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Mental Health-MJ > Meds > Flashcards

Meds Flashcards

1
Q

If we administer Naloxone for an overdose, what do we monitor?

A

Monitor for resp. depression

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2
Q

Benzos not indicated for?

A

Chronic pain syndrome

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3
Q

Early signs of w/d with heroin?

A 
Restlessness
Irritability
Piloerection (goosebumps)
Tremor
Loss of appetite
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4
Q

What time do we administer Donepezil?

A

Bedtime

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5
Q

Most common SE of Buspirone?

A

Drowsiness

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6
Q

What takes Methadone?

A

People coming off opioids

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7
Q

What tests do we do on pts. taking Valproic Acid?

A

Liver function and hematology

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8
Q

Can we give both Valproic acid and Lithium?

A

Yes

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9
Q

What is a drug for w/d from alcohol?

A

Chlordiazepoxide

Benzos! main point

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10
Q

Most common side effect of benzos?

A

Sedation
Dizzy
Drowsy

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11
Q

Benzos cause CNS depression or excitation?

A

Depression

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12
Q

Buspirone causes dizziness, nausea, headache, light-headedness, and agitation. Does this medication interfere with activites?

A

No, because it DOES NOT cause sedation!

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13
Q

SSRI: Paroxetine–CNS depression or excitation?

A

Excitation/Stimulation–> Insomnia

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14
Q

Is there weight gain or loss with SSRIs?

A

Weight gain

20 lbs+ possible with long term use

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15
Q

When does serotonin syndrome ususally being?

A

2-72 hours after initiation of treatment of SSRI

  • Agitation
  • Anxiety
  • Confusion
  • Disorientation
  • Difficulty concentrating
  • Diaphoresis
  • Fever
  • Hallucincations
  • Hyperreflexia
  • Incoordination
  • Tremors
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16
Q

Bruxism is an adverse effect of SSRI. How can we treat–like with what med?

A

Low dose Buspirone

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17
Q

Why do we uses SSRIs cautiously in clients who have bipolar disorder?

A

Due to risk of mania

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18
Q

When should SSRI Paroxetine be administered?

A

In the morning; can take with food

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19
Q

What are 3 big AE of TCA?

A

Orthostatic hypotension
Anticholinergic effects
Sedation

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20
Q

When should TCA be administered?

A

Bedtime (remember it causes sedation)

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21
Q

How many weeks worth of meds can we give if client takes TCA?

A

Give no more than 1 week supply of med to clients who are acutely ill due to the high risk of lethality with overdose

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22
Q

TCA are contraindicated in clients with ___

A

Seizure disorders

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23
Q

SSRIs can cause sexual dysfunction. What med can we give to help with this?

A

Bupropian

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24
Q

When do we give SSRI?

A

In the morning

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25
Q

What 2 SSRIs increase risk of birth defects?

A

Fluoxetine and paroxetine

Use other SSRIs in pregnancy

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26
Q

Is it ok to take St. Johns Wort with SSRI?

A

No

also don’t take with warfarin, TCA, lithium, and NSAIDs, and anticoagulatnts

27
Q

MAOI: CNS depression or stimualation?

A

Stimulation

28
Q

MAOI causes CNS stimulation. What are some other adverse effects besides stimulation (3)?

A
  • Orthostatic hypotension
  • Hypertensive crisis
  • Local rash associated with transdermal prep
29
Q

MAOI: If client is experiencing a hypertensive crisis (headache, nausea, increased HR and BP), what medication can we give?

A

Phentolamine

Nifedipine

30
Q

Why is bupropion contraindicated in clients who have anorexia nervosa or bulimia nervosa?

A

It causes weight loss due to suppression of appetite–those patients don’t need weight loss

31
Q

What “other atypical antidepressant” has therapeutic effects that may occur sooner, and with less sexual dysfunction like SSRIs?

A

Mirtazapine

32
Q

What may be a serious adverse effect of the “other atypical antidepressant” Trazodone?

A

Priapism

33
Q

What is an indication of toxicity for TCAs?

A

Cardiac dysrhythmias

34
Q

When do we give TCA?

