Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

343 Pharm Exam 5 > Chapter 18 &22 & 23 : Psychotherapeutic Drugs > Flashcards

Chapter 18 &22 & 23 : Psychotherapeutic Drugs Flashcards

1
Q

We are going to need to know the chart in this PowerPoint to the tea.
So the following flashcards are regarding that chart

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 5 neurotransmitter we are going to be talking about?

A

Dopamine
Norepinephrine
Serotonin
Aminobutyric acid ( GABA )
Acetylcholine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the function of dopamine? (4)

A

Muscle movement
Integration of emotion and thoughts
Decision making
Hormone releasing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When you have too much dopamine what syndrome do you have ?

A

Schizophrenia mania

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When you have too little dopamine what syndrome do you have? (2)

A

Parkison disease
Depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the function of norepinephrine? (4)

A

Mood
Attention
Arousal
Stimulates fight or flight response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When you have too much norepinephrine what 3 syndromes do you have?

A

Mania
Anxiety
Schizophrenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When you have too little norepinephrine what syndrome do you have?

A

Depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the function of serotonin? (6)

A

Sleep regulation
Hunger
Mood
Pain perception
Aggression
Sexual behavior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What syndrome do you have when you have too much serotonin?

A

Nothing !

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What syndrome do you have when you have too little serotonin?

A

Depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the function of aminobutyric acid? (GABA) (3)

A

Inhibition
Reduces aggression, excitation and anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What syndrome do you have when you have too much GABA?

A

Decreased anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What syndrome do you have when you have too little GABA? (3)

A

Anxiety
Mania
Schizophrenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the function of acetylcholine? (4)

A

Learning
Memory
Mood regulation
Affects sexual & aggressive behavior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What do syndrome do you have when you have too much acetylcholine?

A

Depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What do syndrome do you have when you have too little acetylcholine? (3)

A

Alzheimer disease
Huntington disease
Parkinson disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What does schizophrenia mean?

A

Too many thoughts!!!

So when you’re treating schizophrenia, typically we are gonna use medications to lower the dopamine !

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How would you asssociate GABA neurotransmitter?

A

Like mom
Have a bad day, you go to mom and she calms you down !

When you’re stressed out it’s important to have mom around !

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Psychotherapeutic drugs

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Psychotherapeutic drugs function?
What are they used for?

A

Used in the treatment of emotional and mental disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Psychotherapeutic drugs are used in the treatment of emotional and mental disorders

What ability does it give patients?

A

Ability to cope with emotions can range from occasional depression or anxiety to constant emotional distress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

When are psychotherapeutic drugs indicated for patients?

A

When emotions significantly affect an individuals ability to carry out normal daily functions, treatment with a psychotherapeutic drug is a possible option

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the 3 main emotional and mental disorders?

A

Anxiety
Affective disorders
Psychoses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the 5 psychotherapeutic drugs we are going to talk about?

A

Anxiolytic drugs
Cns depressants
Mood-stabilizing drugs
Antidepressant drugs
Antipsychotic drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

We are gonna start with anxiety first

Anxiety!

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What does anxiety mean?

A

Unpleasant state of mind, characterized by a sense of dread and fear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Anxiety may be based on what? (2)

A

May be Actual anticipated experiences or past experience

Maybe be exaggerated responses to imaginary negative situations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

It’s important to note that a little bit anxiety is good? Why?

A

Because it heighten your senses
And focuses you

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

When do you treat anxiety?

A

When it’s interfered with daily activities or routines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Does there have to be a reason for you to be anxious or even depressed?

A

NO!!

Don’t say that. It’s so insensitive.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the anxiety drug name?

A

Anxiolytic drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the anxiolytic drug medication we are gonna talk about? (2)

A

Benzodiazepines & miscellaneous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is the function of anxiolytic drugs?

A

Reduce anxiety by reducing over activity in CNS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is the function or action of benzodiazepines?

A

Promotes GABA release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Benzodiazepines depress activity in the brainstem and limbic system
What are the 3 medications under this that does that ^

A

Alprazolam (Xanax)
Diazepam (Valium)
Lorazepam (Ativan)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Do benzodiazepines have a risk of addiction in patients? And if so, what do we do?

A

Yes there is dependence

Giving them cautiously & controlled

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Should you take benzodiazepines everyday?

