Final: psychotic meds Flashcards
what are the psychotic disorders
- schizophrenia
- mania
- acute psychosis
what are positive symptoms of psychotic disorders
- hallucinations
- delusions
- racing thoughts
what are the negative symptoms of psychotic disorders
- apathy
- lack of emotion
- poor or nonexistant social functioning
how to promote adherence with psychotic disorders
- ensure med is taken
- encourage family members to oversee med for outpatients
- use an intramuscular depot prep for long term therapy
Haloperidol (haldol) MOA
block receptors for dopamine in the CNS
Haloperidol (haldol) class
1st gen antipsychotic
Haloperidol (haldol) use
- schizophrenia
- acute psychosis
- tourette’s syndrome
Haloperidol (haldol) SE
- serious movement disorder (extrapyramidal symptoms)
- neuroendocrine effects
- prolonged QT interval
- dysrhythmias
- sleep problems
Risperidone (risperdal) class
2nd gen antipsychotic
Risperidone (risperdal) use
- schizophrenia
- mania
Risperidone (risperdal) treats which symptoms
both positive and negative
Risperidone (risperdal) MOA
- produce only moderate blockage of dopamine receptor
- stronger blockade for serotonin
Risperidone (risperdal) SE
- fewer EPS than first gen
- weight gain
- GI problems
Lithium (Lithobid) class
mood stabilizer
Lithium (Lithobid) MOA
causes serotonin receptor block
Lithium (Lithobid) use
- used to prevent and treat manic episodes in bipolar
- can be used in schizophrenia
Lithium (Lithobid) has a
narrow therapeutic index (> 1.5 is toxic)
monitor Lithium (Lithobid) levels every
2-3 ddays at initiation and then every 3-6 months
Lithium (Lithobid) affects which organs most
RENAL
-those with renal impairment must have dose reduced and serum blood levels carefully monitored
Lithium (Lithobid) interactions
do not take diuretics which cause loss of sodium and water (increases lithium tox)
Lithium (Lithobid) SE
- tremors
- polyuria
- goiter
- hypothyroidism
take what with lithium to prevent GI effect
milk
Alprazolam (Xanax) uses
anxiety
Alprazolam (Xanax) class
benzodiazepine like diazepam
Alprazolam (Xanax) SE
similar to diazepam
- CNS depression
- vardiovascular collapse, bradycardia, hypotension
what to watch for with Alprazolam (Xanax)
CNS depression
Buspirone (BuSpar) class
anxiolytic
Buspirone (BuSpar) MOA
unclear
it binds to serotonin and dopamine receptors
Buspirone (BuSpar) adverse effects
CNS effects
-doesnt potentate the CNS depressants (can take with other benzodiazepine)
Buspirone (BuSpar) interactions
- erythromycin
- ketoconazole
- grapefruit juice
when to take Buspirone (BuSpar)
take with meals to prevent gastric irritation
Zolpidem (ambien) class
sedative hypnotic
Zolpidem (ambien) action
enhances inhibitory effects of GABA inducing sleep
Zolpidem (ambien) SE
- drowsiness/dizziness
- parasomnias (unusual sleep bahaviors)
- anmesia (ambulating, eating driving)
when to take Zolpidem (ambien)
admin before bed with 8 hours of possible sleep
do not take what with Zolpidem (ambien)
booze or other CNS depressants
Amphetamine class
CNS stimulant
Amphetamine uses
ADD
ADHD
narcolepsy
Amphetamine risk
high abuse and misuse
Amphetamine SE
- psychosis
- cardiovascular
Amphetamine abrupt withdrawal equals
abstinence syndrome
what to watch with Amphetamine
- BP
- baseline EKG, CBC and platelet
Atomoxetine (strattera) class
selective norepinephrine reuptake inhibitor
Atomoxetine (strattera) MOA
selective inhibitor of norepi reuptake
Atomoxetine (strattera) use
- ADD
- ADHD (children too)
Atomoxetine (strattera) adimin
once a day
Atomoxetine (strattera) risk?
non stimulant so no potential for abuse
Atomoxetine (strattera) adverse effects
- gastrointestional rections
- reduced appetitie
- dizziness
- somnolence
- mood swings
- trouble sleeping
Varenicline (chantix) MO
partial agonist at nicotinic receptors
Varenicline (chantix) use
most effective aid for smoking cessation
Varenicline (chantix) adverse effects
● Nausea
● sleep disturbances, abnormal dreams
● Constipation, vomiting, dry mouth
● Flatulence
● Potential for serious neuropsychiatric effects (Black box for suicide removed)
● Cardiovascular events (small chance if have underlying disease)
