Brainscape's Knowledge GenomeTM

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


See full index

NURS 320 > Exam 1: Chapter 16: Neuro-Psych Disorders And Drugs > Flashcards

Exam 1: Chapter 16: Neuro-Psych Disorders And Drugs Flashcards

1
Q

Limbic System

A

Responsible for emotional expression, learning and memory.

Signs pass to hypothalamus.

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

Reticular Activating System

A

Responsible for sleeping and wakefulness.

Though to be process responsible for feelings such as anxiety, fear and restlessness.

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

Psychotherapeutic Drugs

A

Used in treatment of emotional and mental disorders.

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

Three main emotional and mental disorders treated by Psychotherpeutic drugs

A

Anxiety
Affective Disorders
Psychoses

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

Types of Psychotherapeutic Drugs include

A 
Anxiolytics drugs
Mood-Stabilizing drugs
Antidepressant drugs
Antipsychotic drugs
Beta-Blockers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Anxiety

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
7
Q

Anxiety may be based on

A

May be based on actual anticipated experiences or past experiences

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

Anxiety may be exaggerated responses to

A

Imaginary negative situations

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

Six major anxiety disorders

A
  1. OCD
  2. PTSD
  3. General Anxiety Disorder
  4. Panic Disorder
  5. Social phobia (social anxiety disorder)
  6. Simple Phobia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Anxiolytics Drugs include

A

Benzodiazepines

Buspirone (BuSpar)

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

Anxiolytics Drugs: MOA

A

Reduces over-activity in the CNS: Depresses activity in brain stem (reticular activating system) and limbic system.

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

Benzodiazepines: MOA

A

Reduces over-activity in the CNS.
Increases action of gamma-aminobutyric acid (GABA) which is an inhibitory neurotransmitter in the CNS -> depresses activity in brain stem and limbic system.

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

Benzodiazepines include

A

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

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

Indications for Benzodiazepines

A 
Alcohol withdrawal
Insomnia
Muscle spasms
Seizure disorders
Adjunct in anesthesia
Adjunct for depression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Contraindications of Benzodiazepines

A

Known drugs allergy
Narrow-angle glaucoma
Pregnancy

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

Adverse Effects of Benzodiazepines

A

Benzodiazepines adverse effects are an over expression of their therapeutic effects.
Decreased CNS activity, sedation
Hypotension
Drowsiness, loss of coordination, dizziness, headaches
N/V, dry mouth, constipation
**Potentially habit-forming and addictive

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

Benzodiazepine overdose

A

Dangerous when taken with other sedatives or alcohol.

Treatment is generally symptomatic and supportive.

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

What can reverse the effects of Benzodiazepines’ effects?

A

Flumazenil (Romazicon)

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

Alprazolam (Xanax)

A

Most commonly used.

Indicated for GAD, short-term relief of anxiety symptoms, panic disorder and anxiety associated with depression.

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

Adverse Effects of Alprazolam

A

Confusion
Ataxia
Headache
Others

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

Interactions of Alprazolam

A

Alcohol
Oral contraceptives
Others

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

Indications for Diazepam

A 
Relief of anxiety 
Management of alcohol withdrawal
Reversal of status epilepticus
Preoperative sedation
Adjunct for the relief of skeletal muscle spasms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Diazepam Contraindications

A

Patients with hepatic dysfunction

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

Adverse Effects of Diazepam

A

Headache
Confusion
Slurred speech
Others

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

Diazepam Interactions

A

Alcohol
Oral contraceptives
Others

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

Lorazepam

A

Intermediate-acting benzodiazepine

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

Lorazepam methods of administration

A

Can be given by IV push; useful in the treatment of an acutely agitated patient.
Continuous infusion for agitated patients who are undergoing mechanical ventilation.

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

Lorazepam is used to treat or prevent

A

Alcohol withdrawal

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

Buspirone: MOA

A

Unknown MOA

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

Buspirone

A

Administered on a scheduled basis.

