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Module 6 (Psych Mental Health) > Psychopharmacology > Flashcards

Psychopharmacology Flashcards

Differentiate between the different drug classes; recognize the drug names to the class

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Psychology 101 flashcards GRE® Psychology flashcards
1
Q

Psychotropic drugs

A

drugs that affect the person’s behavior, emotional state

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2
Q

Efficacy

A

maximal aptitude the drug can achieve

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3
Q

Potency

A

amount of drug required for therapeutic effect

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4
Q

Half-life

A

time it takes for the amount of a drug’s active substance in your body to reduce by half
- 5 half-life for clearing the syste

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5
Q

Reuptake

A

neurotransmitters behavior synapses pulled in

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6
Q

Approved use

A

FDA approval for certain diseases

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7
Q

Lipid solubility

A

ability to pass through the lipid walls (chemically) High – MEANS PASS THROUGH WITHOUT PERMISSION (higher chance of overdose)

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8
Q

Off-label use

A

reason used other than intended by FDA

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9
Q

Black box warning

A

strongest warning

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10
Q

Rebound effect

A

stop taking the drugs and withdrawal causes more intense symptoms

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11
Q

Withdrawal

A

= s/s noticed after not taking the substance

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12
Q

Akathisia

A

feel uneasy
inner restlessness or more intense symptoms

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13
Q

The brain monitors

A

changes in the external world (stimuli)
composition of body fluids

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14
Q

The brain regulates

A

contractions of muscles
internal organs
basic drives (hunger, thirst, sex, aggression, self-protection)
mood & emotions
sleep cycles
homeostasis

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15
Q

the brain mediates

A

conscious sedation

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16
Q

the brain produces and interprets

A

language and intellectual functions

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17
Q

the brain stores

A

memories

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18
Q

The cerebellum frontal lobe controls what functions

A

Thought processes
decision-making,
judgment,
motivation,
insight,
social judgment,
plans
personality development

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19
Q

The cerebellum temporal lobe controls what functions

A

Language comprehension, stores sounds into memory, connects with limbic system (the emotional brain)

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20
Q

The cerebellum occipital lobe controls what functions

A

Interprets visual images, visual associations, visual memories, involved with language formation

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21
Q

The cerebellum parietal lobe controls what functions

A

Receives & identifies sensory information, concept formation and abstraction, proprioception with body awareness, reading and math skills, right and left orientation

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22
Q

Proprioception

A

awareness of space

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23
Q

Cerebellum

A

Regulates skeletal muscle (coordination & contraction), & maintains equilibrium

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24
Q

Brainstem

A

midbrain
pons
medulla oblongata

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25
Q

Midbrain

A

Pupillary reflex & eye movement

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26
Q

Pons

A

Processing station in auditory pathways

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27
Q

Medulla Oblongata

A

Reflex center control (balance, heart rate, resp rate and depth, coughing, sneezing, swallowing & vomiting, maintains blood pressure)

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28
Q

Psychoactive Medications affect what in the body

A

thinking
behavior
emotions
perceptions

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29
Q

Neurons:

A

Interconnected nerve cells

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30
Q

Neurotransmitters:

A

Chemical messengers between neurons which triggers a response from one neuron to another

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31
Q

Neurotransmission:

A

Conduction of an electrical impulse from one end of the neuron to the other

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32
Q

Synaptic Transmission:

A

When the electrical impulse reaches the end of a neuron, the neurotransmitter is released at the axon terminal & diffuses across the synapse to the postsynaptic neuron

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33
Q

Inhibitory neurotransmitters:

A

inhibits action in the post-synaptic cell

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34
Q

Excitatory neurotransmitters:

A

Promotes action in the post-synaptic cell

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35
Q

Deficient neurotransmitter

A

the message is not thoroughly delivered as there are too many receptors for the too little messages

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36
Q

Deficient receptor

A

damage quality of the transmission
sender reuptakes when clogged
- no other messages can get though while clogged

