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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
Venlafaxine
Antidepressant- Serotonin Norepinephrine Reuptake Inhibitors (SNRIs) commonly used for anxiety disorders
26
SNRIs common uses
Major depression. Duloxetine is frequently prescribed for neuropathic pain. Venlafaxine is commonly used for anxiety disorders.
27
SNRIs mechanism of action (Clean drug)
Block the reuptake of serotonin and norepinephrine
28
SNRIs adverse effects- The 5 S's and something extra
1. Stomach troubles 2. Slowed metabolism 3. Sexual dysfunction 4. Suicidal ideation (most common in children under 18) 5. Sedation Can also cause Hypertension
29
Bupropion
Antidepressant
30
Trazodone
Antidepressant
31
Es- is what when it comes to drugs
Left side drugs
32
Dex- is what when it comes to drugs
Right side drugs
33
Bupropion common uses
prescribed for depression and smoking cessation and adult ADHD
34
Trazadone common uses
prescribed for depression but is primarily used for insomnia
35
Buproprion mechanism of action
inhibits the reuptake of dopamine and norepinephrine. No significant effect on serotonin
36
Trazadone mechanism of action
Weak serotonin reuptake inhibitor
37
Bupropion adverse effects
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
Trazadone adverse effects
Sedative and anticholinergic effects | Rare cases can cause priapism (a prolonged, painful erection)
39
How long does it take for antidepressants to start working
few weeks
40
Most antidepressants have a black box warning concerning what
increased risk of suicidal thoughts.
41
Mood stabilizer- Lithium
Highly effective Treats from above and below (bipolar) Lowers suicide risk
42
Problem with lithium
Should therapeutic window. Upper limit is 1.5 in therapeutic window
43
Normal side effects of lithium
mild nausea, diarrhea Fine hand tremors Polyuria (peeing a lot) and polydipsia (increased thirst) Weight gain
44
Early signs of lithium toxicity
A- ataxia (in-coordination) C- course hand tremors N- nausea, vomiting, and diarrhea E- Ears ringing
45
Client teaching with lithium
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
Types of Anxiolytic medications
1. Benzodiazepines 2. Buspirone 3. Antidepressants 4. Beta blockers (helps with performance anxiety) 5. Certain antihistamines
47
Benzodiazepines common uses
``` Anxiety disorders Sleep disorders Muscle spasms seizure disorders alcohol withdrawal ```
48
Alprazolam
Benzodiazepine (fastest onset and shortest duration = easiest one to get addicted to)
49
Diazepam
Benzodiazepine
50
Lorazepam
Benzodiazepine
51
Chordiazepoxide
Benzodiazepine
52
Clorazepam
Benzodiazepine (longest onset and longest duration)
53
Benzodiazepine mechanism of action
Help GABA work better. Work immediately after absorption
54
Benzodiazepine side effects
sedation ataxia impaired memory
55
Benzodiazepine adverse effects
``` Highly addictive (slowly stop use) withdrawal can be deadly ```
56
Benzodiazepine precautions
History of drug use Liver disease Elderly
57
Benzodiazepine overdose antidote
Flumazenil but it puts them in withdrawal
58
Buspirone mechanism of action
binds strongly to serotonin receptors and loosely to dopamine receptors
59
Advantages of buspirone
no abuse potential not a CNS depressant No major withdrawal issues
60
Disadvantage of buspirone
Takes much longer to work (weeks)
61
What food to avoid with buspirone
Grapefruit juice
62
Haloperidol
Antipsychotic- First generation (FGA)
63
Chlorpromazine
Antipsychotic- First generation (FGA)
64
FGA common uses
Schizophrenia Agitation/aggression Nausea and vomiting Intractable hiccups
65
The four D's to become a mental disorder
1. Distress 2. Danger 3. Deviant (unusual) 4. Dysfunction
66
Schizophrenia symptoms - hallucinations, delusions, disorganized speech, and bizarre behavior
Positive symptoms (extra things they experience)
67
Schizophrenia symptoms - affective flattering, alogia (absent of thought), avolition (no drive), anhedonia (doesn't experience pleasure), and social isolation
Negative symptoms (they lack that normal people have)
68
FGA mechanism of action
block dopamine receptors
69
FGA problems
1. decrease the positive symptoms of schizophrenia 2. Makes the negative symptoms get worse 3. EPS symptoms 4. cause endocrin problems
70
FGA major side effects
``` anticholinergic effects (dirty drugs) orthostatic hypotension sedation neuroendocrine effects photsensitivity ```
71
Neuroleptic Malignant Syndrome
``` 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
Clozapine
Antipsychotic- Second Generation (SGA)
73
Risperidone
Antipsychotic- Second Generation (SGA)
74
Olanzapine
Antipsychotic- Second Generation (SGA)
75
Aripiprazole
Antipsychotic- Second Generation (SGA)
76
SGA common uses
Schizophrenia Bipolar disorder dementia and psychotic features
77
SGA mechanism of action
block both dopamine and serotonin receptors. Decreases dopamine in areas with too much and increases it in areas with too little
78
SGAs compared to FGA
lower risk of EPS Really high risk of metabolic syndrome Super expensive probably equally effective
79
If taking clozapine or olanzapine
Highly effective can cause agranulocytosis (destroy WBCs 1% chance) requires weekly WBC monitoring report signs of infection immediately

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