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Prototype Drugs > Psychotherapeutic Drugs Chapter 16 > Flashcards

Psychotherapeutic Drugs Chapter 16 Flashcards

1
Q

alprazolam** (Xanax)

CLASS/ INDICATIONS

A

PSYCHOTHERAPEUTIC DRUGS: Chapter 16
CLASS: benzodiazepines
INDICATIONS: anxiety, panic disorder

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2
Q

alprazolam** (Xanax)

DOSAGES

A

PO: 0.25-2 mg tid; do not exceed 4 mg/day ADULT

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3
Q

alprazolam** (Xanax)

ADVERSE EFFECTS

A

amnesia, anorexia, sedation, lethargy, fatigue, confusion, drowsiness, dizziness, ataxia, headache, visual changes, hypotension, weight gain or loss, nausea, weakness

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4
Q

alprazolam** (Xanax)

NURSING IMPLICATIONS/ CONTRAINDICATIONS

A

Schedule IV: addictive

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5
Q

alprazolam** (Xanax)

DRUG INTERACTIONS

A

Additive effects: enhanced CNS depression, sedation, confusion, ataxia (CNS depressants: alcohol, opioids)
Impaired hepatic elimination of benzodiazepine: enhanced benzodiazepine effects: CNS depression (oral contraceptives, azole antifungals, SSRIs, verapamil, diltiazem, opioids, valproic acid)
Enhanced benzodiazepine clearance: reduced therapeutic effects (rifampin)
Antagonistic effects: reduced sedative effects (theophylline)
Reduced clearance: potential for digoxin toxicity (phenytoin)

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6
Q

amitriptyline** (Elavil)

CLASS/ INDICATIONS

A

PSYCHOTHERAPEUTIC DRUGS: Chapter 16
CLASS: Tricyclic
INDICATIONS: depression, insomnia, neuropathic pain

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7
Q

amitriptyline** (Elavil)

DOSAGES

A

PO: 10-300mg/ day ADULT

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8
Q

amitriptyline** (Elavil)

ADVERSE EFFECTS

A

Anorexia, dry mouth, blurred vision, constipation, gynecomastia, sexual dysfunction, altered blood glucose level, urinary retention, agitation, anxiety, ataxia, cognitive impairment, sedation, headache, insomnia, skin rash, photosensitivity, weigh changes, orthostatic hypotension, blood dyscrasias

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9
Q

amitriptyline** (Elavil)

NURSING IMPLICATIONS/ CONTRAINDICATIONS

A

NI: cuases constipation, blurred vision, urinary retention, dysrhythmias
CT: drug allergy, pregnancy, myocardial infarction

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10
Q

amitriptyline** (Elavil)

DRUG INTERACTIONS

A

Enhanced TCA clearance: reduced therapeutic effects (carbamazepine, rifamycins
Reduced carbamazepine clearance: potential for carbamazepine toxicity (carbamazepine)
Enhance serotonergic effects: potential for serotonin syndrome (MAOIs)
Reduced TCA clearance: potential for TCA toxicity (valproic acid)
Additive anticholinergic effects: potential for paralytic ileus (anticholinergics)
Enhanced sympathomimetic effects: potential for cardiac dysrhythmias (sympathomimetics)

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11
Q

bupropion** (Wellbutrin, Zyban)

CLASS/ INDICATIONS

A

PSYCHOTHERAPEUTIC DRUGS: Chapter 16
CLASS: Miscellaneous
INDICATIONS: depression (Wellbutrin), smoking cessation (Zyban)

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12
Q

bupropion** (Wellbutrin, Zyban)

DOSAGES

A

PO: 200-300 mg/day divided bid

PO, SR: 150-300 mg/ day

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13
Q

bupropion** (Wellbutrin, Zyban)

ADVERSE EFFECTS

A

Dizziness, headache, sedation, nausea, blurred vision, tachycardia

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14
Q

bupropion** (Wellbutrin, Zyban)

NURSING IMPLICATIONS/ CONTRAINDICATIONS

A

CT: known drug allergy, seizure disorder, anorexia nervosa, bulimia, MAOIs.