A

Not really, if so, you take it in small doses everyday ( usually at night for sleep )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Benzodiazepines work best for what type of anxiety?

A

Intermittent

Like if you’re anxious on getting on a plane, take it

Public speaking? Take it

Just like a in moment thing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Benzodiazepines depress what activity?

A

CNS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Benzodiazepines increase what neurotransmitter?

A

GABA
( relaxes your body )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Benzodiazepines does not suppress your what?

A

REM sleep

( you can still wake up with that hangover feeling but not as much as other medication )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Benzodiazepines and drug interactions, what are their relationship?

A

They don’t really interact with much

Do not increase metabolism of other drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What are the 4 drug effects of benzodiazepines?

A

Calming effect on the CNS

Useful in controlling agitation and anxiety

Reduce excessive sensory stimulation, inducing sleep

Induce skeletal muscle relaxations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What are the indications of benzodiazepines? (8)

A

Sedation
Sleep induction
Skeletal muscle relaxations
Anxiety relief- anxiety related depression
Acute seizure disorders
ETOH withdrawal
Agitation
Balanced anesthesia:moderate/conscious sedation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What’s the anagram for the indication for benzodiazepines for anxiety medication? (8)

A

Sedation
Sleeps
Scaley
Anna

And
Alcohol
Agitates
Bri

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What is the scale we use for alcohol withdrawal symptoms?

What medication usually is given

A

C1 scale

Ativan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What are the side effects of benzodiazepines? (10)

A

Headache
Drowsiness
Dizziness
Cognitive impairment
Vertigo
Lethargy
Fall hazard for elderly people
( give low dose )

Hangover effect/ daytime sleepy

Monitor for abuse

Alcohol use intensifies side effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Since benzodiazepines usually cause hypotension, we are most worried about falling, mainly old people. What do we tell them??

A

Walk slowly
Get up slowly
Wear good shoes
Night light in bathroom
Empty bladder before going to bed
Make sure you have clear pathway

Call for help

No driving
Hazardous activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

No matter what type of medication
If it causes CNS depressants we don’t want to what?

A

Mix CNS depressants

Like alcohol is cns depressants
Don’t mix it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Can you overdose of benzodiazepines?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What is the antidoate benzodiazepines?

A

Flumazenil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What is the benzodiazepine overdose effects? (4)

A

Somnolence - excessive sleep
Confusion
Coma
Diminished reflexes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Typically people who overdose on benzodiazepines usually don’t die from the benzodiazepine alone because they go into hypotensive states and respiratory depression

Instead usually they can die from what?

A

Another CNS depressant or alcohol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What are the medication that benzodiazepines interact with? (5)

And what do these do?

A

Azole antifungals (PO)
Verapamil
Diltizam
Protease inhibitors
Macrolide antibodies

Prolonged the effectiveness of benzo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What type of juice do we tell these patients to avoid with benzodiazepines because they increase the effectiveness of it?

A

Grapefruit juice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What are some CNS depressants we want patients to avoid when on benzodiazepines? (3)

And why?

A

Alcohol
Opioids
Muscle relaxants

Because it causes increase CNS depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What is the medication that decreases benzodiazepines effectiveness?

A

Rifampin ( TB orange drug )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What are the 2 contraindication to not give benzodiazepines to patients?

A

Glaucoma
Pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

If you have a patient who is anxious and also being treated for TB ( rifampin ), would benzodiazepines be the best medication to treat them?

A

No

Rifampin decrease effectiveness of benzodiazepines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Miscellaneous anxiolytic

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What is the medication we are gonna talk about with miscellaneous anxiolytic?

A

Buspirone ( BuSpar )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What is so great about buspirone (BuSpar)?

A

Non sedating
Non addicting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

How long does buspirone (BuSpar) last for?

A

Take twice a day and long effectivness
Every day!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Buspirone (BuSpar)
What are the drug interactions?
What do you get with this?

A

SSRI

Serotonin syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

What medication do we not want to be mixed or administered with Buspirone (BuSpar)

A

MAOIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

What are the 3 adverse effects of Buspirone (BuSpar)?

A

Paradoxical anxiety
Blurred vision
Headaches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Usually Buspirone (BuSpar) are for those we are what type of anxious?

