CNS Flashcards
Atypical antipsychotics, help diminish what kind of symptoms?
Positive and negative
What is serotonin syndrome?
 Too much serotonin in the brain. Muscle rigidity, high heart rate and blood pressure, tightness in muscles and mental changes. 
What are the four “S” of SSRIs?
 Serotonin syndrome, sexual dysfunction, stomach issues, swollen (weight gain)
What is the black box warning for SSRI?
 Increase risk of suicide because you have the energy to commit suicide at this point
You must wait how many days after going off an MAOI to start a TCA?
14 days 
Tricyclic antidepressants, cause what kind of side effects?
Dizziness, dry mouth, constipation, and orthostatic hypotension
What type of foods should you stay away from when taking an MAOI?
Tyramine. Aged cheese, fermented foods, yogurt, beer, fish, processed meat
If you take an MAOI with tyramine food, what are you at an increased risk for?
Hypertensive crisis
Benzodiazepines should be taken at what time of the day?

At bedtime because they cause sedation
Benzodiazepines should never be taken with what kind of medication for pain?
Any narcotics: black box warning
Benzodiazepines treat what types of conditions
Alcohol or substance withdrawal, anxiety, seizures.
Adverse reactions for benzodiazepines are?
Hypotension, apnea airway, occlusion and respiratory arrest
What medication may cause dark urine, saliva and sweat?
Carbidopa/Levidopa
CNS stimulant: methylphenidate treats what conditions? AND what is it’s therapeutic responses?
ADHD and narcolepsy.
Improvements in school work, focus and social relationships.
What are some side effects of stimulants?
Stimulants can cause weight loss, delayed growth/development, dry mouth and increased HR/BP
All antipsychotics can cause (NMS) neuroleptic malignant syndrome. What are the signs?
High fever, muscle rigidity, altered mental status, autonomic dysfunction.
(High HR, BP and sweating)
What is the antidote for benzodiazepines?
Flumazenil
What is primary anxiety versus secondary anxiety?
Primary it just happens like anxiety attacks
secondary is because of drug use or physiological problem
What type of conditions can benzodiazepines help with?
Substance or alcohol withdrawal, stop, seizures, anxiety 
What is the black box warning for benzodiazepines?
May cause death when used with narcotics or other sedating medication’s
What are analytic or antianxiety medication side effects?
Sedation, dizziness, decreased reflexes, respiratory depression, blurred vision, contraindicated in pregnancy or breast-feeding
Buspar is what kind of medication and should not be taken with what food?
Antianxiety medication should not be taken with grapefruit juice.
 Has fewer side effects and less instances for dependency 
Ambien is used for treatment of what?
Insomnia
OTC sleep medication name?
Benadryl
Why are barbiturates rarely used anymore?
Severe adverse side effects 
Central nervous, stimulants should be taken when and are used to reduce what?
 Take in the morning and reduce appetite 
Amphetamines do what to your mood and alertness?
Produce mood elevation, or euphoria, and increase mental alertness
Xanthines are a class of stimulants that do what?
 Increase mental alertness, and decrease drowsiness/fatigue
Stimulants are a controlled substance. What schedule are they under?
Methylphenidate is a schedule  two controlled substance
What should you monitor in patients that are taking benzodiazepines?
 Mood and suicidal thoughts 
Anti-parkinsonism agents do what for the body?
 They do not cure Parkinsons, but they do help with the symptoms of Parkinson’s like tremors muscle, rigidity and weakness, and shuffling gait while walking
Parkinson’s is caused by an imbalance of which neurotransmitters?
 Dopamine and ACH
 Too much ACH and not enough dopamine
What medication is commonly used to treat Parkinson’s disease?
Hint: anticholinergics
Carbidopa/levodopa
 Carbidopa stops the breakdown of dopamine
Levodopa crosses the blood brain barrier, and is converted to dopamine 
MAO-B inhibitor (selegiline) decreases the enzyme that breaks down dopamine in the brain. What can this interaction cause?
(DRUG INTERACTION with Dopaminergics)
Hypertensive crisis 
Myasthenia Gravis is a progressive weakness and lack of muscle control. What kind of disease is this?
autoimmune disease caused by antibodies against ACH receptors 
What are positive symptoms of psychosis?
 Positive symptoms are anything that is added to the client symptom wise.
 For example, delusions, hallucinations, incoherent, aggressive, or violent behavior 
What are negative symptoms of psychosis?
Negative symptoms of psychosis or anything that is taken away from the client.
 For example, catatonia, social withdrawal, decreased self-care 
Atypical antipsychotics target what type of symptoms?
They target positive and negative symptoms
Phenothiazines a (antipsychotic medication) can cause your urine to turn colors?
Pink to reddish brown
Atypical antipsychotics, Target what symptoms?
both positive and negative symptoms 
Atypical antipsychotics typically have less EPS side effects. What does EPS stand for?
EPS symptoms include:
TD: mouth chewing and tongue
Akathisia: pacing, restlessness
Parkinsonism
Acute dystonia: muscle rigidity 
What kind of side effects can antipsychotics have?