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37
Q

Monoamines types

A

dopamine
norepinephrine
serotonin
histamine

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38
Q

Amino acids

A

y-Aminobutyir Acid (GABA)
Glutamate

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39
Q

Cholinergics

A

acetylcholine

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40
Q

Peptides

A

substance P
somatostatin
neurotensin

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41
Q

Dopamine affects

A

fine muscle mvmt
decision-making
release of sex hormones (sex, thyroid, adrenal)
integration of emotions/thoughts

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42
Q

If you have too much dopamine, what diseases could occur +

A

Schizophrenia
psychosis
mania

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43
Q

If you have too little dopamine, what diseases could occur -

A

Parkinson’
depression

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44
Q

Norepinephrine affects

A

mood
attention
arousal
SNS stimulation (fight or flight)

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45
Q

If you have too much norepinephrine, what diseases could occur +

A

mania
anxiety
psychosis
heightened arousal state

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46
Q

If you have too little norepinephrine, what diseases could occur -

A

depression
lowered arousal state

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47
Q

Serotonin affects

A

Sleep regulation
Hunger
Mood
Pain perception
Libido
Aggression
Hormonal activity

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48
Q

If you have too much serotonin, what diseases could occur +

A

anxiety

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49
Q

If you have too little serotonin, what diseases could occur -

A

depression

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50
Q

histamine affects

A

Alertness
Gastric secretion stimulation
Inflammation response

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51
Q

If you have too much histamine, what diseases could occur +

A

sleep disturbances
anxiety

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52
Q

If you have too little histamine, what diseases could occur -

A

sedation
seizures

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53
Q

ϒ -Aminobutyric acid:(GABA) affects

A

Decreases anxiety
Decreases excitement
Decreases Aggression
Anticonvulsant

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54
Q

If you have too much ϒ -Aminobutyric acid:(GABA), what diseases could occur +

A

reduction of anxiety

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55
Q

If you have too little ϒ -Aminobutyric acid:(GABA), what diseases could occur -

A

mania
anxiety
psychosis

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56
Q

Glutamate affects

A

Memory
Emotions
Cognition

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57
Q

If you have too much glutamate, what diseases could occur +

A

Increased perception of pain
Anxiety
Restlessness

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58
Q

If you have too little glutamate, what diseases could occur -

A

Low energy
Difficulty concentrating
Insomnia
Psychosis

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59
Q

Acetylcholine(ACh) affects

A

Learning
Memory
Mood regulation
Sexual and aggressive behavior
PNS stimulant

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60
Q

If you have too much ACh, what diseases could occur +

A

depression

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61
Q

If you have too little ACh, what diseases could occur -

A

alzheimer’s
parkinson’s
huntington’s chorea

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62
Q

ACh does what to blood vessels

A

dilates

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63
Q

What are the s/s of a cholinergic (ACh) crisis (too much)?

A

INCREASE of
Salivation
Lacrimation (tears)
Urine excess/leakage
Defecation
GI upset
Emesis and vomiting

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64
Q

Antidepressant medication

A

TCAs
MAOIs
SSRIs
SNRIs

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65
Q

Mood stabilizers

A

Lithium
Anticonvulsants

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66
Q

Antipsychotics

A

1st (Typical) and 2nd (Atypical generations

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67
Q

Anxiolytics

A

benzodiazepines
antihistamines
anticonvulsants
beta blockers

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68
Q

Tx purpose for antidepressants

A

Major Depression
Panic disorder
Some anxiety disorders
Bipolar depression
Psychotic depression
- mood improvement and decrease depression and anxiety

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69
Q

SSRIs (Selective Serotonin Reuptake Inhibitors) -
pathos

A

More likely to see discontinuation syndrome in SSRIs with shorter half-life, such as paroxetine
sit in the synapse in the space to continune down the chain

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70
Q

SNRIs (Serotonin Norepinephrine Reuptake Inhibitors)

A

– venlafaxine, duloxetine, desvenlafaxine –
also treat anxiety and neuropathic pain inhibits the reuptake of both serotonin and norepinephrine

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71
Q

SNDIs (Serotonin Norepinephrine Disinhibitors) –

A

mirtazapine –
often combined with SSRIs to enhance antidepressant effects or to reduce SSRI side effects of nausea, anxiety, insomnia

