Exam 2: Units 1, 2, 3 Flashcards
1
Q
(SRI acronym)
Sweaty hot fever
Rigid muscles/Restlessness
Increased HR
are all s/s of
A
serotonin syndrome
2
Q
most serious adverse rxn to MAOIs is
A
hypertensive crisis
3
Q
class phenelzine
A
MAOI
4
Q
MOA phenelzine
A
blocks monoamine oxidase from breaking down certain neurotransmitters in the brain
5
Q
2 main indications for phenelzine
A
depression
panic
6
Q
phenelzine would be considered for a patient if
A
they have not responded to other therapies
7
Q
black box warning for phenelzine
A
suicidal risk
8
Q
avoid this while taking phenelzine
A
tyramine
9
Q
these 4 foods are high in tyramine and should be avoided with phenelzine
A
Fermented foods/wines
Cheese
Meats (sausages)
Chocolate
10
Q
Avoid “CAN” while taking phenelzine (which OTC drugs?)
A
C: Calcium
A: Antacids
N: NSAIDs
11
Q
patient must be completely tapered off of phenelzine for this long before initiating other medications
A
2 week wash-out period
12
Q
main side effect with pheneline
A
orthostatic hypotension
13
Q
combining high-tyramine foods with phenelzine can lead to
A
hypertensive crisis
14
Q
combining phenelzine with St. John’s Wort or other antidepressants can lead to
A
serotonin syndrome
15
Q
avoid these two foods while taking phenelzine
A
caffeine and chocolate
16
Q
class imipramine
A
TCA
17
Q
MOA imipramine
A
blocks reuptake of NE and serotonin
18
Q
3 main indications for imipramine
A
depression
anxiety
neuropathic pain
19
Q
black box warning for imipramine
A
suicidal risk
20
Q
5 side effects of TCA’s
“Amy trips on things”
“imipramine inhibits my peeing”
3 S’s
A
Orthostatic hypotension
Anticholinergic effects
Sedation
Sexual dysfunction
Seizures
21
Q
class fluoxetine
A
SSRI
22
Q
3 main indications for fluoxetine
A
depression
anxiety
PTSD
23
Q
MOA fluoxetine
A
inhibits reuptake of serotonin
24
Q
fluoxetine is safe for
A
pediatrics and geriatrics
25
fluoxetine (SSRIs) is the
preferred drug of choice for treating depression
26
black box warning for fluoxetine
suicidal risk
27
this is a contraindication with fluoxetine
hypersensitivity
28
3 main side effects with fluoxetine (usually improve after 3 months)
Weight gain
Sexual dysfunction
Insomnia
29
fluoxetine does NOT cause
sedation
30
never do this with antidepressant drugs!
never d/c abruptly
31
fluoxetine works faster than
imipramine (TCAs)
32
abrupt d/c from fluoxetine may result in
withdrawal
33
are SSRIs pregnancy safe?
YES - if benefits outweigh the risks
34
class venlafaxine
SNRI
35
MOA venlafaxine
inhibits reuptake of NE and serotonin
36
2 main indications for venlafaxine
depression
anxiety
37
black box warning for venlafaxine
suicidal risk
38
venlafaxine is contraindicated if this kind of drug is also being used concurrently
MAOI
39
venlafaxine should not be used if a mother is
breastfeeding
40
venlafaxine can decrease this in pediatric patients, and increase this overall
decrease overall weight and height in peds
increase BP by 10-15 mmHg
41
class duloxetine
SNRI
42
MOA duloxetine
inhibits reuptake of NE and serotonin
43
2 main indications for duloxetine
depression and anxiety
44
black box warning for duloxetine
suicidal risk
45
avoid this drink while taking duloxetine
alcohol
46
class bupropion
atypical antidepressant
(dopaminergic)
47
bupropion has a chemical structure similar to
amphetamine
48
2 main indications for bupropion
depression
smoking cessation
"Brian is so depressed that he can't stop smoking"
49
black box warning for bupropion
suicidal risk
50
bupropion does NOT cause
sexual dysfunction
51
2 main side effects with bupropion
anticholinergic effects
seizures
52
bupropion may increase the effects of
levadopa
53
main nursing consideration with bupropion
check formulation: different salt forms and dosing schedules
54
class lithium
antimanic
mood stabilizer
alkali metal ion salt
55
indication for lithium
long-term tx of BPD
56
therapeutic range for lithium
0.6-1.2
57
lithium toxicity occurs over
1.5
58
increase these 2 things while taking lithium
"Lithium Let's go of fluid)
Increase fluids and sodium
59
2 main s/s of lithium toxicity
EXTREME thirst
EXCESSIVE urination
60
hold this class of medication with lithium
NSAIDs
61
lithium toxicity can also occur
close to therapeutic levels
62
lithium is
teratogenic
63
do not do this with lithium
do NOT d/c abruptly
64
3 main side effects with lithium
dry mouth
thirst
weight gain
65
intense uncontrollable desire to move
akathisia
66
sudden onset of involuntary muscle contractions that cause abnormal movements and postures
acute dystonia
67
involuntary, repetitive movements of the face and tongue
tardive dyskinesia
68
syndrome characterized by muscle rigidity, postural instability, and tremors
Parkinsonism
69
life-threatening AE to antipsychotic medications
NMS
70
class haloperidol
1st generation (typical) antipsychotic
