Psychopharmacology Flashcards
What are antidepressants medication?
MAOI
Tricyclics
SSRI
SNRI
Bupropion (NDRI)
How Antidepressants medication work?
Block reuptake of serotonin and norepinephrine
Inhibiting the release of MAOIs
Serotonin syndrome occur with what medication take together with Antidepressants medication?
Taken w/ St. John’s Wort (herb)
Buspirone
What is a Serotonin syndrome?
Life-threatening drug reaction
Results from having too much serotonin in your body
Symptoms
- agitation
- hallucinations
- fever
- tremors
- diaphoresis 発汗
Monoamine oxidase inhibitors (MAOIs)?
Extremely strong class of antidepressants
- Preventing the breakdown of the brain chemicals serotonin, dopamine, and norepinephrine.
- This helps them do their work of regulating your mood
Nursing Implications/Antidepressants
Risk for suicide
Risk for injury(related side-effect)
Social isolation
Risk for constipation
Insomnia
Contraindication/Antidepressants
Bupropion for PTs with seizure disorder
-increased risk of seizures
What is a benzodiazepine used for?
Antianxiety
A type of sedative medication.
This means they slow down the body and brain’s functions. They can be used to help with anxiety and insomnia.
What is the most common benzodiazepine?
lorazepam
Alprazolam
Do not take more than 3 weeks – short term
Long term treatment usually use antidepressant meds
If not managed carefully, the patient is at high risk for addiction.
What should we discuss with families and clients regarding the use of lorazepam?
- No smoking and caffeine/dec the effects
- Risk for activity intolerance: don’t drive
- Severe CNS depression
- Can have paradoxical effect – causes insomnia
- Don’t take more than what is prescribed and take when you feel anxiety symptoms
Which of the following medications would be an appropriate prn medication for an individual with anxiety symptoms?
a) Buspirone
b) Alprazolam
c) Fluoxetine
d) Sertraline
b
How can we maintained lithium level?
Remain within a therapeutic levels.
- 0–1.5 mEq/L (acute mania)
- 6–1.2 mEq/L (maintenance)
Contraindication/Lithium
- Pregnancy risk
- Discourage breastfeeding
- Severe renal or cardiac disease, hypovolemia, schizophrenia
- Use cautiously in older adult clients
Side-effect/Lithium
Anticonvulsant
- Weight gain
- Toxicity: NARROW therapeutic window(Lithium Toxicity)
the higher the toxicity levels, the higher chance for death
-Seizures
-Cardiovascular collapse DEATH
Side effects/lamotrigine (Lamictil)
- *Anticonvulsant/treat seizures and bipolar disorder**
- Stevens-Johnson syndrome
- toxic epidermal necrolysis:
- Rash
- inflammatory condition
Lithium characteristic
Mood-stabilizing agent
Controls episodes of mania
Prevents return of mania/depression
Dec incidence of suicide
characteristic
carbamazepine, valproic acid, lamotrigine
Treat/prevent mani /depressive episodes
mixed mania &rapid cycling depressive disorders
Rapid=Four or more hypomania or acute mania within 1 year
increase recurrence rate and resistance to treatment
Typical Antipsychotic Medications name?
Block dopamine receptor
Phenothiazines
- chlorpromazine
- haloperidol
Typical Antipsychotic Medications
Precautions 予防措置
Hypersensitivity
Blood dyscrasias (anemia and cancers)
Parkinson’s disease
Narrow-angle glaucoma
Liver/Renal/Cardiac insufficiency
Elderly
Typical Antipsychotic Medications
Side-effectse
Acute dystonia/ muscle spasm
Tardive dyskinesia/involuntary movement disorder
EPS(extrapyramidal symptoms)
Hormonal side effects:
Decreased libido, retrograde ejaculation
Gynecomastia in men, amenorrhea in women, and galactorrhea
Typical Antipsychotic Medications
Implementation
PTs taking long term should be monitored for abnormal movements.
PT should report signs of muscular stiffness/spasms
Assess for history of diabetes and hyperglycemia
A assess for history of seizures
Educate PT of risk for hypotension and orthostatic hypotension
Smoking increases metabolism of antipsychotics, requiring dosage adjustment.
Increase photosensitivity to sunlight - wear sunscreen
What medications cause neuroleptic malignant syndrome?
Neuroleptic malignant syndrome (NMS) is a rare and life-threatening reaction to the
use of almost any kind of neuroleptic (antipsychotic)
Nuroleptic malignant syndrome
Symptoms
Severe muscle rigidity
Very high fever
Tachycardia
Tachypnea
Fluctuations in BP
What is the extrapyramidal side effects?
A group of symptoms that can occur in people taking antipsychotic medications
What medication are treat extrapyramidal side effects?
- Benztropine (Anti-Tremor) 1-2 mg/day
- Amantadine 100 mg 2-3xs/day
Atypical Antipsychotic Medications name?
olanzapine
clozapine
Asenapine
What is the potential side-effect of olanzapine?
- Metabolic syndrome
- new onset of DM or loss of glucose control
- risk for HTN & other CVD
- weight gain
- inc cholesterol
What test clozapine need to monitor?
Remember that clozapine requires blood monitoring
- Weight/BMI
- WBC count
- Neutrophil count
- Fasting glucose
- Fasting lipid panels
What do we need to do BEFORE start medication to the pt?
A through baseline assessment
What pt must know about medication?
Why to take?
When to take?
Side-effects?
Whom to contact when side-effect?
How do psychotropic medication work?
Most affect the a)___________,producing changes in
b)___________ release and the receptors to which bind
a) neuronal synapses
b) neurotransmitter