Orthostatic hypotension, sedation, hypertension, impaired thermalregulation, convulsions, and EPS syndrome
Antipsychotics should not be stopped due to EPS side effects, the symptoms should be treated by what type of medication?
Anticholinergic: autonomic nervous system medication that decreases tremors and muscle rigidity by blocking cholinergic receptors
Side effects of anticholinergics EPS treatment?
Very dry, mucous membranes, constipation, blurred vision, urinary retention, hypotension
Neuroleptic malignant syndrome is a rare, but potentially fatal syndrome with a sudden onset of what type of symptoms?
High fever, muscle rigidity, altered mental status, changes in blood pressure, tremors, seizures, arrhythmias, acute renal failure, difficulty swallowing or speaking
Neuroleptic malignant syndrome is similar to what other syndrome?
 Serotonin syndrome
Anti-depressant medication’s can help with what types of issues?
Mood, sleep, appetite, anxiety, panic attacks, OCD
Major depression includes what
Seasonal affective disorder and postpartum depression 
What natural remedies are contraindicated when taking an antidepressant?
 St. John’s wort and ginkgo Biloba
Anything that start with a “G” tends to thin blood 
Tricyclic anti-depressants are used to treat major depression, what do they block the reuptake of?
Serotonin and norepinephrine
SSRI are similar to SNRI, but which is given more frequently due to less side effects?
SSRI
What is the black box warning on SSRIs?
Risk of suicide
Medication does not take full affect for 4 to 6 weeks, but they may have more energy by two weeks to commit to their suicidal plan
SSRIs and SNRIs side effects include what syndrome?
Serotonin syndrome
This is a toxicity due to too much serotonin in the body. It can cause autonomic nervous system dysfunction and mental status changes.
SSRIs and SNRIs treat what kinds of issues?
OCD, depression, panic and phobias, PTSD, and anxiety disorders
Atypical anti-depressants such as (Wellbutrin) treats, major depression, anxiety, and helps aid and smoking cessation. It affects which neurotransmitters?
It can affect one, two or all three neurotransmitters: norepinephrine, serotonin, dopamine 
Most antidepressants should not be taken with an MAOI anti-depressant.
How many days do you have to wait before starting a new antidepressant after taking an MAOI?
14 days after you stop the last antidepressant
MAOIs are not commonly used anymore, due to what factors?
Lots of side effects with other medication’s and fatal interactions
Patients taking an MAOI should have what monitored and should not eat which foods?
They should have their blood pressure monitored and avoid foods with tyramine. They should also avoid Saint johns wort.
MAOI medication can cause hypertensive crisis. What is a hypertensive crisis?
Sudden and drastic increase in blood pressure. Can lead to a heart attack.
Lithium is a mood stabilizer for bipolar disorder. What type of patients is lithium contraindicated for?
Lithium is teratogenic, and patients that are of childbearing age should take birth control
Lithium has a narrow therapeutic range of ???? anything over this range can become toxic.
0.5-1.5 mEq/L
Use with caution with diuretics
Lithium toxicity can cause, drowsiness, weakness, tremor, vomiting, ataxia (lack of coordination)
Side effects of mood stabilizers include ?
Dry mouth, bradycardia, increased thirst, increased urination, weight gain, metallic taste, peripheral edema 
Phenytoin is an anticonvulsant medication that treats what?
It has a narrow therapeutic range of?
Grand mal seizures
10-20 mcg/mL serum blood
Phenytoin has two serious adverse reactions. What are they?
Stevens-Johnson syndrome (bad rash)
Toxic epidermal necrolysis (blistering and rash) severe form of SJS syndrome
Gabapentin is an anticonvulsant medication that treats what?
Seizures and chronic pain
What should be monitored in kids taking stimulant?
Development because stimulants can stunt growth
Sleep, appetite, school work, kidney and liver function
Almost all central nervous system medication should be tapered off, no alcohol use and monitor for the risk of suicide?
True or false ?
TRUE
Haloperidol (Typical antipsychotic) has a black box warning of what?
Risk of death in elderly with dementia
Anhedonia is a loss of what?
Loss of interest
Minimum urinary output is what number (milliliters per hour)
30
Anticholinergic medication inhibits the action of acetylcholine. The side effects of this medication cause similar effects of what nervous system?
The sympathetic nervous system

What do anticholinergic medication’s do?
Smooth muscle relaxation: opens airways, decrease risk of aspiration, decreased peristalsis 
Anticholinergics are contraindicated with clients who have?
Benign prostatic hypertrophy, and glaucoma
Sympathomimetic
Working with/stimulating SNS
Sympatholytic
Working against SNS
Cholinergic medication’s mimic the action of what neurotransmitter?
(ACH) acetylcholine
Low acetylcholine levels are found in patients with Alzheimer’s and myasthenia gravis
Typical antipsychotics are highly protein bound meaning?
They are excreted in metabolized very slowly
Neuroleptic malignant syndrome can occur after the 1st dose, after 5 years or at any time while taking an antipsychotic medication. What are nursing interventions associated with NMS?
Stay hydrated!
Monitor I&O, monitor bowel movement’s, vital signs, heart rhythm, and blood.
REDUCTION OF SYMPTOMS
Which two conditions should you never give an anticholinergic medication?
BPH and glaucoma
