Week 4 Flashcards
1
Q
Damage to the ________ causes Parkinson Disease
A
Substantia nigra
2
Q
When substantia nigra neurons die ________ decrease and ________ increase
A
- dopamine
- acetylcholine
3
Q
Sign and Symptoms of Parkinson’s disease
A
(TRAP)
Tremors (resting)
Rigidity (cogwheel)
Akanesia (slow movement
Postural instability
4
Q
Meds for parkinson’s disease increase ________ and decrease _______
A
- dopamine
- acetycholine
5
Q
Dopamine Agonists
A
- levodopa/carbidopa
- Pramipexole
- Ropinirole
(Prescribed for Parkinson’s disease and RLS)
6
Q
Levodopa is converted to __________
A
dopamine (once it has crossed the BBB)
7
Q
Carbidopa help keep __________ low
A
levodopa
8
Q
Pramipexole and Ropinirole are ___________ agonists
A
dopamine (stimulate dopamine receptors)
9
Q
Carbidopa prevents the conversion of
A
levodopa to dopamine before it crosses the BBB
10
Q
Protein, vitamin B6, and iron prevent the absorption of _________
A
levodopa/carbidopa
11
Q
Orthostatic hypotension is caused by ______
A
dopamine alteration
12
Q
Dopaminergic medications can cause paranoia and _____________
A
hallucination
13
Q
Pramipexole and ropinirole can cause __________
A
impulse control issues (gambling, shopping, binge eating)
14
Q
Selegiline oral form is for
A
Parkinson’s disease
15
Q
Selegiline transdermal version is for ___________
A
Depression
16
Q
Selegiline MOA (mechanism of action)
A
- MOA-B inhibitor (prevents breakdown of dopamine)
- Avoid tyramine rich food (cheese, smoke meat, fig, beer, soy sauce)
- Avoid other drugs that increase monoamines
17
Q
Anticholinergics meds
A
- Benztropine
- Trihexyphenidyl
18
Q
Anticholinergic uses and MOA
A
- treat parkinson’s disease and extrapyramidal effects
- Block acetylcholine receptors
- Cause drowiness
19
Q
Monoamine Oxidase Inhibitors (MAOIs) meds
A
- Isocaboxazid
- Phenelzine
- Selegiline transdermal
- Tranylcypromine
20
Q
Monoamines Oxidase Inhibitors (MAOIs) use and MOA
A
- treats major depression
- Blocks monoamine oxidase ( oxidase break down dopamine, serotonin, norepinephrine)
- Increase serotonin, norepinephrine and dopamine levels
- Avoid food containing tyramine (i.e., old and stinky)
- Avoid drugs that increase same neurotransmitters ( antidepressants, cold meds, meperidine, triptan)
21
Q
___________ process produces high levels of tyramine
A
fermenting
22
Q
Tyramine and _____________ cause a patients blood pressure to become too high
A
norepinephrine
(hypertension can manifest as a headache)
23
Q
Serotonin syndrome is characterized by an altered _______ status
A
mental
(also high fever, sweating and clonus)
2. Clonus is involuntary rhythmic muscle contraction
24
Q
Many patients that take MAOI experience __________
A
orthostatic hypotension
25
Tricyclic Antidepressants (TCAs) meds
1. Amitriptyline
2. Nortriptyline
26
TCAs uses and MOAs
1. help treat depression, neuropathic pain, and anxiety disorders
2. Block serotonin and norepinephrine reuptake pump cause them to increase
3. TCA are not selective and causes anticholinergic affects
4. Orthostatic hypotension is common
5. TCAs can cause heart dysrhythmias when overdosed
27
Selective Serotonin Reuptake Inhibitors (SSRIs) meds
1. escitalopram
2. Fluoxetine
3. Paroxetine
4. Sertraline
28
SSRI use and MOA
1. used for depression
2. Block serotonin reuptake pumps
29
SSRI side affects
stomach troubles
slowed metabolism
sexual dysfunction
suicidal ideation
sodium levels decreased
SSRIs are sedating but Fluoxetine is activating (take fluoxetine in the morning)
30
Serotonin Norepinephrine Reuptake Inhibitors (SNRIs) meds
1. desvenlafaxine
2. duloxetine
3. Venlafaxine
31
SNRIs uses, MOA, HYC
1. used for major depression, neuropathic pain and anxiety
2. MOA: Venlafaxine and duloxetine block the reuptake of serotonin and norepinephrine
3. Same as TCAs but cleaner
4. cause hypertension, stomach trouble, slowed metabolism, sexual dysfunction, suicidal ideation, decreased sodium
32
Miscellaneous Antidepressants
1. Bupropion (used for depression, ADHD and smoking cessation)
2. Trazodone (used for depression and insomnia
33
Bupropion
1. Inhibits reuptake of dopamine and norepinephrine
2. does not effect serotonin
3. Increase libido, no weight gain
4. Adverse affects include anxiety and insomnia
5. Contraindicated if a client has risk of seizures
34
Trazadone
1. Weak serotonin reuptake inhibitor
2. Strong sedative and anticholinergic effects and priapism
35
Antidepressant take ______ to _____ weeks to start working
one, four
36
Suicidal ideation is more common with _______ patients
pediatric
37
Manics characteristics include
poor impulse control, racing thoughts, grandiose beliefs, and can be dangerous to others
38
_________ is a milder version of mania
hypomania
39
Hypomania characteristics include
energetic, have a reduced need for sleep, creative, may get alot of work done.
