Mental Health Exam 2

Question 1

Half-life

Answer 1

is the time it takes to remove a portion of the medication from the bloodstream

Question 2

Depot Injection

Answer 2

is a strategy to improve adherence during maintenance therapy - long acting version of a med -given IM

Question 3

Tyramine

Answer 3

is found in certain foods and medications and can be problematic for those taking certain types of medication

Question 4

Neurotransmitters

Answer 4

“neuromessengers” - crosses synapses and attached to a receptor

Question 5

Pharmacodynamics

Answer 5

what the medication does to the body

Question 6

Pharmacokinetics

Answer 6

how medications travel through the body

Question 7

Efficacy

Answer 7

maximum therapeutic effect achievable

Question 8

potency

Answer 8

amount of drug needed to achieve the maximum effect

Question 9

steady state

Answer 9

neurons pay attention when this happens

Question 10

rule of 5s

Answer 10

takes 5 half-lifes to build steady state

Question 11

off-label use

Answer 11

being used for something different than original testing

Question 12

black box warning

Answer 12

serious or life threatening side effects

Question 13

black box warning

Answer 13

serious or life threatening side effects

Question 14

rebound

Answer 14

temporary return of symptoms

Question 15

withdrawal

Answer 15

new symptoms resulting from discontinuing a substance

Question 16

acetylcholine (nm)

Answer 16

too little = DEMENTIA // too much = depression

Question 17

Serotonin

Answer 17

too little = DEPRESSION, OCD

Question 18

GABA

Answer 18

too little = ANXIETY

Question 19

Absorption

Answer 19

stomach to bloodstream

Question 20

Distribution

Answer 20

movement through the body

Question 21

Elimination

Answer 21

how it is removed

Question 22

Psychotropic dugs can impact what?

Answer 22

Nutrition - change in taste, appetite, GI function, absorption, & metabolism

Question 23

ADHD medications

Answer 23

-methylphenidate (s)
-atomoxetine (ns)
-dextroamphetamine (S)

increase attention
reduce impulsivity

Question 24

Adverse Effects of ADHD MEDS

Answer 24

-insomnia
-appetite loss (WEIGHT LOSS)
-headache
-abd pain
-lethargy
-RISK OF SUICIDE

monitor growth

Question 25

Methylphenidate

Answer 25

-stimulant
-monitor height and weight at baseline
-admin right before or right after meals
-provide snacks in evening

Question 26

Atomoextine

Answer 26

-non-stimulant
-monitor height and weight at baseline
-admin right before or right after meals
-take with food if GI distress occurs

Question 27

Buckshot

Answer 27

where the med not only hits intended targets but also everything else around it - disfunction and discomfort

Question 28

Major Classes of Psychotropic Drugs

Answer 28

-Anxiolytics
-Antidepressants
-Mood Stabilizers
-Antipsychotics
-Stimulants
-Memory/Cognitive enhancers

Question 29

Anxiolytics

Answer 29

used for psychological and somatic symptoms for anxiety disorders

Question 30

Benzos

Answer 30

-act on GABA nm
-short term use
-highly addictive
-not recommended for elderly
-CI: alcohol and narcotic abuse

Question 31

Example of Benzos

Answer 31

Diazepam - Valium Clonazepam- Kalonopin Alprazolam -Xanax Lorazepam - Ativan

Question 32

Adverse of effects of Benzos

Answer 32

-life threatening CNS depression (alcohol, opiates, TCAs)
-interfere with motor ability
-reflexes are impaired

Question 33

Buspirone

Answer 33

-Atypical anxiolytic
-better for long term tx
-non-addictive
-SE: dizziness, headache, nervousness, nausea, dry mouth, GI distress
CI: renal/liver impairments, lactating women

Question 34

Antidepressants

Answer 34

-MONITOR FOR SI
-four main groups: Tricyclic
SSRI
MAOI
“Other”

Question 35

TCA

Answer 35

-Amitriptyline
-Nortriptyline

Question 36

Buckshot properties of TCA

Answer 36

CI with seizures, increased suicide risks, lethal in overdose (10 day=fatal, give 1 week supply)

Question 37

SSRIs

Answer 37

FIRST LINE TX
-minimal toxic potential
-SE: N/V, weight changes, sexual changes
-NO grapefruit juice
-risk for serotonin syndrome (St. John Wort)
-Don’t stop taking abruptly
-CI: TCA, MAOI

Question 38

Common SSRI

Answer 38

-Fluoxetine (prozac)
-Sertraline (Zoloft)
-Citalopram (Celexa)
-Escitalopram (Lexapro)

Question 39

Serotonin Syndrome

Answer 39

-can be fatal
-begins 2-72 hrs after tx
-presents as mental confusion, abdominal pain, diarrhea, hallucinations, tremors, hyper-reflexia

Question 40

MAOIs

Answer 40

-used for atypical depression and bulimia
-risk: HTN crisis, orthostatic hypotension, CNS stimulation

Question 41

MAOIs examples

Answer 41

-phenelzine sulfate (nardil)
-tranylcypromine (parnate)
-isocarboxazid (marplan)

Question 42

Pt education for MAOIs

Answer 42

must avoid tyramine foods
-must avoid antidepressants
-must avoid OTC cold medications

pt must be willing to be compliant and educated about risks of hypertensive crisis

Question 43

tyramine foods

Answer 43

aged cheese (pizza)
processed meats
dried fish
beer/wine
banana
avocado
pickled foods
livers
soy sauce
yogurt/sour cream

Question 44

mood stabilzera

Answer 44

• used for bipolar disorder
  -increases energy, euphoria, and grandiosity

-risk of medication nonadherence

Question 45

examples of mood stablizers

Answer 45

-lithium
-carbamazepine (tegretol)
-valproic acid
-lamotrigine (lamictal)

Question 46

lithium

Answer 46

Normal Level- 0.6-1.5
Early toxicity: 1.5

can lead to hypothyroidism and impaired kidney function

edu: maintain sodium intake and avoid caffeine

CI: thiazide diuretics and NSAIDs