Psychopharmacology

Question 1

What is the antidote for a patient who has overdosed on Clonazepam?

Answer 1

Flumazenil (Romazicon)

Question 2

What are the side effects of tricyclic antidepressants?

Answer 2

(ABCDE)
Anticholinergic (dry mouth)
Blurred vision
Constipation
Drowsiness
Euphoria

Question 3

What do ALL psych meds cause?

Answer 3

Blood pressure and weight changes

Question 4

What food items should be avoided when taking a MAOI?

Answer 4

Foods that are high in tyramine (aged cheese, dried fruit, cured meats, and alcohol)
Could cause hypertensive crisis

Question 5

What is the therapeutic range for lithium?

Answer 5

0.6-1.2 mEq/L

Question 6

What are signs of mild to moderate lithium toxicity?

Answer 6

Diarrhea, vomiting, fatigue, tremors, muscle weakness, drowsiness

Question 7

The nurse taking care of a patient starting lithium should tell the patient to do what to avoid toxicity?

Answer 7

Avoid becoming dehydrated. Maintain adequate fluid and salt intake.

Question 8

When is a lithium level considered severe?

Answer 8

2.0 mEq/L

Signs of severe toxicity include seizures, slurred speech, rapid heartbeat, agitation, delirium, and death

Question 9

A 10-year-old patient was just started on Adderall for their ADHD. What side effects of this medication should be discussed with their parents?

Answer 9

Anorexia- can affect growth and development
Insomnia- give sustained release in the AM and instant release at least 6 hours before bedtime
Psychotic symptoms-irritability

Question 10

What medication is commonly prescribed to treat depression in children?

Answer 10

Prozac (fluoxetine)

Question 11

A client diagnosed with general anxiety disorder is placed on clonazepam (klonopin) and buspirone (buspar). Which statement by the client indicates that teaching has been effective?

1. The client states that the clonazepam is to be used for longboard-term therapy in conjunction with buspirone.
2. The client states the buspirone can cause sedation and should be taken at night.
3. The client states that clonazepam is to be used short-term until the buspirone takes full effect.

Answer 11

3. The client states that clonazepam is to be used short-term until the buspirone takes full effect.

Benzodiazepines like clonazepam are for short-term use. Buspirone is approved for long-term use, but can take 4-6 weeks to take effect.

Question 12

A patient has been diagnosed with performance anxiety. The nurse anticipates use of which drug to treat this psychologic disorder?

a) Clonazepam [Klonopin]
b) Alprazolam [Xanax]
c) Propranolol [Inderal]
d) Sertraline [Zoloft]

Answer 12

C. Propanolol

Question 13

A client diagnosed with bipolar disorder has been prescribed with lithium (carbonate) by his physician. Which question will help the nurse identify signs of early lithium toxicity?

A. Have you been experiencing any nausea, vomiting or diarrhea?

B. Do you have frequent headache?

C. Have you been urinating excessively/frequently?

D. Do you experience leg aches over the past few days?

Answer 13

A
The most common early signs of lithium toxicity is gastrointestinal (GI) disturbance including nausea,vomiting, or diarrhea. B, C, D assessment question is unrelated to lithium toxicity.

Question 14

Second-generation antipsychotics typically end in ______ and _____

Answer 14

-pine and -done

Clozapine, risperidone, quetiapine, olanzapine, and ziprasidone

Question 15

Patients taking buspirone (Buspar) for anxiety should avoid _____?

Answer 15

Grapefruit (it increases plasma concentrations of the drug)

Question 16

Benzodiazepines end in ___ and _____

Answer 16

-pam and -lam

alprazolam, lorazepam, diazepam

Question 17

Benzodiazepines promote the activity of what neurotransmitter that has a calming effect?

Answer 17

GABA

Question 18

Nortriptyline (Pamelor) and amitriptyline (Elavil) are what type of medication?

Answer 18

Tricyclic Antidepressants

Question 19

Cholinesterase inhibitors such as donezepil (Aricept) and galantamine (Razadyne) treat Alzheimer’s by _____.

Answer 19

Slowing the rate of memory loss

Question 20

_________ are commonly given for alcohol withdrawal.

Answer 20

Benzodiazepines (lorazepam and diazepam)

Question 21

A patient undergoing alcohol rehabilitation decides to begin disulfiram (Antabuse) therapy. Patient teaching should include the need to: (select all that apply)

a. avoid aged cheeses.
b. avoid alcohol-based skin products.
c. read labels of all liquid medications.
d. wear sunscreen and avoid bright sunlight.
e. maintain an adequate dietary intake of sodium.
f. avoid breathing fumes of paints, stains, and stripping compounds.

