Brainscape's Knowledge GenomeTM

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


See full index

NUR 346 > Chapter 3. Neurobiology and Pharmacotherapy-1 > Flashcards

Chapter 3. Neurobiology and Pharmacotherapy-1 Flashcards

1
Q

Psychiatric illness results in

A

an alteration in neurotransmitters that are the targets of psychotropic drugs

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

Functions of the Brain

A

Maintenance of homeostasis
Regulation of autonomic nervous system (ANS) and hormones
Control of biological drives and behavior
Cycle of sleep and wakefulness
Circadian rhythms
Conscious mental activity
Memory
Social skills

All of these are carried out by interactions of neurons

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

An essential feature of neurons

A

is their ability to initiate signals and conduct an electrical impulse from one end of the cell to the other called neurotransmission.

**get a message and conduct it along, along the way they encounter different chemicals

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

Neurotransmitters

A

Norepinephrine
Serotonin
Glutamate
Y Aminobutyric acid (GABA)

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

Cellular Composition of Brain

A

Presynaptic neuron ==> synapse ==> postsynaptic neuron

When a nerve impulse reaches the end of the axon, the axon releases chemicals from the vesicles and those chemicals are called neurotransmitters

The neurotransmitters then travel across the synapse between the axon and the dendrite of the next neuron which is also called the postsynaptic neuron

These neurotransmitters bind to the membrane of the dendrite and this binding of the neurotransmitters to the receptor can trigger an action potential in the postsynaptic neuron

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

Define insufficient transmission

A

An insufficient degree of transmission may be caused by a deficient release of neurotransmitters from the presynaptic cell or by a decrease in receptors.

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

What causes excessive transmission?

A

may be due to excessive release of a transmitter or to increased receptor responsiveness, as occurs in schizophrenia.

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

What does the core of the brain do?

A

regulates internal organs and vital functions

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

What is the function of the hypothalamus?

A

basic drives and link between thought and emotion and function of internal organs

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

What is the function of the brainstem?

A

Processing center for sensory information

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

Where does brainstem pathways project to?

A

areas of the cerebrum collectively known as the limbic system

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

Key functions of the limbic system

A

plays a crucial role in emotional status and psychological function using norepinephrine, serotonin, and dopamine as its neurotransmitters.

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

Function of the cerebellum

A

Regulates skeletal muscle
Coordination and contraction
Maintains equilibrium
Coordinates smooth muscle movement and balance

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

Function of Cerebrum

A

Mental activities
Conscious sense of being
Emotional status
Memory
Control of skeletal muscles – movement
Language and communication

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

What does an EEG do?

A

Electroencephalography (EEG)

Shows the state a person is in, supports identification of brain abnormalities

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

What does Structured Imaging Techniques show?

A

provide overall images of the brain and layers of the brain.

Shows gross anatomical detail of brain structures

Can reveal schizophrenia and cognitive disorders

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

What does a CT (Computerized Tomography) of the brain show?

A

Urgent, Fast (2.5 min.); Large mass or bleed, lesions, infarcts

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

What does a MRI (Magnetic Resonance Imaging) show?

A

Longer study (~30-60 min.); Detailed brain imaging from application of magnetic field, shows edema, trauma, ischemia, neoplasm

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

What does Functional Imaging Techniques reveal?

A

reveal physiological activity in the brain.

Can detect physiological and biochemical changes in living tissue

Ex: Schizophrenia, mood disorders, adult ADHD

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

What does functional magnetic imagining (fMRI) show?

A

brain activity through blood O2

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

What does Positron Emission Tomography (PET) show?

A

injected tracer shoes activity of the brain and 3D brain imaging

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

What does single photon emission computer tomography (SPECT) show?

A

like PET but shows activity of the brain and brain layers

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

Define disturbances of mental functions that interplay between environment and genetics

A

evidence when talking about concordance in identical twins that grew up in separate environments however still affected by the same mental illness

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

The Biopsychosocial Hypothesis

A

Psychological Factos - traits, coping, defenses

Biological Contribution - often genetically related

Environmental Factors - family, social, cultural, substances, adverse life events

All contribute to a mental illness

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

Dopamine

A

Too much:
Schizophrenia and mania

Too little:
Some forms of depression, ADHD (frontal cortex) , muscular rigidity and tremors found in Parkinson’s disease

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

Function of Dopamine

A

involved in fine muscle movement

Involved in integration of emotions and thoughts

Involved in decision making (frontal lobe)

Stimulates hypothalamus to release hormones (sex.
Thyroid, adrenal)

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

Norepinephrine

A

Too much: Schizophrenia, anxiety states, mania

Too little: Depression

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

Functions of Norepinephrine

A

Level in brain affects mood

Attention and arousal

Stimulates sympathetic branch of autonomic nervous
system for “fight or flight” in response to stress

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

Serotonin

A

Too much: Anxiety states

Too little: Depression and some anxiety disorders especially OCD

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

Functions of serotonins

A

Plays a role in sleep regulation, hunger, mood states and pain perception

Hormonal activity

Plays a role in aggression and sexual behavior

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

GABA

A

Increase reduces anxiety

Too little: anxiety and anxiety disorders, schizophrenia, Mania, huntington’s decease.

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

Functions of GABA

A

Plays a role in inhibition, reduces aggression, excitation, and anxiety.

May play a role in pain perception

Has anticonvulsant and muscle-relaxing properties

May impair cognition and psychomotor functioning

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

Glutamate - NMDA

A

Decrease NMDA in psychosis. Increased NMDA for prolonged period is neurotoxic and causes neurodegeneration in Alzheimer’s disease.

Incease of AMPA improvement in cognitive performance in behavioral tasks

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

Functions of Glutamate - NMDA

A

Is excitatory

AMPA plays a role in learning and memory

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

Cholinergics

A

Increased in depression

Decrease in alzheimer’s disease, Huntinington’s, and Parkinsons

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

Acetylcholine

A

Too much: Depression

Too little in hippocampus: dementia

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

Functions of Acetylcholine

A

Plays a role in learning, memory

Regulates mood: mania, sexual aggression

Affects sexual and aggressive behavior

Stimulates parasympathetic nervous system

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

Adrenaline

A

Too much: anxiety and anxiety disorders

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

Epinephrine

A

Too little: Depression

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

Define Pharmacodynamics

A

What drugs do and how they do it

Drug action and drug responses

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

Define Pharmacokinetics

A

Actions of the body on the drugs (movement of a drug through the body)

ADME

Absorption
Distribution
Metabolism
Excretion

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

Define Pharmacogenetics

A

Effects of genetic variation on drug responses

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

True or False

Ideal drugs do not have side effects

A

FALSE

NO ideal drugs, they ALL have side effects

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

Define Absorption

A

How is the drug absorbed into the body?

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

Define Distribution

A

How id the drug distributed throughout the body?

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

Define Metabolism

A

How is the drug transformed for use and eventual excretion?

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

Define Excretion

A

How is the drug excreted from the body?

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

Define agonists

A

Mimic the effects of neurotransmitter naturally found in the human brain

  • Bind to and stimulate the neurotransmitter’s receptor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Define antagonists

A

Block neurotransmitters from binding to its receptors

  • obstruct the neurotransmitters action
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What are Anxiolytic Agents?

A

Anti-Anxiety drugs

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

List Benzodiazepines

A

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

**all addictive and scheduled CONTROLLED medications

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

Function of Benzodiazepines

A

Promote activity of GABA by binding to receptor on GABAa which increases frequency of CaCl channel opening

==> hyperpolariztion that inhibits cellular excitability which results in a calming effect

possess antianxiety, hypnotic (sleep-inducing), anticonvulsant, amnestic (loss of memory), and muscle relaxant properties.

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

Define SWICKIR

A

Somatic Symptoms
Worries
Irritability
Concentration
Keyed up/on edge
Initial Insomnia
Relaxation difficulties

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

Patients with a SWICKIR score of worries of __ have a significant probability of a clinically important anxiety disorder

A

Patients with a SWICKIR Anxiety Scale score of worries plus 3 other symptoms for at least 6 months are assumed to have a significant probability of a clinically important anxiety disorder.

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

Benzodiazepines for insomnia

A

Flurazepam (Dalmane)

Temazepam (Restoril)

Triazolam (Halcyon)

**These are for treatment of insomnia because they have a predominantly hypnotic (sleep-inducing) effect.

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

Benzodiazepines for alcohol withdrawal

A

Chlordiazepoxide (Librium)

Diazepam (Valium)

Lorazepam (Ativan)

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

Short-acting sedative-hypnotic sleep agents (Z-Hypnotics)

A

Zolpidem (Ambien)
Zaleplon (Sonata)
Eszopiclone (Lunesta)

Help to induce short-term sleep without the antianxiety, anticonvulsant, or muscle relaxant effects of benzodiazepines.

**The FDA has issued warnings on all approved hypnotic medications regarding complex sleep-related behaviors.

58
Q

Nonbenzodiazepine receptor agonists, or Z-hypnotics, include

A

Zolpidem (Ambien)
Zaleplon (Sonata)
Eszopiclone (Lunesta)

*** They possess hypnotic and amnestic effects without the antianxiety, anticonvulsant, or muscle relaxant effects of benzodiazepines. This is due to their selectivity for GABAA receptors containing an alpha ()-1 subunit.

59
Q

Eszopiclone (Lunesta)

A

causes an unpleasant taste in the mouth when you wake up.

60
Q

What is Melatonin

A

a hormone that is excreted at night as part of the circadian rhythm.

61
Q

Function of Ramelteon (Rozerem)

A

Melatonin Receptor Agonist

acts the same way as naturally occurring melatonin to help with sleepiness and regulation of circadian rhythms

Not classified as a scheduled substance, no abuse potential.

SE: Headache, dizziness

Not restricted to short term use.

62
Q

Orexin receptor antagonists (promote sleep)

A

Suvorexant
Lemborexant

63
Q

Suvorexant (Belsomra)

A

is an orexin receptor antagonist.

64
Q

Buspirone (BuSpar)

A

thought to work as a partial serotonin agonist

often better tolerated than benzos

Relieves anxiety with no sedative effect

No potential for addiction

Not a CNS depressant

SE: HA, dizziness, lightheadedness, nausea, insomnia

65
Q

What does melatonin receptor agonists stimulate?

A

the same receptor sites as endogenous melatonin

66
Q

T/F

Many antidepressants have proven to be effective treatments for anxiety disorders.

A

TRUE

67
Q

What are SSRIs?

A

Selective serotonin reuptake inhibitors

68
Q

What are SSRIs (Selective serotonin reuptake inhibitors ) used to treat?

A

OCD, social anxiety disorder (SAD), generalized anxiety disorder (GAD), panic disorder (PD), and posttraumatic stress disorder (PTSD).

69
Q

What is SNRI?

A

selective serotonin norepinephrine reuptake inhibitor

70
Q

What are SNRI (selective serotonin norepinephrine reuptake inhibitor) used to treat?

A

GAD, SAD, and PD. Another drug in that classification, duloxetine (Cymbalta), has FDA approval for GAD

71
Q

What is the monoamine hypothesis of depression regarding anti depressant drugs?

A

Suggests a deficiency in one or more neurotransmitters

72
Q

What is the prolonged use hypothesis regarding anti depressant drugs?

A

Suggests that prolonged use of antidepressants leads to increased neurotrophic factor production

73
Q

T/F

norepinephrine and serotonin help regulate mood

A

True

74
Q

T/F

Deficiency of one or both (norepinephrine, serotonin) within the limbic system causes depression

A

True

75
Q

List Tricyclic Antidrepressants (TCAs)

A

Amitriptyline (Elavil)
Imipramine (Tofranil)
Nortriptyline (Pamelor

76
Q

T/F

Tricyclic Antidrepressants (TCAs) are first line defense

A

False

Used to be the first line defense…no longer because they have more side effects, take longer to reach optimal dose, sedation, more lethal in overdose

77
Q

Function of TCAs

A

Thought to act by blocking reuptake of norepinephrine or both norepinephrine and serotonin

Has anticholinergic side effects: dry mouth, blurred vision, tachycardia, urinary retention, constipation.
May cause sedation and drowsiness
TCA overdose can be fatal.

