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Pharm Exam 2 > Psychotherapeutic Drugs > Flashcards

Psychotherapeutic Drugs Flashcards

1
Q

Main anxiolytic

A

Benzodiazepines: Diazepam and chlordiazepoxide

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2
Q

Indications for chlordiazepoxide or diazepam

A

Anxiety disorders

Muscle relaxants

Alcohol withdrawal

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3
Q

Nursing considerations for chlordiazepoxide and diazepam

A

Teaching: do not take with alcohol, don’t drive if sedated

Eliminated in liver: May become toxic

Addiction potential

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4
Q

What is the anti mania drug

A

Lithium carbonate

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5
Q

Indications for lithium carbonate

A

Bipolar: mania

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6
Q

Side effects of lithium

A

Slight tremor, dull, headache, metallic, taste, polydipsia

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7
Q

Nursing considerations for lithium carbonate

A

Takes several weeks to have effect on acute mania

Narrow therapeutic window: blood level 0.5 to 1.5 mEq/L

Salt is close chemistry of sodium.. if Na is too low, lithium levels go up

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8
Q

What happens when lithium carbonate produces toxicity in the body

A

Disrupts muscle conduction: course tremor, GI upset, confusion, ataxia, coma, death

The person will look drunk: confused, slurred speech

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9
Q

What are the categories of anti-depressants?

A

Monoamine oxidase inhibitors (MAOIs)

Tricyclics

Serotonin selective reuptake inhibitors (SSRIs)

Dopamine reuptake inhibitor

Norepinephrine and serotonin reuptake inhibitor (NSRI)

5HT2 receptor agonist

Noradrenergic agonist

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10
Q

Therapeutic effects for benzodiazepine as an anxiolytic

A

Sedation, Anterograde amnesia, skeletal muscle relaxant

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11
Q

What is the teaching for MAOIs?

A

Low tyramine diet (aged foods) and no decongestants

Suicide assessment!

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12
Q

Why do you need a low tyramine diet while on a MAOI?

A

Too much tyramine in the body becomes a substance similar to epinephrine, that would cause the BP to rise to dangerous levels.

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13
Q

Prototype for MAOIs for treating depression

A

Phenelzine

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14
Q

Prototype for tricyclics

A

Amitriptyline

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15
Q

How long does a tricyclic take to work?

A

2 weeks

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16
Q

Nursing considerations for tricyclics

A

Suicide assessment!! It’s toxic in doses equivalent to a 3 week supply

17
Q

What is the action (therapeutic effect) of all antidepressants?

A

Improve energy first

Other symptoms of depression lifts.. THEN depression mood lifts

18
Q

Side of effects of tricyclics

A

Sedation.. but it eventually wears off

19
Q

Prototype for an SSRI

A

Fluoxetine

20
Q

Nursing considerations for SSRI

A

Not as toxic as tricyclics (hard to OD)

Suicide assessment

21
Q

Adverse effects for SSRI

A

Sexual dysfunction in both sexes

22
Q

What are the 2 antipsychotic drugs?

A

Typical phenothiazines

Atypical antipsychotics

23
Q

What is the prototype for the typical phenothiazines?

A

Prototype at low potency: chlorpromazine

Prototype at high potency: haloperidol

24
Q

What is the indications for the typical phenothiazines

A

Positive symptoms of psychosis like hallucinations

25
Q

Side effects of typical phenothiazines

A

EPS (extrapyramidal side effects) and anticholinergic side effects

High potency = high EPS

Low potency = low EPS

26
Q

Why do we prescribe haldol with an anticholinergic

A

Because it is very likely to cause acute dystonic reaction (a type of EPS)

27
Q

What side effect is most likely to cause patients to stop taking their antipsychotic

A

Akathisia

28
Q

Nursing considerations for Thorazine and haldol

A

Teach: risk and symptoms of tardive dyskinesia

29
Q

What is akathisia

A

Can’t sit still

Inner restlessness

30
Q

What is acute dystonic reaction

A

Painful muscle stiffness in the head and neck- torticollis

Severe reaction may prevent swallowing and presents choke risk.

31
Q

What is neuroleptic malignant syndrome?

A

Severe muscle stiffness, fever, unstable blood pressure

32
Q

Prototype for the atypical antipsychotic

A

Clozaril

33
Q

Indications for Clozaril

A

Negative symptoms of psychosis, like apathy, lack of motivation

(Maybe schizophrenia?)

34
Q

Nursing considerations for clozaril specifically

A

Weekly WBC counts for at least a year because risk of agranulocytosis

35
Q

What is the biggest nursing challenge for the atypical antipsychotics?

A

Weight gain (metabolic syndrome)

Pharm Exam 2 (7 decks)

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