Ch 17 (test 3)

Question 1

psychotherapeutics

Answer 1

treatment of emotional and mental disorders.

Question 2

Psychotropic drug is a treatment option when…

Answer 2

a patient is not able to cope with environment to perform activities of daily living and to interact socially with others.

Question 3

Anti-depressant agents

Answer 3

given for clinical depression to increase concentration of catecholamines in the brain.

Question 4

clinical depression

Answer 4

an affective disorder presented by an over-whelming sadness despair, hopelessness that is inappropriate to the events. (major depression).

Question 5

major depression signs

Answer 5

lack of energy
sleep disorders
no appetite
limited libido
inability to do activities of daily living

Question 6

Biogenic-amine theory of depression

Answer 6

clinical depression occurs when there is an imbalance of certain catecholamines at the adrenergic receptor site in the brain (norepinephrine, serotonin and dopamine)

Question 7

Selective Serotonin Reuptake Inhibitors (SSRI’s)

Answer 7

1. Newer antidepressant with fewer side effects but not quite as effective (affects only serotonin)
2. First line
3. takes 4-6 weeks to kick in.
4. Side effects include: insomnia, sexual dysfunction, and weight gain.

Question 8

Examples of SSRI’s

Answer 8

Prozac
Paxil
Zoloft

Question 9

TCA’s (tricyclic antidepressants)

Answer 9

1. prevents reuptake of neurotransmitters, letting them increase concentration at the receptor site.
2. 2nd line
3. also used for neuropathic pain and insomnia

Question 10

amitriptyline (Elavil)

Answer 10

1. TCA
2. don’t take with MAOI’s
3. pregnancy category D
4. caution w/ cardiac disease, psychosis, seizure history
5. SE: CNS increases anxiety and H/A
   CARDIAC:tachy cardia, ortho hypotension
   GI: weight gain, constipation, dry mouth
   OVERDOSE: use charcoal and na bicarb.

Question 11

MAOI’s monoamine oxidase inhibitors

Answer 11

1. inhibits MAOs to prevent breakdown of norepinephrine and serotonin
2. highly effective but requires diet changes
3. SE: dizziness and insomnia
4. Hypertensive crisis: occurs w/ tyramine

Question 12

Tyramine

Answer 12

ages cheeses, smoke/pickled meats, yeast, red wines, lava beans, beer, avocados.

Question 13

Examples of MAOI’s

Answer 13

Nardil, selegiline transdermal patch (Emsam)

Question 14

Signs of MAOI tyramine interaction

Answer 14

1. severe occipital headache
2. facial flushing and sweating
3. N&V
4. Chest pain and palpitations
5. photophobia
6. increased systolic and diastolic bp
7. nifedipine (Procardia) given to decrease bp and counteract interaction.

Question 15

Selegiline patch

Answer 15

1. 24 hours
2. can have some tyramine
3. avoid heat exposure

Question 16

newest antidepresant drugs

Answer 16

1. Lexapro
2. Cymbalta
3. Wellbutrin (also for cigarette cessation)
4. Zyban

Question 17

Antipsychotic agents

Answer 17

drugs used to treat psychosis

Question 18

psychosis

Answer 18

a biochemical imbalance that produces thought disorders.

Question 19

Schitzophrenia

Answer 19

most common psychotic disorder in which the pt has delusion, hallucinations and inappropriate responses to stimuli. NOT a cure.

Question 20

Anti-psychotic drugs/ neuroleptic agents.

Answer 20

dopamine receptor blockers so that the post-synaptic neurons cannot be stimulated by dopamine.
ALso depress the Reticular activating system

Question 21

Examples of anti-psychotic drugs

Answer 21

Thorazine, Haldol, Navane, Abilify, Loxitane, Clozaril

Question 22

SE of anti- psychotic drugs

Answer 22

Chemical restraints/sedation
weight gain
change urine color (pink/reddish brown)
bone marrow suppression
grapefruit juice; increases drug effectiveness slowing metabolation of the drug.

Question 23

Extrapyramidal effects

Answer 23

permanent side effects of anti-psychotic drugs

1. pseudoparkinsonism
2. dystonia
3. akathesia
4. tardive dyskinesia

Question 24

NMS Neuroleptic malignant syndrome

Answer 24

life threatening response with prolonged use to antipsychotic drugs

1. tachycardia
2. decreased LOC
3. high fever
4. incontinence
5. diaphoresis
6. extrapyramidial effects

Question 25

antimanic drugs

Answer 25

mood stabilizing drugs given to treat mania associated with bipolar disorder.

Question 26

Mania

Answer 26

excessive emotional state: excitement, elation, agitation, flight of ideas, excessive talking, and fleeting attention. May have violent, destructiveor self-destructive behavior.

Question 27

Lithium

Answer 27

mainstay for treatment of mania. 1. salt that changes the Na ion transport in nerve cells resulting in a change in catecholamine metabolism decreasing the responsiveness of hyperactive neurons in the brain. 2. therapeutic range .6-1.2 (2.0 toxic) 3. toxicity signs: cardiac arrhythmia, drowsiness and slurred speech, seizures, and death. 4. normal Na levels needed 135-145 5. lithium is increased during acute manic episodes.