mental health drugs

Question 1

carbamazepine interventions

Answer 1

1. monitor CBC (aplastic anemia and agranulocytosis)

2. bone marrow suppression

Question 2

carbamazepine contraindications

Answer 2

1. grapefuit juice increases toxicity
2. oral contraceptives and warfarin are less effective (stimulates liver to metabolism them faster)
3. HF (promotes ADH -> hypoosmolality)

Question 3

Lamotrigine interventions

Answer 3

1.titrate slowly if discontinuing to avoid seizures

2.

Question 4

Lamotrigine SE

Answer 4

1. blurred/double vision
2. n/v/ dizziness
3. headache
4. SJS (most likely medication to cause)

Question 5

Lamotrigine Contraindications

Answer 5

1. carbamazepine, phenytoin, and phenobarbital decrease blood levels
2. valproic acid increases half life (inhibits drug metabolising enzymes)
3. oral contraceptives are less effective and also decrease effectiveness of lamotrigine

Question 6

Valproic acid SE

Answer 6

1.GI
n/v/ injestion 
2.Hepatotoxicity
3.Pancreatitis 
4.Thrombocytopenia
5.Weight gain

Question 7

Valproic acid contrainidcations

Answer 7

1.concurrent use of another anticonvulesant

2.

Question 8

Valproic acid interventions

Answer 8

1. Liver enzymes
2. LDH
3. Platelet count (thrombocytopenia)

Question 9

Serotonin Syndrome

Answer 9

1. Diarrhea, sweating, tachycardia, Libil BP
2. Myoclonus (muscle spasms)
3. Cardiovascular shock
4. irritability
5. abdominal pain

Question 10

Serotonin syndrome causes

Answer 10

1.SSRIs with fentanyl and lithium and tramadol, tryptophan , buspirone, St johns wort, TCAs, MAOIs triptans are more likly to cause Serotonin syndrome

Question 11

serotonin syndrome treatment

Answer 11

1. Cyproheptadine
2. Methysergide
3. propanolol
4. diazapam
5. dantrolene

Question 12

atypical depression

Answer 12

veggitative symtpoms

-over eating, over sleeping, disinterest in sex

Question 13

SSRIs prototype

Answer 13

1.fluoxetine

Question 14

SSRIs SEs

Answer 14

1. do not cause anticholinergic side effects
2. agitation, tremors, anxiety, sexual dysfunction
3. weight loss (short term) weight gain (long term)
4. seizures
5. abnormal bleeding
6. Hyponatremia

Question 15

TCAs

Answer 15

1.anticholinergic effects
and sedation
2.urinary retention and severe constipation warrant immediant action
3.do cardiac workup before giving
4.dysrhythmias, heart block, MI
5.do not give with MAOIs
6.avoid anything that can cause increased CNS depression
7.Contraindicated in MI, narrow angeled glaucoma