Module 10: Psychopharmacology

Question 1

What are the two basic mechanisms of action of antidepressants?

Answer 1

Blocking the enzymatic breakdown of norepinephrine and slowing the reuptake of serotonin

Question 2

How do you tricyclic antidepressants work?

Answer 2

By inhibiting the reuptake of norepinephrine and serotonin into the presynaptic neuron
- This allows for these neurotransmitters to accumulate in the synapse thus increasing action

Question 3

How do you selective serotonin reuptake inhibitor (SSRI) work?

Answer 3

By slowing the reuptake of serotonin into the presynaptic neuron

Question 4

How do monoamine oxidase inhibitors (MAOI) work?

Answer 4

By inhibiting monoamine oxidase, the enzyme that breaks down neurotransmitters (norepinephrine, serotonin, and dopamine)
- usually prescribed in cases where other antidepressants have not been successful. They have more serious side effects than other antidepressants

Question 5

What are adverse effects of antidepressants?

Answer 5

• Drowsiness/ Sedation
• Orthostatic hypotension
• Palpitations
• Insomnia
• Confusion

Question 6

At what stage of treatment are clients of the greatest risk for suicide?

Answer 6

3-4 weeks after treatment

Question 7

What regions of the brain are responsible for anxiety and wakefulness?

Answer 7

The limbic system and the reticular activating system

Question 8

What are anxiolytics used for?

Answer 8

Drugs that relieve anxiety

Question 9

Low doses of drugs that depress the CNS but do not affect LOC are called

Answer 9

Sedatives

Question 10

Increasing the dose of CNS depressing drugs produce a hypnotic affect (natural sleep) and are called

Answer 10

Hypnotics

Question 11

High doses of CNS depressant drugs are called

Answer 11

Anesthetics

Question 12

What medications are given for insomnia?

Answer 12

Antihistamines – example: diphenhydramine (Benadryl)
Benzodiazepines- Class of hypnotic medication
o Example: lorazepam (Ativan)
Non-benzodiazepines- Class of hypnotic medication (differ in chemical structure
o Example: zopiclone (Imovane)

Question 13

What is the drug of choice for generalized anxiety and insomnia?

Answer 13

Benzodiazepines

Question 14

A client is prescribed Nardil (MAOI). what information needs to be included in discharge teaching out of the following:
Exercise restrictions, dietary restrictions, fluid restrictions, or vitamin a restrictions?

Answer 14

Dietary restrictions

Question 15

What is the effect of sedateive/hypnotics on the body?

Answer 15

Depression of the CNS

Question 16

Define positive psychotic symptom and negative psychotic symptom

Answer 16

Positive symptoms - an excess or distortion of normal functions, such as hallucinations, delusions and thought disorders
Negative symptoms – can be described as a reduction or loss of functions; include slowed thoughts or speech, loss of expressed emotions, lack of motivation, attention deficits and loss of social interest

Question 17

What are the indications for use of antipsychotic meds?

Answer 17

• confirmed mental health diagnosis. (Ex. Schizophrenia and related disorders, mania in bipolar disorders, adjunctive treatment of major depressive disorders)
• Severe psychosis, delusions and hallucinations
• Huntington’s disease
• behaviour that places self or others at risk for injury – temporary

Question 18

What is dystonia?

Answer 18

A state of abnormal tonicity, sometimes described as “muscle spasm”

Question 19

What is Akathisia?

Answer 19

Inability to sit still/intense motor restlessness

Question 20

What is pseudo Parkinsonism?

Answer 20

Resemble symptoms of Parkinson’s disease that are drug induces- Include tremor, muscle rigidity, stooped posture, and a shuffling gait

Question 21

Long term use of phenothiazines may lead to tardive dyskinesia. What is it characterized by?

Answer 21

Unusual tongue and face movements such as lip smacking and wormlike motions of the tongue

Question 22

What is an Analgesic?

Answer 22

Medications that help relieve pain

Question 23

Opioid Analgesics act in the? And are what type of substances?

Answer 23

Act in the CNS, are narcotic substances

Question 24

Non-opioid analgesics act on the? What are some examples?

Answer 24

Acts on the PNS at the pain receptor site

- Salicylates, acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs)

Question 25

What are the drugs of choice for severe pain?

Answer 25

Opioids

Question 26

what are the therapeutic uses and what do they do for Salicylates - A non-opioid analgesic

Answer 26

Therapeutic uses: analgesic and antipyretic
Analgesic
- Inhibits prostaglandin synthesis
- Minimally decreases inflammation
Antipyretic - Stimulates hypothalamus to increase sweating
Example: acetylsalicylic acid (ASA) (Aspirin)

Question 27

What are the drugs of choice for mild to moderate pain? How does it work?

Answer 27

NSAIDs
Inhibit cyclooxygenase (COX), an enzyme responsible for synthesis of prostaglandins.  This inhibition reduces inflammation and pain.

Question 28

What are common side effects and adverse affects of NSAIDs?

Answer 28

Common side effect: GI upset

Adverse effects: ulcers, bleeding, liver and kidney failure

Question 29

What is general anesthesia?

Answer 29

The loss of sensation throughout the entire body, accompanied by loss of consciousness.
necessary for major surgical procedures

Question 30

What is local anesthesia? It acts by blocking what?

Answer 30

Results in loss of sensation to a limited body region without loss of consciousness.
- Blocking sodium channels in neurons