Psychotherapeutic Drugs

Question 1

What are psychotherapeutic drugs?

Answer 1

Drugs used in the treatment of emotional and mental disorders

Question 2

What are the 3 main mental health disorders?

Answer 2

Anxiety
Affective (Mood) Disorders
Psychotic disorders

Question 3

What are the 4 types of psychotherapeutic drugs?

Answer 3

Anxiolytic drugs
Mood-stabilizing drugs
Antidepressant drugs
Antipsychotic drugs

Question 4

What are anxiolytic drugs and name an example

Answer 4

Reduce anxiety by reducing overactivity in the CNS
Benzodiazepines

Question 5

Name 3 benzodiazepines

Answer 5

Alprazolam
Diazepam
Lorazepam

Question 6

What are the adverse effects of benzodiazepines?

Answer 6

Decreased CNS activity, sedation, amnesia
Hypotension
Drowsiness, loss of coordination, dizziness, headaches
Nausea, vomiting, dry mouth, constipation

Question 7

What is the antidote for an OD on benzodiazepines?

Answer 7

Flumazenil

Question 8

What is alprazolam(xanax)? (ID, IE, AE)

Answer 8

ID: Anxiolytic, short-term relief of symptoms, panic disorder and anxiety associated with depression
AE: Confusion, ataxia, headache
IE: Alcohol, antacids, oral contraceptives

Question 9

What is diazepam?(ID, CI, AE, IE)

Answer 9

ID: Anxiety, alcohol withdrawal, status epilepticus, preop sedation, adjunctly for muscle spasms
CI: Hepatic dysfunction
AE: Headache, confusion, slurred speech
IE: Alcohol, oral contraceptives

Question 10

What is lorazepam(ativan)?(ID, routes)

Answer 10

Intermediate-acting
IV or IM
Acutely agitated pts, continuous infusion for agitated patients undergoing mechanical ventilation
Treatment or prevention of alcohol withdrawal

Question 11

What are mood-stabilizing drugs?

Answer 11

Drugs used to treat bipolar disorder

Question 12

Name 2 mood-stabilizing drugs

Answer 12

Lithium carbonate
Lithium citrate

Question 13

What is a consideration for lithium drug treatment?

Answer 13

It has a narrow therapeutic range so it needs blood monitoring
Keeping sodium levels normal helps maintain therapeutic lithium levels

Question 14

What are the adverse effects of lithium?

Answer 14

Cardiac dysrhythmia, drowsiness, slurred speech, epilepsy-type seizures, chore athetotic movements, ataxia, hypotension
Hypothyroidism

Question 15

Name 2 first generation antidepressants

Answer 15

Tricyclics and MAOIs

Question 16

Name 2 second generation antidepressants

Answer 16

SSRIs
Serotonin-norepinephrine reuptake inhibitors (SNRIs)

Question 17

Name a tricyclic antidepressant and what is the MOA?

Answer 17

Amitriptyline
Block reuptake of neurotransmitters, causing accumulation at the nerve endings

Question 18

What are the indications for amitriptyline?

Answer 18

Neuropathic pain, insomnia, anorexia, migraines

Question 19

Although there is no specific antidote, what are treatments for an OD on tricyclics?

Answer 19

Activated charcoal
Speed elimination by alkalinizing urine
Manage seizures and dysrhythmias
basic life support

Question 20

What are the contraindications and adverse effects of amitriptyline?

Answer 20

CI: pregnancy, MI
AE: dry mouth, constipation, blurred vision, urinary retention, dysrhythmias

Question 21

Name 2 nonselective and 1 selective MAOIs

Answer 21

NS: Phenelzine sulphate, tranylcypromine sulphate
S: Selegiline HCL

Question 22

What is a disadvantage for taking MAOIs?

Answer 22

There is a potential to cause a hypertensive crisis when taken with tyramine

Question 23

What food contain tyramine?

Answer 23

Aged, mature cheeses
Smoked, pickled and aged meats, fish and poultry
Yeast extracts
Red wines
Italian broad beans

Question 24

What are the indications for 2nd gen antidepressants?

Answer 24

Depression, BPD, ED, OCD, panic attacks, PTSD, Substance misuse, social anxiety disorder, premenstrual dysphoric disorder, neurologic disorder myoclonus

Question 25

What are the adverse effects of 2nd gen antidepressants?

Answer 25

Insomnia, weight gain, sexual dysfunction Serotonin syndrome: Increase of the effect of serotonin on CNS s/s: delirium, tachycardia, sweating, muscle spasms, hyper reflexes, shivering, tremors

Question 26

What is bupropion HCL?