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72
Q

NDRIs (Norepinephrine Dopamine Reuptake Inhibitors)

A

– buproprion – also prescribed for smoking cessation

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73
Q

SARIs (Serotonin Antagonist/Reuptake Inhibitors) – trazodone – at high doses for antidepressant effects, lower doses for hypnotic effects; can cause priapism

A

– at high doses for antidepressant effects, lower doses for hypnotic effects; can cause priapism

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74
Q

NRIs (Selective Norepinephrine Reuptake Inhibitors) – atomoxetine

A

– used to treat ADHD when stimulants cannot be tolerated

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75
Q

MAOIs (Monoamine Oxidase Inhibitors)

A

– tyramine-restricted diet inhibits the metabolism of the monoamine

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76
Q

TCA are lethal in

A

overdose

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77
Q

SSRI medication names

A

fluoxetine (Prozac)
fluvoxamine (Luvox)
paroxetine (Paxil)
sertraline (Zoloft)
citalopram (Celexa)
escitalopram (Lexapro)
vilazodone (Viibrid)
vortioxetine (Trintellix)

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78
Q

SSRIs do what in the body

A

Inhibit reuptake of serotonin (5HT) making it available longer in the synapse

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79
Q

SSRI side effects

A

Tremors
Anxiety/agitation
Nausea
Dry mouth (sips of water or candy)
Headache
Diarrhea
Insomnia, drowsiness
Hyponatremia
Sexual dysfunction
Bruxism (especially with paroxetine) – grinding in the teeth

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80
Q

SSRI patient teachings

A

with morning food
no alcohol or antihistamines
adherence to regimen
Medication should not be discontinued abruptly

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81
Q

Why should you not abruptly D/C SSRIs

A

prevent withdrawal/discontinuation syndrome - continently for a long time

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82
Q

SSRIs take how long to be therapeutic

A

1-3 weeks - notice and efficiency

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83
Q

Let the physician know immediately when a pt on SSRIs starts having

A

suicidal thoughts increases (opposite effect)

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84
Q

If SSRIs are taken with other serotonin-blocking agents may cause (SSRIs, MAOIs, lithium, triptan, buspirone, tramadol, & OTC cold/cough meds)

A

serotonin toxicity

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85
Q

SSRIs are used cautiosly with what

A

CYP450 enzyme inhibitors or inducers (Example: ketoconazole or rifampin) – ability to metabolize

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86
Q

Withdrawal/Discontinuation syndrome s/s for SSRIs

A

anxiety, insomnia or vivid dreams, headaches, dizziness, tiredness, irritability, flu-like symptoms, including achy muscles and chills, nausea electric shock sensations, and return of depression symptoms

87
Q

Black Box Warning for SSRIs

A

increased risk of suicide

88
Q

Serotonin Syndrome Interventions

A

D/C SSRI
maintain safety (environment)
Monitor physical/mental
Administer
Serotonin receptor blockade
Zofran for nausea
Dantrolene or diazepam for muscle rigidity
Cyproheptadine (histamine 1 receptor antagonist)
Provide reassurance

89
Q

Serotonin Syndrome S/S mnemonic

A

SHIVERS

90
Q

Serotonin Syndrome S/S

A

Shivering
Hyperreflexia and myoclonus (rhabdomyolysis)
increase temp
VS instability (tachy and labile BP)
Encephalopathy (agitation. delirium. and confusion)
restless and incoordination
sweating

91
Q

Labile BP

A

change quickly and spontaneously out of the normal but not too high

92
Q

Tricyclic antidepressant medication names

A

imipramine *
amitriptyline
doxepin
desipramine
nortriptyline
clomipramine *
maprotiline
protriptyline
trimipramine
amoxapine

93
Q

What TCAs are acceptable for 8+ y/o

A

imipramine
clomipramine

94
Q

TCA patho

A

Inhibits reuptake of serotonin (5-HT) & norepinephrine (NE) & blocks cholinergic receptors

