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PHARMACOLOGY > Psych Drugs > Flashcards

Psych Drugs Flashcards

1
Q

What is the most serious adverse effect of tricyclic antidepressant (TCA) overdose is..

A

Cardiac arrhythmias

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2
Q

the nurse is caring for a client who intentionally overdosed on amitriptyline. What action should the nurse prioritize?

A

Obtain a 12 lead electrocardiogram

It is a TCA, has cardiac effects

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3
Q

What to watch oout for with TCAs

What is it for

A

Tachycardia, Cardiac effects (arrhythmias, prolonged QT interval), anticholinergic effects, sedation/sexual dysfunctions)

TCAs are for depression, prevents re-uptake of norepinephrine and serotonin)

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4
Q

What are MAOs

A

Isocarboxazid, phenelzine

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5
Q

What are nursing considerations with MAOIs

A
  1. Avoid foods that are high in tyramine (ages cheeses, wine, pickled meats)
  2. Side effect - hypertensive crisis
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6
Q

What are mood stabilizers

A

LITHIUM

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7
Q

Indication of manic phase

A

Lithium

Caalm down transmitters, promote GABA(calming)

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8
Q

Nsg consideration with lithium

A

***do not administer NSAIDs

Encourange fluid intake

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9
Q

What is the therapeutic level of lithium

What are signs of toxicity?

A

0.6-1.2 mEq/L

Seizures, arrhythmias, fatigue, confusion, nausea, anorexia, hypothyroidism, tremors

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10
Q

What are antipsychotics?

First gen? 2nd gen?

A

1st gen: haloperidol

2nd gen: quetiapine, olanzapine

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11
Q

Nsg considerations with HALOPERIDOL

What does it do

A

Extrapyramidal effects(grimacing),
tardive dyskinesia,
neuroleptic malignant syndrome(high fever** can cause organ damage),
prolong QT interval (grab weekly ECG- can go into TOursaudds ),
contraindicated in pregnancy

It inhibits the effects for dopamine to treat Schizom mania, aggressive behaviour, agitation

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12
Q

action of haloperidol

For what

A

Inhibits effects of dapamine

Indicated to treat Schizo, mania, aggressive behaviour, agitation

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13
Q

Diphenhydramine

Indicate?
Action?
Nsg consideration?

A

Allergy,. Anaphylaxis, sedation

Anatagonizes effects

Drowsiness, anticholinergic effects

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14
Q

Short acting benzo

A

Midazolam

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15
Q

Long acting benzo

A

Diazepam

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16
Q

Benzo. Rapid IV, intermediate PO

A

Lorazepam

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17
Q

Therapeutic class: antianxiety agent

Indication: anxiety, sedation, seizures

Action: general CNS depression

Nursing Considerations:
● Avoid alcohol
● Monitor for respiratory depression
● Antidote - flumazenil

A

LORAZEPAM

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18
Q

What is the antidote for Lorazepam

A

Flumazenil

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19
Q

What classes are considered antidepressants?

A

● SSRIs
○ Fluoxetine
○ Sertraline
○ Escitalopram

● TCAs
○ Amitriptyline
○ Nortriptyline
○ Protriptyline

● MAOIs
○ Isocarboxazid
○ Phenelzine

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20
Q

Give 3 SSRIs

A

Fluoxetine, Sertraline, Escitalopram

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21
Q

Give 3 TCAs

A

Amitriptylone, Nortriptyline, Protriptyline

22
Q

What are MAOIs?

A

Isocarboxazid, Phenelzine

23
Q

Indication: Depression

Action: Prevent reuptake of serotonin increasing the availability of serotonin in the body.

Nursing Considerations:
● Monitor for serotonin syndrome
○ Hypertension, confusion, anxiety, tremors, ataxia, sweating.
● Suicide precautions important for 2-3 weeks
○ When the client’s mood starts to improve, they are are an inreased risk for suicide
○ Why? They now have the energy to follow through with a plan.

A

Selective Serotonin Reuptake Inhibitors - SSRIs

Examples: Fluoxetine, Sertraline, Escitalopram

24
Q

What are nursing considerations in taking SSRIs??? (Fluoxetine, Sertraline, Escitalopram)

A
  1. Monitor serotonin syndrome: htn, confusion, anxiety, tremors, ataxia, sweating
  2. Suicide precautions for 2-3 weeks: when he client’s mood starts to improve, they are an increased risk for suicide
25
Q

Give examples of SSRIs

A

Fluoxetine, Sertraline, Escitalopram

26
Q

Indication: Depression

Action: Prevents the reuptake of norepinephrine and serotonin increasing these transmitters in the body

Side effects: Tachycardia, Cardiac events (arrhythmias, prolonged DT interval), Anticholinergic effects, Sedation/Sexual dysfunction

A

Tricyclic Antidepressants - TCA’s

Examples: Amitriptyline, Nortriptyline, Protriptyline

27
Q

Give examples of Tricyclic Antidepressants - TCA’s

A

Amitriptyline, Nortriptyline, Protriptyline

28
Q

What are side effects of TCAs

A

Tachycardia
Cardiac arrhythmias (arrhythmias, prolonged QT interval)
Anticholinergic effects
Sedation/Sexual dysfunction

29
Q

What meds do we avoid foods that are high in tyramine (such as aged cheeses, wine, pickled meats)???

A

Monoamine Oxidase Inhibitors - MAOIs

Examples: isocarboxazid, phenelzine

30
Q

Indication: Depression

Action: blocks monoamine oxidase enzymes to increase the levels of ALL neurotransmitters ( dopamine, norepinephrine, epinephrine, serotonin)

Nursing Considerations:
● Avoid foods that are high in tyramine.
○ Aged cheeses ○ Wine ○ Pickled meats
● Side effect - hypertensive crisis

A

Monoamine Oxidase Inhibitors - MAOIs

Examples: isocarboxazid, phenelzine

31
Q

Mood Stabilizer

A

Lithium

32
Q

What is Lithium’s therapeutic level

A

0.6 - 1.2 mEq/L

33
Q

Indication: Mania

Action: Inhibits excitatory neurotransmitters such as dopamine and glutamate, and promotes GABA-mediated neurotransmission.

Nursing Considerations:
● Do not administer with NSAIDS
● Monitor drug levels:
○ Therapeutic level - 0.6-1.2 mEq/L
● Encourage adequate fluid intake
● Side effects:
○ Seizures, arrhythmias, fatigue, confusion, nausea, anorexia, hypothyroidism, tremors

A

LITHIUM

34
Q

What are Antipsychotics

A

● First generation
○ Haloperidol

● Second generation
○ Quetiapine
○ Olanzapine

35
Q

Indication: Schizophrenia, mania, aggressive behavior, agitation

Action: Inhibits the effects of dopamine

Nursing Considerations:
● Monitor for extrapyramidal side effects
● Tardive dyskinesia
● Neuroleptic malignant syndrome
● Can prolong the QT interval
○ Weekly EKG
● Contraindicated in pregnancy

A

Haloperidol
Therapeutic class: Antipsychotic

36
Q

What are nursing considerations for Haloperidol?

A

● Monitor for extrapyramidal side effects
● Tardive dyskinesia
● Neuroleptic malignant syndrome
● Can prolong the QT interval
○ Weekly EKG
● Contraindicated in pregnancy

37
Q

What are antihystamine examples

A

● Histamine-1 blocker → block H1 receptors in CNS - stopy allergies!
○ Diphenhydramine

● Histamine-2 blocker → block production of stomach acid!
○ Famotidine
○ Ranitidine

38
Q

Indication: Allergy, anaphylaxis, sedation

Action: Antagonizes effects of histamine, CNS depression

Nursing Considerations:
● Monitor for drowsiness
● Anticholinergic effects

A

Diphenhydramine
Therapeutic class: Antihistamine

39
Q

It is a mood stabilizer and antiepileptic
This mediction is indicated for bipolar disorder and epilepsy
Thos medication MAY adversely cause Steven-Johnson Syndrome (SJS), manifested by tender skin lesions that appear as blisters
This skin eruptions may also involve the eys and mouth.
Prompt treatment is necessary because of the risk os sepsis that may result from skin erosion.
These lesions often spread fast, underslying the necessety of prompt treatment. If this should occur, the offending agent should be withdrawn.

A

LAMOTRIGINE (antiepileptic, class: phenyltriazine)

40
Q

Seizure medication
Therapeutic level: 10-20
Toxic level: >20

A

DILANTIN (PHENYTOIN)

41
Q

Breakdown product of Red Bloos Cells
Always tested in the Newborns on the NCLEX
*In Newborns bilirubin is much higher than in adults
— elevated level: 10 to 20
— toxicity: > 20

A

Bilirubin

42
Q

When bilrubin is around _______ in newborn, consider hospitalization

A

14 - 15

43
Q

What to do when newborn bilirubin is 10 - 13

A

Can be Tx at home with sunlight, fluids

44
Q

Bilirubin in the brain

In the cerebral spinak fluid, meninges

A

Kernicterus

45
Q

Bilirubin in skin

A

Jaundice

46
Q

When level of bilirubin in blod gets >20, gets ________
In the brain, it may cause aseptic (steril) meningitis or encepalopathy
It can be deally

A

Kernicterus

47
Q

looks like possession in harry potter
• Position the newborn assume due to irritation of the meninges from kernicterus
• Presentation: hyperextended posture … (Is a medical emergency)

A

Opisthotonos

48
Q

In what position do you place an opisthotonic newborn?

A

Put newborn on the side

49
Q

It is a drug most commonly indicated for ADHD

A

Methylphenidate

50
Q

Is s serotonergic drug used in the treatment of depressive and anxiety disorders

A

Citalopram

51
Q

It is an anticonvulsant indicated for bipolar disorders as it has mood-stabilizing effect.

A

Carbamezrpine

52
Q

What class of medications causes neuroleptic malignant syndrome (NMS)?

What are signs of NMS?

A

Both typical and atypical antipsychotics

Typical: haloperidol, flupenazine, thiothixene, chlorpromazine
Atypical: Ziprasidone, olanzapine, clozapine, risperidone

NMS is a life threatening neurologic condition characterized by high fever, mental status change, dysautonomia, and muscle rigidity.

PHARMACOLOGY (12 decks)

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