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Pharmacology for Advanced Practice Nurses > Psych > Flashcards

Psych Flashcards

1
Q

5 classes of psychotropics

A 
Antidepressants
• Stimulants
• Mood Stabilizers
• Anxiolytics and Hypnotics
• Antipsychotics (Neuroleptics)
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2
Q

Classes of Antidepressants

A 
Tricyclic antidepressants
Monoamline oxidase inhibitors
SSRI
SNRI
Atypical Antidepressants
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3
Q

Tricyclic antidepressants (TCAs) MOA

A

prevent the reuptake of both norepinephrine and

serotonin (5-HT) into presynaptic nerve terminals

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4
Q

Monoamine oxidase inhibitors (MAOIs) MOA

A

block the action of monoamine oxidase, an
enzyme that breaks down neurotransmitters inside the presynaptic nerve terminals. In other
words, MAOIs slow the destruction of norepinephrine, dopamine, and serotonin, increasing
the levels of these neurotransmitters in the brain.

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5
Q

SSRI MOA

A

prevent the reuptake of serotonin into

presynaptic nerve terminals.

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6
Q

SNRI MOA

A

prevent the reuptake of

serotonin and norepinephrine into presynaptic nerve terminals.

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7
Q

TCA Disadvantages

A

– Action on histamine and Ach
– Orthostatic hypotension
– Cardiac effects
– Potential death via overdose

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8
Q

5-HT

A

5-hydroxtryptamaine

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9
Q

TCA used in

A

Migraine prevention, sleep, depression, and chronic pain

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10
Q

TCA consideration

A

taper off if they have been on long term to prevent symptoms of withdrawal or relapse of depression

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11
Q

TCA side effects

A

anticholinergic side effects due to histamine and Ach action.

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12
Q

TCA is a bad option

A

for people with active SI due to risk for overdose.

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13
Q

MAOI disadvantages

A

Hypertensive crisis/Tyramine
– Drug interactions
– Orthostatic hypotension
– Serotonin syndrome

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14
Q

MAOI are not used

A

1st, 2nd or 3rd line. Used for treatment resistant or refractory depression

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15
Q

MAOI interact with

A

virtually everything

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16
Q

foods that contain tyramine

A

aged foods, like processed meats, beef or chicken liver,, yogurt, peperoni, bologna, sour cream, bananas, raisons, soy sauce, beer, whine, yeast, chocolate.

CAN LEAD TO A HYPERTENSIVE CRISIS

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17
Q

If tyramine in foods isn’t enough then MAOI

A

cause cause orthostatic hypotension and possibly serotonin syndrome

18
Q

Serotonin helps regulate

A

perceive pain,
sleep (cycling between non REM and REM), emotional states, mood,
anxiety

19
Q

SSRI disadvantages

A

GI side effects
– Sexual dysfunction
– Take time to work

20
Q

SSRI GI effects are

A

transient and go away in a week or two

21
Q

SSRI receptors are mostly found in our

A

Gut. 90 to 95%

22
Q

SSRI sexual dsyfunction

A

sexual dysfunction tends to not go away

23
Q

SSRI time it takes to work

A

4 to 6 weeks

24
Q

SSRI benefits

A

cheap and low toxicity

25
Q

SNRI may have more

A

benefit for lethargic, fatigue-based symptoms

26
Q

SNRI and SSRI not all

A

not all are created equally. Depending on the brand it may have a greater affinity for one neurotransmitter over another. As an example sertraline as a greater effect for dopamine then others. It can also be impacted by dose. An example of this would be effexor that has a greater impact on serotonin at lower doses and will not have an impact on norepi until you reach higher dosese

27
Q

SNRI used

A

anxiety, depression, panic, chronic pain

28
Q

SNRI side effects

A

headache, GI, insomnia, sexual side effects,

dose dependent increased BP`

29
Q

Atypical Antidepressants include

A

NDRI and others

30
Q

NDRI example

A

bupropion (wellbutrin, Zyban)

31
Q

NDRI lowers

A

seizure threshold/ alcohol

32
Q

Bupropion does not cause

A

weight gain or sexual dysfunction, which

makes it an appealing option for some clients

33
Q

off-lable use of NDRI

A

ADHD, chronic fatigue, medication induced sexual

dysfunction

34
Q

Mirtazapine, trazodone benefits

A

Faster onset than SSRIs

– Lower incidence of sexual SE

35
Q

mirtazapine, trazadone SE

A

Sedation, weight gain

36
Q

Zyban is used for

A

smoking cessation

37
Q

Be mindful of what with bupropion

A

people who use ETOH or have a seizure disorder, because it can lower the threshold and make it easier to have a seizure

38
Q

histamine contributes to

A

sedation and weight gain

39
Q

Serotonin syndrome

A

Too much serotonin in the synaptic

cleft

40
Q

signs of serotonin syndrome

A 
Tremor, myoclonus, altered
mental status
• Agitation, diarrhea, fever,
diaphoresis
• Hyperreflexia, delirium, coma,
death
41
Q

serotonin syndrome can develop within

A

several hours

42
Q

treatment of serotonin syndrome

A

stop taking and and use supportive measures

Pharmacology for Advanced Practice Nurses (50 decks)

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