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pharmacology > EXAM 4- antidepressants and anti anxiety > Flashcards

EXAM 4- antidepressants and anti anxiety Flashcards

1
Q

psychiatric assessment

A 
Always Send Mail Through the Post Office
Appearance
Speech
Memory/Mood
Thoughts
Perception
Orientation
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2
Q

anxiety

A

Feeling of apprehension, worry, or uneasiness

  • A certain amount of anxiety is normal
  • May or may not be based on reality
  • Excess anxiety can interfere with day to day functioning
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3
Q

anti anxiety drugs

A

used to treat anxiety (anxiolytics)

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4
Q

two main classes of antianxiety

A

benzodiazepines, nonbenzodiazepines

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5
Q

benzodiazepines ex:

A

-alprazolam (xanax)
-diazepam (valium)
-lorazepam (ativan)
long term use can result in physical/psychological dependence*
(Very effective in treating anxiety disorders)

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6
Q

nonbenzodiazepines ex:

A

-Buspirone
-doxepin
-hydroxyzine
(Not as safe and effective as Benzodiazepines)

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7
Q

Antianxiety drugs produce a _______ by __________________.

A

tranquilizing effect, blocking neurotransmitter receptor sites.

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8
Q

benzodiazepines produce its effect by

A

potentiating the effects of GABA

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9
Q

nonbenzodiazepines

A

Produce its effect in a variety of ways

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10
Q

uses of anti-anxiety drugs

A
  1. Anxiety Disorders and panic attacks
  2. Preanesthetic sedation and muscle relaxation
  3. Convulsions and seizure disorders
  4. Alcohol withdrawal
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11
Q

adverse reactions anti-anxiety: early signs

A
  • Mild drowsiness and sedation
  • Lightheadedness or dizziness
  • Headache
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12
Q

adverse symptoms anti-anxiety: late signs

A
  • Lethargy and fatigue
  • Confusion
  • Anger
  • Constipation
  • Dry mouth
  • Restlessness
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13
Q

Anxiolytics should not be abruptly discontinued because of the chance of -

A

the patient undergoing withdrawal symptoms.

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14
Q

symptoms of withdrawal (usually occurs when meds are abruptly discontinued in as little as 3-4 wks)

A
  • Increased anxiety -Headache
  • Fatigue -Tremors
  • Hypersomnia -Muscle cramps
  • Psychoses/Hallucination -Nausea
  • Concentration difficulties -Convulsions
  • Sweating -Confusion
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15
Q

Antianxiety medications should not be administered if

A

the patient has a known hypersensitivity, psychoses, or acute narrow-angle glaucoma.

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16
Q

Feelings of intense sadness, helplessness, worthlessness and the patient usually has some impaired functioning

A

depression,

May also have a poor appetite, sleep disturbances, and lack of interest in their job and family

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17
Q

selective serotonin reuptake inhibitors (antidepressant)

A
  • Blocks the uptake of serotonin=stimulation of the CNS
  • Most commonly prescribed antidepressant because it is safe, has a larger therapeutic index, and less adverse reactions
  • Takes upwards of 2-3 weeks to become effective
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18
Q

ex of SSRI

A
  • citalopram (Celexa),
  • fluoxetine (Prozac),
  • paroxetine (Paxil),
  • sertraline (Zoloft)
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19
Q

Serotonin/Norepinephrine or Dopamine/Norepinephrine Reuptake Inhibitors (ANTIDEPRESSANT)

A
  • Not clearly understood

- It is thought that they affect the neurotransmission of serotonin, dopamine, and norepinephrine

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20
Q

ex of Serotonin/Norepinephrine or Dopamine/Norepinephrine Reuptake Inhibitors

A
  • venlafaxine (Effexor)

- bupropion (Wellbutrin)

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21
Q

tricyclic antidepressants (TCAs)

A
  • Inhibit reuptake of norepinephrine and serotonin in the brain
  • Very narrow therapeutic index-can be fatal in overdoses
  • Serious adverse reactions noted with TCAs
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22
Q

ex of TCAs

A
  • Amitriptyline,
  • clomipramine (Anafranil),
  • imipramine (Tofranil)
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23
Q

Monoamine Oxidase Inhibitors (MAOIs)

A
  • Inhibits the activity of monoamine oxidase an enzyme responsible forinactivating certain neurotransmitters (increase in epinephrine, norepinephrine and serotonin = CNS stimulation)
  • Not first antidepressants of choice due to side effects and dietary restrictions
  • Also problems associated with drug-drug interactions
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24
Q

