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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
Adverse effects of MAOI
Hypertensive Crisis Serotonin Syndrome
26
What are the dietary restrictions of MAIOs
Avoid all foods with tyramine - causes Hypertensive crisis
27
What are the classes of mood stabilizers?
Lithium Antiepileptics - Lamotrigine - Valproic acid - Carbamazepine
28
Lithium - Therapeutic range
0.6 to 1.2
29
Common adverse effects of Lithium
Short-term tx: GI distress (N/V/D), hand tremors, polyuria, lethargy Long term: Renal toxicity, Hypothyroidism Other: Bradydysrhythmias, hypotension, electrolyte imbalance
30
What are the common labs for lithium?
BUN/Creatnine, TSH/T3/T4
31
Lithium Toxicity - Early (1.5 to 2.0)
S/s: confusion, sedation, poor coordination, hand tremors, GI distress Intervention: Hold med and notify MD
32
Lithium Toxicity - Advanced (2.0 to 2.5)
S/s: Polyuria, tinnitus, ataxia, blurred vision, seizures, hypotension, stupor/coma/death Intervention: if alert, give emetic; if not, gastric lavage
33
Lithium Toxicity - Severe (>2.5)
S/s: Rapid s/s leading to coma/death Interventions: Hemodialysis
34
Name all the Antiepileptics
Lamotrigine Valproic acid Carbamazepine
35
Side effects of Lamotrigine
Blurred vision Dizziness HA, N/V Skin rashes - Steven-Johnson Syndrome
36
Side effects of Valproic Acid
N/V Hepatotoxicity Pancreatitis Thrombocytopenia
37
Side effects of Carbamazepine
Blurred vision Vertigo Skin disorders - Steven-Johnson Syndrome 3 blood dyscrasias (leukopenia, anemia, thrombocytopenia)
38
Anxiolytics
Benzodiazepines Buspirone SSRI/SNRI
39
Name all the medications that belong to Benzodiazepines
-zepam/-zolam Chlordiazepoxide
40
What is the antidote of Benzodiazepines?
Flumazenil
41
Adverse effects of Benzos
CNS depression Dependency Withdrawal
42
CAUTIONS with Benzos
Avoid alcohol Don't stop abruptly...TAPER slowely Paradoxical response (opposite of relaxing)
43
Typical - 1st generation Antipsychotics (Treats ONLY positive s/s)
Haloperidol Chlorpromazine Fluphenazine
44
Adverse effects of Typical Antipsychotics
Cardiac dysrhythmias EPS NMS Anticholinergic Orthostatic Hypotension4 Sexual dysfunction
45
EPS
Acute Dystonia: Muscle spasms in neck, face, jaw Akithesia: Restlessness, Pacing Tarditive Dyskanisia: Protruding tongue, smacking lips
46
Assessment and Tx of EPS
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
NMS
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
Atypical - 2nd & 3rd generation Antipsychotics (Treats positive and negative s/s)
2nd: -sidone, -apine 3rd gen: Aripiprazole (AE: Sedation, HA, anxiety)
49
Adverse effects of Atypical Antipsychotics
Metabolic Syndrome Decrease risk of NMS Elevated prolactin levels Orthostatic Hypotension Increased risk of gynecomastia and lactation Risperidone: Risk of EPS Clozapine: Agranulocytosis
50
Agranulocytosis
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
ADHD Meds - Stimulants
Methylphenidate Amphetamine AE: anorexia, insomnia, growth suppression, CV effects, mood changes
52
ADHD Meds - Non-stimulants
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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