A

Bedtime due to risk of sedation and orthostatic hypotension

35
Q

When do we give SSRI?

A

Morning; take with food to minimize GI problems

36
Q

What list of foods should we give to clients taking MAOIs?

A

List of foods to avoid aka Tyramines

37
Q

Ok to take Bupropion with MAOIs?

A

No

38
Q

Do we give lithium with meals? milk?

A

Yes, to both to minimize GI distress

39
Q

What level of lithium:

N.D.V
Thirst
Polyuria
Muscle weakness
Fine hand tremor
Slurred speech
A

Less than 1.5

40
Q

What level of lithium:

Mental confusion
Poor coordination
Coarse tremor
Onging GI distress–NVD

A

1.5-2

41
Q

What level of lithium:

Extreme polyuria of dilute urine
Tinnitus
Blurred vision
Ataxia
Seizures
Severe hypotension leading to coma, and possibly death from resp. complications
A

Greater than 2-2.5

42
Q

What level of lithium:

Rapid progression of manifestations leading to coma and death

A

Greater than 2.5

43
Q

Lithium is teratogenic, especially in 1st trimester. Is it ok to give when breastfeeding?

A

NO-discourage this!!

44
Q

Lithium and pain: should we use NSAIDs or aspirin?

A

Aspirin

45
Q

How often to we give lithium?

A

2-3 times daily–take with food to decrease GI distress

46
Q

When do we administer carbamazepine?

A

At bedtime

47
Q

Who is carabamazepine contrainindicated in?

A

Clients who have bone marrow suppression or bleeding disorders

48
Q

Who is valproic acid contraindicated in?

A

Clients with liver disorders

49
Q

First generation anti-psychotics (conventional)

Treat positive, negative, or both?

A

Mainly positive symptoms of schizo

50
Q

Second generation antipsychitcis (atypical)

Treat positive, negative, or both?

A

Both positive and negative symptoms of schizo

51
Q

Which has fewer EPS: First or second gen?

A

Second gen (atypical)

52
Q

Which has fewer anticholinergics: First or sec gen?

A

Second gen (atypical)

*with the exception of clozapine

53
Q

What are a few examples of first gen antipsychotics (conventional)

A

Chlorpromazine
Haloperidol
Thioridazine

Many more*

54
Q

What are some complications of first. yen antipsychotics (11)?

A
  1. Agranulocytosis
  2. Anti-cholinergic effects
  3. EPS
  4. Neuroendocrine effects (gynecomastia, galactorrhea, menstrual irregularities)
  5. NMS
  6. Orthostatic hypotension
  7. Sedation
  8. Seizures
  9. Severe dysrhythmias
  10. Sexual dysfunction
  11. Skin effects
55
Q

First gens antipsychotics: If client begins to experience EPS acute dystonia, what med can we give?

A

Anticholinergic agents like BENTROPINE (Cogentin) or Diphenhydramine

56
Q

Conventional: If client begins to experience Parkinsonism, what meds can we give?

A

Benztropine
Diphenhydramine
Amantadine

57
Q

How is akathisia managed?

A

BB
Benzo
Anticholinergic meds

58
Q

What are signs of NMS?

A
  • Sudden high fever
  • BP fluctuations
  • Dysrhythmias
  • Muscle rigidity
  • Changes in LOC
  • Coma
59
Q

NMS: What drugs can we give to help this?

A
  1. Antipyretics

2. Dantrolene and bromocriptine (to induce muscle relaxation)

60
Q

When should 1st gens be administered?

A

Bedtime

61
Q

What are examples of 2nd gen antipsychotics?

A

Risperidone
Clozapine (agranulocytosis)
Olanzapine
Quetiapine

*many more

62
Q

What are some adverse effects of 2nd gen antipsychotics?

A

Remember Knappier said 1st gens have more EPS but 2nd gens affect metabolic stuff

  • New onset of diabetes
  • Weight gain
  • Hypercholesterolemia
  • Orthostatic hypotension
  • Anticholinergic effects
  • Agitation, dizzy, sedation, sleep disruption
  • Mild EPS, such as tremor
63
Q

Can we give Risperidone for dementia clients?

A

No

Mental Health-MJ (39 decks)

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