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Mental Health 1 > Psychopharm > Flashcards

Psychopharm Flashcards

1
Q

2 bad things about amphetamines

A

Addictive, toxicity

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2
Q

Whatbis important for the nurse to assess related to psychomedications?

A

List of the meds they are taking including prescribed OTC, herbal, and their allergies

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3
Q

What is important after giving the medication?

A

Monitor side effects and adverse reactions, evaluate effectiveness

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4
Q

What is some pt education you should do when giving pt drugs?

A
  1. Why when and how the med should be taken
  2. Who and when to contact with questions
  3. Expected side effects/adverse reactions
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5
Q

What are some examples of neurotransmitters?

A

Epinephrine, dopamine, serotonin

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6
Q

Whatbare antianxiety agents also called?

A

Anxiolytics (minor tranquilizers)

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7
Q

What are anxiolytics used for?

A

Acute anxiety states (not long term)
Depress CNS

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8
Q

All anxiolytics depress the CNS except for?

A

Buspirone!

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9
Q

What is the most commonly prescribed anxiolytic class?

A

Benzodiazepines

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10
Q

Can anxiolytics/CNS depressants be taken with another CNS depressant?

A

No, take them by themselves

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11
Q

What to avoid when taking anxiolytics?

A

Alcohol, caffeine, opioid/cough meds, herbal depressants

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12
Q

What to do if pt becomes confused while taking anxiolytics?

A

Stop the med, taper off

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13
Q

Alprazolam (Xanax) class

A

Antianxiety

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14
Q

Clonazepam (Klonopin) class

A

Antianxiety

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15
Q

Diazepam (Valium) class

A

Antianxiety

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16
Q

Lorazepam (Ativan) class

A

Antianxiety

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17
Q

Oxazepam (Serax) class

A

Antianxiety

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18
Q

Midazolam (Versed) class

A

Antianxiety

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19
Q

SE of antianxiety meds

A

Orthostatic hypotension
drowsiness
dry mouth
paradoxical excitement (opposite of what we want)
blood dyscrasias (easy bruising, sore throat, fever)

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20
Q

How long can antianxiety meds be used for?

A

About 4 months
After 4 months need to look at meds for long term use

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21
Q

Is buspirone (Buspar) a benzodiazepine?

A

No

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22
Q

What is one uses of benzodiazepines?

A

Depress the CNS

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23
Q

Does buspirone depress the CNS?

A

No

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24
Q

How long should you take buspirone?

A

7-10 days to see improvement
3-4 weeks to reach the optimal level

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25
Q

Does buspirone have addiction potential?

A

No

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26
Q

What to avoid when taking buspirone?

A

Alcohol, CNS depressants, grapefruit juice

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27
Q

Pt education for antianxiety meds

A
  1. Do NOT stop abruptly, taper off slowly for 2-6 weeks
  2. Avoid alcohol, caffeine, smoking, and other CNS depressants
  3. Take with food/milk
  4. Avoid herbals (kava, valerian, melatonin, chamomile)
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28
Q

Buproprion (Welbutrin) class

A

Atypical antidepressants

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29
Q

What do atypical antidepressants treat?

A

Schizophrenia or bipolar

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30
Q

Antidepressants action

A

Increase concentration of norepinephrine, serotonin, and dopamine by blocking reuptake, inhibit the release of monoamine oxidase (MAO)

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31
Q

What class of antidepressants have the least side effects?

A

SSRIs

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32
Q

What do you need to avoid when taking SSRIs?

A

Alcohol and other CNS depressants

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33
Q

How long does it take for SSRIs side effects to decrease?

A

2-4 weeks

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34
Q

What do you need to monitor for pt that are taking SSRIs?

A

Suicidal ideation

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35
Q

Fluoxetine (Prozac) class

A

SSRIs

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36
Q

Sertraline (Zoloft) class

A

SSRIs

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37
Q

Paroxetine (Paxil) class

A

SSRIs

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38
Q

Citalopram (Celexa) class

A

SSRIs

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39
Q

Escatilopram (Lexapro) class

A

SSRIs

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40
Q

What adverse reaction will occur when taking SSRI with buspirone/TCAs/st John’s wort/selegiline?

A

Serotonin syndrome

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41
Q

Serotonin syndrome s/s

A

Diarrhea, restlessness, agitation, vital fluctuation
Late s/s: seizures, hyperthermia, uncontrolled shivering, myoclonus (involuntary muscle contraction throughout the body)

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42
Q

What is myoclonus?

A

Involuntary muscle contraction throughout body

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43
Q

What adverse reaction happens when taking SSRI with MAOIs?

A

Hypertensive crisis

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44
Q

Venlafaxine (Effexor) class

A

SNRIs

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45
Q

Duloxetine (Cymbalta) class

A

SNRIs

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46
Q

Desvenlafaxine (Pristiq) class

A

SNRIs

47
Q

Side effects of SNRIs other than the common ones

A

Hypertension, suicidal ideation, SJS

48
Q

what do TCAs do?

A

Block uptake of norepinephrine and serotonin in the brain, elevate mood, increase ADLs

49
Q

Amitriptylline (Elavil) class

A

TCA

50
Q

Imipramine (Tofranil) class

A

TCA

51
Q

Trimipramine (Surmontil) class

A

TCA

52
Q

Despiramine (Norpramin) class

A

TCA

53
Q

Protriptyline (Vivactil) class

A

TCA

54
Q

What are TCAs used for?

A

OCD, panic attacks, major depression

55
Q

What are some side effects of TCAs?

A

Photosensitivity
Orthostatic hypotension
Blurred vision
Constipation
Sexual dysfunction
Suicidal ideation
Weight gain

56
Q

What can you do if your pt is on TCAs but has been trying hard to lose weight for the last several weeks?

A

Educate them so they know they will not be able to lose weight while taking TCAs
We can ask the doctor for another antidepressant if pt is really trying to lose weight!

57
Q

What is the first antidepressants ever made?

A

MAOIs

58
Q

What do MAOIs do?

A

Increase norepinephrine, epinephrine, dopamine, and serotonin

59
Q

Tranylcypromine sulfate (Parnate) class

A

MAOI

60
Q

Isocarboxazid (Marplan) class

A

MAOI

61
Q

Selegiline (Emsam) class

A

MAOI

62
Q

Phnelzine Sulfate (Nardil) class

A

MAOI

63
Q

What do pt need to avoid while taking MAOIs?

A

Foods that are high in tyramine

64
Q

Side effects of MAOIs

A

Orthostatic hyper!tension! Hypertensive crisis (>180/120, can lead to heart attack, stroke, and death)
Anticholinergic effects (dryyyyyy)

65
Q

If opioid overdose happens, what can be administered?

A

Naloxone (Narcan)

66
Q

what are 2 adverse reactions of antidepressants?

A

Serotonin syndrome
Neuroleptic malignant syndrome

67
Q

Common side effects of antidepressants

A

Dry mouth, sedation, nausea, sexual dysfunction

68
Q

Neuroleptic malignant syndrome s/s

A

Seizure, altered mental status, muscle rigidity, sudden high fever, bp fluctuations, high hr, dysrhythmias, rhabdomyolysis, acute renal failure, resp failure, coma

69
Q

What to do when neuroleptic malignant syndrome occur?

A

Stop the antipsychotic!
Hydration, hypothermic blankets, antipyretics
Benzodiazepines, muscle relaxants

70
Q

What do bipolar mania have?

A

Cycles of low (depression) and high (manic)

71
Q

Lithium carbonate class

A

Mood stabilizers

72
Q

What is lithium’s narrow therapeutic range?

A

0.6-1.2

73
Q

What electrolyte does your body need while taking lithium?

A

Sodium!

74
Q

What happens when your sodium is low while taking lithium?

A

Higher risk for lithium toxicity

75
Q

What drug to avoid while taking lithium?