A

Chronically anxious

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

CNS depressants

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What is CNS depressants, medication name?

A

Nonbenzodiazepines hypnotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What do we use CNS depressants : Nonbenzodiazepine hypnotics?
Like treat what?

A

Insomnia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

What are the nonbenzodiazepine hypnotics medications? (4)

A

Zaleplon (Sonata)
Zolpidem (ambien)
Eszoplicone (lunesta)
Ramelteon (Rozerem)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Ramelteon (Rozerm) does not cause what? (3)

A

CNS depression
No potential abuse
No withdrawal symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Lunesta and extended release zolpidem (ambien) approved for what?

A

Long term therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Should we use nonbenzodiazepine hypnotics everyday?

A

NO!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

What are the important things for nonbenzodiazepine hypnotics ?

A
  1. Crazy things
  2. Works on for 6-8 hours
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

When do we tell patients about nonbenzodiazepine hypnotics about their sleep?

A

Take their medication when they are 100% sure are gonna sleep 8 hours of sleep !!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What if they don’t get enough sleep when taking nonbenzodiazepine hypnotics?

A

Very very tired
Risk for injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

What time do we tell patients to take their nonbenzodiazepine hypnotics?

A

1 hour before sleep time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Affective disorders
Mood disorder

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

What does mood disorders mean?

A

Changes in mood that range from mania

( abnormally pronounced emotions to depression, abnormally reduced emotions )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Some patients are famous for exhibiting both mania and depression, famously known as what disorder?

A

Bipolar disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

What is the mood disorder medication class called?

A

Mood-stabilizing drugs

84
Q

What is the two medication we use for mood-stabling drugs?

A

Lithium carbonate
Lithium citrate

85
Q

Can other drugs like, benzodiazepines, antipsychotic drugs, antieplieptic drugs and dopamine rectors agonist be used with mood stabilizers?

A

Yes

86
Q

Does lithium have a narrow therapeutic window?

A

Yes!!

87
Q

What is the range of lithium?

A

0.6-1.2mEq/L

88
Q

Since lithium has a narrow theruaptic range, what do we usually do before giving this medication to patients?

A

Baseline of liver & kidney test

89
Q

We also usually have to do a what type of work and how many days at the start of treatment of lithium?

And why?

A

Blood work
1-3 days

Because we don’t want a toxic level

90
Q

Lithium is a what?

A

A salt!
Acts the same way as sodium

91
Q

Since lithium is a salt, lithium toxicity can occur with what 2 things?

A

Dehydration
Hypernatremia

92
Q

So patients should do what to help about dehydration and what activity when taking lithium ?

A

Stay hydrated

Avoid strenuous activity during high heat

93
Q

What are the 5 common side effects of lithium?

A

Metallic taste
Tremors
Nausea
Polyuria
Weight gain

94
Q

Antidepressants

A
95
Q

What are antidepressants used for?

A

To treat many mental health disorders

Migraines
Chronic pain syndrome
Sleep disorders

96
Q

What are the 4 categories of antidepressants we are going to discuss about?

A

Tricyclic antidepressants (TCA)
Monoamine oxidase inhibitors ( MAOIS)

seconds generation antidepressants
- Selective serotonin reuptake inhibitors ( SSRIS)

  • serotonin norepinephrine reuptake inhibitors (SNRIS)
  • miscellaneous
97
Q

Second generation antidepressants have 3 things under them, which are?

A
  • Selective serotonin reuptake inhibitors ( SSRIS)
  • serotonin norepinephrine reuptake inhibitors (SNRIS)
  • miscellaneous
98
Q

What is tricyclic antidepressants? (TCA)

Have been replaced by what ?
And are known as ?

A

Have largely been replaced by SSRI as first-line antidepressant drugs

Second line treatment

99
Q

SSRI&SNRIS came out 30 years ago
And have changed the world so much
Why?

A

Because they don’t have many side effects like TCA and MAOIs

100
Q

Back in the day, many providers never put patients on TCA or MAOI why?

A

Because the treatment was worsen than having depression

101
Q

What are the 2 considerations to start treatment on TCA?

A

Patients who fail the usage of SSRI

Adjunct therapy with newer generation

102
Q

TCA should not be given with how many days and with what drug?

A

14 days

MAOI’s

103
Q

Why do we have to wait 14 days of MAOIS for another anti depressants?

A

Because toxic effects

104
Q

What is the medication example of TCA?

A

Amitriptyline (Elavil)

105
Q

What is the mechanism of action of tricyclic antidepressants (TCA)?

A

Inhibits presynaptic re-uptake of norepinephrine and serotonin

106
Q

It is thought that increasing concentration of ______ will correct the abnormally low levels that lead to depression for TCA

A

Neurotransmitter
Norepinephrine and serotonin

107
Q

Can you cold turkey TCA?

So how is the process with switching over to MAOIS

A

No

Taper off slowly with TCA
then wait 14 days (2 weeks)
Then take MAOIS

108
Q

How do we administer TCA?
What is the peak?
What is the half life ?

A

Orally
1-2 hours
8-16 hours

109
Q

Tricyclic antidepressants are metabolized where?
Excreted where?

A

Liver
Kidneys

110
Q

Is Tricyclic antidepressants safer than MAOIS ?

A

Yes

111
Q

What is TCA usually used for, like what type of patients? (4)

A

Major depression
Enuresis (bed wetting)
OCD
Adjunct medication for chronic pain

112
Q

When we are treating something else other than depression when using TCA, what is usually the dose?

A

Usually lower

113
Q

Usually a lower dose for TCA when treating other illness other than depression like migraines and such.
We are the positive?

A

Not that many side effects

114
Q

What are the 2 massive side effects of TCA?

A

Orthostatic hypotension
Cardiac dysrhythmias

115
Q

So the big two side effects of TCA are the
Orthostatic hypotension &
Cardiac dysthrymjas
What about the other side effects?

A

Anticholinergic side effects
- sedation
Dry mouth
Constipation
Urinary retention
Excessive perspiration

116
Q

TCA are something that cause orthostatic hypotension, what do we usually tell patients?

A

Get up slowly
Ask for help

Our biggest worry is them falling, especially elderly patients

117
Q

When you immediate stop taking TCA, what effect can you have?

A

Cholinergic rebound

118
Q

What is cholinergic rebound ?

A

Hyper salivation
Diarrhea
Urinary urgency
Sweating

119
Q

Patients, mainly elderly patients who are on tricyclic antidepressants, our biggest worry is them falling because TCA medications will cause them what side effects? (6)

A

Dizziness
Postural hypotension
Constipation
Delayed micturetion ( urinary retention )
Edema
Muscle tremors

120
Q

What do we educate patients on dry mouth?

A

Sugar free candy
Ice chips
Water- fluid

121
Q

Can you overdose on tricyclic antidepressants?

A

Sadly yes

122
Q

When do symptoms of overdose occur ? Like what is the time frame of TCA ?

A

1-4 hours

123
Q

What are the overdose symptoms of TCA? (5)

A

Nystagmus - rapid involuntary eye movement
Tremor
Seizures
Hypotension
Dysrhythmias

124
Q

Tricyclic antidepressants overdose
70-80% of people don’t what?

A

Don’t make it to the hospital,
It’s so lethal

125
Q

Is there an antidoate to reverse the tricyclic antidepressant?

A

No

126
Q

What is the main death cause from overdosing on tricyclic antidepressants?

A

Cns and cardiovascular system are mainly effect

Seizure or dysrhythmias

127
Q

Since there isn’t an antidote of tricyclic antidepressants, what are we gonna do?

Decrease drug absorption with ___
Speed elimation by __
Manage ___(2)
Basic ___

A

Activated charcoal
Alkalinizing urine
Seizures & dysthymias
Basic life support

128
Q

We usually like putting patients on a lot of fluids on overdose because of what for TCA?

A

Because their hypotensive

129
Q

Making the urine alkalinizing to help with overdose will do what for TCA?

A

Speed elimination by peeing it out

130
Q

How long are these patients on TCA for?

And what are we doing for these patients?

A

Usually a month

Keeping them in contact because we don’t want to give them something they can use to harm themselves

Frequent follow ups
How many pills they can get

131
Q

MAOI inhibitors

A
132
Q

What is the action of MAO inhibitors?

A

Binds to MAO enzyme system in the CNS, increase epinephrine, norepinephrine, serotionin and dopamine

133
Q

MAO inhibitors are as effective as TCA and SSRI, however they are what?

A

Not as safe as

134
Q

How long does it take for MAOI to start showing effectiveness?

A

2-8 weeks

135
Q

What are the indications for MAOI ? (2)

Notes
They also can be used for Parkinson’s disease in a very very low dose!

A

Depression, especially type characterized by vegetative symptoms such as increased sleep & appetite
( reversed depression )

Depression that does not respond to other drugs such as tricycles

136
Q

Usually MAOI are the last what ?

A

Last choice medication

137
Q

What are the 2 most serious side effects of MAOIS?

A

Hypertension
- precipitated by eating foods containing tyramine

138
Q

What other side effects of MAOIS? (5)

Think of the 3Ds and O!!

A

Dysthrymjas
Dizziness
Drowsiness
Sexual dysfunction
Orthostatic hypotension

139
Q

What medications are we gonna tell patients to avoid when taking MAOIS and why? (3) meds
(2) reason why

A

OTC cold & allergies
- because it causing vasoconstriction

SSRI
- serotonin syndrome

140
Q

What is a hypertensive crisis with serious side effects of MAOIS?

A

High blood pressure where it’s like Vasoconstriction and your not getting enough perfusion in your body vital organs

So heart attack, stroke and death easily

141
Q

Can you overdose on an MAOI?

A

Yes

142
Q

How long does it take for overdose symptoms to start showing for MAOI?

A

12 hours after ingestion

143
Q

What are the 4 overdose symptoms of MAOIS?

A

Tachycardia
Circulator collapse
Seizures
Coma

144
Q

The treatment of overdose of an MAOI
Really is to protect the brain & heart and to help eliminate the toxin

So what are the 2 ways we are gonna do this?

A

Urine acidification
Hemodialysis

145
Q

So MAOI is what urine
TCA is what urine?

A

Maoi is acidification
TCA is alkaline

146
Q

Ingestion of foods or drink with tyramine leads to hypertensive crisis, which may lead to cerebral hemorrhage, stroke, coma or death
When patients take what medication?

A

MAOI

147
Q

What are some examples of food that patients should avoid when taking MAOIS that contain tyramine?

A

Aged, mature cheese
( cheddar, blue, Swiss)

Smoked/pickled or aged meats
Fish poultry
( herring, sausage; corned beef, salami, pepperoni, pâté)

Yeast extracts

Red wine
( chianti, burgundy, sherry, vermouth )

Italian broad beans ( fava beans )

148
Q

Second generation antidepressants

A
149
Q

What are the 3 second generation antidepressants categories we are gonna talk about?

A

SSRI
Selective serotonin re uptake inhibitor

SNRI
Selective norepinephrine re uptake inhibitor

Miscellaneous

150
Q

Second generation antidepressants usually are better than TCA and MAOI why?

A

Fewer adverse effects

151
Q

Second generation antidepressants
Are now considered to be what?

A

First line drug for depression

152
Q

How long does it take for second generation antidepressants to reach maximum clinical effectiveness?

A

4-6 weeks

153
Q

Second generation antidepressants have very very few what with food and drugs?

A

Interactions

154
Q

What are your side effects of your second generation antidepressants? (3)

A

Sexual dysfunction
Tired vs energy
Weight gain vs weight loss

155
Q

Do we have to taper off second generation antidepressants ?

A

Yes, slowly taper off

Like if patients have sexual dysfunction, we can change it but typically slowly taper off

156
Q

Notes
Second generation antidepressants indications

Depression
Bi-polar
Obesity ; eating disorders
OCD
panic attack or disorders
Social anxiety disorder
PTSD
Treatment of various substance abuse problems
( bupropion is used for smoking cessation treatment )

A
157
Q

What is the miscellaneous second generation antidepressant medication? (4)

A

Trazodone( desyrel, oleptro)
Bupropion (Wellbutrin)
Nefazodone (serzone)
Mirtazapine (remeron)

158
Q

Trazodone (desyrel,oleptro)
- often used for what?

Bupropion (Wellbutrin)
Used for what?

A

Sleep

Smoking cessation

159
Q

Bupropion (Wellbutrin) puts patient at what risk?

A

Seizures

160
Q

SSRI mechanism of action?

A

Selectively inhibit serotonin reuptake

Little or no effect on norepinephrine or dopamine reuptake

Result in increased serotonin concentrations at nerve endings

161
Q

SNRI mechanism of action?

A

Inhibit reuptake of both serotonin and Norepinephrine

162
Q

SSRI and SNRI have a black box warning
Why and what is this warning?

A

Increases risk of actual suicide

So when the patient usually starts to get better, their idea of suicide is increased

163
Q

When working with anyone who has any mental illness you always wanna open the conversation with what?

A

Are they having any thoughts of harming themselves or killing themselves

164
Q

What is serotonin syndrome?

A

A serious and fatal syndrome

In which occurs when two medications affecting reuptake of serotonin are taken at the same time

165
Q

How long does it take for serotonin syndrome to start?

A

2 hours of taking first dose

166
Q

To avoid serotonin syndrome
What do we tell patients ?

A

Do not take SSRI and MAOI within 5 weeks of each other

167
Q

What are the symptoms serotonin syndrome?

A

Delirium
Tachycardia
Hyperreflexia
Shivering
Agitation
Sweating
Muscle spasms
Coarse tremors

168
Q

What are the severe symptoms of serotonin syndrome? (7)

A

Hyperthermia
Seizures
Renal failure
Rhabdomyloysis
Dysthrymjas
Disseminated Intravascular coagulation ( DIC)

( complication that occurs where you are bleeding & clotting at the same time ^^

Bleeding everywhere and using micro clots, so your body doesn’t have the ability to stop bleeding, most cause of death is really bleeding of death. Most happens in pregnancy & cancer patients )

169
Q

Neuroleptic syndrome and serotonin syndrome symptoms are like literally the same

What are the difference tho?

A

Neuroleptic is caused by antipsychotic medications

Serotioin is caused by antidepressant

170
Q

There will be a test question of a serotonin/neurloleptic syndrome
The symptoms are the same

We have to differentiate due to the medication

A
171
Q

How do we treat the DIC in serotonin syndrome?

A

Heparin and blood products

172
Q

Psychosis !!!

A
173
Q

What is psychosis ?

A

Severe emotional disorder that impairs the mental function of the affected individual to the point that the individual cannot participate in activities of daily living

174
Q

What are 2 examples of psychosis?

A

Schizophrenia
Depressive and drugs induced psychoses

175
Q

What is the hallmark of psychosis?

A

Loss of contact with reality

176
Q

What is the drug class we used for psychosis?

A

Antipsychotics

177
Q

Antipsychotics also have been known as two other names?

A

Tranquilizers
Neuroleptics

178
Q

Antipsychotics are here to treat what?

A

Behavior problem
Psychotic disorders

179
Q

What are the two types of antipsychotics?

A

Typical antipsychotics
Atypical antipsychotics

180
Q

What is the mechanism of action of antipsychotics?

A

Block dopamine repertoire in the brain ( limbic system, basal ganglia) areas associated with emotion, cognitive function and motor function

181
Q

What is the result of antipsychotics?

A

Tranquilizing effect in psychotic patiejtsb

182
Q

In antipsychotics, dopamine levels and CNS levels are what?

A

Decreased

183
Q

What is atypical antipsychotic mechanism of action? (2)

A

Block specific dopamine receptors
Dopamine 2-rectors

Block specific serotonin receptors
Serotonin 2 (5-HT2h receptors )

( this is responsible for their improved efficacy and safety profiles )

184
Q

What is the adverse effects of antipsychotics? (14)

A

Photosensitive
Pruritus
Orthostatic hypotension
Sedation
Delirium
Dizziness
ECG changes
Anti-cholinergic effects
Urinary hesistancy or erection
Leukopenia & agranulocytosis
Galactorrhea
( producing milk but not pregnant )
Irregular menses
( mess up menstrual cycle )
Increase appetite
Polydipsia

185
Q

What is An anagram to help remember antipsychotic? (14)

A

Photoshoot
Praises
Olivia
Sexy
Delirious
Dances
Exactly
As
Uranus
Lover
George
Iggy
Is
Pretty

186
Q

What are the 2 big adverse effects to remember tho for antipsychotics?

A

EPS/ extrapyramidal symptoms
Pseudoparkinsonism

( tremors, rigidity, stopped posture )

Tardive dyskinesia

187
Q

What is tardive dyskinesia? (3)

A

Lip smacking
Worm like movements of the tongue
Uncontrolled chewing & grimacing

188
Q

Patients may also experience
Acute dystonias which is?
Akathisia?

Usually is treated with benztropine ( cogenin ) and trihexypgenidyl (artsne)

Symptoms can be reversible if caught early but if not can be permanent

A

Painful muscle spasms of face, tongue, neck or back

Inability to rest and relax ; pacing

189
Q

What is neuroleptic malignant syndrome?

A

Client suffers a toxic fatal reaction to therapeutic disease of antipsychotic drug

190
Q

What are the symptoms of neuroleptic malignant syndrome ( NMS)?

A

Same as serotonin syndrome

Elevated temperature
Unstable blood pressure
Profuse sweating
Dyspnea
Muscle rigidity
Incontinence

191
Q

What is the main difference once again between neuroleptic malignant syndrome and serotonin syndrome?

A

NMS
- antipsychotic

Serotonin
- antidepressant

192
Q

Herbal products !!

A
193
Q

What’s the the two herbal products ?

A

St. John wort
Ginseng

194
Q

St.john wort is used for what?

A

Depression
Anxiety
Sleep disorders
Nervousness

195
Q

St. John wart may cause what symptoms? (6)

A

Gi upset
Fatigue
Dizziness
Confusion
Dry mouth
Photosensitive

196
Q

St. John wort has a severe interaction if taken with what two drugs?

A

MAOIS & SSRI

197
Q

St. John sort also has a food interaction with what?

A

Tyramine

198
Q

St. John wort also decreases what for females?

A

Birth control pills

199
Q

What is ginseng used for?

A

Stress reduction
Improvement of physical endurance and concentration

200
Q

Ginseng may cause what?

A

Elevated blood pressure
Chest pain
Palpitations
Anxiety
Insomnia
Headache
Gi symptoms

201
Q

Ginseng interactions with what 4 drugs?

A

Anticoagulants - bleeding
Immunosuppressants
Anticonvulsants
Antidiabetics

202
Q

Psychotherapeutic drugs
Nursing implications

A
203
Q

Psychotherapeutic drugs
Nursing implications

Before beginning therapy, assess physical and emotional status of patients

Obtain baseline vital signs, including postural BP readings

Obtain liver and renal functions test

Assess for level of consciousness, mental alertness, potential for injury to self and others

Check the patients mouth to make sure oral doses are swallowed

Advise patients to avoid abrupt withdrawal

Advise patients to change position slowly to avoid postural hypotension and possible injury

The combination of drug therapy and psychotherapy is emphasized because patients need to learn and acquired more effective coping skills

Only small amounts of medications should be dispensed at a time to minimize the risk of suicide attempts

Simultaneous use of these drugs with alcohol or other CNS depressants can be fetal

A
204
Q

Antidepressants nursing implications

Inform patients that it may take several weeks to see therapeutic effects

Monitor patients closely during this times, assess for suicidal tendencies and provide support

Assist elderly or weakened patients with ambulation and other activities because calls may occur because of drowsiness or postural hypotension

Tricycle may need to be weaned and discontinue before undergoing surgery to avoid interactions with anesthetic drugs

Encourage patients to wear medication ID badges naming the drugs being taken

Caffeine and cigarettes smoking may decrease effectiveness of medication therapy

With MAOIS, instruct patients and family regarding tyramine- containing foods and signs and symptoms of hypertensive crisis

A
205
Q

Antipsychotics- phenothizaines
Nursing implications

Instruct patient to wear sunscreen because of photosensitivity

Tell patients to avoid taking antacids or antidiarrheal preparation within 1 hour of a dose

Inform patients to avoid alcohol or other CNS depressants with these medications

Long term haliperidol therapy may result in tremors, nausea, vomiting, or uncontrollable shaking of small muscle groups; report these symptoms to the physician

Oral form may be taken with meals to decrease GI upset

These drug may cause drowsiness, dizziness, or fainting, instruct patients to change position slowly

A
206
Q

Monitor for therapeutic effects
Monitor mental alertness, cognition, affect, mood, ability to carry out activity of daily living, appetite and sleep patterns

Monitor for potential self injury during the delay between the start of therapy and symptomatic improvement

A

343 Pharm Exam 5 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions