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Mental Health > Exam 1 Meds > Flashcards

Exam 1 Meds Flashcards

1
Q

First TCA

A

Thorazine

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2
Q

SSRI and 1st one

A

Selective Serotonin Reuptake Inhibitor
Prozac

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3
Q

Fluoxetine (Prozac)- ED, anxiety, depression, only approved for pregnant women (only sucidal/infantcidal) and adolescents
Fluvoxamine (Luvox)- OCD, anxiety
Paroxetine (Paxil)- anxiety
Sertraline (Zoloft)- anxiety, depression
Citalopram (Celexa)- safest for geriatrics
Escitalopram (Lexapro)

A

SSRI meds

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4
Q

How do SSRI work

A

reuptake of serotonin at presynapse cleft

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5
Q

Indications of SSRI

A

Major Depression
Dysphoric Disorder
Bulimia Nervosa
Anxiety Disorders

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6
Q

NO Anticholinergic Side Effects
Low lethality level for suicide
Decrease in sexual performance
Sweating
Dry mouth
Weight change
Nausea
Diarrhea

A

Side effects of SSRI

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7
Q

Abdominal pain
Diarrhea
Sweating
Fever
Tachycardia
Elevated BP
Delirium, myoclonus
Increased motor activity
Irritability /Hostility
Hyponatremia

A

Serotonin Syndrome

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8
Q

Desvenlafaxine (Pristiq)
Duloxetine (Cymbalta)
Venlafaxine (Effexor, Effexor XR)

A

SNRI (Serotonin Norepinephrine Reuptake Inhibitor)

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9
Q

Indications of SNRI

A

Severe Depression
Somatic symptoms (body)
DM neuropathy

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10
Q

Utero Toxic
GI SE
Headache
Sleep pattern changes
Sweating
Sexual dysfunction (Effexor)
Hypertension

A

side effects of SNRI

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11
Q

Nefazodone ( Serzone)
Trazodone (Desyrel)

A

SARI (Serotonin Agonist and Reuptake Inhibitors)

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12
Q

Sedation
Priapism- sustained erection for more then 4 hours
Liver toxicity
Lower sexual side effect
Less weight gain

A

Side effects of SARI

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13
Q

Norepinephrine Dopamine Reuptake Inhibitior

A

Bupropion (Wellbutrin and Zyban

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14
Q

Reduces appetite
Increase sexual desire
Agitation
Seizures
Headache
GI
Contraindicated with patients with a history of seizure disorder
Monitor weight

A

Side effects of Norepinephrine Dopamine Reuptake Inhibitor

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15
Q

Mirtazapine (Remeron): Blocks alpha-1 adrenergic receptors that normally inhibit norepinephrine and serotonin

May work faster than SSRIs

A

Norepinephrine and Serotonin Specific Antidepressant

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16
Q

Weight gain
Sedation
Dizzines
Headache

Dangerous sedation with alcohol

A

Side Effects of Mirtazapine

17
Q

Amitriptyline (Elavil)
Amoxapine (Asendin)
Clomipramine (Anafranil)
Desipramine (Norpramin)
Doxepin (Sinequan)
Imipramine (Tofranil)
Maprotiline (Ludiomil)
Nortriptyline (Aventyl, Pamelor)
Protriptyline (Vivactil)
Trimipramine (Surmontil)

A

Tricyclic Antidepressants

18
Q

How TCA work

A

Inhibits the reuptake of serotonin and norepinephrine., but also antagonizes adrenergic, histaminergic, muscarinic, and dopaminergic receptors

19
Q

Indications of TCA

A

Melancholic depression
Comorbid conditions

20
Q

side effects of TCA

A

cardiac toxicity
anticholinergic
orthostatic hypotension

21
Q

nursing implications of TCA

A

Orthostatic BP
Nortriptyline levels
EKG with palpitations
Monitor weight
High lethality in suicide

22
Q

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

A

MAOI (Monamine Oxidase Inhibitors)

23
Q

how do MAOI work

A

Inhibits MAO (enzyme) that breaks down the neurotransmitters, serotonin, norepinephrine and dopamine.

