Exam 2 Review: Goldstein Flashcards
5 non-pharmocological interventions for insomnia
- exercise
- decrease noise
- dim the lights
- decrease temp
- reduce screens
- reduce stim
- reduce caffeine
- reduce alcohol
- reduce nicotine
what are 2 drugs from 2 different classes, used for both depression and insomnia
- doxepin
- trazodone
2 drugs for insomnia and anxiety
- lorazepam
- hydroxyzine
2 OTC medications for insomnia
- benadryl
- melatonin
3 drugs from 3 different classes for insomnia that are controlled substances
- zolpidem
- suvorexant
- lorazepam
what is rebound insomnia
- abruptly stopping insomnia medication/discontinuation of benzodiazepines
s/s: sleeplessness, worsening anxiety
first line treatment for depression and anxiety
SSRI
(selective serotonin reuptake inhibitors)
SSRI drugs
- sertraline
- fluoxetine
- escitalopram
- citalopram
- paroxetine
name 3 PRN (as needed) drugs for anxiety
- beta blockers
- antihistamines
- benzodiazepines
3 classes used for daily anxiety
- SSRI
- SNRI
- TCA
name at least 3 different types of anxiety
- generalized
- social
- OCD
- PTSD
- test anxiety
what is a drug class used for physical symptoms of anxiety
beta blockers
name at least 4 education points for a patient prescribed with SSRIs
- do not stop Rx abruptly
- you may experience weight gain
- wait weeks for Rx benefits
- may have increased appetite
- women may experience sexual dysfunction
- still need therapy when taking
SSRI help men with
premature ejaculation
some side effects of taking tricyclic antidepressants
- ECG changes
- CNS depression
- orthostatic hypotension
what are some patient education points specific to phenelzine (hint: MAOI)
must be educated to avoid foods containing tyramine
what drug class inhibits the uptake of norepinephrine
MAOIs
2 primary neurotransmitters related to depression
- serotonin
- norepinephrine
2 screening tools for depression
- PHQ2 (first step approach)
- PHQ9 (further evaluation for PHQ2 positive results)
2 drug classes that do the same thing and works two different ways
- SNRI
- TCA
what 3 drugs can we use for the treatment of bipolar disorder
- lithium
- valproic acid
- chlorpromazine
what lab values should we monitor for lithium?
what do we need to look out for?
- lithium levels
- thyroid
- sodium level
name at least 4 second gen antipsychotics
- aripiprazole
- lurasidone
- olanzapine
- quetiapine
- risperidone
- ziprasidone
name 2 medications for antipsychosis first and second gen
1st gen: haloperidol
2nd gen: ziprasidone
compare first gen and second gen antipsychotics (second gen advantage)
second gen has less side effects such as EPS (extrapyramidal sxs) and NMS (neuroleptic malignant syndrome)
what drug do we use to treat EPS?
benzitropine
what drug do we use to treat NMS
dantrolene
what are extrapyramidal sxs (EPS)
- dystonia
- parkinsonism
- akathisia
- tardive dyskinesia
what are neuroleptic malignant syndrome (NMS) symptoms
- LIFE THREATENING
- severe muscle rigidity
- confusion
- agitation
- increased temperature, pulse and BP
what is the cause of serotonin syndrome
taking multiple serotonin medications
- too much serotonin in CNS
what are SNRIs used for in addition to mental health disorders
- neuropathic pain
- migraine prevention
what is the most common cause of schizophrenia medication to not work
medication compliance
how to help increase medication compliance
direct observation therapy (DOT)
what is the 1st line agent for ADHD
- methylphenidate or
- amphetamine