Medications Flashcards
What are some common benzos?
AlprazoLAM
DiazePAM
LorazePAM
Chlordiazepoxide
What med is often prescribed to treat chronic anxiety and GAD (generalized anxiety)
How does it work?
What are side effects?
Buspirone
Serotonin receptor agonist and dopamine receptor antagonist
Sedation, nausea, headaches, dizziness
How do benzos work?
Side effects?
Work by regulating GABA
Result in large amount of dopamine flooding brain
Addictive
SE: CNS depressant. Sedation, poor concentration, drowsiness, impaired memory
How do MAOIs work?
Prevent or slows the breakdown of NTs serotonin and dopamine at the synapsis.
What is a MAOI?
phenelzine
How do TCAs work?
What are side effects?
Blocks the reuptake of serotonin and norepinephrine
SE: Anticholinergic SE, orthostatic hypotension
How do SSRIs work?
Blocks the reuptake of serotonin
How do SNRIs work?
What is benefits of SNRIs over SSRIs?
Block reuptake of both serotonin and norepinephrine
Have appetite suppressant effect
Also have anti-anxiety effect
What must client stay away from when taking MAOIs?
Tyramine
These will be aged or fermented food/drinks.
Smoked meats
Aged cheese
Red wine
Beer
Chocolate
Avocado
Soy products
Sudafed
Can lead to hypertensive crisis!
How do 1st Gen antipsychotics work?
Block dopamine receptors
Common 1st Gen antipsychotics
haloperidol
fluphenazine
loxapine
chlorpromazine
How do 2nd gen antipsychotics work?
How are they different from 1st gen?
Block dopamine receptors to lesser degree and prevent reuptake of serotonin
Not as potent but have lesser degree of SE
Common 2nd gen antipsychotics
risperidone
olanzapine
quetiapine
clozapine
Common SE of antipsychotics?
Anticholinergic
Can’t see, spit, pee, poo
Orthostatic hypotension
Photosensitive
Increased glucose and cholesterol -2nd gen-
Neuroleptic malignant syndrome -1st gen-
Agranulocutosis -clozapine and 1st gen-
EPS
Weight gain -2nd gen-
Sedation
Therapeutic range of lithium.
Toxic levels?
0.6—1.2
>1.5 is toxic
What other labs are important when lithium is used?
Liver function
Kidney function
WBCs
Platelets
RBCs
Commonly used SSRIs (6)
Fluoxetine (Prozac)
Fluvoxemine (Luvox)-OCD tx
Paroxetine (Paxil)
Sertraline (Zoloft)
Citalopram (Celexa)
Escitalopram (Lexapro)
Side effects of SSRIs and SNRIs
Jittery/Restless/Tremor
Headache/Nausea
Fatigue/Sex dysfunction
Changes in appetite/weight
Sweating
QT prolonged (SSRIs only)
Hyponatremia (SSRIs only)
Common SNRIs (2)
Duloxetine (Cymbalta)
Venlafaxine (Effexor)
Desvenlafaxine (Pristiq)
Common TCAs
ClomiPRAMINE
DesiPRAMINE
ImiPRAMINE
Doxepin
NorTRIPTYLINE
AmaTRIPTYLINE
Side effects of TCAs
Anticholinergic effects
–Can’t spit, see, pee, poo–
What is a non-benzo anxiolytic?
How does it work?
Buspar or buspirone
Binds to serotonin and dopamine receptors
What is suffix for benzos?
-LAM
-PAM
Except chlordiazepoxide
What is effect of Lyrica in anxiety?
Lyrica also called Pregabalin
An anticonvulsant and pain med
Increases GABA
Used for GAD and SAD
What is effect of beta blockers in anxiety?
Blocks beta receptors
Used to treat test anxiety or stage fright.
Propranolol and Atenolol
What is effect of Quetiapine in anxiety?
Also called Seroquel
Blocks serotonin and dopamine
An antipsychotic
Usually given in adjunct with SSRIs
What are signs of lithium toxicity?
Coarse tremors
Slurred speech
Stupor
Seizures
N/V/Diarrhea
Hypotension
Bradycardia
Renal failure
What are expected SE of lithium?
Fine hand tremors
Weight gain
Slow cognition
Taste alterations
–These usually resolve–
What should we teach patients about salt and lithium?
Don’t restrict salt
Stay hydrated!
What part of brain is called the “higher brain”?
What 4 parts is it divided into?
Cerebrum
Four parts are
Parietal lobe-Sensory and Motor
Occipital lobe-Vision
Temporal lobe-Auditory
Frontal lobe-thought process
What does brainstem control?
Heart rate
Respirations
Sleep
LOC
–Many psych meds can alter signals through the brain stem and cause sleepiness–
What part of brain is involved in eye movement, balance, motor control and is altered in schizophrenia?
Cerebellum
What does the limbic brain do?
Made up of the hippocampus and amygdala, hypothalamus, thalamus.
Hippocampus=memories
Amygdala=fear, anxiety
Hypothalamus=maintains homeostasis and controls the master gland, also controls the sympathetic and parasympathetic
—The emotional brain is the limbic system–
What does reuptake mean?
A process that happens in the synaptic cleft of neurons. Once a neurotransmitter is sent across to post synaptic neuron, it is taken back into the presynaptic neuron and recycled or destroyed. Usually by an enzyme called MAO (monoamine oxidase).
What is the only drug in class called serotonin-norepi disinhibitors?
Mirtazapine (Remeron)
–This increases serotonin and norepinephrine–
What is med in norepinephrine-dopamine reuptake inhibitors?
bupropion (Wellbutrin)
–Can use it to quit smoking too, but it is called Zyban–
What med can be prescribed for sleep in lower doses and depression in higher doses? What class med is it?
Trazadone
Serotonin antagonist/reuptake inhibitor (SARI)
What selective norepinephrine reuptake inhibitor is used to treat ADHD?
atomoxetine (Strattera)
What are the Z-hypnotics?
zolpidem (Ambien)
zalephlon (Sonata)
eszopiclone (Lunesta)
What med is a melatonin receptor agonist?
ramelteon (Rozerem)
When a patient on lithium becomes hyponatremic, what effect does this have on lithium levels?
Increases them.
Remember inverse relationship
High Na+ low lithium
Low Na+ high lithium
What are some meds classed as mood stabilizers?
valproate (Depakote or Depakene)
lamotrigine (Lamictal)
carbamazepine (Tegretol)
oxcarbazepine (Trileptal)
gabapentin (Neurontin)
topiramate (Topamax)
What is clozapine?
Biggest dangerous side effect?
A 2nd generation antipsychotic
Agranulocytosis
Common side effects of 2nd gen antipsychotics?
Weight gain»metabolic syndrome
Sedating
Orthostatic hypotension
Sexual dysfunction