95
Q

TCA side effects

A

Sedation
Mydriasis – dilation pupils
Weight gain
Sweating
Toxicity
Sexual dysfunction
Decreased seizure threshold
Orthostatic hypotension
Anticholinergic effects

96
Q

DO NOT GIVE TCA to a petient prone to

A

seizures
suicidal

97
Q

TCA pt teachings

A

avoid alcohol
lethal in overdose
take at night - sedation
caution while driving
adherence

98
Q

TCA absoption

A

HIgh lipid soluble - quick absorption = lethal in overdose

99
Q

TCA effective at

A

4-8 weeks

100
Q

The nurse should question a TCA prescription when

A

given in large quantity as it can lead to overdose

101
Q

MAOIs patho

A

Inhibits enzyme that degrades NE, dopamine, & 5-HT

102
Q

MAOI medication names

A

Isocarboxazid
phenelzine
tranylcypromine
selegiline (comes in transdermal patch form for treatment of depression)

103
Q

MAOI side effects

A

Muscle cramps
Weight gain
Sexual dysfunction
Anticholinergic effects - dries out
Serious food/drug interactions (tyramine)

104
Q

MAOI pt teachings

A

lethal in overdose
Tyramine free diet
Continue diet for 2 weeks after d/c of drug

105
Q

HOw long should you contune the tyramine-free diet when the MAOIs is D/C?

A

2 WEEKS MINIMUM

106
Q

Tyramine-free diet - avoid these foods

A

Aged cheeses &meats
Foods with yeast
Soy
Beer & wine
Avocados & bananas

107
Q

Build up of tyramine in the nerve cells can lead to

A

vasopressor = HTN= circulatory collapse

108
Q

HTN Crisis S/s

A

N/V
chills
sweating
fever
severe HTN
restlessness’
nuchal rigidity
dilated pupils
occiptal HA suddenly
motor agitation
severe nosebleeds

109
Q

SNRI medication types

A

venlafaxine (Effexor)
duloxetine (Cymbalta)

110
Q

SNRI patho

A

Increase serotonin and norepinephrine

111
Q

SNRI side effects

A

Include fewer anticholinergic effects

112
Q

SNDI medication types

A

mirtazapine (Remeron)

113
Q

SNDI patho

A

Increase serotonin and norepinephrine (Combined with SSRIs to augment efficacy or counteract serotonergic side effects)

114
Q

SNDI needs to be given with

A

food

115
Q

1st Generation /Conventional
antipsychotics med names

A

Chlorpromazine
haloperidol (long-acting form)
trifluoperazine
Fluphenazine
loxapineperphenazine
Thioridazine

116
Q

2nd Generation /Atypical
antipsychotics medication names

A

clozapine
cariprazine
amisulpride
brexpiprazole
aripiprazole
ziprasidone
asenapine
sertindole
loperidone
quetiapine
lurasidone
lumateperone
olanzapine (short-and long-acting forms)
paliperidone (long-and very-long-acting forms)
risperidone (short-and long-acting forms)

117
Q

1st Generation /Conventional
antipsychotics patho

A

Dopamine receptor antagonist = Strong dopamine blockade – no control on neg

Also blocks to lesser degree acetylcholine, histamine & NE

118
Q

1st Generation /Conventional
antipsychotics control of what type of symptoms?

A

postive not negative

119
Q

positive symptoms mean

A

+ something added that should not be there

120
Q

negative symptoms mean

A
  • something that is not there anymore
121
Q

2nd Generation /Atypical
antipsychotics patho

A

Serotonin-dopamine antagonists = Less blockade of dopamine plus strong 5HT receptor antagonist
Also blocks to lesser degree acetylcholine, histamine & NE

122
Q

2nd Generation /Atypical
antipsychotics control what type of symptoms

A

positive and negative

123
Q

1st Generation /Conventional
antipsychotics side effects

A

NEURO
Anticholinergic effects
Weight gain
Sexual and/or reproductive organ issues
Increased prolactin levels (both genders)
Seizures
Sedation
Tachycardia and/or prolonged QT interval
Women more common on QT
Orthostatic hypotension
EPS/Tardive Dyskinesia

124
Q

2nd Generation /Atypical
antipsychotics SIDE EFFECTS

A

METABOLIC
Less anticholinergic effects
Weight gain
Type II Diabetes Mellitus
Dyslipidemia
Anxiety
Headache
Sedation

125
Q

1st generation antipsychotics need what procedure done

A

EKG

126
Q

Which antipsychotic generation is more likely to have EPS?