24
Q

Hypertensive Crisis
Insomnia
Nausea
Agitation
Confusion

A

side effects of MAOI

25
Q

Nursing implications of MAOI

A

Tyramine Restricted Diet
Contraindicated with OTC products, cough syrup preparations; SSRIs and TCAs
Narcotics, anesthetics, sedatives, levodopa and stimulants can interact

26
Q

Food to avoid for tyramine

A

avocados
bananas
beef or chicken liver
brewer’s yeast
broad beans
caffeine
aged cheese besides cottage cheese
meat extracts and tenderizers
overripe fruit
papaya
pickled herring
raisins
red wine, beer, sherry
cured meats
sour cream
soy sauce
yogurt

27
Q

Esketamine (Ketanest)NMDA receptor antagonistSchedule III

A

General anesthetic, used for treatment-resistant depression
Given nasal spray or IV
Inhibits dopamine reuptake

28
Q

Side effects of esketamine

A

Dizziness
Dissociation
Nausea
Sleepiness
Anxiety
Increased BP

29
Q

Nursing implications of esketamine

A

Must remain on site after treatment for 2 hours after to monitor for side effects
Eight treatments are usually indicated
Barrier: Cost $4700-6800 for one month

30
Q

Gold Standard
Must have Na in diet
Must drink 2500-3000ml of fluid per day
Levels: Acute manic: 1-1.5 meq/L
Maintenance: 0.6-1.2 meq/L
Notify MD if level reaches 1.5meq/L

A

Lithium

31
Q

1.5-2.0 meq/L: blurry vision, ataxia, NVD, ataxia, tinnitus
2.0-3.5 meq/L: polyuria, increase tremors, muscular irritability, mental confusion, giddiness, psychomotor retardation
3.5 meq/L and above: nystagmus, changes in LOC,, seizures, coma, arrhythmia, MI, ANURIA, OLIGURIA
Kidney injury requires hemodialysis and fluid hydration

A

Lithium levels

32
Q

Avoid caffeine
Adequate sodium intake
If nausea or diarrhea call MD
Avoid excess sweating
Monitor weight
Avoid pregnancy
Level checked every 1-2 months

A

health teaching for lithium

33
Q

Prevent lithium levels from rising
Hydrate the client
Maintain sodium in diet
Avoid dehydration
Notify MD if has flu, excess sweating, prolonged sun exposure

A

Renal toxicity

34
Q

Anticonvulsant or Antiepileptic drug
Increases concentration of gamma- aminobutyric acid (GABA)
Liver toxicity: dark urine, jaundice
Levels; 50-100 meq/L can go up to 125 in mania
Needs to be tapered down
SE: skin rash, HAIR LOSS, nausea, anorexia

A

Valproic Acid (Depakote)

35
Q

Low doses to start
Decreases irregular electrical activity in brain by inhibiting sodium channels
Primarily used for depression in bipolar
Early Rash development a common side effect and discontinue the drug if develops
Can lead to Stevens-Johnsons Reaction
SE: diplopia, insomnia, rhinitis, dizziness, headache, drowsiness, tremor, blurred vision, skin rash, nausea, ataxia, vomiting, abdominal pain, and fever.

A

Lamotrigine (Lamictal)

36
Q

Used in combination with valproic acid
and/or lithium
Therapeutic levels 4-12 mcg/ml
Decreases neural activity
Side effects: NVD, nystagmus, double or blurry vision, unsteadiness

A

Carbamazepine (Tegretol)

37
Q

Verapamil, Isoptin
Requires high dosing
Used in treatment resistant cases
SE: Lightheadedness. Low blood pressure. slower heart rate. Drowsiness, constipation. swelling of feet ankles and legs. increased appetite, gastroesophageal reflux disease (GERD)

A

Calcium Channel Blockers

38
Q

Latuda
Abilify
Saphris
Risperdal
Zyprexa

A

Antipsychotics

Mental Health (2 decks)

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