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Prelims > Pschopharmacology > Flashcards

Pschopharmacology Flashcards

1
Q

occurs as the drug is synthesized, released and metabolized & as it acts on the receptor sites of a neurotransmitter system

A

Primary effects

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2
Q

results from interactions among the neurotransmitters, neuropeptides & hormones as they influence each others functions in the brain

A

Secondary effects

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3
Q

are the final changes in the clinical symptom induced by a drug such as stabilization of anxiety & depression

A

Tertiary effects

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4
Q

an enzyme in nerves & tissues that breaks down Norepinephrine, Dopamine & Serotonin (5HT)

A

Monoamine oxidase

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5
Q

found abundantly thoughout the parasympathetic NS. (Increase salivation,
Excessive sweat, Diarrhea, Bradycardia)

A

Acetylcholine

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6
Q

Inhibits nerve activity

A

Amino Acids- Gama Aminobutyric Acid (GABA)

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7
Q

react with beta receptors in the periphery to modulate pain transmission

A

Peptides- Enkephalins

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8
Q

is important in conceptualizing the pathology & treatment of Alzheimer’s & Parkinson’s disease

A

Acetylcholine

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9
Q

is important in conceptualizing the pathology & treatment of Schizophrenia

A

Dopamine

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10
Q

is important in conceptualizing the pathology & treatment of Anxiety

A

Gamma-aminobutyric Acid (GABA)

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11
Q

is important in conceptualizing the pathology & treatment of mania & depression

A

Norepinephrine

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12
Q

is important in conceptualizing the pathology & treatment of mania & depression

A

Serotonin

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13
Q

Nervous System

A
  1. Neuron
  2. Dendrites
  3. Axon
  4. Nerve cell
  5. Pre-synaptic nerve ending
  6. Synapse
  7. Postsynaptic receptor
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14
Q

is the study of regulation & stabilization of emotions, behavior, & cognition through the interactions of endogenous signaling substances or chemicals in the brain

A

Psychopharmacology

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15
Q

3 types of physiological action

A
  1. respond to stimuli
  2. conduct electrical impulse
  3. release chemicals (neurotransmitters)
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16
Q

fundamental units of brain & nervous system (NS)

A

Neurons

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17
Q

sending of impulse from one neuron to another across synapse

A

Neurotransmission

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18
Q

are chemical messenger that transmit signals from neuron

A

Neurotransmitters

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19
Q
  • amino acid which is main inhibitory
  • for vision, motor control, regulation of anxiety
A

GABA

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20
Q
  • amino acid which is the most plentiful
  • for memory and learning
A

Glutamate

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21
Q
  • a MAOIs- a stress hormone
  • for HR, BP, muscle srength
A

Epinephrine

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22
Q
  • a MAOIs- fight-flight response
  • for BP, HR, fat breakdown
A

Norepinephrine

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23
Q
  • a MAOIs- feel good neurotransmitter
  • for pleasure, motivation, memory, coordination of body movement
A

Dopamine

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24
Q
  • a MAOIs- mood transmitter
  • mood regulation & modulation, sleep, anxiety, sexuality, appetite
A

Serotonin

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25
Q
  • a peptide, which responds to pain
  • inhibit pain, signal transmission, promote feelings & euphoria
A

Endorphins/Enkephalins

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26
Q
  • associated with motor neurons
  • muscle movement, memory learning
A

Acetylcholine

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27
Q

Antipsychotic Agents (Neuroleptic Drugs)

A
  1. Typical Antipsychotics
  2. Atypical Antipsychotics
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28
Q

Contraindications for Psychotropic Drugs

A
  • Hypersensitivity
  • Bone marrow depression
  • Brain damage
  • CVD
  • Glaucoma
  • Parkinson’s disease
  • Seizure disorder
  • Photosensitivity
  • Sever depression
  • Blood dyscrasias
  • Hx of impaired liver function
  • HPT
  • Diabetes
  • Peptic Ulcer
  • Pregnacny
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29
Q

