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MH Exam 2 > Medications > Flashcards

Medications Flashcards

1
Q

side effects of benzos

A

paradoxical response, CNS depression, anterograde amnesia, withdrawal

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2
Q

oral benzo toxicity treatment

A

gastric lavage, activated charcoal

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2
Q

oral benzo toxicity s/s

A

drowsiness, lethargy, confusion

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3
Q

IV benzo toxicity s/s

A

severe hypotension, resp. depression, cardiac arrest

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4
Q

IV benzo treatment

A

flumazenil - reversal agent, monitor VS & airway

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5
Q

how long should benzos be used? why

A

2-4 weeks, tolerance & dependence

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6
Q

why is it important to taper down benzos slowly

A

can cause rebound insomnia & withdrawal symptoms

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7
Q

what patients should not use benzos

A

elderly, pregnant, resp disease, sleep apnea, glaucoma

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8
Q

what should not be taken with benzos

A

other CNS depressants, anticonvulsants, antihistamines

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9
Q

what is buspirone used for

A

anxiety

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10
Q

side effects of buspirone

A

dizziness, drowsiness, weakness, headache, n/v, paradoxical response

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11
Q

how long does buspirone take for full effect

A

2-6 weeks

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12
Q

interactions with buspirone

A

MAOI’s, erythromycin, ketoconazole, St. John’s Wort

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13
Q

contraindications for buspirone

A

kidney/liver disease

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14
Q

what med requires lower doses for ethnic ppl

A

TCAs

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15
Q

side effects of TCAs

A

anticholinergic effects, orthostatic hypoTN, sedation, weight gain, seizure, sweating, cardiac blocks, tachycardia

