Psychiatric Med review

Question 1

What causes agranulocytosis

Answer 1

Clozapine

Question 2

What are the early signs of agranulocytosis?

Answer 2

Fever, Sore throat, Mouth sores

Question 3

What is a rare but potentially life-threatening condition characterized by a severe reduction of WBC

Answer 3

Agranulocytosis

Question 4

What is the nursing intervention for agranulocytosis

Answer 4

-Monitor CBC with differential regularly
-Obtain baseline CBC before starting medication
-Assess for signs of infection

Question 5

When do we discontinue clozapine

Answer 5

-If absolute neutrophil count(ANC) is less than 1500/mm3 or shows signs of agranulocytosis discontinue and notify the provider immediately.

Question 6

What is clozapine best used for

Answer 6

Schizophrenia

Question 7

What is EPS

Answer 7

A group of movement disorders than can occur as side effects of antipsychotic medications especially the TYPICAL HIGH-POTENCY ones such as haloperidol

Question 8

What are the early symptoms of EPS

Answer 8

-Restlessness
-Muscle rigidity
-Tremors

Question 9

What are the symptoms of EPS

Answer 9

-Acute dystonia-rapid onset of muscle spasm(treat with Benadryl)
-Akathisia-feeling of inner restlessness
-Parkinsonism-set of symptoms that resembles Parkinson’s disease

Question 10

What causes EPS

Answer 10

Antipsychotic medications(1st gen)

Question 11

What are the nursing interventions for EPS

Answer 11

-Assess for early symptoms
-Monitor vitals and respiratory status
-Administer anticholinergic meds and benzodiazepines as ordered
-Implement fall precautions

Question 12

what is Tardive Dyskinesia

Answer 12

A movement disorder that can occur as a side effect of long-term use of antipsychotic meds, especially TYPICAL HIGH-POTENCY ones such as haloperidol

Question 13

What are the early symptoms of Tardive Dyskinesia

Answer 13

-Involuntary movements of tongue, lips, and jaw
-May progress to involve the limbs and trunk

Question 14

What causes Tardive Dyskinesia

Answer 14

Long term use of antipsychotic meds

Question 15

What are the nursing interventions for Tardive Dyskinesia

Answer 15

-Assess for early symptoms using AIMS
-Monitor vitals and respiratory status
-Evaluate medication regimen regularly
-Consider switching to a lower potency antipsychotic med
-DC med if Tardive Dyskinesia develops

Question 16

What is Hepatotoxicity

Answer 16

Rare but serious adverse drug reactions can be caused by several classes of psychotropic medications(psychotropic -relating to drugs that affect a person’s mental state)

Question 17

What are the early signs of Hepatotocity

Answer 17

-Nausea
-Vomiting
-Abdominal pain
-Fatigue
-Jaundice

Question 18

What causes Hepatotoxicity

Answer 18

-Mood stabilizers
-Antipsychotics
-Benzodiazepines

Question 19

What are the nursing interventions for Hepatotoxicity

Answer 19

-Monitor liver function tests(LFTs)
-Obtain baseline LFTs before stating med
-Educate pt about signs and symptoms of hepatotoxicity
-Advise pt to avoid alcohol and other hepatoxic meds
-Report any symptoms to HCP immediately

Question 20

What is Neuroleptic Malignant Syndrome(NMS)

Answer 20

A rare bur potentially life-threatening condition that can occur as a side effect of antipsychotic meds especially HIGH-POTENCY ones such as haloperidol

Question 21

What are the early symptoms of NMS

Answer 21

-Fever
-Muscle rigidity
-Altered mental status
-Tachycardia

Question 22

What causes NMS

Answer 22

Antipsychotic meds

Question 23

What are the nursing interventions of NMS

Answer 23

-Monitor Vital signs and respiratory status
-Implement cooling measures
-Administer muscle relaxants, anticholinergics, and benzodiazepines as ordered
-Provide emotional support and reassurance
-Discontinue medication

Question 24

What is a Serotonin Syndrome

Answer 24

A rare but potentially life-threatening condition that can be caused by several classes of psychotropic meds

Question 25

What are the early signs of Serotonin Syndrome

Answer 25

-Agitation -Confusion -Tachycardia -Hyperthermia -Diaphoresis -Myoclonus(a quick jerking movement that you can't control) -Shivering