Side Effects of Psychotropic Drugs

A
  • Delirium
  • Agranulocytosis (Carbamazepine-Clozapine)
  • Sedation
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30
Q
  • occurs in 1 to 3 weeks
    after taking the medication
  • tremors
  • rigidity
  • bradykinesia
  • NR: Avoid abrupt withdrawal, administer
    antiparkinson’s drug
  • give AMANTADINE- dopamine antagonist
A

Parkinson’s Syndrome

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31
Q
  • abnormal movements; irreversible movement of tongue (protrusion), face, trunk & extremities; drooling, shuffling gait
  • NO treatment except discontinue meds
  • NA: Vitamin E- believe to improve pt condition
A

Tardive Dyskinesia

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32
Q
  • 1-2 days after, sudden spasm or contractions of face, tongue, extraocular muscles, neck (torticollosis), dx in swallowing
  • Remain with the client during his/her frightening symptoms
  • Administer antiparkinson drug (Cogentin,
    Benadryl, Artane, Akeniton)
  • Benzotropine mesylate (Cogentin)
  • Diponhydramine (Benadryl)
A

Dystonia

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33
Q
  • 2 weeks after treatment. Characterized by motor restlessness & need to keep moving, ‘inability to sit’, pt complains of feeling jittery having a lot of ‘nervous’ energy.
  • Administer Antiparkinson drug
  • Rule out anxiety or agitation before giving
    anticholinergic drugs
A

Akathisia

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34
Q

occurs in days & weeks after treatment; elevated VS, rigidity, confusion, renal failure, increase creatinine phosphokinase (CPK), increase WBC, coma, death

A

Neuroleptic Malignant Syndrome (NMS)

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35
Q
  • relieves insomnia
  • used to induce a state of natural sleep
A

Hypnotics

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36
Q
  • treat daytime tension
  • may be used to manage withdrawal symptoms associated with alcoholism, to control convulsion & to produce skeletal, muscle relaxation
A

Antianxiety (Anxiolytics)

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37
Q

treatment of choice for anxiety, insomnia & stress-related conditions

A

Benzodiazepines

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38
Q

Librium: 5 to 10 mg TID or QID (for mild) 20 to 25 mg TID or QID PO (for severe)

A

Chlordiazepoxide

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39
Q

Valium, Diastat

40
Q

Tranxene, Gen-xene- for acute alcohol withdrawal

A

Clorazaptate

41
Q

Ativan, Lorazem- for pre-op sedation, insomnia related to anxiety

42
Q

Xanax for anxiety, panic disorder

A

Alprazolam

43
Q

Centrax

44
Q

Clonazepam

45
Q

Buspar (Azasperone), 10 to 40
mg/day

Non-Benzodiazepines

A

Buspirone HCL

46
Q

Seconal, Amytal, (Phenobarbital-Luminal)

Non-Benzodiazepines

A

Barbiturates

47
Q

Equanil- relieves muscle tension
related to anxiety

Non-Benzodiazepines

A

Meprobamate

48
Q

Benzodiazepine & Non-Benzodiazepine

A
  • no alcohol
  • drive cautiously
  • not abruptly discontinue meds
49
Q

Sedative-Hypnotic Drugs

A
  • Flurazepam- Dalmane- 15 to 60 mg/day
  • Triazolam- Halcion- 0.25 to 0.5 mg/day
50
Q

Antihistamines

A
  • Hydroxyzine HCL- Vistarel, Atarax
  • Hydroxyzine Pamoate- Vistaril
  • Diphenhydramine HCL- Benadryl
51
Q
  • used to diminish tachycardia, impulsivity &
    benign tremors
    a. Propanolol- Inderal
    b. Atenolol
    c. Metoprolol- Lopressor
    d. Nadolol
A

Beta Blockers

52
Q

inhibit the reuptake of serotonin at the presynaptic membrane, therefore increases the availability of serotonin in the synapse & at the postsynaptic membrane, thus promoting neurotransmission in the brain

A

Selective Serotonin Reuptake Inhibitors (SSRI)

53
Q

Paxil- may cause male
sexual dysfunction, drowsiness, sweating

SSRI

A

Paroxetine

54
Q

Zoloft- may cause male sexual dysfunction

SSRI

55
Q

Celexa

SSRI

A

Citalopram

56
Q

Prozac- may cause
headache, nervousness

SSRI

A

Fluoxetine

57
Q
  • Do not use together with Antihypertensive, Alcohol, Gingko Biloba
  • May cause painful erection (priapism)
  • Report suicidal symptoms

Atypical Antidepressants

A

Trazodone- Desryl

58
Q

Closely monitor patient’s Bipolar disorder, may cause manic episodes

Atypical Antidepressants

A

Bupropion- Wellbutrin

59
Q
  • may cause dizziness. (non-selective uptake inhibitor)
  • Monitor for suicidal ideation No alcohol, nor
    OTC drugs

Atypical Antidepressants

A

Venlafaxine HCL- Effexor

60
Q
  • No abrupt withdrawal of this drug
  • Let the tablet disintegrate in the tongue & can be swallowed by saliva or chewed

Atypical Antidepressants

A

Mirtrazapine- Remeron

61
Q

Take before meals, food may inhibit absorption

Atypical Antidepressants

A

Nefazadone- Serzone

62
Q
  • increase the level of Neurotransmitters, serotonin or norepinephrine
  • Monitor BP
    a. Nortriptyline- Aventyl, Pamelor
    b. Imipramine- Tofranil- oldest antidepressant & the 1st choice
    c. Doxepin- Senequan, Zonalon
    d. Despiramine HCL- Norpramine
    e. Amitriptyline- Elavil, Endep
A

Tricyclics: Tricyclic Antidepressant (TCAs)

63
Q

major therapeutic effect

A

improved mood

64
Q

Antilirium- given IM or IV
0.5 mg at a rate of 1mg per minute; may be
repeated if necessary. Used when:
* If there is overdose of TCAs (an Antidote)
* Overdose of Atropine

A

Prostigmine-Salicylate

65
Q

‘underused & overly feared’. May trigger
Hypertensive Crisis when tyramine containing
foods are taken

A

Monoamine Oxidase Inhibitors (MAOIs)

66
Q

is an amino acid released from proteins in food when they undergo hydrolysis by fermenting, pickling, smoking & spoiling. When
MAO is inhibited, tyramine may reach adrenergic nerve endings causing the release of large amounts of norepinephrine & produce hypertensive reaction

67
Q

Signs & Symptoms of MAOIs

A
  • Increased BP
  • Diaphoresis
  • Tachycardia
  • Nausea, Vomiting
  • Occipital Headache, stiff neck
  • Sudden unexplained nose bleed
  • Intracerebral Haemorrhage
  • Dilated pupils
68
Q

Foods to be avoided in MAOIs

A

These foods contain tyramine & tryptophan which is a precursor of dopamine, norepinephrine & epinephrine
* A- age cheese, avocados
* B- bananas, beer and ale
* C- caffeine, canned fish, chicken liver, chocolate
* F- fava bean pods
* G- guacamole dip
* Meat- bologna, salami, sausage
* Sour cream, soy sauce, wine, yeast, yogurt

69
Q

new MAOI, no dietary restrictions, lower side effects

A

Moclobemide

70
Q

Side Effects of MAOIs

A
  • Postural light-headedness
  • fluid retention
  • drowsiness
  • delay in ejaculation
  • urinary hesitancy
  • muscle twitching
  • constipation
  • insomnia
  • dry mouth
71
Q

are made of salt & regulates the activity of neurotransmitters in the brain. It alters sodium transport in nerves & muscles, it normalizes synaptic neurotransmission of norepinephrine, serotonin & dopamine

Antimanic Agents (Mood Stabilizing Drugs)

72
Q

the body does not metabolize
Lithium, but is excreted in the renal system

A

Metabolism

73
Q
  • Eskalith, Lithotabs, Lithane, Lithonate, Lithobid, Cibalith S
  • DO NOT LIMIT SALT INTAKE IF PATIENT
    IS ON LITHIUM
  • Increase Na Intake= Increase Lithium
    Excretion
  • Decrease Na Intake= Decrease Lithium
    Elimination
A

Lithium Carbonate

74
Q

Therapeutic Range of Lithium

A

0.5 to 1 mEq/L
(acc. to Sundeen- 0.6 to 1.4 mEq/L)

75
Q

Lithium Overdose

A

1.5 to 2.0 mEq/L

76
Q

diarrhea, vomiting, drowsiness, muscular weakness, lack of coordination

A

Early Signs of Toxicity

77
Q

ataxia, giddiness, tinnitus, blurred vision, large output of diluted urine.

A

Moderate to severe reaction

78
Q

Nursing Intervention for Lithium

A

Lavage, Dialysis, Forced diuresis, parenteral Normal Saline

79
Q
  • Renal- BUN, Creatinine, electrolytes, 24H Creatinine Clearance, HPN, DM, diuretic use, analgesics abuse
  • Thyroid: TSH, T3, T4, RU (Resin Uptake)
  • CBC, ECG, FBS
A

Pre Lithium Workup

80
Q
  • Every 3 months- Lithium level (for the 1st 6 months)
  • Every 6 months- reassess renal status, lithium level, TSH
  • Every 12 months- reassess thyroid function, ECG
A

Maintenance Lithium Considerations

81
Q

The Effects of Lithium is decreased by:

A
  1. Acetazolamine- Diamox (adjunct to treatment of edema)
  2. Sodium Bicarbonate- Increase sodium content
  3. Caffeine- monitor electrolytes, Thyroid Profile, Liver Profile
82
Q

is given if patient does not respond to Lithium or is contraindicated

A

Carbamazine (Tegretol, Carbitral)

83
Q

Common Anticonvulsants

A
  1. Long Acting barbiturates
  2. Benzodiazepine
  3. Hydantoins
  4. Succinimides
84
Q
  • Depakene- effective in the manic phase of Bipolar disorder & Schizoaffective disorder
  • (Depakote, Depakene)- anticonvulsant- increase neurotransmitter GABA
A

Valporic Acid

85
Q

Tegretol- helpful in acute mania & in long term prevention of manic episode. 600 mg/day

A

Carbamazepine

86
Q

Treat EPS

A

Antiparkinson Agents

87
Q

Dopaminergic Drugs

A
  • Dopamine Precursor- Levodopa (Sinemet)
  • Dopamine Releaser- Amantidine Symmetrel
  • Dopamine Receptor agonist- Bromocriptine
    (Parlodel), Pergolide (Permax)
  • Dopamine Metabolism Inhibitor- Selegeline
    (Eldepryl)
88
Q

Anticholinergics

commonly used

A
  • Trihexyphenidyl- Artane
  • Benztropine- Cogentin
  • Biperidine- Akineton
  • Diphenylhydramine- Benadryl
  • Ethopropazine- Parsidol
89
Q

New Treatment for Alzheimer’s Disease

90
Q

1st drug to treat mild to moderate Dementia. It prevents or slows the breakdown of acetylcholine by inhibiting the action of the metabolizing enzyme acetylcholinesterase

A

Tacrine (Cognex)- 10mg QID

91
Q

An excess or loss of acetylcholine is thought
to cause the memory problems associated
with ___.

A

Alzheimer’s Disease

92
Q
  • med for schizophrenia
  • be aware of photosensitivity
A

Chlorpromazine or Thioridazine

93
Q
  • DO NOT GIVE!
  • chicken liver
  • rice w/ gravy
  • ice cream
A

MAOIs medication

94
Q

if there is toxicity give BIPERIDEN 2 mg (NMS)

A

Haloperidol (Haldol)

95
Q
  • useful in preventing mania during episodes of acute mania
  • NM: Monitor platelet count& WBC
A

Carbamazepine

96
Q
  • Valporic Acid to increase GABA
  • V-vomiting
  • A-alopecia
  • L-liver toxicity
  • P-pancreatitis
  • R-retention of fats
  • O-oedema, (edema)
  • A-appetite
  • T-tremor
  • E-enzyme inducer
A

Anticonvulsant

Prelims (7 decks)

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