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Psychotropic medication > medications > Flashcards

medications Flashcards

1
Q

What are the classes of antidepressants?

A

SSRIs
SNRIs
Atypical
TCAs
MAOIs

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2
Q

Name all medication that belong to SSRIs

A

Paroxetine
Sertraline
Fluoxetine
Escitalopram

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3
Q

SSRIs

A

First line therapy for depression; MOA: increase serotonin levels

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4
Q

List 3 main side effects of SSRIs and SNRIs

A

Sick to stomach (N/V/D)
Sexual dysfunction
Serotonin syndrome

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5
Q

What are other common side effects of SSRIs?

A

CNS stimulation (anxiety. insomnia)
Headache
Weight changes (lose to gain)
Hyponatremia

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6
Q

Interventions for SSRIs

A

Administer in AM
Push fluids
Monitor sodium levels
Monitor for serotonin syndrome

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7
Q

Name all the medications that belong to SNRIs

A

Duloxetine
Venlafaxine

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8
Q

What are other common side effects of SNRIs?

A

Diaphoresis
Weight loss

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9
Q

SNRIs

A

Mode Of Action: Increase serotonin and norepinephrine

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10
Q

Interventions of SNRIs

A

Monitor for serotonin syndrome
Push fluids
CAUTION with hx of HTN

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11
Q

CAUTION for SSRIs and SNRIs

A

SUICIDE WARNING

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12
Q

Name all the medications that belong to Atypical Antidepressants

A

Trazadone
Bupropion

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13
Q

What medication is used for:
Sleep, smoking cessation, and weight loss

A

Atypical Antidepressants

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14
Q

Side effects of Trazadone and Bupropion

A

Sedation (ZZZZ)
Dry mouth
Priapism
Weight loss
Insomnia
Agitation
Lower seizure threshold

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15
Q

Interventions of Atypical Antidepressants

A

Avoid ETOH (alcohol)
Give hard candy/gum
Give with food
Take in AM
Safe to breastfeed

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16
Q

Medications belonging to Tricyclic

A

Amitriptyline
Nortriptyline
Imipramine

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17
Q

Tricyclic (“Tripped a line” - QT prolongation)

A

MOA: Increase serotonin and norepinephrine

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18
Q

What is the onset of Tricyclic meds?

A

SLOW; 6-8 weeks

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19
Q

Side effects of tricyclic medications

A

Sedation, Sweating
Orthostatic hypotension
Anticholinergic
Seizures
FATAL overdose

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20
Q

Interventions of -triptyline medications

A

Change positions slow
Fiber fluids, sugar free sugar/gum
Administer in PM

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21
Q

S/S of Serotonin syndrome

A

Abrupt onset; Hyperreflexia, Mydriasis. MyoCLONUS/tremors, N/V/D, abdominal pain

22
Q

Tx of serotonin syndrome

A

Stop meds; begin supportive care

23
Q

MAOI medications

A

Selegiline
Phenelzine

24
Q

What are the medication restrictions of MAIOs?

A

SSRI, TCA, Demerol, OTC, and BP meds - causes SS

25
Q

Adverse effects of MAOI

A

Hypertensive Crisis
Serotonin Syndrome

26
Q

What are the dietary restrictions of MAIOs

A

Avoid all foods with tyramine - causes Hypertensive crisis

27
Q

What are the classes of mood stabilizers?

A

Lithium
Antiepileptics
- Lamotrigine
- Valproic acid
- Carbamazepine

28
Q

Lithium - Therapeutic range

A

0.6 to 1.2

29
Q

Common adverse effects of Lithium

A

Short-term tx:
GI distress (N/V/D), hand tremors, polyuria, lethargy

Long term:
Renal toxicity, Hypothyroidism

Other: Bradydysrhythmias, hypotension, electrolyte imbalance

30
Q

What are the common labs for lithium?

A

BUN/Creatnine, TSH/T3/T4

31
Q

Lithium Toxicity - Early (1.5 to 2.0)

A

S/s: confusion, sedation, poor coordination, hand tremors, GI distress

Intervention: Hold med and notify MD

32
Q

Lithium Toxicity - Advanced (2.0 to 2.5)

A

S/s: Polyuria, tinnitus, ataxia, blurred vision, seizures, hypotension, stupor/coma/death

Intervention: if alert, give emetic; if not, gastric lavage

33
Q

Lithium Toxicity - Severe (>2.5)

A

S/s: Rapid s/s leading to coma/death

Interventions: Hemodialysis

34
Q

Name all the Antiepileptics

A

Lamotrigine
Valproic acid
Carbamazepine

35
Q

Side effects of Lamotrigine

A

Blurred vision
Dizziness
HA, N/V
Skin rashes - Steven-Johnson Syndrome

36
Q

Side effects of Valproic Acid

A

N/V
Hepatotoxicity
Pancreatitis
Thrombocytopenia

37
Q

Side effects of Carbamazepine

A

Blurred vision
Vertigo
Skin disorders - Steven-Johnson Syndrome
3 blood dyscrasias (leukopenia, anemia, thrombocytopenia)

38
Q

Anxiolytics

A

Benzodiazepines
Buspirone
SSRI/SNRI

39
Q

Name all the medications that belong to Benzodiazepines

A

-zepam/-zolam
Chlordiazepoxide

40
Q

What is the antidote of Benzodiazepines?

A

Flumazenil

41
Q

Adverse effects of Benzos

A

CNS depression
Dependency
Withdrawal

42
Q

CAUTIONS with Benzos

A

Avoid alcohol
Don’t stop abruptly…TAPER slowely
Paradoxical response (opposite of relaxing)

43
Q

Typical - 1st generation Antipsychotics
(Treats ONLY positive s/s)

A

Haloperidol
Chlorpromazine
Fluphenazine

44
Q

Adverse effects of Typical Antipsychotics

A

Cardiac dysrhythmias
EPS
NMS
Anticholinergic
Orthostatic Hypotension4
Sexual dysfunction

45
Q

EPS

A

Acute Dystonia: Muscle spasms in neck, face, jaw

Akithesia: Restlessness, Pacing

Tarditive Dyskanisia: Protruding tongue, smacking lips

46
Q

Assessment and Tx of EPS

A

Assess with AIMS (once/month)
- When?: baseline, policy, showing s/s
Tx:
1)Continue 1st gen drug + diphenhydramine or benztropine
2) Discontinue 1st gen drug + start 2nd gen drug

47
Q

NMS

A

S/s: high fever (>103), muscle rigidity, LOC changes, increase vital signs

Actions:
Stop med; transfer to ICU STAT
Administer Dantrolene (muscle relaxant)
Administer Bromacriptine (raises dopamine, lowers prolactin)

48
Q

Atypical - 2nd & 3rd generation Antipsychotics
(Treats positive and negative s/s)

A

2nd: -sidone, -apine

3rd gen: Aripiprazole (AE: Sedation, HA, anxiety)

49
Q

Adverse effects of Atypical Antipsychotics

A

Metabolic Syndrome
Decrease risk of NMS
Elevated prolactin levels
Orthostatic Hypotension
Increased risk of gynecomastia and lactation

Risperidone: Risk of EPS
Clozapine: Agranulocytosis

50
Q

Agranulocytosis

A

S/s: reduced neutrophil count, increased infections

Lab: ANC Count (done 1/week)

Considerations: Clozapine causes this, Potential blood dyscrasia, monitor weekly for 6 months, if neutropenia - hold med and consult MD

51
Q

ADHD Meds - Stimulants

A

Methylphenidate
Amphetamine

AE: anorexia, insomnia, growth suppression, CV effects, mood changes

52
Q

ADHD Meds - Non-stimulants

A

Atomoxetine

AE: Liver damage (s/s: jaundice, clay stools, ascites, cirrhosis, dark urine, abdominal pain), suicidal thinking and behavior

Psychotropic medication (1 decks)

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