Psychopharmacology

Question 1

Legal and ethical issues nurses must consider when administering psychotropic medication?

Answer 1

• education, re lifestyle and side effects
• consent
• rights of medication administration
• can be often via MI or oral medication- least restrictive practice, site, trauma, history
• this can be done when a patient is involuntary

Question 2

What are some factors that contribute to non-adherence who psychotropic medication?

Answer 2

• stigma and discrimination
• side effects
• getting better (then discontinuing use)
• cost of pharmacy access\
• fear of addiction

Question 3

what is a “PRN” medication when might it be used?

Answer 3

“as required” used in break through psychotic symptoms, anxiety agitation

Question 4

what are depot antipsychotics? when might these be used?

Answer 4

IMI often administered 2/52. used when orally not adhered.

Question 5

Consideration related to psychotropic drug use: pregnant and lactating women

Answer 5

haemodilution, foetal addiction, foetal development, medication transference through breast milk

Question 6

Consideration related to psychotropic drug use: children and adolescents

Answer 6

dosaging (lower doses due to drug naivety and lower body weight)
contradictions oth other medications

Question 7

Consideration related to psychotropic drug use: older people

Answer 7

metabolism may be affected, altered due to liver and kidney function potentially decreasing with age
falls risk
frailty
dementia/ or delirium
polypharmacy and drug interactions

Question 8

Pharamcodynamics

Answer 8

effects of drugs and mechanism of action

Question 9

pharmacokenetics

Answer 9

movement of drugs within the body

Question 10

Akathisia

Answer 10

movement disorder characterised by internal restless and drive to move.
side effects of some antipsychotic medication

Question 11

Ataxia

Answer 11

lack of voluntary muscle coordination incorporating gait

Question 12

Dysarthria

Answer 12

Slow and slurred speech that can be difficult to understand

Question 13

Tinnitus

Answer 13

perception of noise or ringing in the ears

Question 14

Extrapyramidal side effects

Answer 14

includes pseudo parkinsonism, akathisia, dystonia and dyskinesia side effects from antipsychotic medication

Question 15

Metabolic syndorme

Answer 15

cluster of conditions that increase the risk of diabetes, stroke and heart disease. this includes increased waist circumference, high BSL, high triglycerides and increase BP

Question 16

Neuroleptic malignant syndrome

Answer 16

rare life threatening condition as a result of some antipsychotic medications (or combination of medication) including fever, muscle rigidity, altered MSE and autonomic dysfunction

Question 17

What are antidepressants?

Answer 17

Antidepressants work by balancing chemicals in your brain called neurotransmitters to address deficiencies in key areas of the brain

Question 18

What is the biomedical explanation for depression?

Answer 18

That depression stems from a deficiency of norepinephrine (NE), dopamins, or serotonin in key areas of the brain.

Question 19

What are the 3 ways an antidepressant addresses deficiencys in the brain?

Answer 19

1. They inhibit the effects of monoamine oxide thus increasing serotonin and norepinephrine in the synaptic cleft
2. They block the reuptake of specific neurotransmitters leading to a build up of these in the synaptic cleft
3. They are involved in regulation at receptor sites and the breakdown of neurotransmitters

Question 20

What are some mild symptoms of serotonin syndrome?

Answer 20

Increased heart rate, shivering, sweating, dilated pupils, myoclonus, and over-responsive reflexes.

Question 21

What do Selective serotonic reuptake inhibitors (SSRIs) and related drugs do? (Antidepressants).

Answer 21

Simply, they are the first line of treatment for depression and have less side-effects than others. Common side effects include: Drowsiness, insomnia, sexual dysfunction, nausea, and vomiting.

Question 22

What is serotonin syndrome?

Answer 22

Serotonin syndrome is a serious drug reaction. It is caused by medications that build up high levels of serotonin in the body. The onset is often rapid and can be life-threatening

Question 23

What are the common side effects from Tricyclic antidepressants (TCAs)?

Answer 23

dry mouth, blurred vision, constipation, urinary retention, drowsiness, and weight gain

Question 24

What are the common side effects from Monoamine oxidase inhibitors (MAOIs)?

Answer 24

Postural hypotension, constipation, drowsiness, dry mouth, fatigue, headache, insomnia, and sexual dysfunction

Question 25

What are mood stabilisers?

Answer 25

Drugs used for the treatment of bipolar affective disorders and schizo-affective disorders - they may also treat manic episodes

Question 26

What is the drug of choice for treatment of acute mania and ongoing maintenance?

Answer 26

Lithium

Question 27

How does Lithium work to treat acute mania?

Answer 27

It mimics the affects of sodium and compromises the ability of neurons to release, activate and respond to neurotransmitters.

Question 28

What are some common side affects of lithium?

Answer 28

Tremor, stomach upset, polyuria, and polydipsia

Question 29

What do Anticonvulsants do?

Answer 29

Anticonvulsants work by calming hyperactivity in the brain in various ways (Stabilising nerve membranes throughout the CNS)

Question 30

What are Anxiolytic (Anti-anxiety) medications?

Answer 30

Anxiolytics are a class of medications used to prevent or treat anxiety symptoms or disorders

Question 31

What do Benzodiazepines (Anxiolytics) do?

Answer 31

They are sedatives / anxiolytics (relieve anxiety) that act in the limbic system to treat anxiety disorders, agitation, insomnia, muscle spasm, and alcohol withdrawl.

Question 32

Why are Benxodiazepines prescribed for short-term use only?

Answer 32

Because people can become physically dependent on them

Question 33

What is pharmocology?

Answer 33

The study of drugs including their actions and effects in living systems

Question 34

What is clinical pharmacology?

Answer 34

A branch of pharmacology that uses drugs to treat, prevent and diagnose disease. It addresses two key concerns: What drugs do to the body and how they do it and also how the body affects a specific drug after administration

Question 35

What are the two different names a drug will have?

Answer 35

A generic name and a brand name

Question 36

What processes can have a major impact on the absorption, distribution, metabolism and excretion of drugs?

Answer 36

Infections and diseases processes

Question 37

Understanding pharmacokinetics help nurses to?

Answer 37

Anticipate therapeutic and adverse drug effects and plan appropriate nursing interventions to ensure the safest and most efficient drug regimen for the patient.

Question 38

Where are drugs absorbed in the body?

Answer 38

most absorption occurs in the small intestine

Question 39

What is the most frequently used route of drug administration?

Answer 39

Oral

Question 40

What are some barriers to the absorption of drugs when taken orally?

Answer 40

A large percentage of the oral dose will be destroyed before it reaches the tissues (First pass effect).

Question 41

What is the first pass effect?

Answer 41

The first pass effect is a phenomenon of drug metabolism whereby the concentration of a drug, specifically when administered orally, is greatly reduced before it reaches the systemic circulation.

Question 42

What is the process of distribution?

Answer 42

A reversible transfer of a drug between one location and another in the body.

Question 43

What is the most important site for metabolism?

Answer 43

The liver

Question 44

What happens to drugs in the liver?

Answer 44

They are changed into new, less active chemicals by enzymes in the liver

Question 45

Clearance (CL) or excretion is what?

Answer 45

The removal of the drug from the body