Psychotherapeutic Drugs

Question 1

Anxiolytic drugs

Answer 1

Benzodiazepines ends in -lam/pam
-alprazolam
-diazepam
-lorazepam

Miscellaneous drug is Buspirone

Question 2

Adverse effects of benzodiazepines

Answer 2

over-expression of therapeutic effects

-drowsy, dizzy
-hypotension (have pt sit before stand)
-headaches
-N/V constipation
-dry mouth

Question 3

Antidote for benzodiazepines

Answer 3

Flumazenil (Romazican)
(Fluh-maz-uh-nil)

Question 4

Interactions w/ benzodiazepines

Answer 4

do not mix w/ alcohol, will have additive CNS depression and death
-occurs more in pt w/ hepatic/renal compromise

Question 5

Buspirone

Answer 5

misc anti-anxiety med
-lacks sedative/dependency properties unlike benzos

Question 6

Alprazolam adverse effects and what to avoid it with

Answer 6

-slow, sleepy, drowsy side effects
-avoid w/ alcohol/contraceptives
-AE: confusion, headaches

Question 7

Diazepam indications, and adverse effects (valium)

Answer 7

given to someone with anxiety/panic attack
-slow, sleepy, drowsy
-avoid in pt w/ hepatic problems
-AE: confusion

Question 8

Lorazepam (ativan) indications

Answer 8

To treat or prevent alcohol withdrawel

Question 9

Mood stabilizing drugs indications

Answer 9

for bipolar disorder
-lithium carbonate
-lithium citrate

Question 10

Drug of choice to treat mania

Answer 10

lithium carbonate/citrate

Question 11

Therapeutic range for lithium

Answer 11

Maintenance range: 0.6-1.2
Acute mania: 1-1.5

Question 12

What should be monitored while taking lithium?

Answer 12

sodium levels (NAtremia) (135-145)
below 135=holds onto lithium=toxicity

Question 13

Most serious adverse effect on lithium

Answer 13

cardiac dysrhymias (monitor the heart)

Question 14

What does long term use of lithium cause

Answer 14

hypothyroidism
(test patients thyroid before administering this medication)

Question 15

Antidepressant drug classifications

Answer 15

tricyclic antidepressants
MAOIs
Second gen
SSRIs
SNRIs

-high risk of suicide at beginning of therapy
-tell pt it can take at least 6 weeks for therapeutic effects to occur

Question 16

Amitriptyline

Answer 16

tricyclic antidepressant
-been replaced by SSRIs as first line antidepressant

Question 17

Amitriptyline indications

Answer 17

treats insomnia/neuropathic pain

Question 18

tricyclic antidepressant indications
(Amitriptyline)

Answer 18

-depression
-childhood eneursis
-adjunctive analgesic for chronic pain

Question 19

Overdose w/ tricyclic

Answer 19

very lethal
CNS/cardiovascular system is mainly effected
-death results from cardiac dysrhythmias/seizures

Question 20

MAOIs indications

Answer 20

-used for PD, rarely for depression
-isoscarboxazid
-phenelzine
-tranylcypromine
-selegiline

Question 21

What can taking tyramine w/ MAOIs result in

Answer 21

hypertensive crisis

Question 22

foods that contain tyramine

Answer 22

-aged mature cheese (cheddar, bleu, swiss)
-smoked pickled aged meats
-red wines
-fava beans (italian beans)
-pepperoni/salami
-yeast extracts
-fish poultry sausage corned beef

Question 23

Second generation antidepressants

Answer 23

Bupropion
SSRIs
-fluoxetine
-sertraline (ends in -ine)

Miscellaneous: Mirtazapine

Question 24

What is bupropion for

Answer 24

helps w/ smoking cessation, brand name is (Zyban)

Question 25

second generation AE:

Answer 25

Insomnia

SSRIs
-fluoxine
-sertraline
-Bupropion

Question 26

Serotonin syndrome in second gen S/S

Answer 26

to much serotonin (feel good chemical)
-hyperthermia
-seizures
-cardiac dysthymias
Rhabdomylosis (muscle breakdown)

Question 27

When do we administer Fluoxetine

Answer 27

SSRI
-give in the morning, causes insomnia
AE: dizzy, drowsy, insomnia, anxiety

Question 28

Duloxetine indications

Answer 28

SNRI
-used for pain resulting from diabetic peripheral neuropathy, or fibromyalgia

Question 29

Mirtazapine indication and when to give this med

Answer 29

An appetite stimulant for older patients that causes sedation, give the dose at bedtime, fall risk

Question 30

Antpsychotics

Answer 30

used for drug induced psychosis, and schizophrenia
-known as tranquilizer

typical:
haloperidol (more ADE)

atypical:
quetiapine (less ADE)
Clozapine

Question 31

Adverse effects w/ antipsychotics

Answer 31

-agranulocytosis (decreased WBC)
-hemolytic anemia (rbc are destroyed)
-tardive dyskinesia (involuntary
contraction of oral/facial muscles)

MONITOR CBC

Question 32

Extrapyramidal symptoms of antipsychotics

Answer 32

-akathisia (restless muscles)
-acute dystonia (painful muscle spams)

Question 33

What can we give a patient to treat acute dystonia

Answer 33

trihexyphenidyl and benztropine

Question 34

Haloperidol indication

Answer 34

long term treatment of psychosis

Question 35

Clozapine adverse effects

Answer 35

second gen atypical antipsychotic

AE: blood dyscrasias (changes in composition of blood)

MONITOR WBC FREQUENTLY, ESPECIALLY IN THE BEGINNING

Question 36

Risperidone

Answer 36

for schizophrenia
therapeutic dose is 1-6
Risperidol consta: last 2 weeks
lnrega sustenna: last 1 month

Question 37

psychotherapeutic nursing interventions

Answer 37

wear sunscreen b/c of light sensitivity
-obtain liver/renal function test

Question 38

Positive symptoms of schizophrenia

Answer 38

-symptoms that a normal person does not have
-hallucinations
-delusions
-conceptual disorganization

Question 39

Negative symptoms of schizophrenia

Answer 39

Not bad, they lack in what a normal person has
-apathy (lack of interest)
-social withdrawel
-catatonia (inable to move properly)