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NP Adv Pharm_S21 > Psych Deck 2 > Flashcards

Psych Deck 2 Flashcards

1
Q

Stimulant MOA

A

block reuptake of NE and DA

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2
Q

Stimulants Indications

A

ADD/ADHD
Narcolepsy
Fatigue, depression (palliative care setting)

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3
Q

Stimulant Adverse effects

A 
Anorexia, weight loss, appetite suppression
Sleep disturbance
Jitteriness
Emotional lability
Increased pulse and BP
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4
Q

Stimulant contraindications

A

diabetes, hyperthyroidism, hypertension, issues with aggression, bipolar disorder, psychosis

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5
Q

Non-stimulant alternative for ADHD

A

atomoxetine (Strattera)
Selective norepinepherine reuptake inhibitor
Not a controlled substance

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6
Q

Commonly used stimulants

A 
Methylphenidate (Ritalin, Concerta)
Dexmethylphenidate (Focalin)
Amphetamines
Dextroamphetamine (Dexedrine)
Dextroamphetamine-amphetamine (Adderall)
Lisdexamfetamine (Vyvanse)
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7
Q

Mood stabilizer drug class

A

Lithium
– Antiseizure Drugs
– Atypical Antipsychotics

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8
Q

mood stabilizers used in

A

bipolar disorder, impulsivity, aggression, depression, anxiety, mood liability, chronic pain, pszhoeffecive disorder

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9
Q

lithium long term use can

A

damage thyroid and kidneys

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10
Q

lithium MOA

A 
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
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11
Q

lithium blood levels

A

Blood levels: 0.6-1.5 mEq/L

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12
Q

lithium baseline labs

A

levels of renal, cardiac,

thyroid, and electrolytes.

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13
Q

Lithium can lead to

A

neuroprotective actions and

long-term plasticity in the brain

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14
Q

Monitor what with lithium

A

sodium levels, when
sodium is lost (dehydration,
excessive sweating, etc.)

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15
Q

lithium toxicity S/S

A

(ataxia, slurred
speech, tremor, N/V, tinnitus,
blurred vision)

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16
Q

Lithium overdose treated with

A

hemodialysis and supportive

care.

17
Q

Lithium levels above ___ cause ___

A

Levels above 2.5 mEq/L can

cause coma, seizure, and death.

18
Q

Things that effect lithium level

A

dehydration, excessive sweating, illness, AKI. Anything that effects fluid an electrolyte imbalance.

19
Q

If there is a change in a lithium level we want to know

A

what caused that change

20
Q

Lithium is excreated through

A

the kidneys

21
Q

Lithium can lead to

A

long term palcicity and protective actions in the brain when treated early.

22
Q

Lithium patient education

A

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

23
Q

Aticonvulsants

A

Carbamazepines
– Drugs that affect GABA: gabapentin, topiramate, lamotrigine
– Valproic Acid

REVIEW THESE FROM MODULE FOUR

24
Q

Benzodiazepines MOA

A

enhancing the effect of GABA

25
Q

Benzodiazapines ADR

A

withdrawal, dizziness, fall risk in elderly, cognitive effects long term

26
Q

Common Benzodiazepine Uses

A 
Insomnia
Induce relaxation and loss of memory of medical procedures or surgery
Reduce anxiety (anxiolytic)
Panic disorders
Treat or prevent seizures
Alcohol withdrawal treatment
Muscle relaxant
27
Q

Benzo black box warning

A

2016 - avoid use with opioids

28
Q

Non-benzodiazepine hypnotic examples

A

(zolpidem (Ambien), zaleplon (Sonata),
eszopiclone (Lunesta)
controlled substances - can cause withdrawal if stopped abruptly

29
Q

ramelteon (Rozerem) MOA

A

melatonin receptor agonist

not a controlled substance

30
Q

Benzo with highest addiction potential and why?

A

Alprazolam - shortest half life (6-12 hours)

31
Q

Non-benzodiazepine hypnotic side effects

A

headache, dizziness, somnolence, nausea, mild transient anterograde amnesia
abnormal behaviors such as sleep driving, worsening depression

32
Q

Zolpidem dosing for women/older adults vs men

A

Women/older adults max 5mg, men 10mg

33
Q

Nonbenzodiazepine hypnotics patient education

A

take immediately before bed time
Get at least 6 hours of sleep
Use caution/avoid driving, heavy machinery
Do not combine with other sleep aides, alcohol

NP Adv Pharm_S21 (25 decks)

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