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psychiatric medications Flashcards

1
Q

Isocarboxazid

A

Antidepressant-Monoamine Oxidase Inhibitor (MAOIs)

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2
Q

Phenelzine

A

Antidepressant-Monoamine Oxidase Inhibitor (MAOIs)

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3
Q

Selegiline transdermal

A

Antidepressant-Monoamine Oxidase Inhibitor (MAOIs)

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4
Q

Tranylcypromine

A

Antidepressant-Monoamine Oxidase Inhibitor (MAOIs)

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5
Q

MAOIs’Mechanism of Action

A

Work by blocking monoamine oxidase - the enzyme that breaks down dopamine, norepinephrine, and serotonin

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6
Q

MAOIs must avoid foods containing what?

A

Tyramine

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7
Q

Tyramine foods are-

A

old and stinky

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8
Q

MAOIs drug interactions to avoid

A

other drugs that increase dopamine, norepineephrine, and serotonin. Examples:
other antidepressants,
over-the-counter cold medications
Meperidine (a strong pain medication)
Triptans (migraine medications (serotonin 1B/1D blockers))

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9
Q

MAOIs adverse effects- 3 things

A
  1. Hypertensive crisis (excessive amounts of tyramine and/or norepinephren levels became too high)
  2. Serotonin Syndrome (excessive amounts of serotonin)- altered mental status, high fever, sweating, and clonus (muscle spasms)
  3. Orthostatic hypotension
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10
Q

Amitriptyline

A

Antidepressant- Tricyclic (TCAs)

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11
Q

Nortriptyline

A

Antidepressant- Tricyclic (TCAs)

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12
Q

MAOIs common uses

A

Major depression but not the first choice

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13
Q

TCAs common uses

A

Major depression, neuropathic pain (ex. diabetes), and anxiety disorders

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14
Q

TCAs mechanism of action

A

Work by blocking serotonin and norepinephrine reuptake pumps. Increases levels of both

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15
Q

TCAs adverse effects- 3 things

A
  1. Anticholinergic effects
  2. Orthostatic Hypotension
  3. Cardiotoxicity (can cause fatal heart dysrhythmias when overdose)
    If client has suicidal thoughts, not the best choice
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16
Q

TCAs is a dirty drug meaning

A

They aren’t selective and go to other places

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17
Q

Escitalopram

A

Antidepressant- Selective Serotonin Reuptake Inhibitors (SSRIs)

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18
Q

Fluoxetine

A

Antidepressant- Selective Serotonin Reuptake Inhibitors (SSRIs)

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19
Q

Paroxetine

A

Antidepressant- Selective Serotonin Reuptake Inhibitors (SSRIs)

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20
Q

Sertraline

A

Antidepressant- Selective Serotonin Reuptake Inhibitors (SSRIs)

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21
Q

SSRIs common uses

A

First-line drugs for depression and are effective at treating anxiety

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22
Q

SSRIs mechanism of action (clean drug)

A

very selective and only block serotonin reuptake pumps to increase levels of serotonin in the brain

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23
Q

SSRIs Adverse Effects- 5 S’s

A
  1. Stomach troubles
  2. Slowed metabolism
  3. Sexual dysfunction
  4. Suicidal ideation (most common in children under 18)
  5. Sedation (except fluoxetine which is very activating)
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24
Q

Duloxetine

A

Antidepressant- Serotonin Norepinephrine Reuptake Inhibitors (SNRIs) frequently prescribed for neuropathic pain

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25
Q

Venlafaxine

A

Antidepressant- Serotonin Norepinephrine Reuptake Inhibitors (SNRIs) commonly used for anxiety disorders

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26
Q

SNRIs common uses

A

Major depression. Duloxetine is frequently prescribed for neuropathic pain. Venlafaxine is commonly used for anxiety disorders.

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27
Q

SNRIs mechanism of action (Clean drug)

A

Block the reuptake of serotonin and norepinephrine

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28
Q

SNRIs adverse effects- The 5 S’s and something extra

A
  1. Stomach troubles
  2. Slowed metabolism
  3. Sexual dysfunction
  4. Suicidal ideation (most common in children under 18)
  5. Sedation

Can also cause Hypertension

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29
Q

Bupropion

A

Antidepressant

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30
Q

Trazodone

A

Antidepressant

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31
Q

Es- is what when it comes to drugs

A

Left side drugs

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32
Q

Dex- is what when it comes to drugs

A

Right side drugs

33
Q

Bupropion common uses

A

prescribed for depression and smoking cessation and adult ADHD

34
Q

Trazadone common uses

A

prescribed for depression but is primarily used for insomnia

35
Q

Buproprion mechanism of action

A

inhibits the reuptake of dopamine and norepinephrine. No significant effect on serotonin

36
Q

Trazadone mechanism of action

A

Weak serotonin reuptake inhibitor

37
Q

Bupropion adverse effects

A
  1. Increase libido
  2. Isn’t likely to cause weight gain, might even cause weight loss
  3. Anxiety
  4. Insomnia
  5. Contraindicated for clients with seizures and bulimia nervosa
38
Q

Trazadone adverse effects

A

Sedative and anticholinergic effects

Rare cases can cause priapism (a prolonged, painful erection)

39
Q

How long does it take for antidepressants to start working

A

few weeks

40
Q

Most antidepressants have a black box warning concerning what

A

increased risk of suicidal thoughts.