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16
Q

anticholinergic effects

A

dry mouth, blurred vision, photophobia, retention, constipation

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17
Q

nursing interventions for anticholinergic effects

A

increase fluid intake, void before taking meds, chew sugar free gum/candy

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18
Q

cardiac side effects of TCAs

A

dysrhythmias, AMS, agitation, seizure, coma, death

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19
Q

how much TCAs should someone be given at once, why

A

1 week supply, high lethality

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20
Q

nursing interventions for TCAs

A

baseline ECGs, frequent VS

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21
Q

s/s of TCA overdose

A

hyperthermia, hallucinations, seizure, block, tachycardia, MI

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22
Q

TCA contraindications

A

liver disease, h/o MI

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23
Q

what cannot be taken with TCAs

A

MAOI’s, CNS depressants, alcohol, antihistamines

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24
caution for TCAs
older adults, h/o cardiac issues, suicidal patients, seizure
25
when should TCAs be taken
before bed
26
venlafaxine
SNRI
27
duloxetine
SNRI
28
side effects of SNRI
headache, nausea, dry mouth, sexual dysfunction, agitation, insomnia, weight loss, sweating
29
how long do SNRI's take to reach full effect
up to 4 weeks
30
pt education for SNRIs
take w food, adequate fluids, weekly weights, may need blood testing
31
what labs should be monitored with SNRIs
LFTs, sodium levels
32
contraindications for SNRIs
hepatic disease, alcoholics
33
bupropion
NDRI
34
side effects of NDRIs
dry mouth, sore throat, nausea, constipation, sexual dysfunction, insomnia, seizure
35
pt teaching for NDRIs
takes 1-3 weeks to kick in, 2-3 months for full effects, take with food
36
what antidepressant med might a patient who is experiencing sexual dysfunction go on
mirtazapine
37
what med has a high risk of priapism?
trazodone
38
side effects of mirtazapine
sleepiness, increased appetite, weight gain, elevated cholesterol
39
selegiline
monoamine oxidase inhibitors
40
phenelzine
monoamine oxidase inhibitors
41
side effects of MAOI
agitation, drowsiness, confusion, nausea, weight gain, edema
42
what should be monitored after starting an MAOI
BP
43
how long do MAOIs take to reach full effect
2-4 weeks
44
how long after stopping an MAOI should restrictions be held
14 days
45
contraindications for MAOI
HF, CV disease, renal disease, diabetes, seizures
46
why should foods containing tyramine be avoided with MAOI
causes hypertensive crisis within 1 hr, risk of CVA
47
s/s of hypertensive crisis
severe headache, increased BP & pulse, n/v, fever, nuchal rigidity, LOC changes
48
treatment for hypertensive crisis
phentolamine, nifedipine, cooling blankets, cont. ECG
49
foods high in tyramine
smoked, fermented, aged, dried or cured meat, cheese, wine, beer, soy sauce, ale, dried/overripe food
50
foods that can cause HTN
chocolate, caffeine, ginseng
51
side effects of St. Johns Wort
photosensitivity, skin rash, tachycardia, GI distress, abdominal pain
52
uses of ECT
treatment resistant depression, elderly, psychotic depression, catatonia, rapid cycling bipolar
53
contraindications for ECT
severe HTN, brain aneurysm, recent MI
54
pre-op care for ECT
informed consent, hold benzos, lithium, anticonvulsants, NPO, may need antihypertensive
55
intra-op care for ECT
ambu bag, cont ECG & vitals, ketamine & succ
56
side effects of ECT
headache, possible short term memory loss
57
ECT frequency
3x a week, 6-15 treatments needed
58
transcranial magnetic stimulation
magnetic pulses to stimulate areas of cerebral cortex, treatment resistant depression
59
vagal nerve stimulation
implanted device in chest, boosts levels of neurotransmitters
60
deep brain stimulation
electrodes implanted into brain, boosts neurotransmitters
61
ketamine usage
treatment resistant depression
62
ketamine
causes disassociation, addiction potential, need to get frequently
63
first line treatment for bipolar mania
lithium
64
lithium onset
5-14 days
65
pt education for lithium
consistent amounts of water & sodium, weight gain, keep medical ID, teach s/s of toxicity, will need routine blood testing
66
how often is lithium testing done
q2-3 days until stable, then every 1-3 months
67
when should lithium levels be drawn
in AM, 10-12 hours after last dose
68
common side effects of lithium
fine hand tremors, mild n/v/d, weight gain, thirst, weakness, polyuria
69
what levels do s/s of early lithium toxicity develop
1.5-2
70
early s/s of lithium toxicity
GI distress, confusion, sedation, tremors
71
at what levels do s/s of advanced lithium toxicity develop
2-3
72
s/s of advanced lithium toxicity
polyuria, kidney damage, agitation, blurred vision, tinnitus, ataxia, jerking, hypoTN, sedation, possible coma
73
what meds can help excrete lithium
urea, mannitol, aminophylline
74
interventions for advanced lithium toxicity
excretion meds, emetic & gastric lavage if dose taken recently, draw Na & lith levels, IV fluids
75
what level does severe lithium toxicity occur
above 3
76
s/s of severe lithium toxicity
arrythmias, peripheral vascular collapse, coma, death
77
interventions for severe lithium toxicity
dialysis, excretion meds
78
long term risks of lithium
hypothyroidism, kidney impairment/toxicity
79
lithium contraindications
renal or cardiac disease, schizophrenia, pregnancy, diabetes, thyroid or seizure disorders
80
lithium interactions
ace inhibitors, fluoxetine, haldol, carbamazepine, TCAs, antihistamines, diuretics
81
what often causes lithium toxicity
dehydration, OD
82
use of anticonvulsants
mixed mania, rapid cycling bipolar
83
therapeutic carbamazepine level
4-12
84
carbamazepine side effects
double vision, vertigo, headache, staggering gait, pancytopenia, SJS, fluid overload
85
therapeutic level of valproic acid
50-120
86
side effects of valproic acid
GI upset, n/v, hepatotoxicity, weight gain, low plts, pancreatitis
87
what should be monitored with valproic acid
LFTs, amylase levels, CBC & coags
88
lamotrigine usage
bipolar maintenance
89
side effects of lamotrigine
blurred vision, headaches, n/v, SJS
90
lurasidone
antipsychotic for bipolar depression
91
ziprasidone
long term mania prophylaxis
92
olanzapine
long term mania prophylaxis
93
aripiprazole
antipsychotic, long term mania prophylaxis, bipolar maintenance
94
what med class causes bruxism?
SSRIs
95
how long do SSRIs take to kick in
7-10 days, 30 for full effects
96
side effects of SSRIs
CNS stimulation, GI upset & bleeding, weight gain, sexual dysfunction, hyponatremia, bruxism, dry mouth
97
s/s of central serotonin syndrome
profuse diarrhea, fever, tachycardia, hyperreflexia, confusion, agitation
98
treatment for CSS
cooling blankets, anticonvulsants, propranolol, cyproheptadine
99
pt teaching for SSRIs
avoid chocolate & alcohol, take w food in AM

MH Exam 2 (7 decks)

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