A

1st generation

127
Q

Which antipsychotic generation has fewer anticholinergic effects?

A

2nd gen

128
Q

Which antipsychotic generation is the 1st choice of initial therapy?

A

2nd gen
- 1st gen reserved for who have been on and tolerate

129
Q

Which antipsychotic generation is used to treat Tourette’s disorder?

A

1st gen

130
Q

Which antipsychotic generation is used for breakthrough psychosis and r/t levodopa use?

A

2nd gen

131
Q

Which antipsychotic generation has the greater risk of metabolic syndrome?

A

2nd gen

132
Q

Which antipsychotic generation can be used for extreme nausea in some situations (chemo)?

A

1st gen

133
Q

1st gen antipsychotics pt teachings

A

limit sunlight, need sunscreen and sunglasses
prevent constipation
reposition frequently
sugar-free liquids and candies for dry mouth

134
Q

1st generation antipsychotics might take up to __________ for effectiveness

A

2-4 weeks

135
Q

2nd gen antipsychotics pt teachings

A

regimen
monitor wt gain and exercise
observe for s/s of DM, INFECTION
sugar-free liquids and candies for dry mouth
REPORT ANY CHANGES TO HCP

136
Q

EPS stands for

A

Extrapyramidal Side Effects

137
Q

EPS consists of

A

acute dystonia
akathesia
pseudoparkinsonism
tardive dyskenesia

138
Q

Acute dystonia s/s

A

stiff neck
facial grimacing
invol upward eye mvmt
muscle spasms of tongue, face, neck, and back
- arching forward
laryngeal spasms

139
Q

Tardive dyskinesia s/s

A

snake-like eye and tongue
involuntary mvmt of the body
protrusion and rolling tongue
sucking/smacking mvmts of the lips
chewing motions
facial dyskinesia

140
Q

Can tardive dyskinesia be reversed

A

yes if caught early on but usually permanent

141
Q

Psuedoparkinsonsism

A

stooped posture
shuffling gait
rigidity
slow mvmt
tremors at rest
pill-rolling hand motion

142
Q

Psuedoparkinsonsism is treated the same way as

A

parkinsons

143
Q

Akathesia

A

restless
trouble standing still
paces
constant motion, rocking back and forth
reversible

144
Q

Dystonia is shown through

A

oculogyric crisis (eyes roll to the top of the head)
opisthotonos (backward arch)
torticollis spasmodic (stiff neck in bad position making it hard and painful to turn

145
Q

Dystonia is caused by

A

starting the antipsychotic or increasing the dose to rapidly
- drug-induced if they have a hx of acute dystonia, young, male, cocaine use

146
Q

Tx for dystonia

A

Haldol with anticholinergic

147
Q

Tx for EPS

A

reduce or stop cause
antihistamine or anticholinergic

148
Q

Tardive dyskinesia is considered _____ EPS

A

late

149
Q

Tardive dyskinesia how long after tx

A

months to years

150
Q

Antipsychotics can mask ________ _____________ of tardive dyskinesia

A

early s/s

151
Q

20-30% of Older patients on long-term 1st gen antipsychotics can get

A

tardive dyskinesia

152
Q

What 2 drugs were introduced to treat Tardive dyskinesia?

A

Valbenazine
Deutetrabenazine

153
Q

NMS

A

Neuroleptic Malignant Syndrome

154
Q

Neuroleptic Malignant Syndrome s/s

A

tachycardia/tachypnea
muscle rigidity
drooling
sudden high fever
diaphoresis
labile BPs
decreased LOC to coma

155
Q

NMS is a

A

emergency

156
Q

Tx for NMS

A

ICU
STOP antipsychotics
Increase fluid with IV
Administer antipyrietics,sedation, and DANTROLENE/BROMOCRIPTINE
Tx fever, BP, and dysrhythmias

157
Q

When a patient has NMS, you should treat the fever with

A

antipyretics
cooling blankets and IV fluids

158
Q

In tx for NMS, what should be considered if they are a good candidate?

