Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Mental Health Nursing > Psychopharmacology > Flashcards

Psychopharmacology Flashcards

You may prefer our related Brainscape-certified flashcards:
Nursing Mental Health flashcards Nursing Management of Care flashcards NCLEX-PN® flashcards NCLEX-RN® flashcards Nursing Fundamentals flashcards Nursing Pediatrics flashcards Nursing Safety & Infection flashcards Nursing Pharmacology flashcards Nursing Maternity flashcards Family Nurse Practitioner (FNP) flashcards
1
Q

Signs and Symptoms of Serotonin Syndrome

A

Mild: Nervousness, insomnia, nausea/diarrhea, tremor, big pupils
Moderate: hyperreflexia, sweating, agitation/restlessness, inducible clonus, side-to-side eye movements
Severe: fever >38.5C/101.3F, confusion/delirium, sustained clonus/rigidity, rhabdomyolysis, Death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Nursing Interventions of Neuroleptic Malignant Syndrome?

A

life threatening, sent out for clearance…

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the risks of the following drug interaction:
-SSRIs (i.e. fluoxetine) and warfarin
• MAOIs (phenelzine, tranylcypromine) and tyramine
• Lithium and NSAIDs
• Lorazepam and sertraline
• Serotonin modulators enhance effects of other serotonin modulators

A
  • bleeding
  • hypertensive crisis
  • lithium toxicity
  • sedation?
  • serotonin syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Examples of Selective Serotonin Reuptake Inhibitors (SSRIs)

A
  • citalopram (Celexa)
  • escitalopram (Cipralex) *
  • fluoxetine (Prozac)
  • fluvoxamine (Luvox)
  • paroxetine (Paxil)
  • sertraline (Zoloft) *
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

A
  • desvenlafaxine (Pristiq)
  • duloxetine (Cymbalta)
  • levomilnacipran (Fetzima)
  • venlafaxine (Effexor) *
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Tricyclic Antidepressants (TCAs)

A
  • amitriptyline (Elavil)
  • clomipramine (Anafranil)
  • desipramine (Norpramin)
  • doxepin (Sinequan )
  • imipramine (Tofranil)
  • nortriptyline (Aventyl)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Monoamine Oxidase Inhibitors (MAOIs)

A
  • moclobemide (Manerix) – reversible inhibitor of MAO
  • phenelzine (Nardil) – irreversible inhibitor of MAO
  • tranylcypromine (Parnate) – irreversible inhibitor of MAO
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Mood Stabilizers

A
  • Lithium (Carbolith, Lithmax )
  • carbamazepine (Tegretol)
  • divalproex (Epival)
  • gabapentin (Neurontin)
  • lamotrigine (Lamictal)
  • valproic acid (Depakene)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is first line treatment for acute mania, acute depression and maintenance treatment in Bipolar Disorder?

A

Lithium
Quetiapine
1st line in acute mania, acute depression and maintenance therapy
• Quetiapine, aripiprazole, risperidone, asenapine - used in combination with mood
stabilizers for faster onset in the management of acute mania
• Treat concomitant psychotic symptoms and rapidly help with agitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

First line treatment for most anxiety disorders?

A

antidepressants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Types of anxiolitics?

A

buspirone

benzodiazepine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are signs and symptoms of discontinuation syndrome?

A 
F lu-like symptoms
I nsomnia
N ausea
I mbalance
S 
H yperarousal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Common Side effects of SSRIs?

A

GI upset, dry mouth, insomnia, somnolence, headache, sexual dysfunction, sweating, agitation, anorexia, increased bleeding risk (with drug interactions), SIADH with hyponatremia, glaucoma, falls risk
(paroxetine is most anticholinergic and caution: discontinuation syndrome)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Common Side effects of SNRIs

A

Similar to above; sleep disturbances, nausea, agitation, as dose increases: increased BP&HR, caution: discontinuation syndrome especially with venlafaxine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Common Side effects of NDRI, ex. bupropion (Wellbutrin) - Norepinephrine-Dopamine Reuptake Inhibitor (NDRI)

A

Insomnia, tremor, sweating, anxiety, decreased appetite, increased risk of seizure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Common Side effects of SARI, ex. trazodone (Desyrel) - Serotonin Antagonist Reuptake Inhibitor (SARI)

A

Sedation, dizzy, falls/fracture risk; decrease BP (alpha blockade)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Common Side effects of NaSSA, ex. mirtazapine (Remeron)* - Noradrenergic and Specific Serotonin Antidepressant?

A

Sedation, increased weight, edema, anticholinergic → dry mouth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Common Side effects of TCAs?

A

Anticholinergic effects (dry mouth, blurred vision, constipation, urinary retention →nortriptyline generally better tolerated), sedation, increase weight, sexual dysfunction, confusion, increase HR, decrease BP, falls risk, cardiac arrhythmias, potentially fatal in overdose

19
Q

Common Side effects of MAOIs?

A

Decreased BP, drowsiness, anticholinergic effects, weight gain, sexual dysfunction (less with moclobemide), drug-food interactions (tyramine) → hypertensive crisis

20
Q

Common side effects of lithium?