ex of MAOIs

A
  • pheneizine (Nardil),
  • tranylcypromine (Parnate),
  • isocarboxazid (Marplan)
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25
uses of TCAs
- Depressive episodes - Bipolar disorder (depressive) - Obsessive Compulsive Disorder (OCD) - Chronic neuropathic pain - Enuresis
26
uses of MAOIs
- Depressive episodes | - Unlabeled use: bulimia, night terrors, migraines, seasonal affective disorder, and multiple sclerosis
27
adverse reactions of SSRIs: neuromuscular
sedation, dizziness, headache, insomnia, tremors, and weakness
28
adverse reactions of SSRIs: GI/GU
-Constipation, dry mouth, nausea, runny nose, and premature ejaculation
29
adverse reactions of miscellaneous antidepressants: neuromuscular
migraines, sedation, hypotension, dizziness, blurred vision, photosensitivity, insomnia, nervousness, tremors
30
adverse reactions of miscellaneous antidepressants: GI
nausea, dry mouth, anorexia, thrist, constipation, bitter taste
31
adverse reactions of miscellaneous antidepressants: generalized body reactions
fatigue, tachycardia, impotence, change in libido, itching, skin rash, flushing, excessive sweating
32
adverse reactions of tricyclics
- Anticholinergic effects: dry mouth, sedation, visual disturbances, urinary retention - Constipation - Photosensitivity - Orthostatic hypotension
33
adverse reactions of MAOIs: neuromuscular
Orthostatic hypotension, sedation, dizziness
34
adverse reactions of MAOIs: GI
Constipation, dry mouth, nausea, and impotence
35
adverse reactions of MAOIs: serious
hypertensive crisis when eating foods high in tyramine
36
MAOI’s must be discontinued two weeks before beginning treatment with tricyclics
Risk of hypertensive crisis
37
foods containing tyramine must not be eaten with
MAOI | Cheese, Wine, Beer, Coffee, Tea, Chocolate, soy sauce, yogurt, sour cream
38
group of symptoms that affect mood and behavior
hallucinations, delusions, disorganized speech, behavior disturbance, social withdrawal, flattened affect, and anhedonia.
39
antipsychotic drugs
Also known as Neuroleptic Medications
40
typical antipsychotics
- haloperidol (Haldol) | - loxapine
41
atypical antipsychotics
- aripiprazole (Abilify) - olanzapine (Zyprexa) - quetiapine (Seroquel) - risperidone (Risperdal) - ziprasidone (Geodon)
42
Typical antipsychotics act by inhibiting or blocking the release of the neurotransmitter_____.
dopamine. | --Because they block dopamine they can cause a serious adverse reaction known as extrapyramidal effects
43
Atypical antipsychotics act by inhibiting ___________.
both serotonin and dopamine receptors. | --The atypical antipsychotics are less likely to cause extrapyramidal effects
44
uses of antipsychotics
Acute and chronic psychoses Bipolar illness (manic-depressive) Agitated behaviors associated with dementia Oppositional defiant disorder
45
adverse reactions of antipsychotics
- Sedation, headache, hypotension - Dry mouth, nasal congestion - Photosensitivity and photophobia - Hyperactivity, paranoid reactions, agitation and confusion
46
extrapyramidal syndrome (EPS)
Affects body posture and muscle groups = causes abnormal muscle movement
47
extrapyramidal effects: parkison's
- Fine tremors, muscle rigidity | - Slowness of movement, slurred speech
48
extrapyramidal effects: akathisia
Extreme restlessness and increased motor activity
49
extrapyramidal effects: dystonia
Facial grimacing, twisting of neck
50
Tardive Dyskinesia
- Rhythmic involuntary movements of the tongue, face, mouth, extremities - Tongue may protrude - Chewing movements - Facial grimacing - Puckering of the mouth
51
neuropletic malignant syndrome (NMS)
Rare reaction - Combination of extrapyramidal effects, hyperthermia, and autonomic disturbances. - Typically occurs 1 month after starting an antipsychotic - Potentially fatal and requires intensive supportive treatment - Immediate discontinuance of the medication is needed - Recovery is usually 7 to 10 days
52
mood disorders
Considered a disturbance in the person’s emotional mood Also known as an Affective Disorder --Most common is bipolar disorder where the patient fluctuates between mania and depression.
53
mood stabilizers
very good at treating mood cycling and manic symptoms
54
If the mood disorder has an underlying depressive disorder ---
mood stabilizers as well as antidepressant is also prescribed to treat the depressive symptoms
55
ex of mood stabilizers
- Lithium-classic mood stabilizer (antimanic) - valproic acid (Depakote) - lamotrigine (Lamictal) - carbamazepine (Tegretol) - oxcarbazepine (Trileptal)
56
uses of mood stabilizers
- Bipolar disorder - Manic episodes - Weight reduction (Topamax) - Appetite suppression (Topamax)
57
adverse reactions of lithium
must be monitored in the blood, can have a toxic effect. The therapeutic index is very narrow.
58
toxic reactions of lithium
-tremors, nausea, vomiting, diarrhea, blurred vision, confusion, hyperreflexia, seizures, coma, palpitations, death
59
adverse reactions valproic acid (depakote)
- Monitor lab values and watch liver function tests - Common side effects: weight gain, tremors, nausea, and hair loss - Must be monitored in the blood to ensure therapeutic effectiveness
60
adverse reactions of Iamotrigine (Lamictal)
- Medication must be titrated slowly - Watch for Steven-Johnson’s syndrome (can be fatal) - Other side effects include: weight gain, headaches, insomnia
61
adverse reactions of carbamazepine (Tegretol)
- dry mouth, constipation, urinary retention, dizziness, nausea, and vomiting - Serious side effects: agranulocytosis, Stevens-Johnson syndrome, and toxic epidermal necrolysis - Very high in the Asian population
62
adverse reactions of oxcarbazepine (Trileptal)
headaches, dizziness, nausea, vomiting, fatigue, visual disturbances, and constipation

pharmacology (26 decks)

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