Psychopharmacology

Question 1

What is the difference between pharmacokinetics and pharmacodynamics

Answer 1

Kinetics: what body does to the drug

dynamics: drug does to the body

Question 2

What are the side effects and important nursing considerations for antidepressants

Answer 2

Side effects:
- GI upset, weight gain, insomnia, headache, nausea and dry mouth

Nursing:

• takes 2-8 weeks to work and always take in the morning due to insomnia
• suicide risk in people under 25 years

Question 3

What kind of antidepressant would you give someone that is depressed because of chronic pain

Answer 3

SNRI because the N is helpful in pain relief so you’ll treat both with one med

Question 4

What are the Tyramine containing foods and with what antidepressant do you want to avoid eating them

Answer 4

Foods: red wine, sardines/herrings, aged cheese, salami, beer and any foods high in sodium

Avoid with MAOIs

Question 5

What antidepressant is a hypertensive crisis a potential side effect with? What are the symptoms

Answer 5

MAOIs

Sx: severe occipital headache, palpitations, N/V, nuchal rigidity, fever, sweating, marked increase in BP, chest pain and coma

Question 6

What are the most important symptoms of serotonin syndrome

Answer 6

• agitation or restlessness
• confusion
• loss of muscle coordination or twitching muscles
• muscle rigidity
• diarrhea

Question 7

Give indications and MOA for antipsychotics

Answer 7

Indications:

• thought disorders - schizophrenia
• bipolar disorder (manic disorders)
• *OFF LABEL: mood lability, impulse control, and sleep

MOA:

• First gen: block dopamine
• Second gen: blocks serotonin
• third gen: stabilize dopamine

Question 8

What are the side effects of first generation (typical) antipsychotics and the important nursing considerations

Answer 8

Side effects:

• higher chance of tardive dyskinesia and NEUROLEPTIC MALIGNANT SYNDROME
• psuedoparkinsonism
• acute dystonia
• **agranulocytosis

Nursing:
- monitor WBC to check for agranulocytosis

Question 9

What are the side effects of the second generation (atypical) antipsychotic meds and the important nursing considerations

Answer 9

Side effects:

• orthostatic hypotension, anticholinergic effects, metabolic syndrome
• neuroleptic malignant syndrome

Nursing:
- monitor BMI, metabolic panel and CBC

Question 10

What is the gold standard for controlling mania in bipolar disorder?

Answer 10

Lithium

Question 11

What are the indication for mood stabilizers/anti-seizure meds

Answer 11

stabilize mood swings - in mania and depression and bipolar 1 and 2

Question 12

Give MOA, side effects, and nursing considerations for lithium

Answer 12

MOA:
- serotonin receptor blockade

Side effects:
- weight gain, fine hand tremors, hypothyroidism, hypotension, thrombocytopenia, GI distress

Nursing:
- normal level for lithium = 0.6-1.2 but want to maintain around 1. hold dose if too high/low because lithium toxicity can occur

Question 13

what are the symptoms of lithium toxicity

Answer 13

mild hand tremors 
mental confusion 
sedation 
uncoordinated motor movements 
diarrhea 
N/v

Question 14

What is the MOA for anti-seizure meds (mostly used for bipolar)

Answer 14

potentiate inhibitory effects of GABA. suppress CNS excitation (calms them down)

Question 15

What are the 3 anti-seizure meds we discussed and the potential side effects for each

Answer 15

Lamotrigine:
- causes SJS

Valproate:
- GI distress, N/V, hepatotoxicity

Depakote:
- most common med given for bipolar disorder