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psychotherapeutic drugs Flashcards

1
Q

three mental health disorders

A

anxiety, affective disorders, psychotic disorders

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2
Q

psychotherapeutic drugs

A

treats emotional and mental disorders

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3
Q

types of psychotherapeutic drugs

A

anxiolytic drugs
mood stabilizing drugs
antidepressants
antipsychotic

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4
Q

anxiety

A

unpleasant state of mind characterized by dread or fear
based on anticipated or past experiences
may be an exaggerated response to imaginary negative experiences

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5
Q

affective disorders

A
  • mood disorders
  • changes in mood from mania to depression
  • some pts have mania and depression (BPD
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6
Q

psychosis

A

severe emotional disorder where they cant participate in ADL
ex- schizophrenia, drug induced psychoses

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7
Q

hallmark

A

loss of contact with reality

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8
Q

anxiolytic drugs

A
  • reduces overactivity in CNS
  • benzodiazepine (depresses activity in brainstem and limbic system
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9
Q

ex of benzodiazepines

A

-alprazolam (xanax)
- diazepam (valium)
- lorazepam (ativan)

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10
Q

benzodiazepine adverse effects

A
  • decreased DNA activity, sedation, amnesia
  • hypotension
  • drowsiness, loss of coordination, dizziness, headaches
  • nausea, vomiting, dry mouth, constipation
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11
Q

benzodiazepine overdose

A
  • dangerous when taken with alc or other sedatives
  • treatment is symptomatic
  • flumazenil can reverse effects
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12
Q

benzodiazepine interactions

A
  • alcohol and CNS depressants
  • interactions more likely in pts with renal or hepatic compromise
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13
Q

alprazolam (xanax)

A
  • most common
  • for GAD, short term relief of anxiety symptoms
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14
Q

alprazolam adverse effects

A
  • confusion, ataxia, headache others
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15
Q

alprazolam interactions

A
  • alcohol, antacids, oral contraceptives
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16
Q

diazepam (valium) indications

A

relief of anxiety, alcohol withdrawal, reversal of staus epilepticus, pre op sedation, relief of skeletal muscle spasms

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17
Q

avoid diazepam in pts with

A

hepatic dysfunction

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18
Q

diazepam adverse reactions

A

headache, confusion, slurred speech

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19
Q

diazepam interactions

A

alcohol, oral contraceptives
- asian ppl metabolize slower

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20
Q

lorazepam (ativan)

A

intermediate acting benzo
- IV or IM
- treatment of acutely agitated pt
- continuous for pts undergoing mechanical ventilation
- treat alcohol withdrawal

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21
Q

micellaneous anxiolytic

A

busprione hcl
- scheduled basis
- adverse effects: paradoxical anxiety, blurred vision, dizzines, headache, nausea
- dont take with MAOIs (need washout period)

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22
Q

mood stabilizing drug ex

A
  • lithium carbonate and lithium citrate
  • treats BPD
  • can be combined with benzos or antipsychotic drugs
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23
Q

lithium

A
  • treats mania
  • potentiate serotonergic neurotransmission
  • narrow therapeutic range (needs blood monitoring_
  • sodium should be 135-145 mmol/L to maintain therapeutic range of lithium. (lithium can become toxic in hyponatremia)
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24
Q

