Kidney disease

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17
Q

Atomoxetine

Class, use, SE & Contradictions

A

SNRI Serotonin Norepinephrine Reuptake Inhibitor

Use

Major Depressive Disorder (MDD):
Generalized Anxiety Disorder (GAD)
Panic Disorder
Fibromyalgia
Social Anxiety Disorder (SAD)
PTSD

SE
Nausea: Common when starting the medication.
Dry Mouth: A frequent side effect.
Dizziness: Often reported, especially when standing up quickly.
Insomnia or Sleep Disturbances: SNRIs can affect sleep patterns.
Sweating: Increased sweating is common.
Loss of Appetite: Some patients experience weight loss.
Sexual Dysfunction: Reduced libido, delayed ejaculation, or orgasm

SERIOUS SIDE EFFECTS

Increased Risk of Bleeding
Serotonin Syndrome
Mania , in bipolar patients

Contradictions

MAOI
HTN
Liver or Kidney disease

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18
Q

Type of Antidepressant that prevents the breakdown of neurotransmitters by enzyme Monoamine Oxidase - Increasing availability of 5-HT, NE, DA

A

MAOI

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19
Q

Used for major depression when other antidepressants have failed. Give examples

A

MAOI

Isocarboxazid
Phenelzine Sulfate
Tranylcypromine Sulfate
Selegiline

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20
Q

Isocaboxazid

Class, use, SE & Contradictions

A

MAOI

Use:

Depression when other meds didn’t work.

Anxiety

Parkinsons: Increase dopamine

Dizziness and Lightheadedness: Especially when standing up quickly, due to a drop in blood pressure (orthostatic hypotension).
Dry Mouth: A frequent side effect.
Constipation: Often reported by users.
Insomnia: MAOIs can interfere with sleep patterns.
Weight Gain: Some patients experience increased appetite and weight gain.
Sexual Dysfunction: Includes decreased libido, delayed ejaculation, or anorgasmia.

Serious Side Effects

HTN Crisis with Tyramine (Cheese Effect)

Serotonin Syndrome

Contradictions

Other antidepressants

Foods containing Tyramine

Pheochromocytoma: A rare tumor of the adrenal glands that can cause dangerous spikes in blood pressure.

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21
Q

Phenelzine

Class, use, SE, Contradictions

A

MAOI

Use:

Depression when other meds didn’t work.

Anxiety

Parkinsons: Increase dopamine

Dizziness and Lightheadedness: Especially when standing up quickly, due to a drop in blood pressure (orthostatic hypotension).
Dry Mouth: A frequent side effect.
Constipation: Often reported by users.
Insomnia: MAOIs can interfere with sleep patterns.
Weight Gain: Some patients experience increased appetite and weight gain.
Sexual Dysfunction: Includes decreased libido, delayed ejaculation, or anorgasmia.

Serious Side Effects

HTN Crisis with Tyramine (Cheese Effect)

Serotonin Syndrome

Contradictions

Other antidepressants

Foods containing Tyramine

Pheochromocytoma: A rare tumor of the adrenal glands that can cause dangerous spikes in blood pressure.

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22
Q

Tranylcypromine

Class, Use, SE & Contradictions

A

MAOI

Use:

Depression when other meds didn’t work.

Anxiety

Parkinsons: Increase dopamine

Dizziness and Lightheadedness: Especially when standing up quickly, due to a drop in blood pressure (orthostatic hypotension).
Dry Mouth: A frequent side effect.
Constipation: Often reported by users.
Insomnia: MAOIs can interfere with sleep patterns.
Weight Gain: Some patients experience increased appetite and weight gain.
Sexual Dysfunction: Includes decreased libido, delayed ejaculation, or anorgasmia.

Serious Side Effects

HTN Crisis with Tyramine (Cheese Effect)

Serotonin Syndrome

Contradictions

Other antidepressants

Foods containing Tyramine

Pheochromocytoma: A rare tumor of the adrenal glands that can cause dangerous spikes in blood pressure.

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23
Q

Selegiline

Class, use, se & Contradictions

A

MAOI

Use:

Depression when other meds didn’t work.

