Pharmocology

Question 1

what neurotransmitter does Anti anxiety medications work on?

Answer 1

Gamma aminobutyric acid (GABA

Question 2

what is a benzodiazepine?

Answer 2

anxiolytic

Question 3

what is the action of benzodiazepines?

Answer 3

promote activity of GABA by binding to GABA receptor complexes, therefore increases GABA

Question 4

examples of Benzodiazepines?

Answer 4

diazepam (valium)

Lorazepam (Ativan)

Question 5

what can Benzodiazepines do for alcohol withdrawl?

Answer 5

they calm over excited neurons

Question 6

what can you not have with benzos

Answer 6

Alcohol or other CNS depressants
opiates
TCAs

Question 7

side effects of Benzos

Answer 7

• decrease in judgement, attention and motor activity (dont drive with them)
• Ataxia
• sedation
• Potential dependence (use only for short term)

Question 8

what part of the brain do Benzos work on?

Answer 8

Cerebellum

Question 9

when do you use Benzos?

Answer 9

• acute mania
• helps with psychomotor agitation in mania
• anxiety

Question 10

what is the alternative drug to Benzos?

Answer 10

Bustab (buspirone hydrochloride)

Question 11

what is the action of Bustab?

Answer 11

maybe increases serotonin and decreases dopamine 2

Question 12

what are the types of antidepressants?

Answer 12

1. TCAs
2. SSRIs
3. SNRIs
4. SNDIs
5. MAOIs

Question 13

what is the therapeutic response of antidepressants?

Answer 13

2-4 weeks

Question 14

what is the action of Tricyclic antidepressants

Answer 14

act by blocking reuptake of norepinephrine and serotonin, and may block muscarinic receptors (acetylcholine)

Question 15

Adverse affects of TCAs

Answer 15

1. Anticholinergic effects
2. esophogeal reflux
3. weight gain
4. Orthostatic hypertension
5. may increase serum bilirubin
6. sedation (histamine blockage)

Question 16

how do anticholinergic effects present

Answer 16

1. blurred vision
2. dry eyes
3. dry mouth
4. urinary retention
5. constipation
6. tachycardia
7. weight gain

Question 17

what herbal drug can you not take with TCAs?

Answer 17

st johns wart

Question 18

if toxic from TCAs what do you give?

Answer 18

Charcoal

Question 19

what are the toxic effects of TCAs?

Answer 19

• dyrhythmias
• tachycardia
• myocardial infarction
• heart block

Question 20

what is the drug name under TCAs

Answer 20

• amitriptyline (Elavil)

Question 21

what is the first line drug for depression?

Answer 21

SSRIs

Question 22

what are examples of SSRIs?

Answer 22

1. fluoxetine hydrochloride (Prozac)
2. citalopram hydrobromide (celexa)
3. Zoloft
4. Paxil

Question 23

what is the action of SSRIs?

Answer 23

• inhibit the re-uptake of serotonin, better than TCAs because they dont have anticholinergic effects

Question 24

when are SSRIs used?

Answer 24

Depression with anxiety
Depression with psychomotor agitation
OCD
Panic
Bulimia

Question 25

what are adverse effects of SSRIs

Answer 25

- aggitation, irritability - insomnia - tension head ache - nausea and vomiting - sexual dysfunction - hyponatremia

Question 26

what tests should you perform with SSRIS

Answer 26

check renal and liver function tests and blood counts

Question 27

what is the toxic effect of SSRIs?

Answer 27

SEROTONIN SYNDROME - too much serotonin in CNS, from OD or from mixing with other antidepressants or MAOIs** - normal range of serotonin is 101-283 mg/L

Question 28

what are symptoms of serotonin syndrome?

Answer 28

- ab pain - diarrhea - sweating and fever - tachycardia and increased BP - altered mental status (delirium) - myoclonus (muscle spasms) - Increased motor activity - irritability, hostility and mood changes - extreme = death

Question 29

what are the nursing interventions for Serotonin Syndrome?

Answer 29

- stop drug for 2-5 weeks - give serotonin- receptor blockers with propranolol - cooling blankets - chlorpromazine for hyperthermia - anticonvulsants and diazepam for muscle rigidity - artificial ventilation

Question 30

what is the action of serotonin norepinephrine re uptake inhibitors (SNRIs) ?

Answer 30

increases serotonin and norepinephrine | can aid in neuropathic pain like in diabetes

Question 31

types of SNRIs?

Answer 31

Effexor XR- venlafaxine

Question 32

example of serotonin and norepinephrine disinhibitors (SNDIs)

Answer 32

mirtazapin (remeron)

Question 33

action of SNDIs

Answer 33

increases NE, dopamine, and serotonin

Question 34

action of Monoamine Oxidase Inhibitors (MAOIs)

Answer 34

blocks monoamine oxidase which normal causes the reuptake of serotonin, NE, dopamine and tyramine

Question 35

adverse effects of MAOIs

Answer 35

increase tyramine... which leads to hypertensive crisis and eventually cardiovascular accident so dont eat foods with tyramine in them when taking this drug

Question 36

what foods have tyramine in them?

Answer 36

- avocados - chocolate - red wine - dairy - bananas - cheese - some meats - some beers

Question 37

when can you give MAOIs?

Answer 37

- atypical depression - panic disorders - social phobias - generalized anxiety disorder - OCD - PTSD - bulimia

Question 38

Adverse drug reactions of MAOIs

Answer 38

``` Orthostatic hypotension weight gain edema change in cardiac rate and rhythm insomnia weakness and fatigue constipation urinary hesitancy sexual dysfunction overactivity and muscle twitch hypo/er manic behaviours ```

Question 39

Toxic effects of MAOIs?

Answer 39

1. increase BP 2. hypertensive crisis** 3. intracranial hemorrhage 4. convulsions 5. coma 6. death check BP for first 6 weeks

Question 40

what can you give for hypertensive crisis?

Answer 40

calcium channel blockers