Answer 21

B, C, F

The patient must avoid hidden sources of alcohol. Many liquid medications, such as cough syrups, contain small amounts of alcohol that could trigger an alcohol-disulfiram reaction. Using alcohol-based skin products such as aftershave or cologne, smelling alcohol-laden fumes, and eating foods prepared with wine, brandy, or beer may also trigger reactions. The other options do not relate to hidden sources of alcohol.

Question 22

Fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), citalopram (Celexa), and escitalopram (Lexapro) are ____?

Answer 22

SSRI’s

Question 23

Symptoms of serotonin syndrome include:

Answer 23

confusion, fever, hallucinations, tremors, agitation, abdominal pain

Question 24

Lithium as well as ________ medications are used to treat bipolar disorder.

Answer 24

Anticonvulsants (carbamazepine, lamotrigine, and valproate)

Question 25

Side effects to watch for in patients taking atypical antipsychotics like Risperdal and Zyprexa include:

Answer 25

weight gain
EKG changes
hyperglycemia

Question 26

Donepezil (Aricept) is prescribed for a client with Alzheimer’s disease. The nurse determines that the medication is having positive effects when what is observed?

a. Absence of wandering
b. Decreased progression of memory loss
c. Increase in “pin rolling”
d. Regaining the ability to drive a car

Answer 26

Answer: b. Decreased progression of memory loss

Rationale: Aricept is effective in the early stages of Alzheimer’s disease. It might slow or decrease progression of symptoms, but it will not reverse behaviors that are lost.

Question 27

A client with Alzheimer’s disease has been receiving medication therapy for several months. The nurse should teach the client and caregiver to report signs of overdose, which include:

a. Bradycardia and muscle weakness.
b. Tachycardia and hypertension.
c. Abdominal pain and dry mouth.
d. Emotional withdrawal and tachypnea.

Answer 27

Answer: a. Bradycardia and muscle weakness.

Rationale: An overdose of drugs to treat Alzheimer’s disease could occur if they are taken improperly, or if decreased liver or renal function occurs. Symptoms of overdose include severe nausea/vomiting, sweating, salivation, hypotension, bradycardia, convulsions, and increased muscle weakness, including respiratory muscles.

Question 28

The client diagnosed with a major depressive disorder asks the nurse, “Why did my psychiatrist prescribe an SSRI medication rather than one of the other types of anti-depressants?” Which statement by the nurse would be most appropriate?

1. “Probably it is the medication that your insurance will pay for”
2. “You should ask your psychiatrist why the SSRI was ordered”
3. “SSRIs have fewer side effects than the other classifications”
4. “The SSRI medications work faster than the other medications”

Answer 28

3. “SSRIs have fewer side effects than the other classifications.”

SSRIs have the same efficacy as MAO inhibitors and tricyclics, but SSRIs are safer because they do not have the sympathomimetic effects (tachycardia and hypertension) and anticholinergic effects (dry mouth, blurred vision, urinary retention, and constipation) of the MAO inhibitors and tricyclics.

Question 29

The client with major depressive disorder is suicidal. The client was prescribed the tricyclic antidepressant imipramine (Tofranil) 3 weeks ago. Which priority intervention should the nurse implement?

1. Determine if the client has a plan to commit suicide
2. Assess if the client is sleeping better at night
3. Ask the family if the client still wants to kill himself or herself
4. Observe the client for signs of wanting to commit suicide

Answer 29

1. Determine if the client has a plan to commit suicide

The nurse should ask if the client has a plan to commit suicide. As the client begins to recover from both psychological and physical depression, the client’s energy level increases, making the client more prone to commit suicide during this time. It takes 2-6 weeks for therapeutic effects of tricyclic antidepressants to be effective

Question 30

The client with major depressive disorder has been taking amitriptyline (Elavil), a tricyclic antidepressant, for more than 1 year. The client tells the psychiatric clinic nurse that the client wants to quit taking the antidepressant. Which intervention is most important for the nurse to discuss with the client?

1. Ask questions to determine if the client is still depressed
2. Ask the client why he or she wants to stop taking the medication
3. Tell the client to notify the HCP before stopping medication
4. Explain the importance of tapering off the medication

Answer 30

4. Explain the importance of tapering off the medication

The client must first know the importance of needing to taper off the medication because rebound dysphoria, irritability, or sleepiness may occur if the medication is discontinued abruptly. Then the client should see the HCP to determine what action doesn’t want to take the medication.

Question 31

First generation antipsychotics typically end in ____?

Answer 31

-azine
chlorpromazine (Thorazine)
fluphenazine (Prolixin)