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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
Q

caution for TCAs

A

older adults, h/o cardiac issues, suicidal patients, seizure

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25
Q

when should TCAs be taken

A

before bed

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26
Q

venlafaxine

A

SNRI

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27
Q

duloxetine

A

SNRI

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28
Q

side effects of SNRI

A

headache, nausea, dry mouth, sexual dysfunction, agitation, insomnia, weight loss, sweating

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29
Q

how long do SNRI’s take to reach full effect

A

up to 4 weeks

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30
Q

pt education for SNRIs

A

take w food, adequate fluids, weekly weights, may need blood testing

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31
Q

what labs should be monitored with SNRIs

A

LFTs, sodium levels

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32
Q

contraindications for SNRIs

A

hepatic disease, alcoholics

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33
Q

bupropion

A

NDRI

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34
Q

side effects of NDRIs

A

dry mouth, sore throat, nausea, constipation, sexual dysfunction, insomnia, seizure

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35
Q

pt teaching for NDRIs

A

takes 1-3 weeks to kick in, 2-3 months for full effects, take with food

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36
Q

what antidepressant med might a patient who is experiencing sexual dysfunction go on

A

mirtazapine

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37
Q

what med has a high risk of priapism?

A

trazodone

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38
Q

side effects of mirtazapine

A

sleepiness, increased appetite, weight gain, elevated cholesterol

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39
Q

selegiline

A

monoamine oxidase inhibitors

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40
Q

phenelzine

A

monoamine oxidase inhibitors

41
Q

side effects of MAOI

A

agitation, drowsiness, confusion, nausea, weight gain, edema

42
Q

what should be monitored after starting an MAOI

A

BP

43
Q

how long do MAOIs take to reach full effect

A

2-4 weeks

44
Q

how long after stopping an MAOI should restrictions be held

A

14 days

45
Q

contraindications for MAOI

A

HF, CV disease, renal disease, diabetes, seizures

46
Q

why should foods containing tyramine be avoided with MAOI

A

causes hypertensive crisis within 1 hr, risk of CVA

47
Q

s/s of hypertensive crisis

A

severe headache, increased BP & pulse, n/v, fever, nuchal rigidity, LOC changes

48
Q

treatment for hypertensive crisis

A

phentolamine, nifedipine, cooling blankets, cont. ECG

49
Q

foods high in tyramine

A

smoked, fermented, aged, dried or cured meat, cheese, wine, beer, soy sauce, ale, dried/overripe food

50
Q

foods that can cause HTN

A

chocolate, caffeine, ginseng

51
Q

side effects of St. Johns Wort

A

photosensitivity, skin rash, tachycardia, GI distress, abdominal pain

52
Q

uses of ECT

A

treatment resistant depression, elderly, psychotic depression, catatonia, rapid cycling bipolar

53
Q

contraindications for ECT

A

severe HTN, brain aneurysm, recent MI

54
Q

pre-op care for ECT

A

informed consent, hold benzos, lithium, anticonvulsants, NPO, may need antihypertensive

55
Q

intra-op care for ECT

A

ambu bag, cont ECG & vitals, ketamine & succ

56
Q

side effects of ECT

A

headache, possible short term memory loss

57
Q

ECT frequency

A

3x a week, 6-15 treatments needed

58
Q

transcranial magnetic stimulation

A

magnetic pulses to stimulate areas of cerebral cortex, treatment resistant depression

59
Q

vagal nerve stimulation

A

implanted device in chest, boosts levels of neurotransmitters

60
Q

deep brain stimulation

A

electrodes implanted into brain, boosts neurotransmitters

61
Q

ketamine usage

A

treatment resistant depression

62
Q

ketamine

A

causes disassociation, addiction potential, need to get frequently

63
Q

first line treatment for bipolar mania

A

lithium

64
Q

lithium onset

A

5-14 days

65
Q

pt education for lithium

A

consistent amounts of water & sodium, weight gain, keep medical ID, teach s/s of toxicity, will need routine blood testing

66
Q

how often is lithium testing done

A

q2-3 days until stable, then every 1-3 months

67
Q

when should lithium levels be drawn

A

in AM, 10-12 hours after last dose

68
Q

common side effects of lithium

A

fine hand tremors, mild n/v/d, weight gain, thirst, weakness, polyuria

69
Q

what levels do s/s of early lithium toxicity develop

A

1.5-2

70
Q

early s/s of lithium toxicity

A

GI distress, confusion, sedation, tremors

71
Q

at what levels do s/s of advanced lithium toxicity develop

A

2-3

72
Q

s/s of advanced lithium toxicity

A

polyuria, kidney damage, agitation, blurred vision, tinnitus, ataxia, jerking, hypoTN, sedation, possible coma

73
Q

what meds can help excrete lithium

A

urea, mannitol, aminophylline

74
Q

interventions for advanced lithium toxicity

A

excretion meds, emetic & gastric lavage if dose taken recently, draw Na & lith levels, IV fluids

75
Q

what level does severe lithium toxicity occur

A

above 3

76
Q

s/s of severe lithium toxicity

A

arrythmias, peripheral vascular collapse, coma, death

77
Q

interventions for severe lithium toxicity

A

dialysis, excretion meds

78
Q

long term risks of lithium

A

hypothyroidism, kidney impairment/toxicity

79
Q

lithium contraindications

A

renal or cardiac disease, schizophrenia, pregnancy, diabetes, thyroid or seizure disorders

80
Q

lithium interactions

A

ace inhibitors, fluoxetine, haldol, carbamazepine, TCAs, antihistamines, diuretics

81
Q

what often causes lithium toxicity

A

dehydration, OD

82
Q

use of anticonvulsants

A

mixed mania, rapid cycling bipolar

83
Q

therapeutic carbamazepine level

A

4-12

84
Q

carbamazepine side effects

A

double vision, vertigo, headache, staggering gait, pancytopenia, SJS, fluid overload

85
Q

therapeutic level of valproic acid

A

50-120

86
Q

side effects of valproic acid

A

GI upset, n/v, hepatotoxicity, weight gain, low plts, pancreatitis

87
Q

what should be monitored with valproic acid

A

LFTs, amylase levels, CBC & coags

88
Q

lamotrigine usage

A

bipolar maintenance

89
Q

side effects of lamotrigine

A

blurred vision, headaches, n/v, SJS

90
Q

lurasidone

A

antipsychotic for bipolar depression

91
Q

ziprasidone

A

long term mania prophylaxis

92
Q

olanzapine

A

long term mania prophylaxis

93
Q

aripiprazole

A

antipsychotic, long term mania prophylaxis, bipolar maintenance

94
Q

what med class causes bruxism?

A

SSRIs

95
Q

how long do SSRIs take to kick in

A

7-10 days, 30 for full effects

96
Q

side effects of SSRIs

A

CNS stimulation, GI upset & bleeding, weight gain, sexual dysfunction, hyponatremia, bruxism, dry mouth

97
Q

s/s of central serotonin syndrome

A

profuse diarrhea, fever, tachycardia, hyperreflexia, confusion, agitation

98
Q

treatment for CSS

A

cooling blankets, anticonvulsants, propranolol, cyproheptadine

99
Q

pt teaching for SSRIs

A

avoid chocolate & alcohol, take w food in AM

MH Exam 2 (7 decks)

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