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L4 Pharm > Antipsychotics > Flashcards

Antipsychotics Flashcards

1
Q

What causes parkinsons disease?

A

Lack of dopamine

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2
Q

What causes schizophrenia?

A

Excess dopamine in the brain

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3
Q

How do antipsychotics work?

A

By blocking dopamine receptor sites

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4
Q

S/Sx of pseudoparkinsonism (6)

A

Rigidity, shuffling gait, mask like features, stooped posture, tremors, bradykinesia

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5
Q

Typical antipsychotics MOA and classes

A

Block dopamine receptors

Pheno and nonphenothiazines

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6
Q

Atypical antipsychotics MOA

A

Moderate blockage of dopamine receptors, stronger blockage of serotonin receptors

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7
Q

Differences btw typical and atypical antipsychotics

A

MOA and likelihood of EPS sx

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8
Q

Phenothiazine medications (3)

A

Chlorpromazine (Thorazine)
Thioridazine (Mellaril)
Fluphenazine (Prolixin)

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9
Q

Nonphenothiazines (3)

A

Haloperidol (Haldol)
Loxapine (Loxitane)
Molindone (Moban)

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10
Q

Which 2 phenothiazines are used as antiemetics?

A

Promethazine and prochlorperazine

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11
Q

Typical antipsychotic uses (4) and adverse effects (4)

A 
Schizophrenia, Tourette’s, etoh w/d
Intractable hiccups (Thorazine)

Drowsiness, orthostatic HoTN, EPS, anticholinergic effects

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12
Q

What are EPS sx? (3)

A

Acute dystonia
Akathesia
Tardive Dyskinesia

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13
Q

What is acute dystonia?

treatment & teaching

A

Muscle spasm of tongue/neck/face/back
Tx: antiparkinson/anticholinergics (benztropine)
Edu: possible laryngospasm

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14
Q

What is akathesia?

Treatment

A

Inability to stand still

Tx: benzodiazepine, possibly beta blocker

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15
Q

What is tardive dyskinesia?

Treatment and teaching

A

Protrusion/rolling of the tongue, lip smacking, chewing
Tx: valvenazine (Ingreza)
Edu: higher incidence in smokers and anticholinergic effects

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16
Q

A patient taking fluphenazine would expectedly have these side effects? (5)

A 
Constipation
Shuffling gait 
Mask like features
Tremors
Dry mouth
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17
Q

Neuroleptic malignant syndrome

w/ sx (7) and tx (6)

A

Potentially fatal reaction to antipsychotics
Sx: muscle rigidity, high fever, AMS, seizures, tachycardia/dysrhythmias, rhabdo, acute renal failure
Tx: immediate attention, stop med, antipyretics, hypothermic blanket, benzo, muscle relaxants

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18
Q 
Typical agents
Nursing considerations (4)
A

Patients avoid alcohol, sedatives, hypnotics, narcotics
Dose individualized
D/C gradually
Monitor for cheeking

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19
Q

Kava kava reaction with phenothiazines

A

Increased risk for dystonic reactions

Esp. W/ fluphenazine

20
Q

What does gingko biloba do to antipsychotics?

A

Potentiates the effects

haloperidol, olanzapine, clozapine

21
Q

St john’s wort effect on clozapine

A

Decreases levels of clozapine

22
Q

Atypical antipsychotic s/e (5)

A 
Weight gain (esp. clozapine and olanzapine)
Increased prolactin
Teratogenic effects
Diabetes
Agranulocytosis
23
Q

Atypical antipsychotic nursing considerations

A

Monitor weight
Encourage healthy diet and exercise
Monitor BG
Monitor for cheeking

24
Q

Atypical antipsychotic teaching

A

Increased prolactin = menstrual disorders, sexual dysfunction and osteoporosis
Watch WBC, report signs of infection, schedule returns for labwork

25
Q

Reactive depression

A

Benzodiazepine

26
Q

Major depression

A

Antidepressants

27
Q

Bipolar

A

Mood stabilizer

28
Q

SJW MOA

A

Decreases reuptake of serotonin, dopamine and norepi

29
Q

How long does it take antidepressants to work?

A

1-3 weeks initially

6-12 weeks for full response

30
Q

Serotonin syndrome sx (5) tx (2)

A

Sx: confusion, anxiety, restlessness, HTN, tremors
Tx: stop med, treat symptoms

31
Q 
Tricyclic antidepressants (TCA)
MOA, s/e, meds
A

Amitriptyline (Elavil)
Imipramine (Tofranil)
MOA: blocks reuptake of norepi and serotonin
S/e: sedation, orthostatic HoTN, drowsiness, anticholinergic effects

32
Q

Selective serotonin reuptake inhibitors (SSRI)

MOA, uses, s/e

A

MOA: blocks reuptake of serotonin
Uses: OCD, panic disorder, social phobia, anorexia, PTSD
S/e: sexual dysfunction, insomnia, nausea, risk of suicide

33
Q

SSRIs (6)

A 
Fluoxetine (Prozac)
Fluvoxamine (Luvox)
Sertraline (Zoloft)
Paroxetine (Paxil)
Citalopram (Celexa)
Escitalopram (Lexapro)
34
Q

Atypical antidepressants MOA, uses

A

MOA: effects reuptake of 1/3 or 2/3 of the neurotransmitters
Uses: major and reactive depression

35
Q

Atypical antidepressant meds

A

SNRIs:
Venlafaxine (Effexor)
Desvenlafaxine (pristiq)
Duloxetine (Cymbalta)

NDRIs: bupropion (Wellbutrin)

Serotonin antagonist:
Mirtazapine (Remeron)
Trazodone (Desyrel)

36
Q

Which atypical antidepressant may increase sexual desire and pleasure and is used for smoking cessation?

A

Bupropion (Wellbutrin)

37
Q

Monoamine oxidase inhibitor (MAOI)

MOA

A

Inhibits the deactivation of norepi, dopamine and serotonin

38
Q

MAOI meds

A

Tranylxypromine (Parnate)
Isocarboxazid (Marplan)
Phenelzine (Nardil)

39
Q

MAOI teaching

A

Avoid tyramine rich food

40
Q

Tyramine rich foods

A

Cheese, cream, yogurt, bananas, raisins, coffee, chocolate, italian green beans, liver, sausage, soy sauce, beer, red wine

41
Q

Drugs used for bipolar

A

Mood stabilizers (lithium, valproic acid, carbamazepine)

42
Q

Lithium therapeutic range/monitoring frequency

Sx of toxicity

A

0.5-1.5 needs checked q1-3 days

S/sx: n/v/d, ataxia, blurred vision, tinnitus

43
Q

Which electrolyte interacts with lithium?

A

Na, hyponatremia = reduced lithium excretion

44
Q

Lithoum teaching

A

Maintain adequate Na intake

Na effected by v/d, sweating, diuretics

45
Q

2 antiepileptic meds used for bipolar

A

Valproic acid and carbamazepine

46
Q

Valproic acid MOA

A

Increases GABA

which suppresses seizure activity, decreases manic episodes, and treats migraine headaches

47
Q

Carbamazepine MOA

A

Affects Na channels in neurons decreasing mania

L4 Pharm (2 decks)

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