Anxiety

Parkinsons: Increase dopamine

Dizziness and Lightheadedness: Especially when standing up quickly, due to a drop in blood pressure (orthostatic hypotension).
Dry Mouth: A frequent side effect.
Constipation: Often reported by users.
Insomnia: MAOIs can interfere with sleep patterns.
Weight Gain: Some patients experience increased appetite and weight gain.
Sexual Dysfunction: Includes decreased libido, delayed ejaculation, or anorgasmia.

Serious Side Effects

HTN Crisis with Tyramine (Cheese Effect)

Serotonin Syndrome

Contradictions

Other antidepressants

Foods containing Tyramine

Pheochromocytoma: A rare tumor of the adrenal glands that can cause dangerous spikes in blood pressure.

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24
Q

How do MAOIs affect 5-HT, NE, DA

A

Increases them

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25
SSRI have this precaution with Warfarin/ NSAIDS
Bleeding Risk, consult HCP
26
Amitriptyline
Class: Tricyclic antidepressants Use: Depression, Anxiety, Neuropathic pain, Bed wetting in children (anticholinergic), migraines. SE: Tachycardia Dry mouth Urine retention Blurred vision Sedation Constipation SUICIDE LEATHAL IN OD
27
Nortriptyline
Class: Tricyclic antidepressants Use: Depression, Anxiety, Neuropathic pain, Bed wetting in children (anticholinergic), migraines. SE: Tachycardia Dry mouth Urine retention Blurred vision Sedation Constipation SUICIDE LEATHAL IN OD
28
Doxepine
Class: Tricyclic antidepressants Use: Depression, Anxiety, Neuropathic pain, Bed wetting in children (anticholinergic), migraines. SE: Tachycardia Dry mouth Urine retention Blurred vision Sedation Constipation SUICIDE LEATHAL IN OD
29
Imipramine
Class: Tricyclic antidepressants Use: Depression, Anxiety, Neuropathic pain, Bed wetting in children (anticholinergic), migraines. SE: Tachycardia Dry mouth Urine retention Blurred vision Sedation Constipation SUICIDE LEATHAL IN OD
30
These medications are 5-HT & NE reuptake inhibitors Amitriptyline Nortriptyline Doxepine Imipramine
Tricyclic antidepressants
31
NE & D2 reuptake inhibitor No sexual Dysfunction Contradicted with seizures, ETOH & Benzo withdrawal Can cause weight loss & anorexia
Buproprion (Wellbutrin)
32
Vilazodone SSRI & 5-HT1A receptor partial agonist Caution with Glaucoma & Seizures due to abnormal bleeding SE Weight gain, GI problems Can it be used for Bipolar?
No may make problems worse
33
Vortioxetine (Trintellix) Serotonergic antidepressant Caution with (2) Avoid use in these types of patients... SE: May cause angioedema, abnormal bleeding, flatulence Expensive
Caution: Abrupt Withdrawal & Seizure disorder Avoid in Elderly
34
Mirtazapine (Remeron) Tricyclic antidepressants Antagonist of NE & 5-HT2 receptors Smoking changes levels in blood quickly Common SE: Weight gain, xerostomia, Constipation, Sedation Serious SE
Agranulocytosis, neutropenia, torsades de pointes, Steven-Johnson syndrome
35
Trazodone Antidepressants but given for Sleep Caution with heart problems Priapism (>4 hr erection) SE xerostomia, drowsiness, blurred vision, HTN, confusion, Sexual Dysfunction Some patients may have a paradoxical reaction. Describe...
Paradoxical reaction is oppsite of what you expect to happen They will become agitated
36
Brexanolone injection (Zulresso) Works on GABA Expensive 34,000$ Used for.... How does it work...
Postpartum- Given immediately after birth Works: Mimics hormone allopregnanolone
37
Zuranolone (Pill form for postpartum) How long is it taken When to expect to see improvement
1qDay x 14 days Improvement in 3 days
38
Lithium Carbamazepine Valproate Lamotrigine Clonazepam Not FDA approved Oxcarbazepine Gabapentin Topiramate This type of medication.... Works by.....
Mood stabilizers Provide a balance between GABA & Glutamate
39
Patients with Bipolar I & II Poor control of anxiety & depression symptoms Kids Behavior issues or OCD PTSD Treatment resistant depression Hormone dysfunction