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15
Q

bupropion** (Wellbutrin, Zyban)

DRUG INTERACTIONS

A

Impaired hepatic metabolism: increased effects (azole antifungals, phenothiazines, protease inhibitors)
Increased metabolism: decreased therapeutic effects (carbamazepine)
Additive effects: increased CNS depression (alcohol, CNS depressants)

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16
Q

diazepam** (Valium)

CLASS/ INDICATIONS

A

PSYCHOTHERAPEUTIC DRUGS: Chapter 16
CLASS: benzodiazepines
INDICATIONS: anxiety

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17
Q

diazepam** (Valium)

DOSAGES

A

PO: 2-10 mg 2-3 times/day ADULT
PO: 1-2.5 mg 3-4 times/day PEDIATRIC

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18
Q

diazepam** (Valium)

ADVERSE EFFECTS

A

amnesia, anorexia, sedation, lethargy, fatigue, confusion, drowsiness, dizziness, ataxia, headache, visual changes, hypotension, weight gain or loss, nausea, weakness

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19
Q

diazepam** (Valium)

NURSING IMPLICATIONS/ CONTRAINDICATIONS

A

NI: can accumulate in pts with hepatic dysfunction/ mainly metabolized in the liver (sedation, resp. depression, coma).
CT: interacts with alcohol and oral contraceptives

20
Q

diazepam** (Valium)

DRUG INTERACTIONS

A

Additive effects: enhanced CNS depression, sedation, confusion, ataxia (CNS depressants: alcohol, opioids)
Impaired hepatic elimination of benzodiazepine: enhanced benzodiazepine effects: CNS depression (oral contraceptives, azole antifungals, SSRIs, verapamil, diltiazem, opioids, valproic acid)
Enhanced benzodiazepine clearance: reduced therapeutic effects (rifampin)
Antagonistic effects: reduced sedative effects (theophylline)
Reduced clearance: potential for digoxin toxicity (phenytoin)

21
Q

fluoxetine** (Prozac)

CLASS/ INDICATIONS

A

PSYCHOTHERAPEUTIC DRUGS: Chapter 16
CLASS: SSRI
INDICATIONS: depression, OCD, bulimia nervosa, panic disorder, premenstrual dysphoric disorder

22
Q

fluoxetine** (Prozac)

DOSAGES

A

PO: 10-20 mg/ day; higher doses up to 80 mg/day divided bid

23
Q

fluoxetine** (Prozac)

ADVERSE EFFECTS

A

Anxiety, dizziness, drowsiness, headache, mild GI disturbance, sexual dysfunction, asthenia, tremor

24
Q

fluoxetine** (Prozac)

NURSING IMPLICATIONS/ CONTRAINDICATIONS

A

CT: known drug allergy, concurrent MAOI therapy

25
Q

fluoxetine** (Prozac)

DRUG INTERACTIONS

A

Additive effects: potential for serotonin syndrome (MAOIs, linezolid, lithium, metoclopramide, buspirone, sympathomimetics, tramadol)
Reduced metabolism: potential benzodiazepine toxicity (benzodiazepines)
Protein binding displacement: potential for warfarin or phenytoin toxicity (warfarin, phenytoin)
Increased propafenone levels: potential for propafenone toxicity (propafenone)

26
Q

lithium** (Generic)

CLASS/ INDICATIONS

A

PSYCHOTHERAPEUTIC DRUGS: Chapter 16
CLASS: Inorganic salt (MOOD STABILIZER)
INDICATIONS: acute mania, prevention of mania

27
Q

lithium** (Generic)

DOSAGES

A

600-1800 mg/day divided bid-tid

28
Q

lithium** (Generic)

ADVERSE EFFECTS

A

GI discomfort, tremor, confusion, sedation, seizures, cardiac dysrhythmia, drowsiness, slurred speech, slowed motor abilities, weight gain, ataxia, hypotension

29
Q

lithium** (Generic)

