Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

semester 4 > pharmacology 2 > Flashcards

pharmacology 2 Flashcards

1
Q

levels of anxiety

A

mild, moderate, severe and panic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

virtually always maladaptive defense mechanisms

A

splitting and displacement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

defense mechanisms

A

Conscious and unconscious attempts to manage anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

are defense mechanisms healthy?

A

as long as they aren’t maladaptive, yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Buspirone (Buspar)

A

anxiolytic
the long term antianxiety agent of choice
lower dependency issues, can be used for long term treatment
good for worry, bad for tension
take with food to prevent nausea.
not for panic attacks, takes 2-3 weeks to reach full effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

drugs for short term use in panic episodes

A

Antianxiety agents, such as benzodiazepines
potential for abuse, addiction, and tolerance is high

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Hydroxyzine (Atarax, Vistaril)

A

an antihistamine
It is used in the treatment of itchiness, insomnia, anxiety, and nausea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

benzodiazepines

A

Alprazolam (Xanax) - for agoraphobia and panic
Clorazepate (Tranxene)
Chlordiazepoxide (Librium)
Clonazepam (Klonopin)
Diazepam (Valium) AND Lorazepam (Ativan) - often used for alcohol withdrawal
Oxazepam (Serax)
Temazepam (Restoril)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

paradoxical effect to Benzodiazepines

A

around 10% of people become disinhibited rather than calm and sedated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

complications of benzodiazepines

A

CNS depression and decreased cognitive abilities (do not drive or operate machinery until effect is known)
Respiratory depression if mixed with alcohol and other CNS depressants
Anterograde amnesia (do not make important decisions after taking medication) Ambien seems to be the worst
Abrupt discontinuation can lead to seizures, coma and death

– can often over sedate a patient –

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

benzodiazepines often used for severe alcohol withdrawal

A

Diazepam (Valium) (longer half life) and Lorazepam (Ativan) (shorter half life)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

antidote for benzodiazepine overdose

A

Flumazenil IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Citalopram (Celexa)

A

SSRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Escitalopram (Lexapro)

A

SSRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Fluoxetine (Prozac)

A

SSRI
like sertraline (zoloft) can be energizing initially, so that can increase anxiety. it subsides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Fluvoxamine (Luvox)

A

SSRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Paroxetine (Paxil)

A

SSRI – helpful in GAD, more calming than the other SSRIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Sertraline (Zoloft)

A

SSRI
like fluoxetine (prozac) can be energizing initially, so that can increase anxiety. it subsides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is the first line choice for many anxiety disorders after busparone?

A

SSRIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

SSRI administration notes

A

can be energizing initially, usually subsides
4 weeks to be full effect
taper discontinuation
Generally no/low overdose potential – good for clients with a history of SI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

SSRI side effects

A

sexual dysfunction, weight gain
Bruxism (use a mouth guard)
can increase liver/kidney issues
GI bleeding history (affects blood coagulation)
Hyponatremia risk when combined with diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

SSRI black box warning

A

rare but not reversible
Increased suicidal risk when energy improves but still suicidal - now “happy to act on their plan”
Slight increase suicides in clients 24 years old and younger compared to other age groups but the difference is not statistically significant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Serotonin Syndrome signs and symptoms

A

Onset in 2-72 hours
Delirium, sudden onset of confusion, agitation
myoclonus – muscle spasms, rigidity
gI pain and diarrhea
hypertension, tachycardia, fever (with diaphoresis)
seizures, apnea, death

24
Q

increased risk for serotonin syndrome

A

St. John’s Wort
MAOIs or TCAs
Lithium
Opioids
Copious caffeine (coffee, black tea, soft drinks with caffeine), caffeine also increases anxiety and should be avoided
Migraine medication
ECT

25
Q

how to treat serotonin syndrome

A

Hold medications and notify PCP
Treat symptoms: i.e., propranolol, anticonvulsants, induce paralysis
Cooling blankets

26
Q

Duloxetine (Cymbalta)

A

SNRI

27
Q

Venlafaxine (Effexor)

A

SNRI – mixed anxiety and depression, nerve pain

28
Q

possible meds if the client has a bipolar disorder with anxiety

A

Gabapentin (Neurontin), Anticonvulsants
Pregabalin (Lyrica), Anticonvulsants

29
Q

Clonidine (Catapres)

A

Alpha2 Agonist – panic attacks

30
Q

Propranolol (Inderal)

A

Beta-blocker – social and performance anxiety

31
Q

Prazosin (Minipress)

A

Alpha1 Agonist - used for nightmares in PTSD

32
Q

Anticholinergic side effects

A

Extrapyramidal Side Effects: pseudoparkinsonism (examples: drooling, mask facies, shuffling, tremor …), acute dystonic reaction, akathisia, tardive dyskinesia
cardiac (alpha blocks) – check orthostatic BP and pulse, may need ECG to check for Q-T interval
agranulocytosis (report flu like symptoms) Neuroleptic Malignant Syndrome – rare but dangerous
Metabolic Syndrome
Hyperprolactinemia– even in males, can cause amenorrhea in females, lactation in all
Cholestatic jaundice – rare, reversible

