PHARMACOLOGY Flashcards
This refers to the maximal therapeutic effect that can be achieved by a drug.
EFFICACY
This describes the amount of drug needed to achieve that maximum effect
Drugs that have a low _______ require higher dosages to achieve efficacy
High-_____ drugs achieve efficacy at lower doses.
POTENCY
This is the amount of time it takes for half of the drug to be removed from the bloodstream.
Drugs with a shorter ________ may need to be given 3 or 4 times in a day, but drugs with a longer half-life may be given once a day.
The amount of time needed for a drug to leave the body completely after it has been discontinued is about five times its ________
HALF-LIFE
A medication is selected based on its effect on the client’s ___________ _________, such as delusional thinking, panic attacks, or hallucinations.
TARGET SYMPTOMS
The effectiveness of the medication is evaluated in large part by its ability to ___________ the target symptom.
DEMINISH OR ELIMINATE
As a rule, elderly persons require _______ dosages of a medication to produce therapeutic effects, and it may take longer for a drug to achieve its full therapeutic effect.
LOWER
Psychotropic medications are often __________ __________ rather than abruptly discontinued.
DECREASED GRADUALLY
Problems when Psychotropic medications are abruptly discontinued.
- _____________ (temporary return of symptoms)
- ______________ of the original symptoms
- ____________ (new symptoms resulting from discontinuation of the drug)
- Rebound (temporary return of symptoms)
- Recurrence of the original symptoms
- Withdrawal (new symptoms resulting from discontinuation of the drug)
______________ care is essential to ensure compliance with the medication regimen, to make needed adjustments in dosage, and to manage side effects.
FOLLOW-UP
These are also known as NEUROLEPTICS / MAJOR TRANQUILIZERS
These are used to treat symptoms of psychosis, such as delusions and hallucinations.
They work by blocking the receptors of the neurotransmitter Dopamine.
ANTIPSYCHOTIC DRUGS
Antipsychotic drugs are Indicated to Schizophrenia and Other Psychosis
Desired effect: __________ of SYMPTOMS
Best taken_________meals
- CONTROL OF SYMPTOMS.
- BEST TAKEN WITH MEAL
Antipsychotic drugs that blocks all three dopamine receptors (D2, D3, D4)
DRUGS END WITH “ZINE” & “DOL”
HELPS DIMINISH POSITIVE SYMPTOMS
TYPICAL DRUGS / FIRST GENERATION ANTIPSYCHOTICS
WEAK BLOCKERS OF D2 RECEPTORS
DRUGS END WITH “PINE” & “DONE”
HELPS DIMINISH POSITIVE AND NEGATIVE SYMPTOMS
ATYPICAL DRUG/ SECOND GENERATION ANTIPSYCHOTICS
SIDE EFFECTS OF ANTIPSYCHOTIC MEDICATION
- B_________ _____N
- D____ ________H
- P________Y
- O_____C H_______N
- E____ P_______ S____
- A____________S
- N__________ M_________ S________
- BLURRED VISION
- DRY MOUTH
- PHOTOSENSITIVITY
- ORTHOSTATIC HYPOTENSION
- EXTRA PYRAMIDAL SYMPTOMS
- AGRANULOCYTOSIS
- NEUROLEPTIC MALIGNANT SYNDROME
EXTRA PYRAMIDAL SYMPTOMS
A_____
P_____
A_____
T_____
AKATHISIA
PSEUDOPARKINSOSISM
ACUTE DYSTONIA
TARDIVE DYSKINESIA
RESTLESS LEG SYNDROME
“ANT’S IN THE PANTS”
AKATHISIA
pill-rolling tremors
mask-like face
cog-wheel rigidity
propulsive gait
PSEUDOPARKINSONISM
Defect in muscle tone
ACUTE DYSTONIA
ACUTE DYSTONIA
Defect in muscle tone
T______- CERVICAL SCOLIOSIS
O______- TRUNK RIGIDITY
O_______-EYE BALL (UPWARD MOVEMENT)
L________- MUSCULAR CONTRACTION OF THE VOCAL CORDS
TORTICOLLIS
OPISTHOTONUS
OCULOGYRIC CRISIS
LARYNGOSPASM
Tongue-thrusting and protrusion
lip-smacking,
blinking, grimacing and other excessive, unnecessary facial movements
TARDIVE DISKINESIA
NURSING ACTION?
