Psychiatric Key Concepts Flashcards
Briefly describe anxiety as a disorder
Apprehension, nervousness, tension that occurs when one perceives a situation to be threatening to one’s physical, emotional, social, or economic well being. Includes phobias, panic, OCD and PTSD.
What classification of medications is used to treat anxiety, What family of drugs specifically
Benzodiazepines
AM family
What is the antidote to benzodiazepines
Flumazenil
What is a medication commonly used to treat general anxiety disorder?
Buspirone
Acts on serotonin instead of GABA, anxyolitic without CNS depresssion, less sedation and dependance than benzos
Lithium Key facts
Therapeutic Level
Acute Mania 1-1.5
Long term maintenance 0.6-1.2
-Do not start med if unable to monitor level
-used in bipolar patients/treat mania
-action:alters levels of neurotransmitters in the brain resulting in control of manic behavior
-ADR:slowed reflexes and reaction time, urinary frequency, lithium toxicity
Decreased Sodium = increased lithium
increased sodium=decreased lithium
NSAID AND DIURETICS increase lithium levels because they can damage the kidneys
What other types of medications can treat mood disorders
-Valproates - disadvantage of higher incidence of suicide than with lithium advantage of not needing frequent monitoring, may be used in combo with lithium. ex: divalproex, valproic acid.
-atypical antipsychotics - ex: aripiprazole, brexpriazole
- patients with bipolar may also be on antidepressant
-should not be monotherapy, monitor it does not result in increased mania
What is EPS?
-Extrapyramidal Symptoms
-Impaired motor function, muscle rigidity, drooling, involuntary muscle movements
-EPS TREATMENT: DIPHENHYDRAMINE OR BENZTROPINE @ BEDTIME
What are the main classes of antidepressants?
TCA, MAOI, SSRI, SNRI
BLACK BOX WARNING: SUICIDAL THOUGHTS AND BEHAVIORS
TCA key facts
TRICYCLIC ANTIDEPRESSANTS
-correct the imbalance in concentrations of neurotransmitters, serotonin and norepi
ADR: orthostatic hypotension, arrhythmias, anti-cholinergic effects of dry mouth, urinary retention, constipation
-CAN BE TOXIC IF OVERDOSE DUE TO ADVERSE CARDIAC EFFECTS
ex: amitriptyline, imipramine
MAOI key facts
MONOAMINE OXIDASE INHIBITORS
-block monoamine oxidase which is what normally inactivates catecholamines: “block the blocker”, end result is norepi levels
-ex: tranylcypromine, phenelzine
-LIFE THREATENING HYPERTENSIVE CRISIS IF TAKEN CONCURRENTLY WITH TYRAMINE CONTAINING FOODS (AGED OR SMOKED MEATS, CHEESE, RED WINE)
SSRI key facts
SELECTIVE SEROTONIN REUPTAKE INHIBITOR
-most commonly used today
-blocks uptake of serotonin back into synaptic cells, resulting in more free serotonin for activity
-ex: fluoxetine, paroxetine, sertraline
SNRI key facts
SEROTONIN/NOREPINEPHRINE REUPTAKE INHIBITOR
-end result of more NE, more dopamine, depending on drug
-can increase BP
-Ex: vanlafaxine, desvenlafaxine,duloxetine
all antidepressants key facts
-usually 4-6 weeks before desired effect is achieved
-most antidepressants can’t be taken within 2 weeks of MAOI therapy
-monitor VS, provide safety measures including suicide precautions
-risk of suicide is greatest once patient is energetic again
-dont stop meds abruptly
What is Serotonin Syndrome? What are the classic signs and symptoms?
A serious drug reaction, a condition primarily of hyperactivity, too much serotonin in the body
-occurs in individuals taking high levels of one or a DDI with more than one drug ex: ssri + tramadol for pain
-S&S: agitation, hyper reflexia, fever, diaphoresis, tachycardia, seizures, death
What are typical antipsychotic medications? what are the main considerations for medications like these? list examples of medications
-PHENOTHIAZINES (3 SUBCLASSES) end in “zine”
-chlorpromazine (thorazine) drug commonly used for “take down” OLDEST rarely used anymore