A

intubation

159
Q

Benzodiazepines

A

alprazolam
oxazepam
triazolam
lorazepam
diazepam
clonazepam
chlordiazepoxide
PAM and LAM driving in their BENZ

160
Q

Benzodiazepines do what to the body

A

Depresses neurotransmission in limbic and cortical areas of the brain
- promote GABA in the receptor complex
slows transmissions

161
Q

Benzodiazepines are used for

A

short-term anxiety/acute anxiety

162
Q

Benzodiazepines patient may develop a

A

Dependence & tolerance

163
Q

Benzodiazepines frequent uses are linked to

A

rebound anxiety
Dementia
increased fall risk: hypersexual, agitated, and high metabolisms
higher mortality

164
Q

Benzodiazepines should NOT be combined with

A

opioid medications

165
Q

Benzodiazepines side effects

A

Sedation
Dizziness
Fatigue
Impaired driving
Impaired cognitive function
CNS depression

166
Q

Benzodiazepines pt teachings

A

avoid alcohol (potentiates effects)
caution whikle driving due to slow reflexes and responses
NEVER D/C apruptly - fatal withdrawal
does not care underlying illness
highly addictive - long-term

167
Q

Benzodiazepines Withdrawal Syndrome
- short-term

A

Anxiety
Insomnia
Sweating
Tremors
Dizziness

168
Q

Benzodiazepines Withdrawal Syndrome
- long-term

A

Panic
Paranoia
Delirium
HTN
Muscle twitches
Seizures

169
Q

Buspirone (Buspar) patho

A

Stimulates serotonin type 1A receptors on nerves, altering the chemical messages that nerves receive

rescue for anxiety attacks

170
Q

Buspirone (Buspar) side effects

A

Dizziness
Nausea
Headache
Nervousness
Lightheadedness
Excitement

171
Q

Buspirone (Buspar) pt teachings
- DO NOT TAKE IF

A

Do not use buspirone if you have taken an MAO inhibitor in the past 14 days.
- non-addictive

172
Q

Buspirone (Buspar) effectiveness

A

2-4 weeks

173
Q

Hydroxyzine pamoate (Vistaril) patho

A

1st generation antihistamine – blocks histamine

174
Q

Hydroxyzine pamoate (Vistaril) side effects

A

drowsiness
headache
dry mouth

175
Q

Hydroxyzine pamoate (Vistaril) pt teachings

A

Don’t take with other CNS depressants
Non-addicting

176
Q

Hydroxyzine pamoate (Vistaril) effectiveness

A

20-30 minutes

177
Q

Hydroxyzine pamoate (Vistaril) if used for a long time can cause

A

cardiac dyskinesia

178
Q

Benzodiazepines
onset
sedating?
dependence and withdrawal?
PRN?

A

Rapid onset
Sedating
Dependence & withdrawal
Tolerance varies with increased age
May be used prn

179
Q

Buspirone
onset
sedating?
dependence and withdrawal?
PRN?

A

Delayed onset
Non-sedating
No dependence or withdrawal
No pharmacokinetic change with age
Not suitable for prn use

180
Q

Hydroxyzine pamoate
onset
sedating?
dependence and withdrawal?
PRN?

A

Rapid onset
Sedating
No dependence or withdrawal
May be used PRN

181
Q

What other medications can be used for anxiety

A

Antidepressants (Anxiety often linked to depression)
Antihistamines
Anticonvulsants
Antipsychotics
Beta blockers

182
Q

What herbal medications can be used for anxiety

A

Kava Kava
Valerian Root
Melatonin

183
Q

KAVA KAVA is not used for pts with

A

psychosis
and liver damage

184
Q

VALERIAN ROOT is not used for pts with

A

aductive use of CNS depressants as it potentiate and becomes ineffective

185
Q

Melatonin can cause the pt to experience

A

vivid/bizarre dreams

186
Q

With anxiety, tx is base on

A

individualized

187
Q

Anticonvulsant med names

A

valproic acid (Depakote)
lamotrigine (Lamictal)
carbamazepine (Tegretol)
oxcarbazepine (Trileptal)
gabapentin (Neurontin)
topiramate (Topomax)