33
Q

Anticholinergic side effects

A

Extrapyramidal Side Effects: pseudoparkinsonism (examples: drooling, mask facies, shuffling, tremor …), acute dystonic reaction, akathisia, tardive dyskinesia
cardiac (alpha blocks) – check orthostatic BP and pulse, may need ECG to check for Q-T interval
agranulocytosis
Neuroleptic Malignant Syndrome – rare but dangerous
Metabolic Syndrome
Hyperprolactinemia– even in males, can cause amenorrhea in females, lactation in all
Cholestatic jaundice – rare, reversible

34
Q

anticholinergic adverse drug reactions

A

anticholinergic toxicity
acute dystonic reaction (CONGENTIN STAT)
agranulocytosis (report flu like symptoms)
neuroleptic malignant syndrome
cholestatic jaundice

35
Q

what to do about dry mouth

A

hard sour candy (xylitol better than sugar), glycerin swaps, ice chips and water sips

36
Q

what to do about mydriasis (dilated pupils)

A

Photosensitivity – limit sunlight, sunscreen, sunglasses, sun hat
Blurred vision: magnifiers, may improve in 2 weeks

37
Q

what to do about dry eyes

A

artificial tears

38
Q

what to do about sexual dysfunction

A

artificial lubricants

39
Q

what to do about constipation

A

fiber, water, exercise, monitor b.m. frequency and bowel sounds

40
Q

what to do about urinary retention

A

bladder scan

41
Q

Anticholinergic Toxicity s/s

A

dry, hot and red
emergency
Unstable VS
No peristalsis or micturition
Repetitive motor movements
Seizures
Delirium (increased psychosis)

42
Q

treatment for anticholinergic toxicity

A

cooling, catheterize, sedation (benzodiazepines), physostigmine

43
Q

Acute Dystonic Reaction

A

Opisthotonos – ‘titanic’ tetany body arching
Oculogyric crisis – eyes roll upwards, backwards, and lock
Laryngeal dystonia – may not be able to breath

44
Q

acute dystonic reaction treatment

A

benztropine (Cogentin) IM to relax muscles and prevent muscle damage, maintain airway if needed

45
Q

Agranulocytosis

A

less than 100 neutrophils (you’re supposed to have 1500+)
Flu like symptoms: sore throat, fever, malaise – report right away, may see these before abnormal lab test results

Highest risk for clozapine

46
Q

Neuroleptic Malignant Syndrome

A

can be sudden onset, but not always
high fever – “CARDINAL” symptom
diaphoresis, altered mental status
muscle rigidity
Increased CPK levels from muscle breakdown
can die if not treated

47
Q

neuroleptic malignant syndrome possible treatment

A

may include Bromocriptine for muscle rigidity and fever, dantrolene for muscle spasms

48
Q

antipsychotic black box warning

A

older adults, especially those with dementia have an increased risk of death (usually related to heart failure and pneumonia)

49
Q

typical (first generation) antipsychotics

A

Chlorpromazine (CPZ, Thorazine)
Fluphenazine (Prolixin)
Haloperidol (Haldol) – common IM against clients will for psych emergencies
Loxipine (Loxitane) - lox is an old person breakfast
Mesoridazine (Serentil)
Molindone (Moban)
Perphenazine (Trilafon)
Pimozide (Orap)
Thioridazine (Mellaril)
Thiothixene (Navane)
Trifluoperazine (Stelazine)
(z/x/ i/e ne and haldol for some reason)

50
Q

atypical (second generation) antipsychotics

A

Aripiprazole (Abilify)
Asenapine (Saphris)
Clozapine (Clozaril)
Lurasidone (Latuda)*
Olanzapine (Zyprexa)*
Olanzapine + Samidorphan (Lybalvi) (Samidorphan is an opioid antagonist)*
Paliperidone Palmate (Invega Sustena)
Quetiapine (Seroquel)*
Risperidone (Risperdal)*
Ziprasidone (Geodon)
2016: Cariprazine (Vraylar)* - capri sun for kids

(zoles, dones, and pines)
*Also used to help decrease mania/hypomania in clients with a Bipolar Disorder

51
Q

Asenapine (Saphris)

A

second generation anti psych
- sublingual, the patient should not eat or drink for 10 minutes before and after

52
Q

Long-Acting Injections

A

PERSERIS® (per-SAIR-iss) (risperidone)
Inject a ‘gel pillow’ SQ, biodegrades, lasts one month - okay if there’s still a bump by next dose

53
Q

Typical/FGA quick review

A

Primarily treat: Positive symptoms
Have a higher risk, compared to SGAs, for: EPSE
Can make Negative symptoms worse

54
Q

Atypical/SGA quick review

A

Primarily treat: Negative symptoms
Have a higher risk, compared to FGAs, for: Metabolic Syndrome

55
Q

side effects of antipsychotics

A

sedation, extrapyramidal side effects (pseudoparkinism, dystonic reactions), opisthotonos (arched back torso), oculogyric crisis (eyes roll upwards, backwards, and lock), laryngeal dystonia (may not be able to breathe), akathisia, hypotension, prolonged Q-T interval, being dry,

56
Q

adverse reactions of antipsychotics

A

acute dystonic reactions ((STAT benztropine (Cogentin) IM, diphenhydramine (Benadryl) can help as well), cardiac arrest,

57
Q

zoloft can give you zoomies

A

suzanne said to remember it can make you hyper in the first few weeks

semester 4 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions