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Module 6 > psychopharmacology > Flashcards

psychopharmacology Flashcards

1
Q

medications that affect behavior mimicking emotion

A

psychotropic drugs

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2
Q

max therapeutic effect you can achieve with any drug

A

efficacy

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3
Q

amount of drug needed to attain max drug affect

A

potency

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4
Q

time it takes for half of the drug to go through the blood stream

A

half life

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5
Q

happens when you take someone off of a medication

A

rebound effect

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6
Q

symptoms you have when you remove drug from the pt system

A

withdrawals

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7
Q

a movement disorder

A

akathisia

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8
Q

chemical messengers between neurons which triggers a response form one neuron to another

A

neurotransmitters

*believed to play major role in mental illness

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9
Q

most psychotropic medications work by either ________ or _______ action at the ______ ________

A

agonistic; antagonistic; neural synapse

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10
Q

what are the 4 groups of neurotransmitters

A

monoamines, amino acids, peptides, and cholinergics

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11
Q

what are the 4 monoamines of neurotransmitters

A

dopamine
norepinephrine
serotonin
histamine

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12
Q

what are the functions of dopamine (has many receptors)

A

fine muscle movement, decision making, release of hormones form hypothalamus, integration of emotions and thoughts

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13
Q

if there is an increase in dopamine it causes…

A

schizophrenia and mania

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14
Q

if there is a decrease in dopamine it causes…

A

parkinsons and depression

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15
Q

what are the functions of norepinephrine (has many receptors)

A

mood, attention, arousal, stimulation of SNS (fight of flight response)

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16
Q

if there is an increase in norepinephrine it causes…

A

mania, anxiety, and schizophrenia

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17
Q

if there is a decrease in norepinephrine it causes…

A

depression

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18
Q

what are the functions of serotonin (has many receptors)

A

sleep regulation, hunger, mood, perception of pain, libido, aggression, hormonal activity

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19
Q

if there is an increase in serotonin it causes…

A

anxiety

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20
Q

if there is a decrease in serotonin it causes…

A

depression

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21
Q

what are the functions of histamine (only has 2 receptors)

A

alertness, gastric secretions, inflammation response

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22
Q

if there is a decrease in histamine it causes…

A

sedation and weight gain

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23
Q

what are the 2 amino acids of neurotransmitters

A

aminobutyric acid

glutamate

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24
Q

what is the function of aminobutyric acid (only has 2 receptors)

A

decreased anxiety, excitement or aggression; affects pain perception, anticonvulsant and muscle relaxing properties; potentially impairs cognition and psychomotor function

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25
Q

if there is an increase in aminobutyric acid it causes…

A

reduction of anxiety

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26
Q

if there is a decrease in aminobutyric acid it causes…

A

mania, anxiety, schizophrenia

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27
Q

what is the function of glutamate (only has 2 receptors)

A

receptor AMPA plays role in learning

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28
Q

if there is an increase in glutamate it causes…

A

if prolonged in receptor NMDA can result in neurotoxicity and neurodegeneration as seen in alzheimers

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29
Q

if there is a decrease in glutamate it causes…

A

in NMDA can lead to psychosis

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30
Q

what is the cholinergic of neurotransmitters

A

acetylcholine

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31
Q

what is the function of acetylcholine (only has 2 receptors)

A

learning and memory, regulation of mood, affects sexual and aggressive behavior

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32
Q

if there is an increase in acetylcholine it causes…

A

depression

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33
Q

if there is a decrease in acetylcholine it causes…

A

alzheimers and parkinson disease, huntingtons chorea

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34
Q

what are the 3 antidepressants categories we will talk about

A

SSRIs, TCAs, and MAOIs

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35
Q

what are the 8 SSRIs

A 
fluoxetine
fluvoxamine
paroxetine
sertraline
citalopram
escitalopram
vilazodone
vortioxetine
36
Q

what is the MOA for SSRIs

A

inhibit repute of serotonin making it available longer in the synapse

37
Q

what is the time to effectiveness of SSRIs

A

2-3 weeks

38
Q

what are side effects of SSRIs

A 
tremors
nausea
headache
insomnia, drowsiness
sexual dysfunction
anxiety/agitation
dry mouth
diarrhea
hyponatremia
39
Q

what are patient teachings of SSRIs

A

take med with food in the morning
do not stop abruptly
inform patient they have to take the med long enough before deciding it does not work
teach signs of serotonin syndrome

40
Q

what are the 5 TCAs

A 
amitripyline
nortriptyline
desipramine
imipramine
doxipin
41
Q

what is the MOA of TCAs

A

inhibits reuptake of serotonin and norepinephrine (and block cholinergic receptors)

42
Q

what is the time to effectiveness of TCAs

A

4-6 weeks

43
Q

what are the side effects of TCAs (remember these are very LETHAL in overdoses)

A 
weight gain
toxicity
decreased seizure threshold
sexual dysfunction
orthostatic hypotension
sweating
mydriasis
44
Q

what are pt teachings of TCAs

A 
avoid alcohol
lethal 
take in evening (sedating effects)
use caution when driving
takes several weeks to be therapeutic
45
Q

what are the 4 MAOIs

A

phenelzine
tranylcypromine
isocarboxazid
selegiline

46
Q

what is the MOA of MAOIs

A

inhibits enzyme that degrades NE, dopamine, and serotonin

47
Q

what are the side effects of MAOIs

A 
muscle cramps
weight gain 
sexual dysfunction
anticholinergic effects
food interactions
48
Q

what are pt teaching of MAOIs

A

follow tyramine free diet
dietary restrictions continue for at least 2 weeks after drug discontinued
use caution when driving

49
Q

what foods have tyramine in them

A

aged cheese, aged meats (pepperoni, sausage), foods with yeast (pizza), soy, beer, wine, avocados, bananas

50
Q

what crisis could happen when taking MAOIs

A

hypertensive crisis

51
Q

what are symptoms of hypertensive crisis

A 
nausea
chills
fever
restlessness
dilated pupils
motor agitation
vomiting
sweating
severe hypertension
nuchal rigidity
occipital headache
severe nosebleeds
52
Q

how can we lower the chance of hypertensive crisis

A

since tyramine is a very potent vasocompressor if we limit the amount by the food we ingest then this will lower the chances

53
Q

this syndrome is caused by one or more medications with serotonin-enhancing properties

A

serotonin syndrome

54
Q

what are symptoms of serotonin syndrome

A 
fever
trremors
anxiety
mood change
diarrhea
sweating
irritability
abd pain
altered mental state
death
55
Q

what are nursing interventions when we suspect serotonin syndrome

A

stop/discontinue med
admin serotonin receptor blockade
pt will need to be hospitalized until all symptoms are under control

56
Q

what is the difference in MOA between conventional and atypical antipsychotic meds

A

conventional is a dopamine receptor antagonist while atypical is a serotonin-dopamine antagonist

57
Q

conventional antipsychotics control ______ symptoms while atypical antipsychotics control both ______ and _______ symptoms

A

positive; positive and negative

58
Q

what are the main side effect differences between conventional and atypical antipsychotics

A

conventional has increased prolactin levels, EPS/Tardive dyskinesia while atypical has excessive weight gain in abd, diabetes

59
Q

which antipsychotic is choses first

A

second generation (atypical) unless a pt is successfully already on first generation we do not want to change it on them

60
Q

which generation of antipsychotics has a more likelihood of EPS

A

first gen (conventional)

61
Q

what are pt teaching of conventional antipsychotics

A

limit sun exposure, use sunscreen, wear sunglasses, chance position slowly due to hypotention
may take 2-4wk if not months for full effect

62
Q

what are the pt teaching of atypical antipsychotic meds

A 
monitor weight gain
exercise
measure abd growth
observe for signs of diabetes
observe for signs of infection
63
Q

what are extrapyramidal side effects (EPS)

A

acute dystonia
akithisia
pseudoparkinsonism

64
Q

are EPS symptoms reversible with appropriate treatment

A

yes

65
Q

what is considered LATE and PERMANENT EPS

A

tardive dyskinesia

66
Q

what is the main cause of tradeoff dyskinesia

A

long term use of conventional antipsychotics

67
Q

tardive dyskinesia is _______ but can ______ down when pt is taken off the med

A

irreversible; slow

68
Q

what are neuroleptic malignant syndrome symptoms

A 
tachycardia/tachypnea
muscle rigidity
drooling
sudden high fever
diaphoresis
labile BPs
decreased LOC up to coma
69
Q

what are nursing interventions of pt with symptoms of neuroleptic malignant syndrome

A

send to ICU
stop med
may use dantrolene or bromocriptine (muscle relaxant)
increase fluid intake
treat fever
treat BP
*usually resolved quickly once med is stopped

70
Q

what main drug category is used for antianxiety

A

benzodiazepines (pam’s)

71
Q

what are benzos used for

A

anxiety, also used for insomnia, alcohol withdrawal, seizures, and preoperative sedation

72
Q

what are side effects of benzos

A

sedation, drowsiness, impaired memory and poor concentration, tolerance and dependence

73
Q

what is the antidote for benzos

A

flumazenil

74
Q

benzodiazepines have a _____ onset and most commonly prescribed med for _____ anxiety

A

rapid; acute

75
Q

another antianxiety med, buspirone, is used for more _____ states of anxiety since it takes ______ to take effect

A

chronic; longer

*buspirone is non addicting and non sedating unlike benzos

76
Q

what is the FIRST LINE of medication tx for CHRONIC anxiety disorders

A

SSRIs (due to fewer side effects, quicker acting and more effective than TCAs)

77
Q

mood stabilizers are used to treat

A

bipolar mania, mood disorders

78
Q

what are first line mood stabilizers

A

lithium and divalproex sodium (anticonvulsant)- has a quick response to it

79
Q

if pt is taking lithium they need to make sure they are taking in ______ amount of ____ but not too much, if they take in too much ____ the body is going to release the _____

A

normal; salt; salt; lithium

80
Q

what are pt teaching of lithium

A

do not take if pregnant
take with food to decrease GI upset
stress fluid and sodium intake
monitor blood levels

81
Q

what is the blood level of acute mania

A

0.6-1.2

82
Q

what is the maintenance blood level of lithium

A

0.4-1

83
Q

if there is a lithium toxicity when we draw up the blood what should we do

A

stop the drug if level is high

can treat with urea, mannitol, and urophlin

84
Q

what is the first line drug for anticonvulsants

A

divalroex sodium

85
Q

what is considered rapid cyclers of anticonvulsants

A

carbamazepine

86
Q

what pt teaching should be done for anticonvulsants

A

report pregnancy
monitor blood levels
do NOT stop abruptly
oral suspension should be shaken properly

Module 6 (11 decks)

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