Question 26

What causes Serotonin Syndrome

Answer 26

-Antidepressants -Atypical antipsychotics -Certain Opioids( tramadol, and meperidine- because they increase serotonin) -Migraine meds(triptans)

Question 27

What are the nursing interventions for Serotonin syndrome

Answer 27

-Monitor Vital signs and respiratory status -Implement cooling measures -Administer serotonin-blocking meds, benzodiazepines, and supportive measures as ordered -Educate pt about the importance of not taking multiple serotonergic meds or supplements -Monitor pt at least 24hr after discontinuing serotonergic meds -Discontinue the medication

Question 28

What is Stevens-Johnson Syndrome

Answer 28

A rare but potentially life-threatening condition that can be caused by anticonvulsant medications such as lamotrigine.

Question 29

What are the early signs of Steven-Johnsons Syndrome

Answer 29

-Flu-like symptoms -Rash -Blistering -Mucous membrane involvement

Question 30

What causes Steven-Johnsons syndrome

Answer 30

Mood stabilizers(Lamotrigine, carbamazepine)

Question 31

What are the nursing interventions for Steven-Johnsons syndrome

Answer 31

-Obtain baseline skin and eye exams before starting the med -Monitor patients for signs and symptoms of rash or blistering -Educate pt about signs and symptoms of stevens-johnson syndrome -Discontinue med and notify the provider immediately if symptoms occur

Question 32

What medications treat depression

Answer 32

ANTIDEPRESSANTS **MAOIS-** Phenelzine, tranylcypromine **Tricyclics**-amitriptyline, nortriptyline, imipramine **SSRI-**fluoxetine, sertraline, escitalopram **SNRI**-Venlafaxine, duloxetine, desvenlafaxine

Question 33

Which antidepressants treat anxiety disorder

Answer 33

ALL Anti-depressants except MAOIs

Question 34

What causes Tyramine sensitivity, hypertensive crisis, serotonin syndrome

Answer 34

Antidepressants(MAOIs)

Question 35

What causes Anticholinergic effects, cardiotoxicity, and lethal overdose

Answer 35

Antidepressants(Tricyclics)

Question 36

What causes serotonin syndrome, sexual dysfunction, suicidality

Answer 36

Antidepressants(SSRI)

Question 37

What causes discontinuation syndrome, serotonin syndrome, and HTN

Answer 37

Antidepressants(SNRIs)

Question 38

What do Benzodiazepines(-Zepam and Zolam) treat

Answer 38

-Anxiety disorders -Insomnia -Alcohol withdrawal

Question 39

What do NON-Benzodiazepines HYPNOTICS(Zolipidem, eszopiclone, zaleplon) treat

Answer 39

Insomnia

Question 40

What are the common side effects of Benzodiazepines and NON-Benzodiazepines

Answer 40

-Dependence -Sedation -Drug interactions Only difference is benzos have withdrawal as side effect

Question 41

What do mood stabilizers(Lithium, lamotrigine and carbamazepine) treat

Answer 41

Bipolar disorder

Question 42

What the signs of lithium toxicity

Answer 42

Avoiding Dehydration, Sodium intake Thyroid monitoring

Question 43

What does lamotrigine cause

Answer 43

steven jonsons syndrome

Question 44

What do **TYPICAL Antipsychotics**(chlopramazine,haloperidol,fluphenazine) treat

Answer 44

Schizophrenia Manic episodes Aggression

Question 45

What causes EPS, Tardive Dyskenesia, NMS

Answer 45

Typical Antipsychotics **Chlorpromazine Haloperidol Fluphenazine**

Question 46

What does ATYPICAL Antipsychotics (Aripiprazole, clozapine, risperidone) treat

Answer 46

Schizophrenia Bipolar disorder Depression Tourettes syndrome Autism

Question 47

What causes Metabolic effects, NMS, agranulocytosis(clozipine)

Answer 47

ATYPICAL Antipsychotics **Aripiprazole Clozapine Risperidone**

Question 48

What do CNS stimulants(methylphenidate, amphetamine, dextroamphetamine) treat

Answer 48

ADHD Narcolepsy

Question 49

What causes abuse potential, anorexia/WL, Insomnia

Answer 49

CNS stimulant **-Methylphenidate -Amphetamine -Dextroamphetamine**