Pharm II-Exam 2 Flashcards
1
Q
- Major neurotransmitter affecting psychopathology
- Describe Serotonin
- What are psychiatric agents
A
- GABA (anxiety, Serotonin, Dopamine
- sleep wakeful, mood, delusions, hallucination, interaction w/ others
- treat chemical imbalances in the brain
2
Q
- Things psychosis can contribute to
- Theory behind psychosis
- What is the major cateogry of psychosis
A
- coping everyday life, difficult processing info, schizophrenia
- Dopamine imbalance
- Schizophrenia, Chronic (college age)
3
Q
- +Schizo, exageration of normal function
- -Schizo- loff of function/motivation. Chronic/Persis
- What is the action of antipsychotics
A
- agitation, delusion, pranoia, hallucination, incoherent speech
- poor self care, poverty of speech, social withdrawal, lack of motivation
- Block doapime receptors in the brain
4
Q
- First generation antipsychotic
- 3 Groups of Phenothiazines
- Side effects of (Aliphatic) Chlorpromazine
A
- Phenothiazines- more side effects
- Aliphatic, Piperazine, Piperidine
- sedation, orthostatic hypotension, EPS (pseudopariksonism)
5
Q
- (Piperazine) Fluphenazine Side Effects
- (Piperidine) Mesoridazine Besylate SE
- A nonphenothiazine
A
- low sedation, strong antiemetic, severe EPS, Akathisia (constant moving about)
- Strong sedation, hypotension, few EPS effects
- Haloperidol
6
Q
- How does fluphenazine used for?
- What can happen if yout ake with alcohol or CNS depressants?
- If you take it with Kava kava what can happen
A
- Schizophrenia
- Increase depression
- increase EPS
7
Q
- What should you educate regarding Fluphenazine?
- What is Haloperidol used for
- When is Haloperidol contraindicated?
A
- need to take med their entire life, non compliance is common
- Chronic psychosis, dementia, schizo, tourette’s
- glaucoma, sedation, liver, kidney CV disease, blood dyscrasias
8
Q
- What is a side effect of all antipsychotic drugs?
- Halperidol SE
- What happens if you take this with alcohol
A
- Agranulocytosis, monitor CBC
- sedation, headache seizures, EPS, dry mouth, blurred vision, urinary retention, dysrhythmias
- increased sedation
9
Q
- What happens if you take Haloperidol with anticholinergics
- What drugs can decrease the effects of Haloperidol
- Factors of EPS Syndrome
A
- increased toxicity
- Phenobarbital, carbamazepine, caffeine
- Pseudoparkinsonism, Acute dystonia, Akathisia, Tardive Dyskinesia
10
Q
- What is Tardive Dyskineisa
- neuroleptic malignant syndrome S/Sx
- Nursing intervention
A
- chewing, sucking motions, protrustion of the tongue
- rigid, fever, bp fluctation, rhabdomyolosis (renal failure), respiratory failure
- Stop taking the drug, administer fluids
11
Q
- How do you tx NMS?
- Name Atypical Antipsychotics
- What does aripiprazole do?
A
- withdrawal of antipsychotics, antipyretics, hypothermic blankets, benzodiazepines, muscle relaxants
- Clazapine, Quetiapine, Risperidone, Ziparasidone, Aripiprazole
- Wired, Antidepressant, antipsychotic
12
Q
- Advantes of Atypical Antipsychotics?
- Action of atypicals?
- Side Effects of Clozapine?
A
- treats positive and neg symptoms schizo, less likely to cause EPS or dardive dyskinesia
- block serotonin and dopaminergic D4 receptors.
- Weight Gain, Diabetes, agranulocytosis
13
Q
- This drug is an atypical antipsychotic that does not cause agranulocytosis OR EPS.
- What SE does it cause
- Risperidone is an atyp antipsych drug, what are SE’s
A
- Olanzapine
- Restless leg syndrome, insomnia, dizzy, headaches
- EPS, seizures, orthostatic hypotension, hyperglycemia, weight gain, tachycardia, u.reteion
14
Q
- What does risperidone do to antihtn’s
- What drug decreases rispridone?
- If you take risperidone with cisapride what can it cause?
A
- increase effects
- carbamazepine
- dysrhthmias
15
Q
- What does Aripiprazole do?
- What is it used for?
- What are some side effects
A
- stabilizes dopamine, also interferes with seritonin
- schizo, bipolar, major depressive
- headache, agitation, anxiety, insomnia, N/V
16
Q
- What drug should you give Ztrack Im using large gague needle
- How long does it take antipsychotics to become effective?