40
Dysthymia
A persistant mild form of depression
41
Bipolar disorder treatment difficulties
1. Requires a combination of meds
2. Medication adherence due to unpleasant side effects
3. Many clients enjoy feeling hypomanic
42
Lithium is used to treat __________
Bipolar disorder
43
Lithium common uses
1. prescribed for acute manic episodes
2. used for long term maintenance therapy for bipolar disorder
44
Lithium HYCs
1. has a narrow therapeutic index
2. Level no greater than 1.5
45
Lithium Side effects
1. mild GI problems, mild thirst, polyuria and fine hand tremors
2. Signs of Toxicity: Sedation and slurred speech, coarse hand tremors, ataxia, nausea, diarrhea
46
Kidney cannot tell the difference between _________ and _______
lithium and sodium (both are salts) (kidney will remove both or retain both)
47
How to avoid lithium toxicity
1. maintain consistent amounts of sodium
2. avoid excessive sweating
3. stay well hydrated.
48
Longterm effects of Lithium
1. Damage to thyroid and kidney
49
Benzodiazepine meds
1. Alprazolam
2. Diazepam
3. Lorazepam
4. Chlordiazepoxide
5. Clonazepam
50
Benzodiazepine common uses
1. treat anxiety
2. insomnia
3. muscle spasms
4. seizure disorders
5. reducing the severity of alchohol
51
Chloride is a _________ charged ion
negatively (decrease anxiety and alertness)
52
Benzodiazepine help ___________ work better
GABA
53
Benzodiazepine HYC
1. Cause CNS depression (sedation, slurred speech, dizziness, etc)
2 Don't mix with opioids
3. Avoid alcohol
4. Increase risk of falls and injury
5. Highly addictive
6. Short term use; longterm users should avoid abrupt discontinuation
54
Anxiety Meds
Antidepressants
Benzodiazepine
Buspirone
Beta blockers
Certain antihistamines
55
Schizophrenia is caused by ___________
excessive dopamine
56
Positive symptoms of schizophrenia include
Treated with antipsychotics
1. hallucinations
2. delusion
3. paranoia
4. agitation
5. disorganized thinking and speech
57
Negative symptoms of schizophrenia
Decrease in normal functions
1. social withdrawal
2. lack of motivation
3. decreased emotional expression
4. inability to recognize one's illness
5. poor judgement
6. poor self care
58
First Gen Antipsychotic meds
1. Chlorpromazine
2. Haloperidol
59
Chlorpromazine treats ______
hiccups
60
Haloperidol help manage _________
tourette's syndrome
61
Chlorpromazine and Haloperidol block __________
dopamine (D2) receptors
62
Extrapyramidal symptoms
Akathsia
Acute dystonia
parkinsonism
Tardive dyskinesia
63
Neuroleptic Malignant Syndrome signs
caused by 1st gen antipsychotic
1. fever
2. elevated WBC and CPK levels
3 Vital signs instability
4. Encephalopathy
5. Rigidity
64
Chlorpromazine and Haloperidol cause
1. photosensitivity (wear sunscreen)
2. dirty drugs (cause anticholinergic effects, sedation and orthostatic hypotension)
65
2nd Gen antipsychotic meds
Treat schizophrenia and prevent bipolar mania
1. Aripiprazole
2. Clozapine
3. Olanzapine
4. Risperidone
66
2nd gen antipsychotics block ________ and __________
1. dopamine and serotonin
2. help reduce positive symptoms of schizophrenia
67
2nd Gen antipsychotics HYC
1. Cause extrapyramidal symptoms
2. Neuroleptic Malignant syndroms
3. metabolic effects (weight gain, unhealthy cholesterol levels, diabetes)
4. Agranulocytosis
68
Clozapine is a _________ med
1. 2nd gen antipsychotic med
2. most effective antipsychotic
3. destroy white blood cells
69
__________ neurons cause seizures
hyperexcitable
70
Area of brain that initiates seizures is called the _______
focus
71
Seizure Medications include
1. Antiepileptics
2. Benziazepines
72
Antiepileptics Meds:
1. phenytoin
2. Carbamazepine
3. Vampiric acid
4. Lamotrigine
5. Levetiracetam
73
Anti-epileptics med are used for
1. different kinds of seizures
Valproic acid, Lamotrigine, and carbamazepine are prescribed for:
Bipolar disorder
74
Antiepileptics MOA and HYCs
1. slow down central nervous system (sedation, ataxia, double vision, etc)
2. Drug interactions
3. Teratogenic (can cause birth defects)
4. Phenytoin (narrow therapeutic index, between 10 and 20), cause enlargement of gum, facial hair growth, interfere with vitamin D and K.
75
Carbamazepine and Clouzapine cause destruction of __________ and decreased __________ levels
1. white blood cells
2. sodium
76
Valproic Acid cause
1. weight gain
2. hair loss
3. toxic to liver
(THINK HOMER SIMPSON)
77
Lamotrigine causes
1. Sevens- Johnson syndrome
2. Start low and go slow
3. Teach client to report any new rashes
78
Levetiracetam is an antiepileptics that is
1. much better tolerated
2. Little CNS depression
3. Wider therapeutic index
4. Does not interact with many meds thus its commonly prescribed