41
Q

Mood stabilizer- Lithium

A

Highly effective
Treats from above and below (bipolar)
Lowers suicide risk

42
Q

Problem with lithium

A

Should therapeutic window. Upper limit is 1.5 in therapeutic window

43
Q

Normal side effects of lithium

A

mild nausea, diarrhea
Fine hand tremors
Polyuria (peeing a lot) and polydipsia (increased thirst)
Weight gain

44
Q

Early signs of lithium toxicity

A

A- ataxia (in-coordination)
C- course hand tremors
N- nausea, vomiting, and diarrhea
E- Ears ringing

45
Q

Client teaching with lithium

A
  1. take with food
  2. drink fluids (2 to 3 L a day) and eat salt
  3. Avoid strenuous exercise
  4. Look for signs of toxicity
46
Q

Types of Anxiolytic medications

A
  1. Benzodiazepines
  2. Buspirone
  3. Antidepressants
  4. Beta blockers (helps with performance anxiety)
  5. Certain antihistamines
47
Q

Benzodiazepines common uses

A 
Anxiety disorders
Sleep disorders
Muscle spasms
seizure disorders
alcohol withdrawal
48
Q

Alprazolam

A

Benzodiazepine (fastest onset and shortest duration = easiest one to get addicted to)

49
Q

Diazepam

A

Benzodiazepine

50
Q

Lorazepam

A

Benzodiazepine

51
Q

Chordiazepoxide

A

Benzodiazepine

52
Q

Clorazepam

A

Benzodiazepine (longest onset and longest duration)

53
Q

Benzodiazepine mechanism of action

A

Help GABA work better. Work immediately after absorption

54
Q

Benzodiazepine side effects

A

sedation
ataxia
impaired memory

55
Q

Benzodiazepine adverse effects

A 
Highly addictive (slowly stop use)
withdrawal can be deadly
56
Q

Benzodiazepine precautions

A

History of drug use
Liver disease
Elderly

57
Q

Benzodiazepine overdose antidote

A

Flumazenil but it puts them in withdrawal

58
Q

Buspirone mechanism of action

A

binds strongly to serotonin receptors and loosely to dopamine receptors

59
Q

Advantages of buspirone

A

no abuse potential
not a CNS depressant
No major withdrawal issues

60
Q

Disadvantage of buspirone

A

Takes much longer to work (weeks)

61
Q

What food to avoid with buspirone

A

Grapefruit juice

62
Q

Haloperidol

A

Antipsychotic- First generation (FGA)

63
Q

Chlorpromazine

A

Antipsychotic- First generation (FGA)

64
Q

FGA common uses

A

Schizophrenia
Agitation/aggression
Nausea and vomiting
Intractable hiccups

65
Q

The four D’s to become a mental disorder

A
  1. Distress
  2. Danger
  3. Deviant (unusual)
  4. Dysfunction
66
Q

Schizophrenia symptoms - hallucinations, delusions, disorganized speech, and bizarre behavior

A

Positive symptoms (extra things they experience)

67
Q

Schizophrenia symptoms - affective flattering, alogia (absent of thought), avolition (no drive), anhedonia (doesn’t experience pleasure), and social isolation

A

Negative symptoms (they lack that normal people have)

68
Q

FGA mechanism of action

A

block dopamine receptors

69
Q

FGA problems

A
  1. decrease the positive symptoms of schizophrenia
  2. Makes the negative symptoms get worse
  3. EPS symptoms
  4. cause endocrin problems
70
Q

FGA major side effects

A 
anticholinergic effects (dirty drugs)
orthostatic hypotension
sedation
neuroendocrine effects
photsensitivity
71
Q

Neuroleptic Malignant Syndrome

A 
F- fever
E- elevated WBCs and CPK (leak out of muscle and break down faster)
V- vital signs are unstabel
E- encephalopathy
R- Rigidity
72
Q

Clozapine

A

Antipsychotic- Second Generation (SGA)

73
Q

Risperidone

A

Antipsychotic- Second Generation (SGA)

74
Q

Olanzapine

A

Antipsychotic- Second Generation (SGA)

75
Q

Aripiprazole

A

Antipsychotic- Second Generation (SGA)

76
Q

SGA common uses

A

Schizophrenia
Bipolar disorder
dementia and psychotic features

77
Q

SGA mechanism of action

A

block both dopamine and serotonin receptors. Decreases dopamine in areas with too much and increases it in areas with too little

78
Q

SGAs compared to FGA

A

lower risk of EPS
Really high risk of metabolic syndrome
Super expensive
probably equally effective

79
Q

If taking clozapine or olanzapine

A

Highly effective
can cause agranulocytosis (destroy WBCs 1% chance)
requires weekly WBC monitoring
report signs of infection immediately

Pharm (7 decks)

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