EPS
1. AKATHISIA
2.PSEUDOPARKINSOSISM
3. ACUTE DYSTONIA
4. TARDIVE DYSKINESIA
Report at once
1)Lowering the dosage of the antipsychotic
2) Changing to a different antipsychotic
3) Administering anticholinergic medication
NEUROLEPTIC MALIGNANT SYNDROME TRIAD
R______
H______
U______
Treatment:
Immediate discontinuance of all antipsychotic
RIGIDITY
HIGH FEVER
UNSTABLE BLOOD PRESSURE
Common indication: Anxiety disorders
Desired Effect: Decreased anxiety, adequate sleep
MINOR TRANQUILIZERS/ ANXIOLYTICS
Examples:
Diazepam (Valium)
Oxazepam (Serax)
Chlordiazepoxide (Librium)
Chlorazepate Dipotassium (Tranxene)
Alprazolam (Xanax)
MINOR TRANQUILIZERS/ ANXIOLYTICS
MINOR TRANQUILIZERS/ ANXIOLYTICS
Nursing Implications:
Best taken ____________ meals
Advise to avoid d______
Avoid a______l and c_________e-containing foods
Administer it _________ with any drug
BEST TAKEN AFTER MEALS
AVOID DRIVING
AVOID ALCOHOL AND CAFFEINE-CONTAINING FOODS
ADMINISTER SEPARATELY WITH OTHER DRUGS
Desired effects: increased appetite, adequate sleep
ANTIDEPRESSANTS
Examples:
Imipramine (Tofranil) Amitriptyline (Elavil)
TRYCICLIC ANTIDEPRESSANTS
Tricyclic Antidepressants
Nursing Implications:
Best given______ meals
Effectivity: after ________________(INITIAL) _________(OPTIMUM)
Check the ___, it causes ____tension
Check the h_______E, it causes cardiac a_________s
BEST GIVEN AFTER MEALS
EFFECTIVITY
INITIAL: AFTER 2-3 WEEKS
OPTIMUM: AFTER 4-6 WEEKS
CHECK BP, IT CAUSE HYPOTENSION
CHECK HEART RATE, IT CAN CAUSE ARRYTHMIAS
Indication: refractory depression
MAO INHIBITORS
Examples:
* Tranylcypromine (PA____________)
* Phenelzine (NA_____________)
* Isocarboxazid (MA__________)
MAO INHIBITORS
PARANTE
NARDIL
MARPLAN
MAO INHIBITORS
Nursing Implications:
Best taken _____ meals
Report headache; it indicates _____________ _____________
Avoid __________ containing foods like:
* Avocado
* Banana
* Cheddar and aged cheese
* Soysauce
* Preserved foods
Effectivity: _____ weeks
Monitor the _____
There should be at least a ___-week interval when shifting from one anti-depressant to another
BEST TAKEN AFTER MEALS
HEADACHE INDICATES HYPERTENSIVE CRISIS
AVOID TYRAMINE FOODS
AFFECTIVITY IS AFTER 2-3 WEEKS
MONITOR BP
INTERVAL OF AT LEAST 2 WEEKS when shifting from one anti-depressant to another
Examples:
Fluoxetine (Prozac)
Celatopram (Celexa)
Sertraline (Zoloft)
Paroxetine (Paxil)
Fluvoxamine (Luvox)
SELECTIVE SEROTONIN REUPTAKE INHIBITORS
SELECTIVE SEROTONIN REUPTAKE INHIBITORS
Nursing Implications:
Avoid the use of:
d_______m
A_______l
Tryptophan
Monitor P__, P_
Never give to _____________ / lactating mothers.
AVOID THE USE OF DIAZEPAM
ALCOHOL
MONITOR PTT &PT
NEVER GIVE TO PREGNANT WOMEN
Examples:
Lithium Citrate (Cibalith)
Lithium Carbonate (Eskalith, Lithane, Lithobid)
ANTI-MANIC AGENT
ANTI-MANIC AGENT
Nursing implications:
Best taken _____ meals
Never give to pregnant mothers
TAKEN AFTER MEALS
ANTI-MANIC AGENT
Nursing implications:
Increase intake of:
__________ (3 L /day)
__________ (3 gm/day)
WATER (3 L /day)
SODIUM (3 gm/day)
ANTI-MANIC AGENT
Nursing implications:
Avoid activities that increase _____________
PERSPIRATION
ANTI-MANIC AGENT
Nursing implications:
Effectivity: ____ ____ DAYS
10-14 days
ANTI-MANIC AGENT
Nursing implications:
Antipsychotic is administered during the first 2 weeks
Therapeutic level: _____________ meq/L
IDEAL LEVEL:____
EXACT LEVEL:_____
Therapeutic level: 0.5 - 1.5 meq/L
IDEAL LEVEL: 0.7-1.2 meq/L
EXACT LEVEL: 1 meq/L
ANTI-MANIC AGENT
Toxic Effect: These include:
Severe d_____
V________g
D___________s
M________e w_______s
Lack of c________n
Toxic Effect
Severe diarrhea
Vomiting
Drowsiness
Muscle weakness
Lack of coordination