NURSING IMPLICATIONS/ CONTRAINDICATIONS

A

NI: Pts serum sodium levels require monitoring: directly affects lithium therapeutic levels
CT: dehydration, sodium imbalance, renal or cardiovascular disease (can increase lithium toxicity)

30
Q

lithium** (Generic)

DRUG INTERACTIONS

A

Decreased lithium excretion: increased lithium toxicity (thiazide diuretics, angiotensin converting enzyme inhibitors, verapamil, diltiazem, NSAIDs)

31
Q

lorazepam** (Ativan)

CLASS/ INDICATIONS

A

PSYCHOTHERAPEUTIC DRUGS: Chapter 16
CLASS: benzodiazepines
INDICATIONS: anxiety, alcohol withdrawal, agitation, panic disorder

32
Q

lorazepam** (Ativan)

DOSAGES

A

PO: 0.5-6 mg/ day in 2-3 divided doses ADULT

33
Q

lorazepam** (Ativan)

ADVERSE EFFECTS

A

amnesia, anorexia, sedation, lethargy, fatigue, confusion, drowsiness, dizziness, ataxia, headache, visual changes, hypotension, weight gain or loss, nausea, weakness

34
Q

lorazepam** (Ativan)

NURSING IMPLICATIONS/ CONTRAINDICATIONS

A

NI: IM injections must be diluted: irritating to the muscle/ good for administration to agitated pts

35
Q

lorazepam** (Ativan)

DRUG INTERACTIONS

A

Additive effects: enhanced CNS depression, sedation, confusion, ataxia (CNS depressants: alcohol, opioids)
Impaired hepatic elimination of benzodiazepine: enhanced benzodiazepine effects: CNS depression (oral contraceptives, azole antifungals, SSRIs, verapamil, diltiazem, opioids, valproic acid)
Enhanced benzodiazepine clearance: reduced therapeutic effects (rifampin)
Antagonistic effects: reduced sedative effects (theophylline)
Reduced clearance: potential for digoxin toxicity (phenytoin)

36
Q

mirtazapine** (Remeron)

CLASS/ INDICATIONS

A

PSYCHOTHERAPEUTIC DRUGS: Chapter 16
CLASS: Tetracyclic
INDICATIONS: depression, bipolar disorder

37
Q

mirtazapine** (Remeron)

DOSAGES

A

PO: 15-45 mg at bedtime

38
Q

mirtazapine** (Remeron)

ADVERSE EFFECTS

A

drowsiness, abnormal dreams, dry mouth, constipation, increased appetite, asthenia

39
Q

mirtazapine** (Remeron)

NURSING IMPLICATIONS/ CONTRAINDICATIONS

A

NI: strongly associated with sedation/ usually dosed at bedtime. Appetite stimulant.
CT: drug allergy, concurrent use of MAOIs

40
Q

mirtazapine** (Remeron)

DRUG INTERACTIONS

A

Additive effects: increased toxicity (alcohol, CYP inhibitors)

41
Q

risperidone** (Risperdal)

CLASS/ INDICATIONS

A

PSYCHOTHERAPEUTIC DRUGS: Chapter 16
CLASS: Benzisoxazole (Atypical Antipsychotic)
INDICATIONS: schizophrenia/ negative symptoms, schizophrenia, mania, irritability associated with autism

42
Q

risperidone** (Risperdal)

DOSAGES

A

PO: 2-8 mg/day in either one or two doses
IM: depot form (Risperdal Costa): 25-50 mg every 2 wk

43
Q

risperidone** (Risperdal)

ADVERSE EFFECTS

A

Elevated prolactin levels, abnormal dreams, insomnia, dizziness, headache

44
Q

risperidone** (Risperdal)

NURSING IMPLICATIONS/ CONTRAINDICATIONS

A

CT: known drug allergy

45
Q

risperidone** (Risperdal)

DRUG INTERACTIONS

A

Tachycardia, akathisia, agitation, asthenia, ataxia, seizures, dyskinesia, dizziness, drowsiness, headache, insomnia, dry mouth, dyspepsia, anxiety, increased appetite, weight gain

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