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Pharmacology > Psych Drug Names And Classes > Flashcards

Psych Drug Names And Classes Flashcards

0
Q

What is the action of Imipramine (Tofranil)?

A

Blocks reuptake of norepinephrine and serotonin.

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1
Q

Tricyclics

A

Imipramine (Tofranil)

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2
Q

What are adverse effects of Imipramine (Tofranil)?

A 
Orthostatic hypotension
Anticholinergic effects
Sedation
Tachycardia
Seizures
Hypomania
Confusion
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3
Q

What is patient teaching for imipramine (Tofranil)?

A 
Change positions slowly
Increase fluids and fiber
Tips for dry mouth
Effects take 1-3 weeks
Don't stop drug suddenly
Drowsiness may occur
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4
Q

Things to report: imipramine (Tofranil)

A

Report palpitations, urinary retention, blurred vision.
Do not drink alcohol or use other cns depressants
Family: report worsening depression, suicidal thoughts.
Confusion, hypomania

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5
Q

Monoamine oxidase inhibitors (MAOIs)

Action

A

Monoamine oxidase converts NE, S, and DA into inactive products. Also inactivates tyramine found in many foods.

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6
Q

MAOIs

A

Phenelzine (Nardil)

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7
Q

What happens when pt taking MAOI eats tyramine?

A

Hypertensive crisis from increase in NE.

Causes vasoconstriction, n/v, ha, increase p and bp

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8
Q

Foods containing tyramine

A

Aged cheese, red wine

Smoked/pickled/fermented meat, fish, poultry

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9
Q

Patient teaching with MAOIs

A 
Avoid vasopressors (amphetamines, epinephrine, caffeine)
Drug interactions: tricyclics or SSRI antidepressants.
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10
Q

Selective serotonin reuptake inhibitors (SSRIs)

Action

A

Selective inhibition of serotonin reuptake

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11
Q

SSRI uses

A

Depression, hot flashes, anxiety disorders

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12
Q

SSRI pharmacokinetics

A

Half life=7 days.

Takes 4 weeks to achieve steady plasma level

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13
Q

SSRI common adverse effects.

A

Nausea, ha, fatigue, insomnia, anxiety.

Decreased libido, anorgasmia, delayed ejaculation.

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14
Q

SSRI example

A

Sertraline (Zoloft)

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15
Q

What is serotonin syndrome?

A

Too much serotonin in the cns.
Causes disorientation, confusion, agitation, mania
Rigidity, ataxia, hyperactivity, hyperreflexia.
Shivering, hyperthermia, hypertension, tachycardia, diaphoresis

16
Q

SNRIs- serotonin norepinephrine selective reuptake inhibitors.
Examples

A

Mirtazapine (remeron)

Buproprion (Wellbutrin)

17
Q

SNRI action

A

Potentiate effects of both serotonin and norepinephrine

18
Q

SNRI side effects

A

Similar to SSRI
Nausea, ha, fatigue, insomnia, anxiety
Decreased libido, anorgasmia, delayed ejaculation
Buproprion-no weight gain, decreased sexual effects.

19
Q

SNRI nursing implications

A

Assess for suicidal ideation
Teach length of time needed to see improvement.
Keep taking meds 6-12 months to prevent relapse
Asians and Hispanics need smaller doses than Caucasians
Do not stop abruptly.

20
Q

St. John’s wort

A

Perennial herb used to treat depression
Leaves and flowers can be brewed as tea.
No well established doses.
May inhibit production of MAO
Increases mood, promotes sleep
Adverse effects: GI symptoms, allergic reaction, fatigue

21
Q

Anti-manic drugs

A 
Lithium carbonate (eskalith)
Valproic acid (depakote)
Gabapentin (neurontin)
22
Q

Uses for anti-manic drugs

A

Mania associated with bipolar illness
Recurrent major depressive disorder
Schizoaffective disorder
Long term prophylaxis.

23
Q

Lithium carbonate

Action

A

Alters sodium transport in nerve cells.

Affects metabolism of NE, DA, S

24
Q

Lithium carbonate side effects

A

Fine hand tremor, h/a, lethargy, drowsiness, dizziness.

Cholinergic effects, v/d, polyuria, hypotension, weight gain or anorexia.

25
Q

Lithium carbonate- narrow therapeutic window

A

Toxic side effects
Mild: <1.5 mEq/L
N/v/d, polyuria, hand tremors, slurred speech and muscle weakness.
Moderate: 1.5-2 mEq/L
Persistent GI upset, course hand tremor, confusion, lack of coordination, sedation, EKG changes.

26
Q

What is severe lithium toxicity?

A

2.0-2.5 mEq/L

Ataxia, giddiness, very dilute urine, serious EKG changes, hypotension, seizures and possible death.

27
Q

Lithium nursing implications

A

Monitor blood levels
0.6-1.2 maintenance range.
Look for clinical signs of toxicity
Monitor kidney/thyroid function and electrolytes.
Contraindicated in 1st trimester of pregnancy

28
Q

Lithium pt. teaching

A 
Take as prescribed 
Importance of monitoring blood levels-keep appointments. 
Maintain adequate fluid intake
Maintain adequate sodium intake
Take with meals.

Pharmacology (1 decks)

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