Psych Deck 2 Flashcards
Stimulants are the most
typically prescribed drugs for the treatment of ADHD
Stimulant MOA
block reuptake of NE and DA
Stimulant Adverse Effects
Activating/Agitating
– Cardiac issues
– Appetite Suppressant
Stimulant formulations can be
short acting or extended release
Risks for stimulatns
misuse/abuse
stimulants are also used for
narcolepsy, neurobehavioral symptoms after TBI, Elderly for fatigue like depression, weight loss, cognitive impairment who have HIV infection
Stimulants’ are
controlled substances
stimulants do what
increase motor active, focus, attention, and elevation of the persons food.
simulant side effects
irritability, insomnia, dizznies, palpatations, euphoria, weight loss, sudden death, depdendece and psychosis.
stimulant contraindications
diabetes, hyperthyroidism, hypertension, issues with aggression, bipolar disorder, psychosis, terets disoroder
Ticks
can be unmasked by stimulant disorders
If you have been on a stimulant for a long time
do not abruptly stop or you will experience withdrawal
Stimulant two types
Methylphenidate Products
Amphetamine Salt Products
Methylphenidate (d) Formulations examples
Focalin, Focalin XR
Methylphenidate (d,l) Formulations examples
Ritalin IR and ER, Metadate,
Concerta, QuilliChew, Aptensio,
Quillivant, Daytrana, etc.
Amphetamine Mixed Salts (d,l)
Formulations
Adderall IR and XR, Adzenys XR
ODT, Mydayis, Dyanavel XR
Dextroamphetamine (d)
Formulations (amphetamine salt)
Dexedrine, ProCentra, Zenzedi
Lisdexamfetamine (amphetamine salt)
Vyvanse
the d-isomer is more potent for
dopamine
transporter (DAT) binding, both d- and l- isomers
are equally potent for NE (NET) transporter
binding.
d-amphetamine will have more action on
DAT
than NET
Mood stabilizer drug class
Lithium
– Antiseizure Drugs
– Atypical Antipsychotics
mood stabilizers used in
bipolar disorder, impulsivity, aggression, depression, anxiety, mood liability, chronic pain, pszhoeffecive disorder
gold standard for bipolar
lithium
lithium long term use can
damage thyroid and kidneys
lithium MOA
Competes with sodium to enter cell- acts like sodium in the body • Cholinergic and GABA activity, dopamine receptor sensitivity, serotonergic activity, inhibits second messenger system
lithium blood levels
Blood levels: 0.6-1.5 mEq/L
lithium baseline labs
levels of renal, cardiac,
thyroid, and electrolytes.
Lithium can lead to
neuroprotective actions and
long-term plasticity in the brain
Monitor what with lithium
sodium levels, when
sodium is lost (dehydration,
excessive sweating, etc.)
lithium toxicity S/S
(ataxia, slurred
speech, tremor, N/V, tinnitus,
blurred vision)
Lithium overdose treated with
hemodialysis and supportive
care.
Lithium levels above ___ cause ___
Levels above 2.5 mEq/L can
cause coma, seizure, and death.
Things that effect lithium level
dehydration, excessive sweating, illness, AKI. Anything that effects fluid an electrolyte imbalance.
If there is a change in a lithium level we want to know
what caused that change
Lithium is excreated through
the kidneys
Lithium can lead to
long term palcicity and protective actions in the brain when treated early.
Lithium patient education
limit ETOH and caffene, avoid tasks requirein coodination, may cause dry mouth, maintain steady salt, fluid intake, report vomiting, diarrhea, muscle weakness, tremors, drowsiness, ataxia, monitor levels
Aticonvulsants
Carbamazepines
– Drugs that affect GABA: gabapentin, topiramate, lamotrigine
– Valproic Acid
REVIEW THESE FROM MODULE FOUR
First line treatment for anxiety and second line
CBT then antidepressants
Benzodiazepines work by
increasing GABA
Benzodiazepines work
really well for anxiety
You can ____ from benzo withdrawal
die
Benzodiazapines ADR
withdrawal, dizziness, fall risk in elderly, cognitive effects long term
serotonergic Anxiolytic example
buspirone
Buspirone works by
increasing serotonin
buspirone is used on
a daily prescirbed basis as an adjuct to an SSRI
Barbituates
short and log acting formulations. Work on GABA in a different way than benzo, CNS depressants. Risk for tolerance, dependence and overdose.
Sedative hypnotics
Nonbenzodiazepine Hypnotic
GABA non-benzodiazepine receptor examples
(zolpidem (Ambien), zaleplon (Sonata),
eszopiclone (Lunesta)
melatonin receptor agonist example
(ramelteon
Rozerum
Orexin receptor antagonist example
Orexin receptor antagonist