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Mental Meds Exam 3 > mental meds > Flashcards

mental meds Flashcards

1
Q

Selective serotonin reuptake inhibitors (SSRIs) meds (5)

A

Fluoxetine, Paroxetine, Sertraline, Citalopram, Escitalopram

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2
Q

SSRIs MOA

A

Blocks the reuptake of serotonin

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3
Q

SSRI common side effects (6)

A

anxiety, insomnia, sedation, akathisia, sexual dysfunction, increased risk of suicide

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4
Q

What is serotonin syndrome?

A

Serotonin syndrome occurs when you take medications that cause high levels of the chemical serotonin to accumulate in your body.

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5
Q

How can MILD serotonin syndrome be fixed?

A

Milder forms of serotonin syndrome may go away within a day of stopping the medications that cause symptoms and, sometimes, after taking drugs that block serotonin.

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6
Q

Serotonin syndrome side effects

A

agitation, sweating, fever, tachycardia, hypotension, rigidity, hyperreflexia, confusion, coma and death.

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7
Q

SSRI nursing considerations

A
  • Takes 4 weeks for full therapeutic effect. Some improvement in 2-3 weeks.
  • Take w/ food to minimize nausea
  • Sedation, take at bedtime
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8
Q

Tricyclic antidepressants (2)

A

Amitriptyline, and Imipramine

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9
Q

Tricyclic antidepressants MOA

A

Block reuptake of norepinephrine and serotonin to some degree

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10
Q

Tricyclic antidepressant side effects

A
  • Weight gain

- Anticholinergic side effect such as, dry mouth, urinary retention, constipation, vision changes

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11
Q

Tricyclic antidepressant nursing considerations

A

These medications take 4-6 weeks for full effectiveness

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12
Q

TETRAcyclic antidepressants (1)

A

Mirtazapine

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13
Q

TETRAcyclic antidepressants MOA

A

antagonizes alpha-2 adrenergic and serotonin 5-HT2 receptors

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14
Q

TETRAcyclic antidepressants COMMON side effects

A

somnolence (drowsiness/sleepy), xerostomia (dry mouth), increased appetite, and weight gain

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15
Q

TETRAcyclic antidepressants SERIOUS side effects

A

agranulocytosis (low WBC), serotonin syndrome, orthostatic hypotension, seizures, akathisia, torsade de points and Steven-Johnson syndrome

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16
Q

What is torsade de points? What side effect medication is it associated with?

A

TETRAcyclic antidepressants

-polymorphic ventricular tachycardia characterized by a gradual change in amplitude and twisting of the QRS complexes around an isoelectric line on the electrocardiogram.

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17
Q

What is Steven-Johnson’s syndrome?

A

SJS is a rare, serious disorder of the skin and mucous membranes. It’s usually a reaction to medication that starts with flu-like symptoms

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18
Q

What are the symptoms of SJS?

A

Flu-like symptoms, fever, rash, blisters, peeling of skin and rhabdomyolysis (muscle break-down)

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19
Q

TETRAcyclic antidepressants nursing considerations

A

LABS: CBC, liver function tests (LFTs), blood glucose, cholesterol

monitor weight and suicide risk

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20
Q

TETRAcyclic antidepressants nursing considerations

A

LABS: CBC, liver function tests (LFTs), blood glucose, cholesterol

monitor weight and suicide risk

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21
Q

Serotonin norepinephrine reuptake inhibitors (SNRIs) drugs (3)

A

Venlafaxine, Duloxetine, Atomoxetine

-ine endings

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22
Q

SNRIs MOA

A

Block reuptake of norepinephrine and serotonin

23
Q

SNRIs SERIOUS side effects

A

suicide, serotonin syndrome, HTN, EPS, seizures

24
Q

SNRIs COMMON side effects

A

insomnia, abnormal dreams, anxiety, sexual dysfunction, anorexia, n/v, and weight loss

25
Q

SNRIs monitor labs…

A

creatinine at baseline, lipid panel if on long term

26
Q

SNRIs monitor for ?

A

suicide, BP, monitor height/weight in children

27
Q

Atomoxetine (SNRI) is used for?

A

ADHD, not a stimulant

28
Q

Miscellaneous antidepressants (2)

A

Burpoprion and Trazodone

29
Q

Miscell. antidepressants are?

A

Norepinephrine dopamine reuptake inhibitors (NDRIs)

30
Q

NDRIs MOA

A

inhibits uptake of norepinephrine and dopamine

31
Q

NDRIs SERIOUS side effects

A

suicide, HI, HTN, arrhythmias, MI, hepatotoxicity, seizures

32
Q

NDRIs COMMON side effects

A

Xerostomia, diaphoresis, abnormal dreams, insomnia, tinnitus, anorexia, weight loss and anxiety.

33
Q

NDRIs monitor for?

A

suicide and BP

34
Q

NDRIs labs

A

creatinine at baseline

35
Q

MAOI drugs (2)

A

phenelzine, tranylcypromine

36
Q

MAOIs MOA

A

interfere with metabolism of enzyme

37
Q

MAOI side effects

A

sedation, insomnia, weight gain, dry mouth, orthostatic hypotension, sexual dysfunction

38
Q

MAOI SERIOUS side effect

A

HTN crisis due to tyramine ingestion

39
Q

Tyramine sources:

A

aged cheeses, aged meats/cold cuts , tofu, avocado, tap/microbrew beer, soy sauce, yogurt, sour cream, brewers yeast and MSG

40
Q

Mood stabilizer drug (1)

A

Lithium

41
Q

Lithium MOA

A

Normalizes reuptake of serotonin, norepinephrine, acetylcholine, and dopamine

42
Q

Lithium side effects

A

anorexia, nausea, hand tremors, polydipsia/uria, metallic taste in mouth, fatigue, weight gain, acne

43
Q

Lithium toxicity

A

severe diarrhea, vomiting, drowsiness, muscle weakness, lack of coordination, coma/death

44
Q

Lithium labs:

A

1.5 or HIGHER is lithium toxicity.
safe range: 0.6 - 1.2
monitor everyday for 2-3 days then monthly

45
Q

Anticonvulsant mood stabilizers (2)

A

Valproic acid and carbamapezine

46
Q

Valproic acid and carbamapezine MOA

A

unknown, increase levels of GABA. Inhibits kindling process of seizures

47
Q

Valproic acid and carbamapezine side effects

A

drowsiness, sedation, dry mouth, blurred vision, rashes, orthostatic hypotension, weight gain, alopecia and hand tremors

48
Q

Valproic acid and carbamapezine labs:

A

liver function at baseline periodically (3-6 months)
requires blood levels
take with meals to decrease nausea

49
Q

Sensitizing agent for alcohol

A

disulfiram

50
Q

Disulfiram MOA

A

inhibits enzyme aldehyde dehydrogenase, needed for ethanol metabolism

51
Q

disulfiram COMMON side effects

A

rash, drowsiness, impotence, headache, acne, metallic taste

52
Q

disulfiram SERIOUS side effects

A

hepatoxicity, psychosis, peripheral neuropathy, optic neuritis

53
Q

disulfiram labs

A

liver functions at baseline

after 10-14 days, CBC, serum chemistries

54
Q

disulfiram teaching

A

all sources of alcohol in diet, mouthwash, aftershave, cologne, cough preparations, vanilla, and to READ LABELS

Mental Meds Exam 3 (2 decks)

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