psychopharmacology

Question 1

Biopsychosocial approach

Answer 1

an interdisciplinary model that looks at the inter connection between biology, psychology, and socio-environmental factors

Question 2

Sedative (anxiolytic)

Answer 2

should reduce anxiety and exert a calming effect with little or no effect on motor or mental functions

Question 3

Hypnotic

Answer 3

should produce drowsiness and encourage the onset and maintenance of a state of sleep that as far as possible resembles the natural sleep state

Question 4

Sedatives-hypnotic agents

Answer 4

benzodiazepines and non-benzodiazepines

Question 5

benzodiazepines

Answer 5

• anti-anxiety
• block GABA
• decreases arousal

Question 6

non-benzodiazepines

Answer 6

• barbiturates
• smaller therapeutic index
• abuse potential

Question 7

pharmakokinetics for sedatives

Answer 7

• highly lipid soluble
• oral admin
• absorbed in GI
• metabolized in liver
• excretion: susceptible to re-absorption (hangover)
• risk for dependence

Question 8

SSRI mediactions

Answer 8

• escitalopram (lexapro)

- sertraline (zoloft)

Question 9

Side effects of SSRI

Answer 9

GI complaints
insomnia
HA
sexual dysfunction

Question 10

time until improved mood on ssri’s

Answer 10

• peak effects: 4.5 to 8 hours

- may take up to 6 weeks for full effects (zoloft); 3-6 weeks (lexapro)

Question 11

Serotonin syndrome

Answer 11

• Side effect of depression/ anxiety meds
• Precipitated by over activation of serotonin or impaired metabolism —usually occurs 2‐72 hours after Rx onset
• Mental status changes :hallucinations,agitation,coma
• Autonomic instability: tachycardia,hyperthermia,changes in BP
• Neuromuscular hyperactivity: hyperreflexia, incoordination, clonus, tremors,
• GI disturbances: N/V/D

Question 12

Black box warning for SSRI

Answer 12

may cause suicidal ideation/ plans (younger than 24 years of age)
- gives energy to fulfill plans

Question 13

ISPATHWARM

Answer 13

- warning signs of suicide
ideation
substance abuse
purposelessness
anxiety
trapped
hopelessness
withdrawal
anger
recklessness
mood change

Question 14

tranquilizers

Answer 14

action- slow brain function
short-term effects: sleepy, uncoordinated initially, but diminish; high doses impairs memory, judgement and coordination, paranoid, and suicidal ideation

Question 15

CNS depression

Answer 15

Occurs secondary to CNS dx
Caused by barbiturates, alcohol, and benzodiazepines
slows heart rate and breathing, can affect brain function, thinking, perception, movement, and speech

Question 16

Major depression

Answer 16

• depressed mood or loss of interest in activities
• loss of energy
• indecisiveness
• difficulty thinking
• inappropriate feelings of guilt and worthlessness
• loss of appetite or excess eating
• sleep disturbance
• obsession with death

Question 17

Tricyclic anti-depressant

Answer 17

• depression medication

- side effects- muscle weakness, sedation, highest OD risk

Question 18

MAO inhibitors

Answer 18

• anti depressants
• not front line
• side effects- restlessness, irritability, increased BP, food interactions

Question 19

Tricyclic overdose

Answer 19

• lethal (70-80% die)
• CNS and CV systems are affected
• death results from seizures or dysrhythmias
• no specific antidote
• decrease drug absorption with activated charcoal
• speed elimination by alkalinizing urine

Question 20

MAOI overdose

Answer 20

• symptoms appear 12 hours after ingestion
• tachycardia, circulatory collapse, seizures, coma
• tx: protect brain and heart, eliminate toxin

Question 21

PT concerns for antidepressants

Answer 21

• rehab process will be perceived positively
• fall prevention
• HTN crisis
• suicidal tendencies

Question 22

2nd gen antidepressants therapeutic uses

Answer 22

• depression, very few serious side effects
• obesity
• eating disorders
• obsessive-compulsive disorder
• panic disorder
• myoclonus