Lacks sedative properties and dependency potential

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

Adverse Effects of buspirone

A

Paradoxical anxiety
Blurred vision
Headache
Nausea

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

Insomnia

A

A sleep disorder that may be caused by anxiety

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

Types of insomnia

A
  1. Short-term or behavioral insomnia
  2. Long-term insomnia
  3. Rebound insomnia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Short-term or behavioral insomnia

A

Attributed to stress caused by hectic lifestyles or inability to resolve daily conflicts.
Common with worries about work, marriage, children, health problems, economy.

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

Long-term insomnia

A

Caused by depression, manic disorders and chronic pain

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

Rebound insomnia

A

Occurs when a sedative drug is discontinued abruptly or after it has been after it has been taken for a long time.
Sleeplessness and symptoms of anxiety then become markedly worse.

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

Pharmacologic Interventions for Insomnia

A

Benzodiazepines
Nonbenzodiazepine, non barbiturate CNS depressants
Atypical antidepressants
Barbiturates

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

Benzodiazepines used to treat Insomnia include

A

Lorazepam (Ativan)
Temazepam (Restoril)
Triazolam (Halcion)

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

Nonbenzodiazepine, nonbarbiturate CNS depressants used to treat Insomnia include

A

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

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

Atypical Antidepressants used to treat Insomnia include

A

Trazodone (Desyrel)

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

Zolpidem (Ambien)

A

Schedule IV controlled substance.

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

Zolpidem (Ambien) administration

A 
Limited to short-term treatment of insomnia -> generally not more than 7-10 days. 
Rapid onset (7-27) should be taken prior to expected sleep.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Adverse Effects of Zolpidem (Ambien)

A

Headache
Prolonged drowsiness
Dizziness
Coma

44
Q

Contraindications of Zolpidem (Ambien)

A 
Patients with:
Respiratory impairment
High risk suicide
Older adults
Concurrent use of CNS depressants
45
Q

Antidepressants

A

Ability to reduce anxiety symptoms by altering neurotransmitters in the brain (norepinephrine and serotonin)
Assists with neurotransmitter imbalances.

46
Q

Antidepressants Indication

A 
GAD
OCD
Panic Disorder
Social Phobia
PTSD
47
Q

Antidepressants include

A

Tricyclic Antidepressants (TCAs)
Monoamine Oxidase Inhibitors (MAOIs)
Selective Serotonin Reuptake Inhibitors (SSRIs)
Serotonin Norepinephrine Reuptake Inhibitors (SNRIs) (Atypical Antidepressants)

48
Q

Tricyclic Antidepressants include

A

Amitriptyline*
Nortriptyline
Imipramine

49
Q

Monoamine Oxidase Inhibitors (MAOIs) include

A

Phenelzine (Nardil)

50
Q

Selective Serotonin Reuptake Inhibitors (SSRIs) include

A 
Citalopram (Celexa)
Fluoxetine (Prozac)
Paroxetine (Paxil)
Sertraline (Zoloft)
Escitalopram (Lexapro)
51
Q

Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)/Atypical Antidepressants

A

Duloxetine (cymbalta)
Venlaxafine (Effexor, Effexor XR)
Bupropion (Wellbutrin)
Desvenlafine (Pristiq)

52
Q

Tricyclic Antidepressants

A

Have largely replaced SSRIs as first line antidepressant drugs.

53
Q

Tricyclic Antidepressants are considered second line drugs in patients

A

Who fail SSRIs or other newer generation antidepressants.

As adjunct therapy with newer generation antidepressants

54
Q

Amitriptyline (Elavil)

A

Oldest and most widely used of all the TCAs

55
Q

Amitriptyline Uses

A

Commonly used to treat Insomnia and neuropathic pain

Original indication was despression

56
Q

Amitriptyline Adverse Effects

A 
Dry mouth
Constipation
Blurred vision
Urinary retention
Dysrhythmias
57
Q

Tricyclic Antidepressants: Overdose

A

Lethal: 70-80% die before reaching the hospital
CNS and cardiovascular systems are mainly affected.
Death results from seizures or dysrhythmias.

