Medications Flashcards
1
Q
Stimulant Meds
A
- Adrenergic agonists
- Mimic body’s natural SNS activation
2
Q
Beta-Blockers
A
- Adrenergic antagonists
- Block the body’s natural SNS activation
3
Q
Cholinergics
A
- Stimulate PNS receptors
Ie) nicotine
4
Q
Anticholinergics
A
- Depress PNS receptors
Ie) antipsychotics
5
Q
Glutamate
A
- Excitatory
- Elevated levels associated with psychotic symptoms
6
Q
GABA
A
- Inhibitory
- Low levels associated with anxiety, mania, impulse control
7
Q
Dopamine
A
- Essential in learning, emotion, executive function
- Reuptake associated with depression
8
Q
Serotonin
A
- Role in mood
- Reuptake associated with depression
9
Q
Adherence
A
Meds must be taken as prescribed
10
Q
Adherence Importance
A
- Recovery often requires symptom management
- Lapses in adherence may cause set backs
Ie) significant symptom instability
11
Q
Tapering
A
Meds must be tapered up & down
12
Q
Antidepressants
A
- Depression is caused by decreased monoamine neurotransmitters
- Ie) serotonin, norep, dopamine
- Increased neurotransmitters in brain by blocking reuptake
13
Q
Antidepressant Uses
A
- Depression
- Anxiety
- Mania
- Chronic pain
- Insomnia
14
Q
Antidepressant Effects
A
- 4-6 weeks
- Trial treatment for 3 months
15
Q
Antidepressant Action
A
- Blocking re-uptake of neurotransmitter into pre-synaptic cell
- More neurotransmitter in synapse
- Neurotransmitter either hangs in synapse or binds to post synaptic cell & triggers action
16
Q
Serotonin Related S/E
A
- Agitation
- Insomnia
- Irrirability
- Anxiety
- NVD
- Sexual dysfunction
- Weight gain
17
Q
Serotonin Function
A
- Mood regulation
- Sleep
- Digestion
18
Q
Norepi Function
A
Increase HR & cardiac workload
19
Q
Norepi S/E
A
- Hypertension
- Tachycardia
20
Q
SSRI (-pram) Action
A
- Inhibit reuptake of serotonin
- Increasing serotonin in synapse
21
Q
SNRI (-axine) Action
A
Inhibit reuptake of serotonin & norepi
22
Q
TCA Action
A
Inhibit reuptake of norepi & some serotonin
23
Q
MAOI Action
A
Inhibits serontonin & norepi breakdown
24
Q
MAOI & GI System
A
- Block break down food monoamines
- Tyramine increases
-Increase BP, hypertensive crisis
25
Serotonin Syndrome Complications
- Altered mental statis
- Neuromuscular abnormalities
- Autonomic abnormalities
- Develop within 24 hours of dose increase/med start
- Resolves within 24h of treatment
26
Antidepressant Considerations
- 4-6 weeks for effect (trial)
- May increase anxiety first, reduces in time
- Take med in morning to reduce insomnia
- Alcohol interactions
27
Serotonin Syndrome Intervention
- Discontinue med
- Oxygen
- Support vitals
- Fluid infusion
- Cardiac monitoring
- Serotonin antagonists
- Resolves within 24h of treatment
28
Litium
- Stabilize mood (bipolar & schizoaffective disorders)
- Increases norepi re-uptake & serotonin sensitivity
- Lithium is a SALT
- Responds inversely to fluid & sodium levels in body
29
Litium Effectiveness
- 5-7 days for noticeable efficacy
- 10-21 days for full efficacy
30
Lithium S/E
- Sedative
- Respiratory depression
- Tremors
- Agitation
- Hallucinations
31
Lithium Monitoring
- Serum lithium - 0.6-1.2 mEq/L
- Electrolytes (sodium)
- Renal function
- Thyroid function
32
Lithium Nursing Considerations
- Narrow therapeutic window
- Adherence to routine blood work
- Hydration/salt intake teaching
- Monitor for signs of diabetes (thirst, urination)
- Increase hypothyroid risk - inhibits thyroid hormone
- Lithium toxicity risk
- Contraindicated with pregnancy
33
Lithium Toxicity Levels
- Mild 1.2-1.5
- Moderate 1.5-2.5
- Severe >2.5
34
Medications that Treat Anxiety
- SSRIs
- SNRIs
- Benzodiazepines
- Beta blockers
- Pregabalin
35
Benzodiazepines (asepam)
- Antianxiety
- Stimulate effects of GABA
36
Benzodiazepines S/E
- Sedative
- Respiratory depression
- Tremors
- Agitation
- Hallucinations
37
Benzodiazepines Nursing Considerations
- Pregnancy
- Tolerance
- Misuse
- Dependence
- Safety post dose (driving)
- Alcohol - exacerbate sedative effects
38
Antipsychotic Types
- Typical - more side effects
- Atypical - less side effects
39
Antipsychotics
- Changes in dopamine functioning in brain - psychosis
- Dopamine receptor blockers
- Reduction of hallucinations 3-6 weeks
40
Typical Antipsychotics
- Block all dopamine receptors
- Cause more side effects
41
Atypical Antipsychotics
- Block selective dopamine receptors
- Less side effects
- '-apine'
42
Typical Antipsychotic S/E
- Anticholinergic symptoms
- Drowsy
- Dizzy
- Restless
- Weight gain
- ND
- Low BP
- Increase prolactin
43
Typical Antipsychotic Nursing Considerations
- Anticholinergic symptoms
- Extrapyramidal symptoms
- Tardive dyskinesia
44
Extrapyramidal Side Effects (EPS)
- Akathisia
- Rigidity
- Bradykinesia
- Tremor
- Dystonia
Treat with anticholinergics
45
Akathisia
- Restless
- Trouble standing still
- Paces the floor
- Feet in constant motion rocking back & forth
46
Tardive Dyskinesia
- Protrusion & rolling tongue
- Sucking/smacking lips
- Chewing motion
- Involuntary movements
47
Atypical Antipsychotics S/E
- Anticholinergic symptoms
- Sedative
- Hypotension
- Hypersalivation
- Cardiac (QT prolongation, myocarditis)
48
Atypical Antipsychotics Nursing Considerations
- Metabolic syndrome risk
- Clozapine: blood work & monitor toxicity, low WBCs
49
Neuroleptic Malignant Syndrome
- Potentially fatal syndrome resulting from antipsychotic drugs
- Developed over days to weeks
50
Neuroleptic Malignant Syndrome S/S
- Fever
- Altered mental status
- Muscle rigidity
- Autonomic dysfunction
51
Neuroleptic Malignant Syndrome Intervention
- Discontinue med
- Oxygen
- Support vitals
- IV fluid infusion
- Cardiac monitoring
- Resolves 7-9 days from treatment