- How long a=can antipsychotic stay in plastic syringe?
A
- Haloperidol
- 3 to 6 weeks
- within 15 mintues.
17
Q
- What drugs are used to treat short term anxiety (primary)
- Why is long term anxiety not treated with meds?
- What is an anxiolytic drug?
A
- Anxiolytics
- tolerance quickly
- Benzos
18
Q
- Name some Benzodiazapines
- What are the multiple uses for Benzos
- How does Lorazepam work (Ativan)
A
- Alprazolam, Lorazepam, Diazipam, Librium
- Anticonvulsant, Muscle relaxant, sedative, perop, anxiolytic
- limbil, thalamic, hypothalamic, inhibits GABA transmission
19
Q
- Side effects of Lorazepam
- What drug is used to reverse benzos from sedation, anasthesia or overdose?
- How do you deliver Romazicon?
A
- confusion, drowzy, restless, hallucination, GI upset
- Romaizon
- Iv .2 over 15-30 sec, repeat .2 at 1 min intervals
20
Q
- What do anxiolytics do to phenytoin levels (anticonvulsant)
- What do anxiolytics do to levodopa effects (antiparkinson)
- What does smoking do to anziolytics?
A
- Increase
- Decrease
- Decrease
21
Q
- How long does withrawal develop with Anxiolytics?
- Symptoms
- How long does therapeutic response take?
- How long should they take it?
A
- 2-10 days, may last weeks
- Tremors, sweating, insomnia, anorexia, muscle cramps
- 1 to 2 weeks
- 2 to 4 months. (no more)
22
Q
- What is the proper tecnique for discontinueing anxiolytics?
- What is the most common disorder?
- What is reactive depression?
A
- ween
- Depression
- death of a loved one, sudden onset
23
Q
- What is major depression?
- What is bipolar depression?
- Patho behind depression
A
- Loss of interest in work or home, inability to complete tasks
- euphoric to depressive
- insufficient monamine (serotonin, dopamine, norepinephrine)
24
Q
- What causes post partum depression
- Name an antidepressant Tricyclics
- How does Amitriptyline work?
A
- drop in estrogen and progesterone after delivery
- Amitriptyline
- increases effect of norepi and serotonin in the brain, blocks histamine receptors, anticholinergic
25
Q
- What does Amitriptyline do to insomnia?
- What type of depression is it used for?
- What happens if you take it with -thiazine or haloperidol?
A
- Decreases
- Major- increases interest in ADL’s
- increased sedation and anticholinergic effects
26
Q
- Major SE of Tricyclics?
- How long does it take to see effects?
- Examples of SSRIs
A
- urinary retention, weight gain, orthostatic hypotension, EPS, agranulocytosis
- 4 wks
- Fluozetine, Sertraline, Paroxetine, Escitalopram
27
Q
- What are SSRI’s used for?
- Name the drug used for OCD?
- What foods to avoid with SSRI
A
- Major depression, anxiety, migrain headaches, N/V
- Fluvoxamine (Luvox)
- Citrus
28
Q
- SSRI SE’s
- How long does it take before side effects subside?
- Mothers at risk for severe post partum depression, psychosis
A
- suicidal ideation, tremors, insomnia, GI, seizures.
- 2 to 4 weeks
- depression, bipolar
29
Q
- A typical Antidepressants?
- How do they work?
- What can you not use these with?
A
- Amoxapine, Bupropion, Venlafaxine
- affect 1 or 2 of the 3 neurotransmitters (serotonin, norepi, dopamine)
- Monoamine Oxidase inhibitors
30
Q
- Name an MOA inhibitor drug?
- What does it do?
- What is it used for
- This drug can cause a hypertensive crisis if taken with?
A
- Isocarboxazid
- inactivates norepi, dopamine, epi and serotonin
- Depressed not controlled by TCS
- Tyramine (cheese, coffee, cream, yogurt, liver, yeas, chocoalte, beer, red wine)
31
Q
- When should antidepressants be taken?
- What herbs may interact with antidepressants?
- What drugs are used to treat bipolar disorder
A
- At bedtime
- st John’s wort, ginseng
- Mood stabilizers
32
Q
- Name mood stabilizer drugs
- What drugs can also be used with antidepressants and benzos?
- How do mood stabilizer work?
A
- Lithium, Valproid Acid
- Antipsychotic drugs
- increase receptor sensitivity to serotonin
33
Q
- These drugs may increase lithium levels?
