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NURS 305 - Exam 5 > Neuro > Flashcards

Neuro Flashcards

1
Q

What is the drug class of citalopram (Celexa)?

A

SSRI

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2
Q

When is the maximum clinical effectiveness of citalopram (Celexa) achieved?

A

6 - 8 weeks

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3
Q

Describe the MOA of citalopram (Celexa)

A

Inhibits serotonin reuptake - more serotonin

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4
Q

What are the indications of citalopram (Celexa)?

A
  • Depression
  • OCD
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5
Q

citalopram (Celexa) has a ______ half-life

A

Short - withdrawal syndrome

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6
Q

What is the primary contraindication of citalopram (Celexa)?

A

MOAI use in the last 2 weeks

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7
Q

What are the side effects of citalopram (Celexa)?

A
  • CNS stimulation
  • Insomnia
  • Sexual dysfunction
  • Suicidal thoughts
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8
Q

Describe the nursing considerations of citalopram (Celexa)

A
  • Take in morning to decrease insomnia
  • Taper when weaning off
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9
Q

What is the drug class of venlafaxine (Effexor)?

A

SNRI

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10
Q

Describe the MOA of venlafaxine (Effexor)

A

Serotonin and norepinephrine increased in nerve cells

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11
Q

What are the side effects of venlafaxine (Effexor)?

A
  • Tachycardia
  • Hypertension
  • GI bleed
  • Seizures
  • Suicidal thoughts
  • Serotonin syndrome
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12
Q

What are the interactions associated with venlafaxine (Effexor)?

A
  • MAOIs
  • SSRIs
  • Triptans
  • TCAs
  • Grapefruit juice
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13
Q

What is the dosage of venlafaxine (Effexor) IR

A

2 - 3 times / day

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14
Q

What is the dosage of venlafaxine (Effexor) ER

A

Once daily

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15
Q

What is the drug class of bupropion HCL (Wellbutrin)?

A

Atypical DNRI

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16
Q

Describe the MOA of bupropion HCL (Wellbutrin)

A

Dopamine and norepinephrine reuptake inhibitors

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17
Q

What are the indications of bupropion HCL (Wellbutrin)?

A
  • Depression
  • Smoking cessation
  • Sexual adverse effects secondary to SSRIs
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18
Q

What are the contraindications of bupropion HCL (Wellbutrin)?

A
  • Seizure disorders
  • MAOI use
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19
Q

What are the side effects of bupropion HCL (Wellbutrin)?

A
  • Seizures
  • Loss of appetite
  • Weight loss
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20
Q

Avoid ______ use with bupropion HCL (Wellbutrin)

A

Alcohol / CNS depressants

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21
Q

What is the drug class of trazodone (Desyrel)?

A

Serotonin modulator

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22
Q

Describe the MOA of trazodone (Desyrel)

A

Selectively inhibit serotonin reuptake but minimally affect norepinephrine reuptake

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23
Q

trazodone (Desyrel) has minimal adverse effects on ______

A

The cardiovascular system - better choice for patients with CHF, hypertension, etc.

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24
Q

What are the indications of trazodone (Desyrel)?

A
  • Depression
  • Insomnia
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25
Q

What are the side effects of trazodone (Desyrel)?

A
  • Sedation
  • Impaired cognitive function in older adults
  • Priapism - prolonged erections resulting in tissue death
26
Q

Avoid ______ use with trazodone (Desyrel)

A

Alcohol / CNS depressants

27
Q

Describe the primary nursing consideration associated with trazodone (Desyrel)

A

Take at bedtime - sedative effects

28
Q

Describe the general nursing considerations associated with antidepressants

A
  • Require at least 6 weeks of therapy with adequate doses to be able to fully evaluate results
  • May require upward titration of dosages over several weeks
  • Use in conjunction with psychotherapy
  • Increased risk of suicide among adult / pediatric population
29
Q

What is the drug class of lithium (Lithobid)?

A

Mood stabilizing drug

30
Q

Describe the MOA of lithium (Lithobid)

A

Alters ion transport in muscle and nerve cells/increased serotonin receptor sensitivity

31
Q

What are the indications of lithium (Lithobid)?

A
  • Bipolar disorder
  • Drug of choice for mania
32
Q

What is the therapeutic range for lithium (Lithobid)?

A
  • 0.6 – 1.2 mEq/L
  • > 1.5 – 2.5 mEq/L begin to produce toxicity
33
Q

What are the manifestations of lithium (Lithobid) toxicity?

A
  • GI discomfort
  • Tremors
  • Confusion
  • Somnolence
  • Seizures
  • Death
34
Q

Describe the nursing considerations associated with lithium (Lithobid)

A
  • Keep sodium levels in normal range (135-145 mEq/L) to maintain therapeutic lithium level
  • Toxicity risk increased by dehydration or sodium depletion
  • Teach patients to keep sodium intake consistent for maintain normal sodium level to maintain therapeutic drug level
  • Narrow therapeutic index – routine drug monitoring
35
Q

What are the side effects of lithium (Lithobid)?

A
  • Drowsiness
  • Fine muscle tremors
  • GI discomfort
  • Increased thirst
  • Electrolyte imbalances
  • Weight gain
  • Renal toxicity
36
Q

Long-term treatment using lithium (Lithobid) may cause ______

A

Hypothyroidism

37
Q

What are the indications of antipsychotics?

A
  • Drug-induced psychoses
  • Schizophrenia
  • Autism
  • Extreme mania (as an adjunct to lithium)
  • BPD
  • Depression that is resistant to other therapy
  • Tourette’s syndrome
  • Intractable hiccups
38
Q

Describe the MOA of antipsychotics

A
  • Block dopamine receptors in the brain (limbic system, basal ganglia), areas associated with emotion, cognitive function, motor function
  • Decreased dopamine levels in CNS - tranquilizing effect in psychotic patients
39
Q

What are the side effects of antipsychotics?

A
  • Agranulocytosis / hemolytic anemia
  • Drowsiness
  • EPS - extrapyramidal syndrome
  • Insulin resistance
  • Weight gain
  • Changes in serum lipid levels
  • Metabolic syndrome
40
Q

What are the manifestations of extrapyramidal syndrome (EPS)?

A
  • Pseudoparkinsonism
  • Acute dystonia
  • Akathisia
  • Tardive dyskinesia
41
Q

What is extrapyramidal syndrome (EPS)?

A

Involuntary muscle symptoms similar to those of Parkinson’s disease

42
Q

What is acute dystonia?

A
  • Painful muscle spasms
  • Treated with benztropine (Cogentin) / benzo-like lorazepam
43
Q

What is akathisia?

A
  • Distressing muscle restlessness
  • Treated with benzo-like lorazepam / beta blocker
44
Q

Describe the treatment of tardive dyskinesia

A
  • Stop antipsychotic drug
  • Benzos
  • Beta blockers
  • CCB
45
Q

What is the drug class of haloperidol (Haldol)?

A

Antipsychotic

46
Q

Describe the MOA of haloperidol (Haldol)

A

Block postsynaptic dopamine receptors in the brain

47
Q

What are the indications of haloperidol (Haldol)?

A
  • Psychosis
  • Low dose for nausea
48
Q

What are the side effects of haloperidol (Haldol)?

A
  • Extrapyramidal symptoms (EPS)
  • QT prolongation
  • Tachycardia
  • Orthostatic hypotension
49
Q

What are the contraindications of haloperidol (Haldol)?

A
  • PD
  • Patients on large doses of CNS depressants
  • CV disease
  • Hepatic disease
50
Q

Describe the black box warning associated with haloperidol (Haldol)

A

Not approved for dementia related psychosis - increased mortality in elderly dementia patients

51
Q

Describe atypical / second generation antipsychotics

A
  • Advantageous properties over conventional drugs
  • Block specific dopamine receptors: dopamine-2 (D2) receptors
  • Also block specific serotonin receptors: serotonin 2 (5-HT2) receptors
  • This is responsible for their improved efficacy and safety profiles
52
Q

What is the drug class of risperidone (Risperdal)?

A

Atypical / second generation antipsychotic

53
Q

Describe the MOA of risperidone (Risperdal)

A

Antagonizes or inhibits dopamine / serotonin receptors

54
Q

What are the side effects of risperidone (Risperdal)?

A
  • Sedation
  • Somnolence
  • Tachycardia
  • Agitation
  • Ataxia,
  • Insomnia
  • Dry mouth
  • Increased appetite
  • Weight gain
  • EPS
  • Tardive dyskinesia - less than first generation
55
Q

What is the primary indication of risperidone (Risperdal)?

A

Schizophrenia

56
Q

Describe the black box warning associated with risperidone (Risperdal)

A
  • May increase suicide in children, adolescents, & young adults
  • Not approved for dementia related psychosis, increased mortality in elderly dementia patients
57
Q

What is the drug class of benztropine (Cogentin)?

A

Anticholinergic drug - crosses blood brain barrier

58
Q

Describe the MOA of benztropine (Cogentin)

A
  • Blocks acetylcholine at receptors in brain
  • Increased acetylcholine = SLUDGE
  • Anticholinergics have opposite effects
59
Q

What are the indications of benztropine (Cogentin)?

A
  • Adjunct for EPS
  • Decreases severity of rigidity, akinesia, tremors
  • Parkinson’s disease
60
Q

Use caution with benztropine (Cogentin) in what conditions?

A

Hot weather / exercise - risk of hyperthermia

61
Q

What are the adverse effects of benztropine (Cogentin)?

A
  • Tachycardia
  • Confusion
  • Disorientation
  • Toxic psychosis
  • Urinary retention
  • Dry mouth
  • Constipation
  • N / V

NURS 305 - Exam 5 (4 decks)

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