Mood stabilizer Lithium Carbamazepine Valproate Lamotrigine Clonazepam Not FDA approved Oxcarbazepine Gabapentin Topiramate
40
Check these labs before giving Lithium Kidney function.. Serum Creatinine, GFR, BUN Electrolytes... Which electrolyte level is a concern Lithium levels .... Therapeutic vs Toxic levels Thyroid.... Pregnancy...
Serum Creatinine: Hold if: Creatinine >1.3 mg/dL (indicates impaired kidney function). Glomerular Filtration Rate (GFR): Hold if: GFR <60 mL/min/1.73 m² (suggests reduced kidney filtration). Blood Urea Nitrogen (BUN): Hold if: BUN >20 mg/dL, especially with high creatinine (suggests kidney dysfunction). Electrolytes: Hold if: Sodium <135 mEq/L (hyponatremia can increase lithium toxicity risk). Thyroid: TSH >4.5 mIU/L is particularly significant because it indicates hypothyroidism, which can be caused or worsened by lithium. Elevated TSH suggests that the thyroid is not producing enough thyroid hormones (T3 and T4), and this could warrant holding lithium to prevent further thyroid dysfunction. Contradicted in preggers
41
Lithium toxicity Describe Toxicity Level and # associated with it. Gastrointestinal Symptoms: Nausea, vomiting, diarrhea Neurological Symptoms: Hand tremors, mild confusion, drowsiness Muscle Symptoms: Weakness, fatigue Describe Lithium toxicity level Neurological Symptoms: Severe tremors, confusion, ataxia (loss of coordination), muscle twitching Cognitive Symptoms: Slurred speech, agitation, worsening confusion Cardiovascular Symptoms: Arrhythmias, increased heart rate Describe Lithium Toxicity level Neurological Symptoms: Seizures, coma, severe confusion, stupor Renal Symptoms: Decreased urine output, kidney failure Cardiovascular Symptoms: Hypotension, severe arrhythmias Other Symptoms: Respiratory failure, potential death if untreated
Mild Toxicity (Lithium Level: 1.5–2.0 mEq/L): N/V, hand tremors, mild confusion, drowsiness, weak Moderate Toxicity (Lithium Level: 2.0–2.5 mEq/L): Severe tremors, confusion, ataxia, muscle twitch, Slurred Speech, Worsening confusion , agitation, Arrhythmia Severe Toxicity (Lithium Level: >2.5 mEq/L): Seizures, coma, severe confusion, decrease urine output, kidney failure, hypotension, Respitory failure
42
Bradycardia Ataxia (Jerky Movement) & acne Tremour & hypothyroid Teratogenic ( birth defects or abnormalities in a developing fetus ) Edema Rash & Renal Toxicity Leukocytosis BATTERY Describes side effects for ...
Lithium
43
Match the mood stabilizers Valproate, carbamazepine, lamotrigine Maintenance, not for acute mania, frequently used in borderline personality Acute mania Mixed episodes of mania & depression
Lamotrigine Maintenance, not for acute mania, frequently used in borderline personality Carbamazepine Acute mania Valproate Mixed episodes of mania & depression
44
Carbamazepine: Acute Mania (Mood Stabilizer) Therapeutic range.... SE: Anticholinergic, Orthostatic Hypotension, pruritus, HTN, ataxia, arrhythmias Serious SE
Therapeutic range 4 - 12 Serious: Agranulocytosis & Steven Johnson Syndrome
45
Valproate: Mixed Episodes (Mood Stabilizer) *boost gaba SE: weight gain, mental dull, tremor, hair loss, libido loss, thrombocytopenia, pancreatitis, liver failure Contradiction Pregnancy & liver issues Therapeutic range:..... Labs....
Therapeutic range 50 - 100mL Labs AST (Aspartate Aminotransferase): Safe Range: 10-40 U/L Why: Elevated AST can indicate liver damage, so levels should be within the normal range to safely start or continue valproate. ALT (Alanine Aminotransferase): Safe Range: 7-56 U/L Why: ALT is more specific to the liver, and elevated levels suggest liver injury, which is a concern with valproate use. Albumin: Safe Range: 3.5-5.0 g/dL Why: Albumin reflects liver function and nutritional status. Low albumin may indicate liver dysfunction or malnutrition, which can increase the risk of valproate-related side effects. CBC (Complete Blood Count): Safe Findings: White Blood Cells (WBC): 4,500-11,000 cells/mcL Platelets: 150,000-450,000/mcL Hemoglobin: 13.8-17.2 g/dL (men), 12.1-15.1 g/dL (women) Why: Valproate can cause thrombocytopenia (low platelets) and affect white blood cell counts, so a normal CBC is important before starting the medication. Ammonia: Safe Range: 15-45 µmol/L Why: Elevated ammonia levels can indicate a risk of hyperammonemia, a possible side effect of valproate, which can lead to serious complications like encephalopathy.