71
2 main indications for haloperidol
schizophrenia
tourette's (motor movements)
72
MOA haloperidol
depresses cerebral cortex, limbic system, and hypothalamus to control motor activity and aggressions
73
black box warning for haloperidol
increased mortality if used in patient's with dementia
74
haloperidol is strongly contraindicated in these 3 patients who have
Parkinson's
Dementia
Seizure disorders
75
haloperidol can increase
the QT interval
76
2 main side effects with haloperidol
anticholinergic effects
EPS (including NMS)
77
a patient taking haloperidol experiencing a fever, changes in LOC, and tremors is most likely going to be dx with
NMS
78
do not give haloperidol with
lithium (irreversible brain damage)
79
black box warning among ALL atypical antipsychotics
increased mortality in patients with dementia
NOT for dementia-related psychosis
80
class risperidone
2nd generation (atypical) antipsychotic
81
risperidone is contraindicated in these 2 things
hypersensitivity
lactation
82
MOA risperidone
blocks dopamine receptors
83
class quetiapine
2nd generation (atypical) antipsychotic
84
MOA quetiapine
antagonizes dopamine and serotonin receptors
85
main adverse effect with quetiapine
lens changes
86
patient should do this while taking quetiapine
eye exams every 6 months
87
class ziprasidone
2nd generation (atypical) antipsychotic
88
MOA ziprasidone
antagonizes dopamine and serotonin receptors
89
main side effect with ziprasidone
QT prolongation (may lead to dysrhythmias)
90
class aripiprazole
2nd generation (atypical) antipsychotic
91
MOA aripiprazole
partial dopamine agonist
92
3 contraindications for aripiprazole
hypersensitivity
seizure disorder
lactation
93
considered 'bad' cholesterol
LDL
94
considered 'good' cholesterol
HDL
95
estrogen increases this and decreases this
increases HDL and decreases LDL
96
estrogen is usually combined with this in hormone therapy
progestins
97
MOA conjugated estrogen
binds to estrogen receptors
98
main indication for estrogen
s/s menopause
99
conjugated estrogen is contraindicated in
pregnancy
100
3 black box warnings for conjugated estrogen
may increase risk for dementia
risk DVT, stroke
increased risk endometrial cancer
101
patients should not do this while taking estrogen
should not smoke
102
progesterone promotes
breast development
103
decreased levels of progesterone causes
menses
104
class medroxyprogesterone
progestin
105
MOA medroxyprogesterone
prevents surge of LH which also prevents ovulation
106
2 main indications for medroxyprogesterone
dysfunctional uterine bleeding
prevent ovulation
107
black box warning for medroxyprogesterone
same as estrogen if given as combination therapy
108
medroxyprogesterone can cause this infection
vaginal yeast infection
109
medroxyprogesterone can cause this in the breasts and overall
breast tenderness
weight gain
110
estradiol + norethindrone is given as a combination
oral contraceptive
111
black box warning for oral contraception
thromboembolisms and endometrial cancer
(same as estrogen)
112
estradiol + norethindrone is contraindicated in
suspected or known breast cancer
pregnancy
113
class of medication that decreases effectiveness of oral birth control
antibiotics
114
class testosterone
androgen
115
MOA testosterone
replaces or enhances male hormone
116
black box warning for testosterone
virilization of women and children - avoid accidental exposure
117
testosterone is contraindicated in these 2 cancers if taking as a male
male breast cancer
prostate cancer
118
testosterone is contraindicated in this patient is taking as a female
pregnancy
119
2 main side effects with testosterone
libido changes
acne
120
schedule testosterone
schedule III
121
class sildenafil
phosphodiesterade-5 inhibitor
122
MOA sildenafil
enhances nitric oxide0induces vasodilation in the penis
123
main indication for sildenafil
erectile dysfunction
124
sildenafil is the
first line of treatment for ED
125
3 side effects with sildenafil (think head)
headaches
dizziness
nasal congestion
126
prolonged erection
priapism
127
patient taking sildenafil should seek immediate medical attention if this occurs
erection lasting longer than 4 hours
128
class finasteride
5-alpha reductase inhibitor
anti-androgen
129
MOA finasteride
inhibits 5-alpha reductase in order to decrease testosterone production in the prostate gland
130
2 main indications for finasteride
Benign Prostatic Hyperplasia (BPH)
Male pattern hair loss
131
finasteride is contraindicated in
hypersensitivity
132
____ and ____ should not take finasteride
women and children
133
finasteride may cause
sexual dysfunction
134
a patient taking finasteride is unable to
unable to donate blood
135
class doxazosin
alpha 1 blocker
136
MOA doxazosin
blocks alpha 1 receptors and relaxes smooth muscle in the urethra and prostate
