Psychopharmacology Flashcards
Legal and ethical issues nurses must consider when administering psychotropic medication?
- 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
What are some factors that contribute to non-adherence who psychotropic medication?
- stigma and discrimination
- side effects
- getting better (then discontinuing use)
- cost of pharmacy access\
- fear of addiction
what is a “PRN” medication when might it be used?
“as required” used in break through psychotic symptoms, anxiety agitation
what are depot antipsychotics? when might these be used?
IMI often administered 2/52. used when orally not adhered.
Consideration related to psychotropic drug use: pregnant and lactating women
haemodilution, foetal addiction, foetal development, medication transference through breast milk
Consideration related to psychotropic drug use: children and adolescents
dosaging (lower doses due to drug naivety and lower body weight)
contradictions oth other medications
Consideration related to psychotropic drug use: older people
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
Pharamcodynamics
effects of drugs and mechanism of action
pharmacokenetics
movement of drugs within the body
Akathisia
movement disorder characterised by internal restless and drive to move.
side effects of some antipsychotic medication
Ataxia
lack of voluntary muscle coordination incorporating gait
Dysarthria
Slow and slurred speech that can be difficult to understand
Tinnitus
perception of noise or ringing in the ears
Extrapyramidal side effects
includes pseudo parkinsonism, akathisia, dystonia and dyskinesia side effects from antipsychotic medication
Metabolic syndorme
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
Neuroleptic malignant syndrome
rare life threatening condition as a result of some antipsychotic medications (or combination of medication) including fever, muscle rigidity, altered MSE and autonomic dysfunction
What are antidepressants?
Antidepressants work by balancing chemicals in your brain called neurotransmitters to address deficiencies in key areas of the brain
What is the biomedical explanation for depression?
That depression stems from a deficiency of norepinephrine (NE), dopamins, or serotonin in key areas of the brain.
What are the 3 ways an antidepressant addresses deficiencys in the brain?
- They inhibit the effects of monoamine oxide thus increasing serotonin and norepinephrine in the synaptic cleft
- They block the reuptake of specific neurotransmitters leading to a build up of these in the synaptic cleft
- They are involved in regulation at receptor sites and the breakdown of neurotransmitters
What are some mild symptoms of serotonin syndrome?
Increased heart rate, shivering, sweating, dilated pupils, myoclonus, and over-responsive reflexes.
What do Selective serotonic reuptake inhibitors (SSRIs) and related drugs do? (Antidepressants).
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.
What is serotonin syndrome?
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
What are the common side effects from Tricyclic antidepressants (TCAs)?
dry mouth, blurred vision, constipation, urinary retention, drowsiness, and weight gain
What are the common side effects from Monoamine oxidase inhibitors (MAOIs)?
Postural hypotension, constipation, drowsiness, dry mouth, fatigue, headache, insomnia, and sexual dysfunction
What are mood stabilisers?
Drugs used for the treatment of bipolar affective disorders and schizo-affective disorders - they may also treat manic episodes
What is the drug of choice for treatment of acute mania and ongoing maintenance?
Lithium
How does Lithium work to treat acute mania?
It mimics the affects of sodium and compromises the ability of neurons to release, activate and respond to neurotransmitters.
What are some common side affects of lithium?
Tremor, stomach upset, polyuria, and polydipsia
What do Anticonvulsants do?
Anticonvulsants work by calming hyperactivity in the brain in various ways (Stabilising nerve membranes throughout the CNS)
What are Anxiolytic (Anti-anxiety) medications?
Anxiolytics are a class of medications used to prevent or treat anxiety symptoms or disorders
What do Benzodiazepines (Anxiolytics) do?
They are sedatives / anxiolytics (relieve anxiety) that act in the limbic system to treat anxiety disorders, agitation, insomnia, muscle spasm, and alcohol withdrawl.
Why are Benxodiazepines prescribed for short-term use only?
Because people can become physically dependent on them
What is pharmocology?
The study of drugs including their actions and effects in living systems
What is clinical pharmacology?
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
What are the two different names a drug will have?
A generic name and a brand name
What processes can have a major impact on the absorption, distribution, metabolism and excretion of drugs?
Infections and diseases processes
Understanding pharmacokinetics help nurses to?
Anticipate therapeutic and adverse drug effects and plan appropriate nursing interventions to ensure the safest and most efficient drug regimen for the patient.
Where are drugs absorbed in the body?
most absorption occurs in the small intestine
What is the most frequently used route of drug administration?
Oral
What are some barriers to the absorption of drugs when taken orally?
A large percentage of the oral dose will be destroyed before it reaches the tissues (First pass effect).
What is the first pass effect?
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.
What is the process of distribution?
A reversible transfer of a drug between one location and another in the body.
What is the most important site for metabolism?
The liver
What happens to drugs in the liver?
They are changed into new, less active chemicals by enzymes in the liver
Clearance (CL) or excretion is what?
The removal of the drug from the body
