Medications

Question 1

What are some common benzos?

Answer 1

AlprazoLAM
DiazePAM
LorazePAM
Chlordiazepoxide

Question 2

What med is often prescribed to treat chronic anxiety and GAD (generalized anxiety)
How does it work?
What are side effects?

Answer 2

Buspirone
Serotonin receptor agonist and dopamine receptor antagonist
Sedation, nausea, headaches, dizziness

Question 3

How do benzos work?
Side effects?

Answer 3

Work by regulating GABA
Result in large amount of dopamine flooding brain
Addictive
SE: CNS depressant. Sedation, poor concentration, drowsiness, impaired memory

Question 4

How do MAOIs work?

Answer 4

Prevent or slows the breakdown of NTs serotonin and dopamine at the synapsis.

Question 5

What is a MAOI?

Answer 5

phenelzine

Question 6

How do TCAs work?
What are side effects?

Answer 6

Blocks the reuptake of serotonin and norepinephrine
SE: Anticholinergic SE, orthostatic hypotension

Question 7

How do SSRIs work?

Answer 7

Blocks the reuptake of serotonin

Question 8

How do SNRIs work?
What is benefits of SNRIs over SSRIs?

Answer 8

Block reuptake of both serotonin and norepinephrine
Have appetite suppressant effect
Also have anti-anxiety effect

Question 9

What must client stay away from when taking MAOIs?

Answer 9

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!

Question 10

How do 1st Gen antipsychotics work?

Answer 10

Block dopamine receptors

Question 11

Common 1st Gen antipsychotics

Answer 11

haloperidol
fluphenazine
loxapine
chlorpromazine

Question 12

How do 2nd gen antipsychotics work?
How are they different from 1st gen?

Answer 12

Block dopamine receptors to lesser degree and prevent reuptake of serotonin
Not as potent but have lesser degree of SE

Question 13

Common 2nd gen antipsychotics

Answer 13

risperidone
olanzapine
quetiapine
clozapine

Question 14

Common SE of antipsychotics?

Answer 14

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

Question 15

Therapeutic range of lithium.
Toxic levels?

Answer 15

0.6—1.2
>1.5 is toxic

Question 16

What other labs are important when lithium is used?

Answer 16

Liver function
Kidney function
WBCs
Platelets
RBCs

Question 17

Commonly used SSRIs (6)

Answer 17

Fluoxetine (Prozac)
Fluvoxemine (Luvox)-OCD tx
Paroxetine (Paxil)
Sertraline (Zoloft)
Citalopram (Celexa)
Escitalopram (Lexapro)

Question 18

Side effects of SSRIs and SNRIs

Answer 18

Jittery/Restless/Tremor
Headache/Nausea
Fatigue/Sex dysfunction
Changes in appetite/weight
Sweating
QT prolonged (SSRIs only)
Hyponatremia (SSRIs only)

Question 19

Common SNRIs (2)

Answer 19

Duloxetine (Cymbalta)
Venlafaxine (Effexor)
Desvenlafaxine (Pristiq)

Question 20

Common TCAs

Answer 20

ClomiPRAMINE
DesiPRAMINE
ImiPRAMINE
Doxepin
NorTRIPTYLINE
AmaTRIPTYLINE

Question 21

Side effects of TCAs

Answer 21

Anticholinergic effects
–Can’t spit, see, pee, poo–

Question 22

What is a non-benzo anxiolytic?
How does it work?

Answer 22

Buspar or buspirone
Binds to serotonin and dopamine receptors

Question 23

What is suffix for benzos?

Answer 23

-LAM
-PAM
Except chlordiazepoxide

Question 24

What is effect of Lyrica in anxiety?

Answer 24

Lyrica also called Pregabalin
An anticonvulsant and pain med
Increases GABA
Used for GAD and SAD

Question 25

What is effect of beta blockers in anxiety?

Answer 25

Blocks beta receptors Used to treat test anxiety or stage fright. Propranolol and Atenolol

Question 26

What is effect of Quetiapine in anxiety?

Answer 26

Also called Seroquel Blocks serotonin and dopamine An antipsychotic Usually given in adjunct with SSRIs

Question 27

What are signs of lithium toxicity?

Answer 27

Coarse tremors Slurred speech Stupor Seizures N/V/Diarrhea Hypotension Bradycardia Renal failure

Question 28

What are expected SE of lithium?

Answer 28

Fine hand tremors Weight gain Slow cognition Taste alterations --These usually resolve--

Question 29

What should we teach patients about salt and lithium?

Answer 29

Don't restrict salt Stay hydrated!

Question 30

What part of brain is called the "higher brain"? What 4 parts is it divided into?

Answer 30

Cerebrum Four parts are Parietal lobe-Sensory and Motor Occipital lobe-Vision Temporal lobe-Auditory Frontal lobe-thought process

Question 31

What does brainstem control?

Answer 31

Heart rate Respirations Sleep LOC --Many psych meds can alter signals through the brain stem and cause sleepiness--

Question 32

What part of brain is involved in eye movement, balance, motor control and is altered in schizophrenia?

Answer 32

Cerebellum

Question 33

What does the limbic brain do?

Answer 33

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--

Question 34

What does reuptake mean?

Answer 34

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).

Question 35

What is the only drug in class called serotonin-norepi disinhibitors?

Answer 35

Mirtazapine (Remeron) --This increases serotonin and norepinephrine--

Question 36

What is med in norepinephrine-dopamine reuptake inhibitors?

Answer 36

bupropion (Wellbutrin) --Can use it to quit smoking too, but it is called Zyban--

Question 37

What med can be prescribed for sleep in lower doses and depression in higher doses? What class med is it?

Answer 37

Trazadone Serotonin antagonist/reuptake inhibitor (SARI)

Question 38

What selective norepinephrine reuptake inhibitor is used to treat ADHD?

Answer 38

atomoxetine (Strattera)

Question 39

What are the Z-hypnotics?

Answer 39

zolpidem (Ambien) zalephlon (Sonata) eszopiclone (Lunesta)

Question 40

What med is a melatonin receptor agonist?

Answer 40

ramelteon (Rozerem)

Question 41

When a patient on lithium becomes hyponatremic, what effect does this have on lithium levels?

Answer 41

Increases them. Remember inverse relationship High Na+ low lithium Low Na+ high lithium

Question 42

What are some meds classed as mood stabilizers?

Answer 42

valproate (Depakote or Depakene) lamotrigine (Lamictal) carbamazepine (Tegretol) oxcarbazepine (Trileptal) gabapentin (Neurontin) topiramate (Topamax)

Question 43

What is clozapine? Biggest dangerous side effect?

Answer 43

A 2nd generation antipsychotic Agranulocytosis

Question 44

Common side effects of 2nd gen antipsychotics?

Answer 44

Weight gain>>metabolic syndrome Sedating Orthostatic hypotension Sexual dysfunction