188
Q

Lithium patho

A

Unknown
(but believed to inhibit release of dopamine & norepinephrine, hasten the destruction of catecholamines, serotonin receptor blockade & decrease sensitivity of postsynaptic receptors)

189
Q

Lithium side effects

A

NEURO EXPECTED - no vomiting
Fine hand tremor
Polyuria
Mild thirst
Mild nausea
Weight gain
Sedation
Acne
Cognitive problems
Delayed sexual response
Hair loss

190
Q

Lithium’s therapeutic index

A

NARROW

191
Q

Lithium normal lab values for maintenance

A

0.6-1.0

192
Q

Lithium normal lab values for acute use

A

0.5-1.2

193
Q

Lithium normal lab values for TOXIC

A

> 1.5

194
Q

With lithium, the blood draws consist of

A

peak and trough before each dose and regular lab level

195
Q

Early Lithium Toxicity lab level

A

<1.5

196
Q

Early Lithium Toxicity s/s

A

Nausea
Vomiting
Diarrhea
Thirst
Polyuria
Slurred speech
Muscle weakness

197
Q

Advanced Lithium Toxicity lab values

A

1.5-2

198
Q

Advanced Lithium Toxicity s/s

A

Coarse Tremors
Confusion
EEG changes
Incoordination
Worsening GI upset
Hyperirritability in muscles

199
Q

Severe Lithium Toxicity lab

A

2-2.5

200
Q

Severe Lithium Toxicity s/s

A

Clonic movements
Copious dilute urine
Seizures
Stupor
Severe hypotension
Ataxia
Tinnitus

201
Q

Lethal Lithium Toxicity labs

A

> 2.5

202
Q

Lethal Lithium Toxicity s/s

A

Coma
Dysrhythmias
Circulatory collapse
Oliguria
Proteinuria
Death

203
Q

Lithium can make it potentiate the severity of itself by

A

causing vomiting, diarrhea, and polyuria
- increases the concentration of lithium in the body

204
Q

If the nurse notices the patient on Lithium vomiting or diarrhea, what should they do

A

D/C lithium
STAT lithium levels

205
Q

If the patient has a dose of furosemide next but they are on lithium, what should the nurse do

A

question the diuretic and call the doctor to confirm

206
Q

Lithium pt teaching effetiveness

A

5.7 days
-max at 2-3 weeks

207
Q

Lithium pt teaching

A

NOT for pregnant women
expected vs toxicity s/s
With food to lower GI upset
I&Os
frequent and early blood draws

208
Q

Anticonvulsants for mood stabilizers patho

A

Potentiates the inhibitory effects of GABA; inhibits glutamate suppressing CNS excitement; & slows Ca+ & Na+ movement back into the neuron extending the time it takes the neuron to return to active state

209
Q

Valproic acid (Depakote) adverse effects

A

Blood dyscrasias
Hepatoxicity
Pancreatitis
- immune depressants

210
Q

Carbamazepine (Tegretol)
adverse effects

A

Agranulocytosis – teach to report a sore throat**
Aplastic anemia
- immunodepressants

211
Q

A patient on carbamazepine has a sore throat, what should the nurse do?

A

report to the HCP

212
Q

Anticonvulsant pt teachings

A

Report pregnancy
Monitor blood levels as prescribed
**Do not stop abruptly or if pregnant*
Take as prescribed
Will require monitoring

213
Q

Psychopharmacological principles

A

target s/s
adequate doages for sufficient timing
lowest dose for maintenance
lower doses for the elderly
-taper than abrupt
-follow-up
-simplify
- informed consent required

214
Q

Agranulocytosis tx

A

monitor WBCs (extreme low)
Cloraepine protocol for any signs of infection

Module 6 (Psych Mental Health) (12 decks)

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