CNS Flashcards by Rylee Polster

Atypical antipsychotics, help diminish what kind of symptoms?

Positive and negative

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What is serotonin syndrome?

Too much serotonin in the brain. Muscle rigidity, high heart rate and blood pressure, tightness in muscles and mental changes.

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What are the four “S” of SSRIs?

Serotonin syndrome, sexual dysfunction, stomach issues, swollen (weight gain)

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What is the black box warning for SSRI?

Increase risk of suicide because you have the energy to commit suicide at this point

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You must wait how many days after going off an MAOI to start a TCA?

14 days

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Tricyclic antidepressants, cause what kind of side effects?

Dizziness, dry mouth, constipation, and orthostatic hypotension

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What type of foods should you stay away from when taking an MAOI?

Tyramine. Aged cheese, fermented foods, yogurt, beer, fish, processed meat

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If you take an MAOI with tyramine food, what are you at an increased risk for?

Hypertensive crisis

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Benzodiazepines should be taken at what time of the day?

At bedtime because they cause sedation

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Benzodiazepines should never be taken with what kind of medication for pain?

Any narcotics: black box warning

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Benzodiazepines treat what types of conditions

Alcohol or substance withdrawal, anxiety, seizures.

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Adverse reactions for benzodiazepines are?

Hypotension, apnea airway, occlusion and respiratory arrest

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What medication may cause dark urine, saliva and sweat?

Carbidopa/Levidopa

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CNS stimulant: methylphenidate treats what conditions? AND what is it’s therapeutic responses?

ADHD and narcolepsy.

Improvements in school work, focus and social relationships.

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What are some side effects of stimulants?

Stimulants can cause weight loss, delayed growth/development, dry mouth and increased HR/BP

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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)

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What is the antidote for benzodiazepines?

Flumazenil

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What is primary anxiety versus secondary anxiety?

Primary it just happens like anxiety attacks

secondary is because of drug use or physiological problem

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What type of conditions can benzodiazepines help with?

Substance or alcohol withdrawal, stop, seizures, anxiety

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What is the black box warning for benzodiazepines?

May cause death when used with narcotics or other sedating medication’s

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What are analytic or antianxiety medication side effects?

Sedation, dizziness, decreased reflexes, respiratory depression, blurred vision, contraindicated in pregnancy or breast-feeding

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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

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Ambien is used for treatment of what?

Insomnia

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OTC sleep medication name?

Benadryl

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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)

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