Answer 26

2nd gen antidepressant indication for depression and smoking cessation AE: Dizziness, agitation, tremors, dry mouth

Question 27

What is duloxetine HCL? (ID, AE, IE, CI)

Answer 27

SNRI ID: Depression, GAD, Pain resulting from diabetic neuropathy or fibromyalgia, chronic back pain, osteoarthritis AE: Dizziness, drowsiness, headache, GI upset, anorexia and hepatotoxicity IE: SSRIs, triptans and alcohol CI: Angle-closure glaucoma, MAOIs

Question 28

What is fluoxetine? (ID, AE, CI)

Answer 28

SSRI ID: Depression, bulimia, OCD, Panic disorder, Premenstrual dysphoric disorder CI: MAOI AE: anxiety, dizziness, drowsiness, insomnia

Question 29

What are antipsychotics?

Answer 29

Drugs used to treat serious mental illness: Psychoses, autism, schizophrenia Also used to treat extreme mania, BPD, depression resistant to other meds, certain movement disorders (Tourette's)

Question 30

What are the 3 classes of antipsychotics? Name the drugs we are to know in the classes

Answer 30

Conventional/1st gen: Haloperidol 2nd gen Atypical: Clozapine, risperidone

Question 31

What is the MOA of antipsychotics?

Answer 31

Block dopamine receptors in the brain, areas associated with emotion, cognitive function and motor function

Question 32

What are the positive and negative symptoms of schizophrenia?

Answer 32

P: Hallucinations, delusions and conceptual disorganization N: Apathy, social withdrawal, blunted affect, poverty of speech and catatonia

Question 33

T/F: Conventional (1st gen) antipsychotics are effective at treating positive and negative schizophrenia symptoms

Answer 33

F: Atypical antipsychotics are effective at treating positive and negative schizophrenia symptoms. Conventional are less effective in managing negative symptoms

Question 34

What are the indications for antipsychotics?

Answer 34

Psychotic illness, commonly schizophrenia Anxiety and mood disorders

Question 35

What is NMS?

Answer 35

Neuroleptic malignant syndrome High fever, unstable BP, myoglobinemia

Question 36

What is EPS?

Answer 36

Extrapyramidal symptoms: Involuntary muscle symptoms similar to parkinsons Akathisia (distressing muscle restlessness) Acute dystonia (painful muscle spasms)

Question 37

What is used to treat EPS?

Answer 37

Benztropine and trihexyphenidyl

Question 38

What are the adverse effects of antipsychotics?

Answer 38

Tardive dyskinesia (Involuntary contracts of oral and facial muscles) Insulin resistance Weight gain Abnormal serum lipid levels Cardiometabolic syndrome Agranulocytosis (Decreased WBC) Hemolytic anemia (Breakdown of RBCs)

Question 39

What is Haloperidol? (ID, CI, Routes)

Answer 39

1st gen antipsychotic ID: Long-term treatment of psychosis CI: Parkinson's, CNS depressants PO, IM

Question 40

What is the MOA of atypical antipsychotics?

Answer 40

Block dopamine and serotonin receptors

Question 41

What is clozapine?

Answer 41

Atypical antipsychotic Associated with minor or no EPS AE: Blood dyscrasias

Question 42

What is risperidone?

Answer 42

Atypical antipsychotic ID: Schizophrenia AE: Minimal EPS at therapeutic dosages of 1 to 6 mg/day

Question 43

What is st. john's wort? (ID, AE, IE)

Answer 43

ID: Depression, anxiety, sleep disorders, nervousness AE: GI upset, fatigue, dizziness, dry mouth, photosensitivity IE: MAOIs, SSRIs, Tyramine

Question 44

What can be done to prevent the risk of suicide attempts?

Answer 44

Only dispense small amounts of medication at a time

Question 45

What is a consideration regarding antidepressants?

Answer 45

May take several weeks to see therapeutic effects

Question 46

What is a consideration regarding antidepressants for pts preparing to undergo surgery?

Answer 46

Tricyclics may need to be weaned and discontinued to avoid interactions with anesthetic drugs

Question 47

What is a consideration regarding antipsychotics?

Answer 47

Wear sunscreen because of photosensitivity

Question 48

Avoid taking antacids within __________ of antipsychotics

Answer 48

1 hour

Question 49

What are the therapeutic levels of lithium?

Answer 49

0.6 to 1.2 mmol/L