A
  • N/V/D
  • polyuria, polydipsia
  • fatigue
  • weight gain
  • hand tremor
  • alopecia
  • acne, psoriasis
  • hypothyroidism
  • hyperparathyroidism, increased calcium
  • increased potassium
  • increased SCr, renal impairment
  • cardiac effects
  • leukocytosis
21
Q

What and when to monitor when taking lithium?

A
  • SCr
  • CBC
  • weight
  • TSH
  • ECG
  • lytes
  • Ca++
  • 12-hour post dose serum levels (5 days after initiating therapy or change in therapy)
22
Q

What are signs and symptoms of mild, moderate and severe lithium toxicity?

A

➢ Mild: GI upset (diarrhea, vomiting), confusion, agitation,
muscle weakness, fatigue, fine hand tremor, slurred speech
➢ Moderate: lethargy, nystagmus, course hand tremors, fluctuating LOC
➢ Severe: seizures, organ failure, coma, death

23
Q

What factors effect lithium concentration?

A
  • hydration status
  • salt intake
  • renal function
  • drug interactions
24
Q

Common side effects of carbamazepine (Tegretol)?

A

N/V, drowsiness, blurred vision, menstrual irregularities Rare: aplastic anemia, severe skin reactions (esp. in Asian population)
LOTS of drug interactions!

25
Q

Common side effects of divalproex (Epival) & valproic acid (Depakene)?

A

Prodrug of valproic acid, divalproex usually less GI issues than valproic acid
N/D, weight gain, dizzy, ataxia, alopecia, menstrual disturbances
Rare: pancreatitis, decreased platelets, decreased WBC, teratogenic defects

26
Q

Common side effects of gabapentin (Neurontin)?

A

N/V, Dizzy, ataxia, nystagmus, blurred vision, weight gain

27
Q

Common side effects of lamotrigine (Lamictal)?

A

N/V, dizzy, ataxia, diplopia,

Rare: Stevens-Johnsons rash and toxic epidermal necrolysis)

28
Q

Common side effects of benzodiazepine?

A
  • headaches
  • confusion
  • ataxia
  • daytime drowsiness
  • risk of falls
  • withdrawal upon discontinuation
  • “Rebound” phenomenon
29
Q

Nursing management of Serotonin Syndrome?

A
  • Stop presumptive causative agent(s)
  • Refer patient to hospital
  • Provide supportive care
  • Control agitation, hyperthermia, HR, BP
  • Use 5-HT2A antagonists (i.e. cyproheptadine)
30
Q

First generation (typical) antipsychotics?

A

haloperidol, chlorpromazine

31
Q

Second generation (atypical) antipsychotic?

A

risperidone, olanzapine

32
Q

Third generation anti

A

aripiprazole, brexpiprazole

33
Q

What antipsychotics can be used for acute agitation?

A

haloperidol, loxapine, olanzapine, risperidone, zuclopenthixol acetate (Acuphase)-not a chemical restraint

34
Q

Key differences between side effect profile of typical and atypical antipsychotics?

A

Typical (D2 antagonism): more EPS, edocrine effects

Atypical: Metabolic S/E, depression, anxiety

35
Q

Acute dystonic crisis treatment?

A

anticholinergics: benztropine, diphenhydramine

benzos

36
Q

Akathisia treatment?

A

Reduce dose
Stop/switch antipsychotics Anticholinergic ?
Propranolol
Benzodiazepines

37
Q

Tardive dyskinesia treatment?

A

stop anticholinergic, discontinue antipsychotic

switch to atypical or clozapine

38
Q

Pseudoparkinsonism (Resting tremor (pill-rolling) Cogwheel rigidity Bradykinesia
Salivation
Stooped posture Shuffling gait) treatment?

A

Reduce dose
Stop/switch antipsychotics Anticholinergic for rigidity
daily Propranolol

39
Q

Signs and symptoms of NMS?

A

muscle rigidity, fever and acute change in mental status – Autonomic Dysfunction (tachycardia, tachypenia, incontinence )
– Altered consciousness

40
Q

Treatment-resistant schizophrenia?

A

failure of an adequate trial of at least 2 different APs

41
Q

Clozapine monitoring guidelines?

A

Bloodwork:q weekly, q14 days, q28days
Bowel monitoring: 1st line lactulose, PEG, 2nd line stimulants (sennosides, bisacodyl)
caution: – Fiber and bulk-forming products (i.e. psyllium, inulin fiber, etc.) -Can worsen constipation/cause impaction in patients with underlying dehydration
– Use with caution

42
Q

Signs and symptoms of clozapine-induced myocarditis?

A

chest pain, rapid or abnormal HR, dyspnea, fluid retention/ fatigues, s/s of viral infection (headache, joint pain, fever, sore throat, diarrhea)

43
Q

Life-threatening side effects of clozapine?

A

agranulocytosis, constipation, myocarditis

44
Q

What medication is used to reduce alcohol consumption…

A

naltrexone

Mental Health Nursing (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions