Chapter 4- Psychopharm Flashcards
tolerance
over time, may need increased dosage to achieve same effect
dependence
physical or psychological
with stopping, withdrawal symptoms
anxiolytics
Benzodiazepines
buspirone
Benzodiazepines
decreases the CNS (limbic and reticular system)
antidote: flumazenil
also can be used for: ETOH withdrawal, seizures, spasms, sedation
SE: have GABA potentiation, may have paradoxical effect
do not give to elderly/parkinson
common benzos
clonazepam
lorazepam
alprazolam
diazepam
buspirone
BuSpar
does not depress CNS
no risk of abuse
has a delayed action (takes 3-4 weeks to reach full effect)
antidepressants
MAOIs
Tricyclics
SSRIs
SNRIs
atypical antidepressants
MAOIs
inhibit MAO enzyme that inactivates neurotransmitters
increases risk for suicide initially
avoid tyramine and OTC cold meds
commons MAOIs
selegiline
isocarboxazid
phenelzine
Tricyclics
block reuptake of norepi and serotonin
SE: anticholinergic, orthostatic hypotension
toxicity causes cardiac arrhythmias
common tricyclics
nortriptyline
amitriptyline
desipramine
doxepin
anticholinergic effects
dry mouth
blurred vision
photophobia
constipation
tachycardia
urinary retention
SSRIs
block the reuptake of serotonin
SE: dry mouth, sexual dysfunction, hyponatremia
toxicity= serotonin syndrome
common SSRIs
fluoxetine
sertraline
citalopram
escitalopram
fluoxetine
Prozac
sertraline
Zoloft
citalopram
Celexa
escitalopram
Lexapro
serotonin syndrome
toxicity of SSRIs
diarrhea
hyperreflexia
fever
spasms + seizure
dilated pupils
shivering
tachycardia
HTN
SNRIs
similar SE of SSRIs
common SNRIs
venlafaxine
duloxetine
desvenlafaxine
atypical antidepressants
bupropion- for withdrawal
trazodone- helps w insomnia
mirtazapine- increases appetite
Mood Stabilizers
treat bipolar disorder
increase suicide risk
Lithium
Anticonvulsants
Antipsychotics
lithium
narrow therapeutic range (0.6-1.2)
SE: weight gain, hypotension
antidote: mannitol
Educate: maintain adequate fluid intake, ensure sodium intake is stable. will need to draw blood 12 hrs after last dose
trough level
lowest concentration of med
draw blood for lithium 12 hrs after last dose
sodium and fluid impact on lithium
increased sodium=decreased effect of lithium
if dehydrated=increased effect of lithium
Anticonvulsants
inhibits glutamate, causes suppresssion of CNS excitation
SE: hyponatremia, steven johnson syndrome
can cause birth defects, will need pregnancy test in women
common anticonvulsants
clonazepam
carbamazepine
valproate
topiramte
Antipsychotics
“neuroleptics” “major tranquilizers”
treat schizophrenia, adjunct med for depression, can be used as an antiemetic for Tourettes
Typical vs Atypical
Antipsychotic side effects
EPS + neuroleptic malignant syndrome w typicals.
temperature regulation issues
anticholinergic
decreased libido
amenorrhea
weight gain
prolonged QT
diabetes
photosensitivity
Extrapyramidal symptoms
acute dystonias
akinesia
akathisia
oculogyric crisis
tardive dyskinesias
antidote for EPS from antipsychotics
benztropine
Antipsychotic contraindications
elderly
Parkinson’s
glaucoma
seizures
CNS depression
positive schizophrenia symptoms
hallcuinations, delusions, disorganized thoughts
negative schizophrenia symptoms
blunted affect, alogia
Typical antipsychotics
treat positive symptoms only
meds: haloperidol, loxapine, phenothiazines
Atypical antipsychotics
treat positive AND negative symptoms
low potential for EPS
meds: clozapine, risperidone, quetiapine
clozapine major SE
agranulocytosis
ADHD medications
Amphetamines
atomoxetine- inhibits reuptake of norepi
bupropion- blocks uptake of serotonin, dopamine, norepi
Amphetamines
CNS stimulants
increase neurotransmitters
SE: anorexia, overstimulation, palpitations, tachycardia, insomnia, restlessness
Educate: dont give w/in 6hrs of bedtime, do not consume caffeine, monitor blood sugar
common amphetamines
methylphenidate
dexmethylphenidate
dextroamphetamine
lisdexamfetamine
Amphetamine contraindications
hypertension
hyperthyroidism
glaucoma
MAOIs