- Major SE of lithium
- Normal levels of lithium?
A
- thiazides, methyldopa, haloperidol, NSAIDS, antidepressants, Theophylline, phenothiazines
- Monitor electroyles, polyuria, glycosuria, d.insipidus, agranulocytosis. Monitor sodium
- 0.5-1.5 mEq/L
34
Q
- Patient ed regardin lithium
- How is Fluoxetine (Prozac) initially ordered?
- What is the maxium increase dose?
A
- Id bracelet, take 1-2 weeks, crash diets, NSAIDS, diuretics
- 20 mg in the morning
- 80 mg
35
Q
- Lithium signs of toxicity
- Antipsychotics do what to the CNS
- Antidepressants do what to the CNS
A
- vomiting, diarrhea, slurred speech, dec coordination, twitching
- Depress
- Stimulate
36
Q
- What is the name of the bacteria that causes acne?’
- What does it do?
A
- P. Acnes, Anerobic
- Converts sebum into irritant fatty acid
37
Q
- Types of lesions you might see with mild acne?
- Types of lesion you might see with moderate acne?
- Severe Acne
A
- Comedones (Blackheads), noniflammatory lesions
- Papules, Pustules
- Cystic
38
Q
- This is a bactericidal agent against P. Acnes, does not promote resistance
- What type of acne is it used for?
- What does keratolytic effect mean?
A
- Benzoyl Peroxide (cream lotion, gel or wash)
- Mild to moderate-
- helps dry out and shed the outer layer of the epidermis (sloughs)
39
Q
- How should you use benzoyl peroxide
- This topical drug is used to treat mild/moderate acne and takes 6-12 weeks for a response?
- It has an antibacterial action as well as..
A
- Gradually increase max 3x/day if tolerated
- Clindamycin, Erythromycin
- Antiinflammatory
40
Q
- What type of acne is topical retinoid used for?
- How long should you wait to apply to the skin after washing face?
- Newer formulation may have less intense effects, what are they?
A
- Moderate-Severe, 2nd and 3rd line therapy
- 20-30 minutes, very irritating!
- Avita, and Retin-A Micro
41
Q
- If topical treatments do not work what is the next step?
- Name some systemic antibiotics
- What are alternative to these
A
- Systemic Antibiotics, used in combo with topical retinoid
- Minoclycine, doxycycline (must be >12 yrs)
- Tetracycline/Erythromycin (tetra- discolors teeth)
42
Q
- How long does it take for systemic antibiotics to have maximum benefits?
- What happens when symptoms are controlled
- How long is Acne treated with Isortretinoin
A
- 3-6 months, but good results
- Switch to a topical antibiotic for long-term maintenance
- 20 weeks
43
Q
- If a 2nd course is needed for Isotretinoin, how long should patient wait before starting?
- What is a major SE of Acutane
- SE of acutane
A
- 8 weeks
- elevated triglycerides (alcohol makes worse)
- mood changes, depression and suicide
44
Q
- What drugs increase risk for toxicity with Accutane?
- What is required before before prescribing and refills?
- What else is required
A
- Tetracyclines Vitamin A supplements
- 2 neg preg tests (1 mnth before and 1 mnth after)
- 2 forms of contraceptive
45
Q
- What is found in males taking accutane
- Can you donate blood whilte taking this?
A
- isotretinoin in semen (so they shouldn’t be taking while trying to conceive)
- NO!
46
Q
- Thorazine - antipsychotic- what is a can it cause?
- Antipsychotic assessment if its working?
- What is more likely to cause EPS?
A
- Neuroleptic Malignant Syndrome.
- PQRST
- Haldol
47
Q
- Lithium labs
- Action for tardy kyskinesia
- Drugs that take 6-12 weeks to work
A
- liver, BUN, Electrolyes, levels
- Stop the med, contact provider
- antidepressant, topical clindomycin
48
Q
- 1 lb = (Oz?)
- 1 lb=(kg?)
- Drop factor Formula
A
- 16 Oz
- 2.2 kg
- Volume/Time x Drop Factor = flow rate
49
Q
- Calculating Dosage formula
- 1 oz, how manly mLs
- 1 tsp, how many mL?
- 1 tbsp
A
- Desire/Available x amount
- 30
- 5
- 15
50
Q
- Tripyline SE’s
- Prozac SE’s
A
- Suicide, lethargy, sedation, dysrhythmia
- neuroleptic malignant syndrome, insomnia, drowsy, anxiety, seizure