78
Q

Side effects of TCAs

A

Orthostatic hypotension (esp. with elderly), confusion, disturbed concentration; anti-cholinergic side effects including blurred vision, dry mouth, constipation, urinary retention

ER/MEDICAL FLOOR TIP: In overdose, may cause fatal arrhythmias, slows AV conduction (consider monitored bed, telemetry)

79
Q

Nursing considerations of TCAs

A

suicidal precautions, sugarless lozenges for dry mouth, titrate down doses to avoid HA, Vertigo, wt. changes, avoid alcohol, sleeping pills, In bipolar patients, Tx with TCA’s may lead to hypomania or mania.

80
Q

List Monoamine oxidase (MAOIs)

A

Isocarboxazid (Marplan)
Phenelzine (Nardil)
Selegiline (EMSAM)
Tranylcypromine (Parnate)

81
Q

T/F

MAOIs are organic compounds

A

True

82
Q

What are Monoamine oxidase Inhibitors?

A

drug that inhibits action of MAO (enzyme that destroys monoamines) by preventing destruction of monoamines… So synaptic level of neurotransmitters is increased and makes the antidepressant effects possible

83
Q

What must a patient avoid when taking MAOIs?

A

must avoid tyramine rich foods (aged cheese, pickled or smoked fish, meats, wine) or risk hypertensive crisis

Hypertensive crisis (requiring emergency treatment):
Potentially causing a hemorrhagic stroke.

84
Q

Side Effects of MAOIs

A

HTN crisis with consumption of high tyramine foods, photosensitivity, weight gain, sexual dysfunction

85
Q

Nursing Considerations for MAOIs

A

Low tyramine diet; D/C 10 days prior to anesthesia, Monitor for urinary retention, Meds lower seizure threshold, Suicidal precautions.

Dietary restriction of tyramine must be maintained for 2 weeks after stopping MAOIs.

86
Q

What is tyramine found in?

A

some over-the-counter (OTC) medications, beer, wine, aged cheese, organ meats, avocadoes, and other foods.

87
Q

Adverse Drug Effect: Serotonin Syndrome

A

Can occur when multiple medications that alter serotonin metabolism are used together (MAOIs + SSRI, etc.)

Can be life-threatening

88
Q

S/S of Serotonin Syndrome

A

Tachycardia
Sweating (diaphoresis)
Fever progressing to hyperthermia
Shivering, Tremor
Muscle rigidity (myoclonus)
Restlessness/Agitation/Delirium/Coma

89
Q

List Selective Serotonin Reuptake Inhibitors (SSRs)

A

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

***Most common class prescribed for depressed mood

90
Q

What is the function of SSRIs?

A

Block reuptake and destruction of serotonin.
Less anticholinergic and sedating side effects
SE: apathy, low libido, N and V

91
Q

Indication of use for SSRIs

A

Depression, Anxiety disorders, OCD, Obesity, Bulimia

92
Q

S/S of SSRIs

A

Anti-cholinergic, nausea, headache, painful menstruation, sexual dysfunction, insomnia, rash, taste changes, dry mouth, anxiety, tremor, dizziness, weight loss/gain

93
Q

Nursing Considerations for SSRIs

A

Suicide precautions, Use in AM, Requires 4 weeks for full effect, monitor weight, good mouth care

94
Q

Indications for Serotonin

A

Depression, Anxiety disorders, OCD, Obesity, Bulimia

95
Q

Serotonin-norepinephrine reuptake inhibitors (SNRIs)

A

Venlafaxine (Effexor)
Desvenlafaxine (Pristiq)
Duloxetine (Cymbalta)
Levomilnacipran (Fetzima)

96
Q

T/F

Levomilnacipran (Fetzima) is an SNRI with less effect on norepinephrine reuptake than any of the other SNRIs available for treating depression.

A

FALSE

Levomilnacipran (Fetzima) is an SNRI with a GREATER effect on norepinephrine reuptake than any of the other SNRIs available for treating depression.

Increasing norepinephrine may be responsible for observed increases in heart rate and blood pressure in some patients.

97
Q

What does SNRIs increase?

A

Increases both norepinephrine and serotonin.

98
Q

Side effects of SNRIs

A

HTN is side effect in some pts with higher doses
Side effects include fewer anticholinergic effects.

99
Q

What does Cymbalta work best on?

A

on nerve pain, limits pain signals ascending to brain

100
Q

Norepinephrine and serotonin-specific antidepressant (NaSSA)

A

Mirtazapine (Remeron)

101
Q

Norepinephrine dopamine reuptake inhibitor (NDRI)

A

Bupropion (Wellbutrin) (Zyban)

used for depression
Also used for smoking cessation
No sexual dysfunction as a SE
Can not abruptly stop taking= seizure risk
May cause appetite suppression

102
Q

Mirtazapine (Remeron)

A

H1 antagonists

2nd or 3rd line antidepressant

useful in patients that experience sexual side effects

risk of elevated lipid levels

commonly used in elder patients

useful in combination therapy

103
Q

Serotonin antagonists and reuptake inhibitors (SARI)

A

Nefazodone (formerly sold as Serzone)
Trazodone (formerly sold as Desyrel) (Oleptro)
Brexpiprazole (Rexulti)

104
Q

T/F

trazodone (Desyrel) is NOT first choice for antidepressant treatment, but useful for insomnia. Can cause priapism.

A

True

105
Q

What does Rexuli cause?

A

weight gain

106
Q

Serotonin partial agonist reuptake inhibitor (SPARI)

A

Vilazodone (Viibryd)

107
Q

Function of Vilazodone (Viibryd)

A

Dual activity makes this a SPARI
Enhances serotonin by inhibiting the transporter and by stimulating serotonin
SE: Diarrhea, Nausea, vomiting, insomnia

108
Q

Serotonin Modulator and Stimulator

A

Vortioxetine (Trintellix)

109
Q

Function of Vortioxetine (Trintellix)

A

Inhibits serotonin reuptake (like SSRIs), and partially agonizing or antagonizing the 5-HT receptors

May also improve cognitive deficits in the elderly

SE: Constipation, Nausea, Vomiting
Serious SE: hyponatremia, induction of hypo(mania)

110
Q

Mood Stabilizing Agent - Lithium

A

lithium (Eskalith, Lithobid)

“The Gold Standard”
Stabilizes depression and mania (bipolar disorder).
Narrows the therapeutic index.
Has a potential for toxicity.
Toxic effects can include tremor, ataxia, confusion, convulsions, and N/V.
mechanism of action unknown. May act by affecting electrical conductivity in neurons bc it is a positively charged ion

Affects cardiac contraction can lead to sinus bradycardia

111
Q

Function of Valproate (Depakote/Depakene)

A

very effective in managing impulsive aggression.

112
Q

Function of carbamazepine (Tegretol)

A

Is administered for acute mania.

113
Q

Function of lamotrogine (Lamictal)

A

Is administered for maintenance therapy (most commonly used for patients with frequent depressive episodes).

***Watch for rash; may indicate Stevens-Johnson syndrome.

114
Q

Anticonvulsant Agents

A

Carbamazepine (Tegretol)
Divalproex (Depakote)
Lamotrigine (Lamictal)
Oxcarbezepine (Trileptal)

115
Q

Side Effect Profiles of Mood Stabilizers

A

Weight gain
Somnolence
Agranulocytosis
Thrombocytopenia
Hepatitis
Steven Johnson Syndrome- life threatening rash.

116
Q

T/F

A

Lithium and most anticonvulsant agents require monitoring of blood levels and organ functions.

117
Q

Therapeutic Blood Level for Lithium

A

0.8 to 1.4 mEq/L

118
Q

Maintenance Blood level for Lithium

A

0.4 to 1.3 mEq/L

119
Q

Maintenance Blood level for Depakote (Divalproex )

A

50 to 100 mcg/mL

120
Q

Maintenance Blood level for Lithium Tegretol (Carbamazapine)

A

4 to 12 mcg/mL

121
Q

Toxic Blood level for Lithium

A

1.5 mEq/L and above

122
Q

T/F

Lithium (a salt) competes with Sodium. Our body responds to Lithium in the same way it responds to Sodium.

A

True

123
Q

What affects Lithium levels?

A

New blood pressure medication (most of them shift lithium levels)

NSAIDs (non-steroidal anti-inflammatories) can significantly shift Lithium Levels

The most obvious is over-taking Lithium or continuing to take Lithium while losing a lot of water due to the flu, diarrhea, vomiting or excessive exercise without replenishing fluid.

124
Q

Signs of Lithium Acute Toxicity

A

Diarrhea; Nausea; Vomiting, Stomach Pains
Dizziness; Weakness
Confusion; Memory problems; Psychosis
Hand tremors; Muscle twitching; Ataxia (incoordination)
Nystagmus
Seizures; Coma; Kidney Failure

125
Q

Signs of Lithium Chronic Toxicity

A

Tremors; Slurred Speech; Increase reflexes

126
Q

What to do for Lithium overdose?

A

Activated Charcoal if overdose suspected; Nasal gastric tube to remove stomach content if lithium overdose, Force fluids through IV

127
Q

Antipsychotic Drugs

A

Phenothiazines
Thioxanthenes
Butyrophenones

**first generation

128
Q

What does first generation drug mean?

A

conventional, typical or standard antipsychotic drugs

129
Q

Function of second-generation (atypical) antipsychotic drugs

A

Produce fewer extrapyramidal side effects (EPS)
Target both the negative and positive symptoms
Predominantly D2 (dopamine) and 5-HT2A (serotonin) antagonists (blockers)
Often chosen as first-line treatment

130
Q

Side effects of second-generation antipsychotic drugs

A

Increase the risk of metabolic syndrome (increased weight, blood sugar, triglycerides)
Insulin resistance - long term

131
Q

Second-generation (atypical) antipsychotic drugs

A

Clozapine (Clozaril)
Risperidone (Risperdal)
Quetiapine (Seroquel)
Olanzapine (Zyprexa)
Ziprasidone (Geodon)
Aripiprazole (Abilify)
Paliperidone (Invega)
Iloperidone (Fanapt)
Lurasidone (Latuda)
Asenapine (Saphris)

132
Q

Clozapine (Clozaril)

A

The first atypical antipsychotic

Highly effective in treating treatment-resistant schizophrenia

Has the least possibility of causing extrapyramidal side effects
compared to traditional antipsychotics.

Requires regular blood monitoring for agranulocytosis

133
Q

What is monitored when taking Clozapine

A

Requires regular blood monitoring for agranulocytosis

134
Q

Describe extrapyramidal side effects

A

Extrapyramidal side effects including drug-induced parkinsonism (DIP) and tardive dyskinesia (TD) have been identified as frequent side effects of antipsychotics and have been associated with impaired quality of life1 and depression2 in patients with schizophrenia.

135
Q

Black Box Warning for Clozapine

A

agranulocytosis
seizures
myocarditis
for “other adverse cardiovascular and respiratory effects”,
for “increased mortality in elderly patients with dementia-related psychosis.“ ~ FDA

136
Q

Side Effects of Clozapine

A

often causes less serious side effects such as hypersalivation and weight

137
Q

What lab is obtained when giving Clozapine?

A

Obtain an absolute neutrophil count (ANC) for patients in accordance with the clozapine Prescribing Information and aligned with the patient’s monitoring frequency.

138
Q

ADHD (Attention Deficit Hyperactivity Disorder) Medication Treatment

A

Methylphenidate (Ritalin, Concerta)
Amphetamines (Adderall, Vyvanse)
Atomoxetine (Strattera): Nonstimulant: labeled for 6+
Guanfacine (Intuniv)
Clonidine (Kapay)

139
Q

Function of ADHD Medication

A

For short attention span, impulsivity, and overactivity

Sympathomimetic amines, function as agonists at adrenergic receptor sites
May inhibit overactive part of limbic system

***Due to their norepinephrine and dopamine enhancing effects, psychostimulants cause insomnia and increased blood pressure and heart rate.

140
Q

Medication Treatment for Alzheimers Disease

A

Cholinesterase inhibitors (slow the destruction of acetylcholine):
- Donepezil (Aricept)
- Galantamine (Razadyne)
- Rivastigmine (Exelon)

Glutamate-blocking agent:
- Memantine (Namenda, Namenda XR)

NUR 346 (10 decks)

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