A

NSAIDs (ibuprofen, neproxen, aspirin) b/c lithium toxicity

76
Q

Carbamazepine (Tegretol) class

A

Mood stabilizer

77
Q

Divalproex (Depakote) class

A

Mood stabilizer

78
Q

Lamotrigine (Lamictal)

A

Mood stabilizer

79
Q

Ziprasidone (Geodon) class

A

Mood stabilizer

80
Q

Aripiprazole (Abilify) class

A

Mood stabilizer

81
Q

Side effects of mood stabilizers

A

Drowsiness, dizziness, nausea, vomiting, headache, dry mouth, weight loss/gain

82
Q

What are antipsychotic agents also called?

A

Neuroleptics

83
Q

A bad adverse reaction with certain antipsychotics

A

Agranulocytosis

84
Q

What are some s/s of DRESS?

A

Rash, fever, swollen lymph nodes

85
Q

Hormonal side effects of antipsychotics

A

Galactorrhea (having milk while not pregnant)
Amenoria (no periods)
Gynecomastia (male breast dev)

86
Q

Olanzapine (Zyprexa) class

A

Antipsychotics

87
Q

Quetiapine (Seroquel) class

A

Antipsychotics

88
Q

Risperidone (Risperdal) class

A

Antipsychotics

89
Q

Haloperidol (Haldol) class

A

Antipsychotics

90
Q

Side effects of antipsychotics

A

Constipation, NVD, dry mouth, insomnia, sedation, sexual dysfunction, weight gain

91
Q

Whatbisnextra pyramids symptoms (EPS)?

A

A side effect of antipsychotics

92
Q

What symptoms do EPS include?

A

Pseudoparkinsonism (drooling, tremors, shuffling gait)
Tardive dyskinesia (ex: involuntarily chewing motion)
Dystonia（uncontrolled muscle contraction）
Akinesia（loss of ability to move muscles）
Akathisia（muscle restlessness）

93
Q

What can the nurse do when EPS occurs?

A

Can change meds or treat EPS

94
Q

What can you use to block pseudoparkinsonism and dystonia?

A

Use benztropine (Cogentin) to block the cholinergic activity.
Oral: onset 2-3 days
IM/IV: onset within minutes

95
Q

What are sedative hypnotics used for?

A

Short term management of anxiety and insomnia

96
Q

What does sedative hypnotics do?

A

Depress CNS
May produce tolerance or dependence except for Ramelteon (Rozerem) (not a controlled substance)

97
Q

Contraindications of sedative hypnotics

A

Severe hepatic/cardiac/renal/resp disease or insufficiency
Children and older adults

98
Q

What to avoid when taking sedative hypnotics?

A

Alcohol and other CNS depressants

99
Q

What to do after giving ot sedative hypnotics?

A

Continuously monitor for abnormal thinking and behavior changes
Always look for black box warning

100
Q

Butabarbital (Butisol) class

A

Sedative hypnotics

101
Q

Phenobarbital (Sezaby) class

A

Sedative hypnotics

102
Q

Temazepam (Restoril) class

A

Sedative hypnotics

103
Q

Eszopiclone (Lunesta) class

A

Sedative hypnotics

104
Q

Zolpidem (Ambien) class

A

Sedative hypnotics

105
Q

What schedule of controlled substance is amphetamine?

A

2

106
Q

What is the FDA approval video game for ADHD?

A

EndeavorRx

107
Q

Amphetamine (Adderall) class

A

ADHD agents

108
Q

Methylphenidate (Ritalin) class

A

ADHD agents

109
Q

Atomoxetine (Strattera) class

A

ADHD agents

110
Q

Lisdexamfetamine (Vyvanse) class

A

ADHD agents

111
Q

When should pt take ADHD agents?

A

At night b/c they are sedative

112
Q

When taking lithium, what needs to be done once a month?

A

Report for blood tests

113
Q

Gabapentin (Neurontin) class

A

Mood stabilizer

Mental Health 1 (12 decks)

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