Psych Drug Names And Classes

Question 0

What is the action of Imipramine (Tofranil)?

Answer 0

Blocks reuptake of norepinephrine and serotonin.

Question 1

Tricyclics

Answer 1

Imipramine (Tofranil)

Question 2

What are adverse effects of Imipramine (Tofranil)?

Answer 2

Orthostatic hypotension
Anticholinergic effects
Sedation
Tachycardia
Seizures
Hypomania
Confusion

Question 3

What is patient teaching for imipramine (Tofranil)?

Answer 3

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

Question 4

Things to report: imipramine (Tofranil)

Answer 4

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

Question 5

Monoamine oxidase inhibitors (MAOIs)

Action

Answer 5

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

Question 6

MAOIs

Answer 6

Phenelzine (Nardil)

Question 7

What happens when pt taking MAOI eats tyramine?

Answer 7

Hypertensive crisis from increase in NE.

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

Question 8

Foods containing tyramine

Answer 8

Aged cheese, red wine

Smoked/pickled/fermented meat, fish, poultry

Question 9

Patient teaching with MAOIs

Answer 9

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

Question 10

Selective serotonin reuptake inhibitors (SSRIs)

Action

Answer 10

Selective inhibition of serotonin reuptake

Question 11

SSRI uses

Answer 11

Depression, hot flashes, anxiety disorders

Question 12

SSRI pharmacokinetics

Answer 12

Half life=7 days.

Takes 4 weeks to achieve steady plasma level

Question 13

SSRI common adverse effects.

Answer 13

Nausea, ha, fatigue, insomnia, anxiety.

Decreased libido, anorgasmia, delayed ejaculation.

Question 14

SSRI example

Answer 14

Sertraline (Zoloft)

Question 15

What is serotonin syndrome?

Answer 15

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

Question 16

SNRIs- serotonin norepinephrine selective reuptake inhibitors.
Examples

Answer 16

Mirtazapine (remeron)

Buproprion (Wellbutrin)

Question 17

SNRI action

Answer 17

Potentiate effects of both serotonin and norepinephrine

Question 18

SNRI side effects

Answer 18

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

Question 19

SNRI nursing implications

Answer 19

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.

Question 20

St. John’s wort

Answer 20

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

Question 21

Anti-manic drugs

Answer 21

Lithium carbonate (eskalith)
Valproic acid (depakote)
Gabapentin (neurontin)

Question 22

Uses for anti-manic drugs

Answer 22

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

Question 23

Lithium carbonate

Action

Answer 23

Alters sodium transport in nerve cells.

Affects metabolism of NE, DA, S

Question 24

Lithium carbonate side effects

Answer 24

Fine hand tremor, h/a, lethargy, drowsiness, dizziness. | Cholinergic effects, v/d, polyuria, hypotension, weight gain or anorexia.

Question 25

Lithium carbonate- narrow therapeutic window

Answer 25

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.

Question 26

What is severe lithium toxicity?

Answer 26

2.0-2.5 mEq/L | Ataxia, giddiness, very dilute urine, serious EKG changes, hypotension, seizures and possible death.

Question 27

Lithium nursing implications

Answer 27

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

Question 28

Lithium pt. teaching

Answer 28

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