Pharmocology Flashcards

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1
Q

what neurotransmitter does Anti anxiety medications work on?

A

Gamma aminobutyric acid (GABA

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2
Q

what is a benzodiazepine?

A

anxiolytic

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3
Q

what is the action of benzodiazepines?

A

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

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4
Q

examples of Benzodiazepines?

A

diazepam (valium)

Lorazepam (Ativan)

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5
Q

what can Benzodiazepines do for alcohol withdrawl?

A

they calm over excited neurons

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6
Q

what can you not have with benzos

A

Alcohol or other CNS depressants
opiates
TCAs

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7
Q

side effects of Benzos

A
  • decrease in judgement, attention and motor activity (dont drive with them)
  • Ataxia
  • sedation
  • Potential dependence (use only for short term)
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8
Q

what part of the brain do Benzos work on?

A

Cerebellum

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9
Q

when do you use Benzos?

A
  • acute mania
  • helps with psychomotor agitation in mania
  • anxiety
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10
Q

what is the alternative drug to Benzos?

A

Bustab (buspirone hydrochloride)

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11
Q

what is the action of Bustab?

A

maybe increases serotonin and decreases dopamine 2

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12
Q

what are the types of antidepressants?

A
  1. TCAs
  2. SSRIs
  3. SNRIs
  4. SNDIs
  5. MAOIs
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13
Q

what is the therapeutic response of antidepressants?

A

2-4 weeks

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14
Q

what is the action of Tricyclic antidepressants

A

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

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15
Q

Adverse affects of TCAs

A
  1. Anticholinergic effects
  2. esophogeal reflux
  3. weight gain
  4. Orthostatic hypertension
  5. may increase serum bilirubin
  6. sedation (histamine blockage)
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16
Q

how do anticholinergic effects present

A
  1. blurred vision
  2. dry eyes
  3. dry mouth
  4. urinary retention
  5. constipation
  6. tachycardia
  7. weight gain
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17
Q

what herbal drug can you not take with TCAs?

A

st johns wart

18
Q

if toxic from TCAs what do you give?

A

Charcoal

19
Q

what are the toxic effects of TCAs?

A
  • dyrhythmias
  • tachycardia
  • myocardial infarction
  • heart block
20
Q

what is the drug name under TCAs

A
  • amitriptyline (Elavil)
21
Q

what is the first line drug for depression?

A

SSRIs

22
Q

what are examples of SSRIs?

A
  1. fluoxetine hydrochloride (Prozac)
  2. citalopram hydrobromide (celexa)
  3. Zoloft
  4. Paxil
23
Q

what is the action of SSRIs?

A
  • inhibit the re-uptake of serotonin, better than TCAs because they dont have anticholinergic effects
24
Q

when are SSRIs used?

A
Depression with anxiety
Depression with psychomotor agitation
OCD
Panic
Bulimia
25
Q

what are adverse effects of SSRIs

A
  • aggitation, irritability
  • insomnia
  • tension head ache
  • nausea and vomiting
  • sexual dysfunction
  • hyponatremia
26
Q

what tests should you perform with SSRIS

A

check renal and liver function tests and blood counts

27
Q

what is the toxic effect of SSRIs?

A

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
28
Q

what are symptoms of serotonin syndrome?

A
  • 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
29
Q

what are the nursing interventions for Serotonin Syndrome?

A
  • 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
30
Q

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

A

increases serotonin and norepinephrine

can aid in neuropathic pain like in diabetes

31
Q

types of SNRIs?

A

Effexor XR- venlafaxine

32
Q

example of serotonin and norepinephrine disinhibitors (SNDIs)

A

mirtazapin (remeron)

33
Q

action of SNDIs

A

increases NE, dopamine, and serotonin

34
Q

action of Monoamine Oxidase Inhibitors (MAOIs)

A

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

35
Q

adverse effects of MAOIs

A

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

36
Q

what foods have tyramine in them?

A
  • avocados
  • chocolate
  • red wine
  • dairy
  • bananas
  • cheese
  • some meats
  • some beers
37
Q

when can you give MAOIs?

A
  • atypical depression
  • panic disorders
  • social phobias
  • generalized anxiety disorder
  • OCD
  • PTSD
  • bulimia
38
Q

Adverse drug reactions of MAOIs

A
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
39
Q

Toxic effects of MAOIs?

A
  1. increase BP
  2. hypertensive crisis**
  3. intracranial hemorrhage
  4. convulsions
  5. coma
  6. death

check BP for first 6 weeks

40
Q

what can you give for hypertensive crisis?

A

calcium channel blockers