58
Q

Antidote for Tricyclic Antidepressant Overdose

A 
No specific antidote.
Decrease drug absorption w/ activated charcoal.
Speed elimination by alkalinizing urine.
Manage seizures and dysrhythmias.
Provide basic life support.
59
Q

Monoamine Oxidase Inhibitors (MAOIs)

A

Nonselective and Selective

Rarely used for depression.

60
Q

MAOIs are used for

A

Parkinson’s Disease

61
Q

Disadvantage of MAOIs

A

Potential to cause hypertensive crisis when taken with tyramine.

62
Q

MAOIs and Tyramine

A

Ingestion of food or drinks with tyramine leads to hypertensive crisis which may lead to cerebral hemorrhage, stroke, coma or death.

63
Q

Foods that contain tyramine include

A

Aged, mature cheeses (cheddar, bleu, Swiss)
Smoked, pickled or aged meats, fish, poultry (sausage, corned beef, salami, pepperoni cheese pate.)
Yeast extracts
Red wines (Chianti, burgundy, sherry, vermouth)
Italian broad beans (fava beans)

64
Q

Selegiline Transdermal Patch (Emsam)

A

Selective MAO-B inhibitor

Indicated for major depression

65
Q

Selegiline Transdermal Patch Contraindication

A

Known drug allergy

66
Q

Nursing Management for Selegiline Transdermal Patches

A

Avoid exposing the patch to external sources of heat or prolonged direct sunlight because heat speeds absorption.

67
Q

Second Generation Antidepressants include

A

Vortioxetine (Brintelix)

68
Q

Second-Generation Antidepressants benefits

A

Fewer adverse effects than TCAs and MAOIs

Very few adverse drug-drug or drug-food interactions

69
Q

Second-Generation Antidepressants

A

Now considered first line drugs for depression.

Takes about 4-6 weeks to reach maximum clinical effectiveness.

70
Q

Second-Generation Antidepressants MOA

A

Inhibition of Serotonin reuptake and possible effects on norepinephrine and dopamine reuptake.

71
Q

Indications for Second-Generation Antidepressants Indications

A

Depression
BPD, obesity, eating disorders, OCD, panic attacks or disorders, Social anxiety disorder, PTSD, premenstrual dysphoric disorder, Neurologic disorder myoclonus and various substance abuse problems such as alcoholism.

72
Q

Adverse Effects of Second-Generation Antidepressants

A

Insomnia (partly caused by reduced rapid eye movement and sleep), weight gain and sexual dysfunction

73
Q

Bupropion

A

Originally indicated for treatment of depression; now also indicated as an aid in smoking cessation.

74
Q

Bupropion is sometimes added as

A

An adjunct antidepressant for patients experiencing sexual adverse effects secondary to SSRI therapy.

75
Q

Zyban

A

Approved for smoking cessation treatment and was the first nicotine-free prescription medicine used to treat nicotine dependence.

76
Q

Citalopram (Celexa)

A

One of the most commonly used SSRIs.

77
Q

Citalopram (Celexa) Indications

A

Treatment of depression and OCD

78
Q

Adverse Effects of Citalopram (Celexa)

A

Discontinuation syndrome

Anxiety, dizziness, drowsiness, insomnia and others.

79
Q

Duloxetine (Cymbalta) Indications

A

Depression
GAD
Pain resulting from diabetic peripheral neuropathy or fibromyalgia

80
Q

Duloxetine (Cymbalta) Adverse Effects

A

Dizziness, drowsiness, headaches
GI upset, anorexia
Hepatoxicity

81
Q

Duloxetine (Cymbalta) Interactions

A

SSRIs and Triptans (increased risk of serotonin syndrome)
Alcohol (increased risk of liver injury)
Can worsen uncontrolled angle-closure glaucoma.

82
Q

Fluoxetine (Prozac)

A

Prototypical SSRI

83
Q

Fluoxetine (Prozac) Indications

A 
Depression
Bulimia
OCD
Panic Disorder
Premenstrual dysphoric disorder
84
Q

Fluoxetine (Prozac) Contraindications

A

Known drug allergy

Concurrent MAOI therapy

85
Q

Fluoxetine (Prozac) Adverse Effects

A 
Anxiety
Dizziness
Drowsiness
Insomnia
Others
86
Q

Mirtazapine (Remeron) MOA

A

Promotes the presynaptic release of serotonin and norepinephrine in the brain.
Sedation

87
Q

Mirtazapine (Remeron) Indications

A

Depression including BPD
Reducing sexual adverse effects in male patients receiving SSRI therapy
Appetite stimulant

88
Q

Mirtazapine (Remeron) Contraindications

A

Drug allergy

MAOIs

89
Q

Mirtazapine (Remeron) Adverse Effects

A

Drowsiness
Abnormal dreams
Dry mouth, constipation, increased appetite
Asthenia

90
Q

Mirtazapine (Remeron) Interactions

A

Additive CNS depressant effects with alcohol and CYP inhibitors

91
Q

St. John’s Wort

A

Herbal product used for depression, anxiety, sleep disorders and nervousness.

92
Q

St. John’s Wort may cause

A 
GI upset
Fatigue 
Dizziness
Confusion
Dry mouth
Photosensitivity
93
Q

St. John’s Wort Interactions

A

Severe GI taken with MAOIs and SSRIs; many other drug interactions.
Food-drug interaction with tyramine-containing foods.

94
Q

Ginseng

A

Herbal products used in stress reduction, improvement of physical endurance and concentration.

95
Q

Ginseng Adverse Effects

A 
Elevated BP
Chest pain
Palpitations
Anxiety
Insomnia
Headache
GI symptoms
96
Q

Ginseng Interactions

A

Anticoagulants
Immunosuppressants
Anticonvulsants
Antidiabetic drugs

97
Q

Psychotherapeutic Drugs: Nursing Implications Assessment

A
  • Before therapy, assess emotional and physical status.
  • VS and postural BP
  • Liver and renal function tests.
  • Contraindications, interactions and cautious use.
  • Assess LOC, alertness and potential injury.
  • Check mouth to make sure oral doses are swallowed.
98
Q

Psychotherapeutic Drugs: Nursing Implications Patient Education

A

Provide simple explanations about the drug, its effects and the length of time before therapeutic effects can be expected.
Advise patient to avoid abrupt withdrawal.
Advise patients to change positions slowly to avoid postural hypotension and possible injury.

99
Q

Only small amounts of meds should be dispensed at a time to

A

Minimize the risk of suicide attempts.

100
Q

The combination of drug therapy and psychotherapy is emphasized because

A

Patients need to learn to acquire more effective coping skills

101
Q

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

A

Fatal

102
Q

Antianxiety drugs nursing implications in the elderly

A

Monitor closely for over Sedation and profound CNS depression

103
Q

Antidepressant Nursing Implications

A

May take several weeks to see therapeutic effects.
Monitor patients closely for suicidal tendencies and provide support.
Assists older adults and weakened patients with ambulation and other activities because falls may occur d/t drowsiness or postural hypotension.

104
Q

Tricyclics may need to be weaned and discontinued before

A

Undergoing surgery to avoid interactions with anesthetic drugs.

105
Q

Anxiolytics: Monitor for therapeutic effects

A

Improved mental alertness, cognition and mood
Fewer anxiety and panic attacks
Improved sleep patterns and appetite
Less tension and irritability; fewer feelings of fear, impending doom and stress
More interest in self and others

106
Q

Antidepressants: Monitor for therapeutic effects

A

Improved sleep patterns and nutrition
Increased feelings of self-esteem
Decreased feelings of hopelessness
Increased interest in self and appearance
Increased interest in daily activities
Fewer depressive manifestations or suicidal thoughts or ideations

NURS 320 (28 decks)

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