46
Lamotrigine (Depression in Bipolar) Moderates release of Glutamate SE: Dizzy, Ataxia, blurred vision, HA, Anticholinergic, Photosensitivity Therapeutic range.... Major dangerous SE:....
Therapeutic range 3 - 14 Steven Johnson Syndrome. Rash first sign
47
Oxcarbazepine Not FDA approved Mood Stabilizer Similar to Carbamazepine Lesser risk of Rash & Hepatotoxicity Adverse reactions.....
CNS depression & hyponatremia
48
Erythema multiforme Hypersensitivity reaction to meds or infections Symptoms Fever Itching Joint aches Skin lesions RASH AKA.....
Stevens-Johnson syndrom Life threatening
49
Avolition vs Anhedonia
Avolition = Lack or inability to start or complete goals Anhedonia = lack of interest in things you once enjoyed
50
Low Potency / High Dose: Examples: (2) Characteristics: These drugs require higher doses to achieve the desired antipsychotic effect. Low potency antipsychotics have weaker dopamine-blocking effects but tend to have more sedative effects and anticholinergic side effects (like dry mouth, constipation, and blurred vision). They are more likely to cause orthostatic hypotension (a drop in blood pressure when standing up) and weight gain High Sedation & Ach SE (Wine Coolers)
Chlorpromazine, Thioridazine First gen Traditional Antipsychotics
51
High Potency / Low Dose: Examples: (2) Characteristics: These drugs require lower doses to be effective. High potency antipsychotics have stronger dopamine-blocking effects, which means they are effective at lower doses. They are more likely to cause extrapyramidal symptoms (EPS), such as tremors, rigidity, and bradykinesia (slow movements), which are movement disorders. These drugs generally have fewer sedative and anticholinergic side effects compared to low potency antipsychotics.
Fluphenazine, Haloperidol
52
List Positive & Negative symptoms of Psychosis
Positive Hallucinations Delusions Disorganized thoughts Agitated body movements Negative symptoms Flat affect Anhedonia Avolition Poverty of speech & thought Neglect ADLs
53
Chlorpromazine
1st generation antipsychotic (Blocks dopamine) Low Potency/ High Dose SE: High Sedation/ Ach SE Low EPS Agranulocytosis Orthostatic hypotension
54
Thioridazine
1st generation antipsychotic (blocks dopamine) Low Potency/ High Dose High Sedation & Ach Low EPS ORTHOSTATIC HYPOTENSION
55
Fluphenazine
1st generation antipsychotic (Blocks dopamine) High Potency/ Low Dose Low Sedation/ Ach SE High EPS
56
Haloperidol
1st generation antipsychotic (Blocks dopamine) High Potency/ Low Dose Low Sedation/ Ach SE High EPS
57
Trifluoperazine
1st generation antipsychotic (Blocks dopamine) High Potency/ Low Dose Low Sedation/ Ach SE High EPS
58
Perphenazine
1st generation antipsychotic (Blocks dopamine) High Potency/ Low Dose Low Sedation/ Ach SE High EPS
59
1st generation antipsychotics work well controlling which type of symptoms associated with psychosis
Positive Hallucinations Delusions Disturbed thought process
60
Risperidone Class, Use, SE, Contradictions Labs before starting Normal values: BMI, BP, A1c, fasting lipids
2nd generation atypical antipsychotics. First line treatment Target Postive & Negative Symptoms SE: Lower risk for ESP Weight gain Increased cholesterol Contradicted Dementia / CVA Body Mass Index (BMI): Normal range: 18.5 to 24.9 kg/m² Blood Pressure (BP): Normal range: Systolic: 90-120 mm Hg Diastolic: 60-80 mm Hg Hemoglobin A1c (HbA1c): Normal range: 4.0% to 5.6% Pre-diabetes range: 5.7% to 6.4% Diabetes: 6.5% or higher Fasting Lipid Panel: Total Cholesterol: < 200 mg/dL Low-Density Lipoprotein (LDL): < 100 mg/dL High-Density Lipoprotein (HDL): Men: > 40 mg/dL Women: > 50 mg/dL Triglycerides: < 150 mg/dL
