Neuro Flashcards
What is the primary adverse effect associated with antidepressants?
Suicidal thoughts
What are the general interactions associated with antidepressants? (2)
- MOAIs
- Alcohol / CNS depressants
What is the drug class of citalopram (Celexa)?
SSRI
When is the maximum clinical effectiveness of citalopram (Celexa) achieved?
6 - 8 weeks
Describe the MOA of citalopram (Celexa)
Increases serotonin
What are the indications of citalopram (Celexa)? (2)
- Depression
- OCD
citalopram (Celexa) has a ______ causing withdrawal syndrome
Short half-life
What are the side effects of citalopram (Celexa)? (2)
- Insomnia
- Sexual dysfunction
Describe the education associated with citalopram (Celexa)
Take in morning to decrease insomnia
What is the drug class of venlafaxine (Effexor)?
SNRI
Describe the MOA of venlafaxine (Effexor)
Increases serotonin and norepinephrine
What are the indications of venlafaxine (Effexor)? (2)
- Depression
- GAD
What are the side effects of venlafaxine (Effexor)? (3)
- Tachycardia
- Hypertension
- Serotonin syndrome
What are the manifestations of serotonin syndrome? (4)
- Nausea
- Drowsiness
- Headache
- Dry mouth
What are the interactions associated with venlafaxine (Effexor)? (4)
- SSRIs
- TCAs
- Triptans
- Grapefruit juice
What is the drug class of bupropion HCL (Wellbutrin)?
DNRI
Describe the MOA of bupropion HCL (Wellbutrin)
Increases dopamine and norepinephrine
What are the indications of bupropion HCL (Wellbutrin)? (3)
- Depression
- Smoking cessation
- Sexual dysfunction from SSRIs
What are the side effects of bupropion HCL (Wellbutrin)? (2)
- Decreased appetite
- Weight loss
What is the drug class of trazodone (Desyrel)?
Serotonin modulator
trazodone (Desyrel) has minimal adverse effects on ______
The cardiovascular system
trazodone (Desyrel) is a better choice for patients with what conditions? (2)
- CHF
- Hypertension
What are the indications of trazodone (Desyrel)? (2)
- Depression
- Insomnia
What are the side effects of trazodone (Desyrel)? (3)
- Priapism
- Sedation
- Impaired cognitive function in older adults
What is priapism?
Prolonged erections resulting in tissue death
Describe the education associated with trazodone (Desyrel)
Take at bedtime - sedative effects
Describe the general nursing considerations associated with antidepressants (2)
- Require at least 6 weeks of therapy
- May require increased dosages
Antidepressants should be used in conjunction with ______
Psychotherapy
What is the drug class of lithium (Lithobid)?
Mood stabilizing drug
What is the primary indication of lithium (Lithobid)?
Bipolar disorder (drug of choice for mania)
lithium (Lithobid) has a ______ therapeutic range
Narrow
What lithium (Lithobid) levels begin to produce toxicity?
> 1.5 – 2.5
What are the manifestations of lithium (Lithobid) toxicity? (4)
- Tremors
- Confusion
- Sedation
- Seizures
What factors increase the risk of lithium (Lithobid) toxicity? (2)
- Dehydration
- Hyponatremia
Describe the monitoring associated with lithium (Lithobid) (2)
- Sodium levels
- Routine drug monitoring - maintain therapeutic levels
Describe the education associated with lithium (Lithobid)
Maintain consistent sodium intake
What are the side effects of lithium (Lithobid)? (3)
- Increased thirst
- Renal toxicity
- Weight gain
Long-term treatment using lithium (Lithobid) may cause ______
Hypothyroidism
What are the indications of antipsychotics? (5)
- Autism
- Tourette’s
- Schizophrenia
- Extreme mania
- Intractable hiccups
Describe the MOA of antipsychotics (2)
- Block dopamine receptors
- Causes a tranquilizing effect
What is the primary concern associated with antipsychotics?
Extrapyramidal syndrome (EPS)
What is extrapyramidal syndrome (EPS)?
Involuntary muscle spasms similar to those of Parkinson’s disease
What are the manifestations of extrapyramidal syndrome (EPS)? (4)
- Akathisia
- Acute dystonia
- Tardive dyskinesia
- Pseudoparkinsonism
Describe the treatment of akathisia (2)
- Lorazepam
- Beta blockers
Describe the treatment of acute dystonia (2)
- Lorazepam
- benztropine (Cogentin)
Describe the treatment of tardive dyskinesia (3)
- Benzos
- Beta blockers
- Calcium channel blockers
What is the drug class of haloperidol (Haldol)?
Antipsychotic
What is the primary indication of haloperidol (Haldol)?
Psychosis
haloperidol (Haldol) can be given at a low dose to treat ______
Nausea
What is the primary contraindication of haloperidol (Haldol)?
Patients on large doses of CNS depressants
Describe the black box warning associated with haloperidol (Haldol)
Not approved for dementia related psychosis
Why are atypical / second generation antipsychotics preferred over conventional antipsychotics?
They block SPECIFIC dopamine / serotonin receptors
What is the drug class of risperidone (Risperdal)?
Atypical / second generation antipsychotic
risperidone (Risperdal) is less likely to cause ______ than first generation antipsychotics
Tardive dyskinesia
What is the primary indication of risperidone (Risperdal)?
Schizophrenia
Describe the black box warning associated with risperidone (Risperdal) (2)
- Not approved for dementia related psychosis
- Increased risk of suicide in children, adolescents, and young adults
What is the drug class of benztropine (Cogentin)?
Anticholinergic - crosses blood brain barrier
Describe the MOA of benztropine (Cogentin)
Increases acetylcholine
What are the indications of benztropine (Cogentin)? (2)
- Extrapyramidal syndrome (EPS)
- Parkinson’s disease
Use caution with benztropine (Cogentin) in what conditions?
Extreme heat / exercise - risk of hyperthermia
benztropine (Cogentin) causes ______ side effects
Anticholinergic
Describe anticholinergic side effects (4)
- Blurred vision
- Urinary retention
- Dry mouth
- Constipation