lithium adverse effects

A
  • cardiac dysrhythmias
  • drowsy, slurred speech, choreoathetotic movements
  • long term can cause hypothyroidism
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25
first gen antidepressants
- tricyclics and MAOIs
26
second gen antidepressants
- SSRIs -serotonin norepinephrine reuptake inhibitors (SNRIs)
27
tricyclic antidepressants
- replaced by SSRIs - for pts who dont respond to SSRIs and as adjunct therapy with new gen drugs - amitriptyline
28
tricyclic antidepressant indications
neuropathic pain migraines insomnia childhood enuresis OCD anorexia
29
tricyclic adverse effects
sedation impotence orthostatic hypotension
30
tricyclic overdose
-lethal -CNS and cardiovascular systems effected -death from seizure or dysrhythmias - no specific antidote but can decrease absorption with activated charcoal
31
amitriptyline (elavil)
- oldest and most widely used - for depression - commonly used to treat insomnia and neuropathic pain
32
amitriptyline contraindications
- known allergy - pregnancy - recent myocardial infarction
33
amitriptyline adverse effects
dry mouth, constipation, blurred vision, urinary retention, dysrhythmias
34
nonselective MAOIs
phenelzine sulphate and tranylcypromine sulphate
35
selective MAOIs
selegiline hcl
36
MAOIs are rarely used for
depression. used for parkinsons
37
MAOIs disadvantages
potential to cause hypertensive crisis when taking tyramine
38
MAOIs and tyramine
- ingestion of food or drinks with tyramine leads to hypertensive crisis and can lead to stroke, cerebral hemorrhage, coma or death - avoid foods with tyramine
39
foods containing tyramine
-aged cheese - smoked, pickled, aged meats fish or poultry - yeast extracts - red wines - italian broad beans (fava beans)
40
second generation antidepressants
bupropion (Wllbutrin) SNRI- duloxetine hcl (cymbalta) SSRI- fluoxetine (prozac)
41
second generation antidepressant indications
- depression - BPD, obesity, eating disorders, OCD, panic attacks, SAD, PTSD, premenstrual dysphoric disorder, myoclonus, alcoholism
42
second generation antidepressant adverse effects
insomnia, weight gain, sexual dysfunction - watch for serotonin syndrome
43
serontonin syndrome
- reaction to SSRI or SNRIs - symptoms= delirium, tachycardia, sweating, muscle spasms, hyper reflexes, shivering - discontinue drug to treat
44
bupropion hcl
- indicated for depression and smoking cessation - adjuct for pts experiencing sexual adverse effects secondary to SSRI therapy - Zyban ( first nicotine free prescription med used to treat dependence).
45
duloxetine hcl indications
- for depression, GAD, peripheral neuropathy, chronic back pain, osteoarthritis
46
duloxetine hcl adverse effects
- dizziness, drowsiness, headache, GI upset, anorexia, hepatotoxicity
47
duloxetine interactions
SSRIs and triptans (increased risk of serotonin synd) alcohol (increased liver injury) worsen glaucoma
48
fluoxetine (prozac) indications
SSRI for depression, bulimia, OCD, panic disorder, premenstural dysphoric disorder
49
fluoxetine CI
MAOI therapy and allergy
50
fluoxetine adverse effects
anxiety, dizziness, drowsiness, insomnia
51
antipsychotics
- treats serious mental illness like drug induced psychosis, schizophrenia, autism - treats extreme mania, BPD, movement disorders, other medical conditions
52
first gen antipsychotic ex
haloperidol
53
atypical antipsychotics
clozapine and resperidone
54
antipsychotic MOA
- block dopamine receptors in areas responsible for emotion, cognitive and motor function - results in tranquilizing effect
55
positive schizophrenia sympt
hallucinations, delusions, conceptual disorganization
56
neg schizo sympt
apathy, social withdrawal, blunted effect, poverty of speech, catatonia
57
antipsychotics improve ___ effects of schizophrenia
positive
58
atypical antipsychotics treat ____ symptoms
postive and negative
59
antipsychotic indications
- psychotic illness (schizo), anxiety, mood disorders - prochlorperazine (antiemetic)
60
antiphsychotic adverse effects
agranulocytosis and hemolytic anemia - CNS effects; drowsiness, NMS, EPS, tardive dyskinesia - insulin resistance -weight gain changes in serum lipid cardiometabolic syndrome
61
NMS
neuroleptic malignant syndrome - life threatening - high fever, unstable BP, myoglobinemia
62
EPS
- extrapyramidal symptoms - similar to parkinson mvmt - akathisia - acute dystonia
63
EPS treatment
benztropine and trihexphenidyl
64
tardive dyskinesia
- involuntary contractions of oral and facial muscles - choreoathetosis - with long term psychotherapeutic therapy
65
haloperidol
- long term treatment of psychosis - CI= parkinsons, large amounts of CNS depressants - PO and IM - good for ppl with schizophrenia that were nonadherent
66
atypical antipsychotics
clozapine and risperidone
67
clozapine
- blocks dopamine receptors in mesolimbic region in brain - minor to no EPS - AE= blood dyscrasias
68
risperidone
- for schizophrenia - AE= minimal EPS PO and long acting inject
69
st johns wort
- for depression, anxiety, sleep disorders, nervousness - GI upset, fatigue, photosensitivity, dry mouth, confusion, dizziness - severe interactions with SSRI and MAOIs - interacts with tyramine containing foods
70
why do you check pts mouth after PO meds
make sure they swallowed and arent saving them
71
why small amounts of meds admin at once
reduce suicide risk
72
using these drugs with ___ and ___ can be fatal
alcohol and CNS depressants
73
antianxiety and older adults
monitor for oversedation and CNS depress
74
antidepressant therapeutic onset
several weeks
75
antidepressants and interactions with anaesthetic drugs
tricyclics may be weaned and discontinued before surgery
76
when MAOIs are given, inform pt about
tyramine containing foods and symptoms of hypertensive crisis
77
antipsychotic- phenothiazine considerations
- wear sunscreen bc of photosensitivity - avoid antacids within 1 hr of dose - avoid CNS depress, alc, sauna and hot tubs
78
long term haloperidol use
tremors, nausea, vomiting shaking
79
therapeutic effects of lithium
less mania and lithium levels of 0.6-1.2 mmol/L
80
SSRIs take ___ weeks to work
4-6

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