61
Olanzapine Labs to check
2nd generation atypical antipsychotics. First line treatment Target Postive & Negative Symptoms SE: Lower risk for ESP Weight gain Increased cholesterol Contradicted Dementia / CVA Body Mass Index (BMI): Normal range: 18.5 to 24.9 kg/m² Blood Pressure (BP): Normal range: Systolic: 90-120 mm Hg Diastolic: 60-80 mm Hg Hemoglobin A1c (HbA1c): Normal range: 4.0% to 5.6% Pre-diabetes range: 5.7% to 6.4% Diabetes: 6.5% or higher Fasting Lipid Panel: Total Cholesterol: < 200 mg/dL Low-Density Lipoprotein (LDL): < 100 mg/dL High-Density Lipoprotein (HDL): Men: > 40 mg/dL Women: > 50 mg/dL Triglycerides: < 150 mg/dL
62
Quetiapine Class, use, SE, Contradictions Labs to check first
2nd generation atypical antipsychotics. First line treatment Target Postive & Negative Symptoms SE: Lower risk for ESP Weight gain Increased cholesterol Contradicted Dementia / CVA Body Mass Index (BMI): Normal range: 18.5 to 24.9 kg/m² Blood Pressure (BP): Normal range: Systolic: 90-120 mm Hg Diastolic: 60-80 mm Hg Hemoglobin A1c (HbA1c): Normal range: 4.0% to 5.6% Pre-diabetes range: 5.7% to 6.4% Diabetes: 6.5% or higher Fasting Lipid Panel: Total Cholesterol: < 200 mg/dL Low-Density Lipoprotein (LDL): < 100 mg/dL High-Density Lipoprotein (HDL): Men: > 40 mg/dL Women: > 50 mg/dL Triglycerides: < 150 mg/dL
63
Ziprasidone Class, use, SE, Contradictions Labs to assess first
2nd generation atypical antipsychotics. First line treatment Target Postive & Negative Symptoms SE: Lower risk for ESP Weight gain Increased cholesterol Contradicted Dementia / CVA Body Mass Index (BMI): Normal range: 18.5 to 24.9 kg/m² Blood Pressure (BP): Normal range: Systolic: 90-120 mm Hg Diastolic: 60-80 mm Hg Hemoglobin A1c (HbA1c): Normal range: 4.0% to 5.6% Pre-diabetes range: 5.7% to 6.4% Diabetes: 6.5% or higher Fasting Lipid Panel: Total Cholesterol: < 200 mg/dL Low-Density Lipoprotein (LDL): < 100 mg/dL High-Density Lipoprotein (HDL): Men: > 40 mg/dL Women: > 50 mg/dL Triglycerides: < 150 mg/dL
64
Paliperidone Class, use, SE, Contradictions Labs to assess first
2nd generation atypical antipsychotics. First line treatment Target Postive & Negative Symptoms SE: Lower risk for ESP Weight gain Increased cholesterol Contradicted Dementia / CVA Body Mass Index (BMI): Normal range: 18.5 to 24.9 kg/m² Blood Pressure (BP): Normal range: Systolic: 90-120 mm Hg Diastolic: 60-80 mm Hg Hemoglobin A1c (HbA1c): Normal range: 4.0% to 5.6% Pre-diabetes range: 5.7% to 6.4% Diabetes: 6.5% or higher Fasting Lipid Panel: Total Cholesterol: < 200 mg/dL Low-Density Lipoprotein (LDL): < 100 mg/dL High-Density Lipoprotein (HDL): Men: > 40 mg/dL Women: > 50 mg/dL Triglycerides: < 150 mg/dL
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Lurasidone Class, use, SE, Contradictions Labs to assess first
2nd generation atypical antipsychotics. First line treatment Target Postive & Negative Symptoms SE: Lower risk for ESP Weight gain Increased cholesterol Contradicted Dementia / CVA Body Mass Index (BMI): Normal range: 18.5 to 24.9 kg/m² Blood Pressure (BP): Normal range: Systolic: 90-120 mm Hg Diastolic: 60-80 mm Hg Hemoglobin A1c (HbA1c): Normal range: 4.0% to 5.6% Pre-diabetes range: 5.7% to 6.4% Diabetes: 6.5% or higher Fasting Lipid Panel: Total Cholesterol: < 200 mg/dL Low-Density Lipoprotein (LDL): < 100 mg/dL High-Density Lipoprotein (HDL): Men: > 40 mg/dL Women: > 50 mg/dL Triglycerides: < 150 mg/dL
66
Clozapine Class, use, SE, Contradictions Special Requirements:...... Teach:.....
2nd generation atypical antipsychotics. Atypical antipsychotics Used to prevent suicide First line treatment Target Postive & Negative Symptoms SE: Lower risk for ESP Agranulocytosis in 1% Weight gain Increased cholesterol Contradicted Dementia / CVA Maybe the labs associated with 2nd generation apply? Special requirements Patients must be on federal mandatory registry (REMS) Required CBC (ANC >1500) Teach Monitor for sore throat, fever, s/s infection Get Flu Vaccines
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Brexipipazole (Used with antidepressants, agitation in dementia) Class, use, SE & Contradictions
3rd generation antipsychotic Less Sedation Less weight Gain Insomnia Akathisia (Restlessness)
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Cariprazine (Bipolar I disorder, MDD) WITH Antidepressants Class, use, SE & Serious side effects
3rd generation antipsychotic Less Sedation Less weight Gain Insomnia Akathisia (Restlessness)
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Aripiprazole Class, use, SE, Contradictions
3rd generation antipsychotic Less Sedation Less weight Gain Insomnia Akathisia (Restlessness)
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Long Acting Injectable Antipsychotics LAIs Distinguish 1st from 2nd generation Fluphenazine Aripiprazole Olanzapine Paliperidone Haloperidol Risperidone
1st generation Fluphenazine Haloperidol 2nd Generation Aripiprazole Olanzapine Paliperidone Risperidone
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This heart wave pattern is seen with Antipsychotics Leading to which problems
Q-T prolongation Arythmias, torsade de pointes, V Fib
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Movement Disorders: Extrapyrmidal Symptoms Dopamine DOWN & Acetylcholine UP Dystonia: Involuntary muscle contractions causing abnormal postures or movements, often due to antipsychotic use. Medical emergency? Onset after ingestion of antipsychotic meds
Medical emergency: Yes, if muscles in throat or neck are affected Onset: can start within 4 hrs.
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Movement Disorders: Extrapyrmidal Symptoms Dopamine DOWN & Acetylcholine UP ____: Restlessness of mind and body associated with antipsychotic use. High risk suicide (According to PP)
Akathesia
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Movement Disorders: Extrapyrmidal Symptoms Dopamine DOWN & Acetylcholine UP Slowed movements Muscle stiffness Shuffling walk Flat affect Pill rolling Stooped posture Reduced arm swinging
Pseudoparkinsonism
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EPS symptoms such as akathisia & Tardive dyskinesia will stop when antipsychotic medications are Discontinued T or F
F All EPS symptoms will stop upon discontinuation Except Tardive dyskinesia
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Neuroleptic Malignant Syndrome (NMS) Life threatening condition from use or with drawl of Antipsychotic medication Symptoms: ______
Fever Muscle rigidity Decreased LOC Arythmia Tachycardia Diaphoresis BP changes
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Treatment for NMS incldue: Discontinuation of Meds Continuation of Meds if Withdrawal is problem Dantrolene (Muscle Relaxant) Cool measures Stabilize electrolyte levels Which medications cause NMS...
1st generation antipsychotic
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SSRI mixed with..... MAIO mixed with...... Can cause Serotonin Syndrome
SSRI St. Johns Wort MAIO mixed with Any Antidepressants
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How long after stopping MAIO to wait before starting new Antidepressants
2 weeks
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SSRI Paroxetine, Sertraline, Fluvoxamine Fluoxetine, Citalopram, Exitalopram Most common SE Dangerous SE
Usually improve 3 months Weight Gain Sexual Dysfunction Insomnia Dangerous: Suicide high risk 18 - 24 (Report more energy without change in depression) Serotonin Syndrome
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Sexual Dysfunction Weight gain Insomnia GI Disturbances Anxiety Headache Common SE with SSRIs Fluoxetine Fluvoxamine Paroxetine Sertraline Citalopram Exitalopram Name the common SE with SNRI
Same as SSRI also Increased BP Xerostomia Diaphoresis Atomoxetine Levomilnacipran Venalfaxine Desvenlafaxine Duloxetine
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Atomoxetine Levomilnacipran Venalfaxine Desvenlafaxine Duloxetine Name common and serious SE Type of medication...
SNRI Common SE Sexual Dysfunction Weight gain Insomnia GI upset Headache Anxiety Increase BP Xerostomia Diaphoresis Serious Suicide Serotonin Syndrome
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Watch for HTN with these SNRIs
Venalfaxine & desvenalfaxine
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2nd generation antipsychotics have SE of weight gain leading to Diabetes. What is a normal range for. Body Mass Index (BMI):
Normal range: 18.5 to 24.9 kg/m² Blood Pressure (BP):
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2nd generation Antipsychotics have a SE of weight gain leading to Diabetes What is a normal Hemoglobin A1c (HbA1c):
Normal range: 4.0% to 5.6% Pre-diabetes range: 5.7% to 6.4% Diabetes: 6.5% or higher
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2nd generation Antipsychotics have a SE of weight gain leading to Diabetes What is a normal Hemoglobin A1c (HbA1c):
Normal range: 4.0% to 5.6% Pre-diabetes range: 5.7% to 6.4% Diabetes: 6.5% or higher
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2nd generation Antipsychotics have a SE of weight gain leading to Diabetes What is a normal Fasting Lipid Panel: Total Cholesterol: Low-Density Lipoprotein (LDL): High-Density Lipoprotein (HDL): Men: Women: Triglycerides:
Total Cholesterol: < 200 mg/dL Low-Density Lipoprotein (LDL): < 100 mg/dL High-Density Lipoprotein (HDL): Men: > 40 mg/dL Women: > 50 mg/dL Triglycerides: < 150 mg/dL
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Valporate - mood stable Therapeutic range 50 - 100mL Labs AST (Aspartate Aminotransferase):
Safe Range: 10-40 U/L Why: Elevated AST can indicate liver damage, so levels should be within the normal range to safely start or continue valproate.
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Valporate Treats Mood Disorders Therapeutic range 50 - 100 ALT (Alanine Aminotransferase):
Safe Range: 7-56 U/L Why: ALT is more specific to the liver, and elevated levels suggest liver injury, which is a concern with valproate use.
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Valporate Treats mood disorders Therapeutic range 50 - 100 Albumin: (Safe Range)
Safe Range: 3.5-5.0 g/dL Why: Albumin reflects liver function and nutritional status. Low albumin may indicate liver dysfunction or malnutrition, which can increase the risk of valproate-related side effects.
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Valporate Treats mood disorders Therapeutic range 50 - 100 CBC (Complete Blood Count): Safe Range WBC Platelets Hemoglobin
Safe Findings: White Blood Cells (WBC): 4,500-11,000 Platelets: 150,000-450,000 Hemoglobin: 13.8-17.2 g/dL (men), 12.1-15.1 g/dL (women) Why: Valproate can cause thrombocytopenia (low platelets) and affect white blood cell counts, so a normal CBC is important before starting the medication.
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Valporate Treats mood disorders Therapeutic range 50 - 100 Ammonia: Safe range
Safe Range: 15-45 µmol/L Why: Elevated ammonia levels can indicate a risk of hyperammonemia, a possible side effect of valproate, which can lead to serious complications like encephalopathy
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Why might an MAOI be given to a Parkinsons patient?
To increase dopamine. Lack of dopamine makes them shake.
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Type of medication which maybe prescribed for neuropathic pain.
SNRI

Nurs 1446 A Meds (2 decks)

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