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Final Exam Flashcards

1
Q

How to administer eye drops (glaucoma drugs)

A

Pull down the bottom eyelid
Place eyedrop in “well”
Have the patient apply pressure to inner canthus for 60 seconds

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2
Q

Why don’t we want eye meds (especially beta blockers) to get into the inner canthus?

A

So there is no system circulation

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3
Q

If a person doesn’t like getting eye drops or its a child what is another way of administering the meds?

A

Have the patient squeeze their eyes closed
Put the drop in the the inner corner and then have them open their eyes
The med will flow into the eye

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4
Q

Anxiolytic drugs are indicated for

A

Anxiety disorders

ANXIolytic = ANXIety

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5
Q

Anxiolytic drugs: Benzodiazepines prototypes

A

Alprazolam (Xanax)
Diazepam (Valium)

LAM and PAM!

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6
Q

Alprazolam and Diazepam risks

A

Can be habit forming

Risk of overdose

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7
Q

Alprazolam and Diazepam overdose

A

Flumazenil (Romazicon) is the antidote for all benzos

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8
Q

Alprazolam and Diazepam AE/SEs

A 
Confusion*
Ataxia
Headache
CNS depression*
- Drowsiness* 
- Dizziness*
Postural hypotension
Disinhibited (truthful)*
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9
Q

Alprazolam and Diazepam interactions

A

Other CNS depressants

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10
Q

Alprazolam and Diazepam are often ordered how?

A

PRN

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11
Q

Anxiolytic drugs: Non-benzodiazepines prototype

A

Buspirone (Buspar)

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12
Q

Buspirone half life

A

Short - dosed 2-3 times daily

NOT HABIT FORMING

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13
Q

Buspirone interactions

A

Many, including grapefruit

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14
Q

Buspirone is often ordered how?

A

Scheduled, not PRN

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15
Q

Mood stabilizers are indicated for

A

Bipolar disorder

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16
Q

Mood stabilizers prototypes

A 
Lithium (Eskalith or Lithobid)
Valproic acid (Depakote)
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17
Q

Lithium therapeutic range

A

Very narrow: 0.6-1.2 mEq/L

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18
Q

Lithium patient education

A

Required regular monitoring - blood draws on a regular basis

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19
Q

Lithium interactions

A

Sodium - kidney treats both similarly

  • Low sodium can lead to high lithium
  • Drink lots of water but not too much
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20
Q

Lithium toxicity

A

Dialysis (no antidote)

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21
Q

Lithium AEs

A 
GI discomfort
Tremor
Confusion
Somnolence
Seizures and cardiac dysrhythmia (toxicity)
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22
Q

Valproic acid therapeutic range

A

50-125 mcg/mL

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23
Q

Valproic acid contraindications

A

Liver impairment (hepatotoxicity)

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24
Q

Valproic acid interactions

A

MANY

Highly protein bound

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25
Tricyclic antidepressants (TCA) prototype
Amitriptyline (Elavil)
26
Amitriptyline overdose
Very lethal | ALMOST ALWAYS FATAL
27
Amitriptyline toxicity s/s
Seizures and cardiac dysrhythmias
28
Amitriptyline indications
Depression More often used for - Neuropathic pain - Insomnia
29
Amitriptyline patient | education
High risk for increased depression/SI at the start (plus overdose) Patient will only receive a small dose (a few days or a week) at the start
30
Antidepressants: Monoamine Oxidase Inhibitors (MAOIs) prototype
Phenelzine (Nardil)
31
Phenelzine controindication
Tyramine (foods)
32
Phenelzine interactions
Everything :) | Alcohol!
33
Phenelzine AEs
``` Hypertensive crisis (tyramine) Postural hypotension ```
34
Phenelzine patient education
OTC cold meds are likely to interact NO ALCOHOL
35
In general, how long does it take for antidepressants to reach full therapeutic affect?
4 weeks
36
What do doctors suggest along with medications to treat depression?
Therapy/counseling
37
Antidepressants: Selective Serotonin Reuptake Inhibitors (SSRIs) prototype
Fluoxetine (Prozac)
38
Fluoxetine AEs
Serotonin syndrome
39
Fluoxetine interactions
St John's wort MAOI Other SSRIs Sumatriptan (all of these increase serotonine)
40
Antidepressants: Serotonin/Norepinephrine Reuptake Inhibitors (SNRI) prototype
Venlafaxine (Effexor)
41
Venlafaxine AEs
Serotonin syndrome
42
Venlafaxine patient education
Capsules can be opened and sprinkled on applesauce/food Best to take with food Can lead to weight loss in children
43
Venlafaxine interactions
Things that increase serotonin
44
Antidepressants: Norepinephrine-Dopamine Reuptake Inhibitors (NDRIs) are also known as
Atypical Antidepressants
45
Antidepressants: Norepinephrine-Dopamine Reuptake Inhibitors (NDRIs) prototype
Bupropion (Wellbutrin)
46
Bupropion contraindications
Hx of seizures - lowers seizure threshold
47
Bupropion indications
Depression Used mainly for - Smoking cessation - Weight loss
48
What is the black box warning for all antidepressants?
Higher risk for suicide | - Especially for children and those up to age 24
49
AE for all antidepressants
Antidepressant discontinuation syndrome - don't stop abruptly S/S - dizziness - headache - N/V Severe cases can cause aggression, mood disturbances, SI
50
All meds cause sexual side effects except
Bupropion
51
All meds cause weight gain except
Bupropion
52
Conventional antipsychotics indications
Effective for positive symptoms (added effects) - Hallucinations - Delusions - Disorganized thinking Less effective for negative symptoms (things that are missing) - Withdrawal - apathy - flat effect, lack of desire to do things
53
Conventional antipsychotics AEs
Extra Pyramidal Symptoms (EPS) | Neuroleptic Malignant Syndrome (NMS)
54
What is EPS?
Extra pyramidal symptoms - Muscle movements - Akathisia - Acute dystonia - Tardive dyskinesia (can be permanent even if med is discontinued)
55
What is NMS?
Neuroleptic Malignant Syndrome - Potentially life threatening and rare - Like malignant hyperthermia (high BP, fever) **Can occur after the first dose or after 20 years, so keep monitoring patient**
56
Conventional antipsychotic forms of administration
PO | IM - for deep injection to the ventrogluteal site
57
Conventional antipsychotics prototypes
Chlorpromazine (Thorazine) | Haloperidol (Haldol)
58
Chlorpromazine AE
IV and IM can cause hypotension - keep in recumbent position for 30 minutes after administration
59
Chlorpromazine administration
Push 1 mL/min VERY SLOW
60
Haloperidol IM versus IV administration
IM injection given every 4 weeks - long acting IV used for acute situations - bad episode of psychosis
61
Atypical Antipsychotics prototype
Risperidone (Risperdal)
62
Risperidone indications
Treats positive AND negative symptoms of psychosis
63
Risperidone AE
Metabolic syndrome - gain weight, become type 2 diabetic, high cholesterol **can cause stoke or MI**
64
Why is Risperidone preferred over older class of antipsychotics?
Causes minimal EPS
65
Risperidone administration
IM onset is 3 weeks **Must take PO until IM is effective**

Pharm 1 (6 decks)

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