Psychotherapeutic Dugs

Question 1

What are the two classes of Anxiolytic drugs?

Answer 1

1) Benzodiazepine

2) Buspirone

Question 2

(T/F) Buspirone is always administered on a scheduled basis (not “as needed”).

Answer 2

True

Question 3

Name two advantages that Buspirone has over Benzodiazepines.

Answer 3

1) Lacks sedative properties (doesn’t put u to sleep)

2) Lacks dependency properties (u won’t get addicted)

Question 4

What are the 5 adverse effects of Buspirone?

Answer 4

1) Paradoxical anxiety
2) Dizziness
3) Blurred vision
4) Headache
5) Nausea

Question 5

What is the indication of lithium?

Answer 5

Lithium is a “mood stabilizing drug” indicated for bipolar illness (mania, hypomania and depression).

Question 6

For management of acute mania, what lithium serum level is usually required?

Answer 6

Acute Mania - 1 to 1.5 mEq/L

Longterm Maintenance - 0.6 to 1.2 mEq/L

Question 7

When is the best time to measure blood levels of lithium?

Answer 7

Blood levels are best measured 8 to 12 hours after the last dose (roughly the midpoint of the drug half-life), because the half-life is usually between 18 and 24 hours.

Question 8

What are the 4 contraindications to the use of lithium?

Answer 8

1) Dehydration
2) Sodium imbalance
3) Major renal disease
4) Major CV disease

Question 9

Describe the Biogenic Amine Hypothesis

Answer 9

Theory that suggests depression results from a deficiency of NE and mania from an excess of NE.

Question 10

Describe the Permissive Hypothesis

Answer 10

Theory that suggests depression results from decreases in both serotonin and NE levels, whereas mania results from increased NE levels but decreased serotonin levels.

Question 11

Describe the Dysregulation Hypothesis

Answer 11

A theory that views depression and affective disorders as caused not simply by decreased or increased NE and serotonin activity but by failure of the brain to regulate the levels of these neurotransmitters.

Question 12

What is the mechanism of action of Tricyclic Antidepressants?

Answer 12

TCAs work by blocking the presynaptic reuptake of serotonin and NE, which makes them available for transmission of nerve impulses to adjacent neurons in the brain.

Question 13

What are the 3 indications of Tricyclic Antidepressants (TCAs)?

Answer 13

1) Antidepressants
2) Neuropathic pain syndromes
3) Insomnia

Question 14

what are the 4 indications to the use of TCAs?

Answer 14

1) Use of MAOIs within the previous 14 days
2) Pregnancy
3) Cardiac problems
4) Seizures

Question 15

What are the 6 adverse effects of TCAs?

Answer 15

1) Constipation
2) Urinary retention
3) Cardiac conduction disturbances
4) Hypotension
5) Sedation
6) Sexual dysfunction

Question 16

List 4 methods used to manage a TCA overdose.

Answer 16

1) Activated Charcoal - Reduces TCA absorption
2) Sodium Bicarbonate - Speeds up elimination of TCA by alkalinizing the urine.
3) Diazepam - Limits CNS damage
4) Antydysrhythmics - Controls cardiac dysrhythmias

Question 17

What is the major disadvantage of MAOIs?

Answer 17

Their potential to cause a hypertensive crisis when taken with a substance containing Tyramine, which is found in many common foods and beverages.

Question 18

How long does it typically take the Antidepressants (TCAs, MAOIs and SSRIs) to take effect?

Answer 18

4 to 6 weeks

Question 19

What is the mechanism of action of SSRIs?

Answer 19

SSRIs inhibit the reuptake of serotonin.

Question 20

What are the 4 adverse effects of SSRIs?

Answer 20

1) Insomnia
2) Weight Gain
3) Sexual Dysfunction
4) Serotonin Syndrome

Question 21

What are the mechanisms of action of the older Antipsychotic drugs and the newer Antipsychotic drugs?

Answer 21

1) Older Antipsychotics (Phenothiazines) - Blocks dopamine receptors in the CNS
2) Newer Antipsychotics (Conventionals) - Blocks dopamine2 and serotonin2 receptors in the brain.

Question 22

What are the 6 contraindications to the use of Antipsychotics?

Answer 22

1) Coma
2) CNS depression
3) Brain damage
4) Liver or Kidney disease
5) Blood dyscrasias
6) Epilepsy

Question 23

What are 4 the indications of Antipsychotics?

Answer 23

1) Psychotic Illnesses (i.e., schizophrenia, autism)
2) Anxiety
3) Antiemetic
4) Mood disorders

Question 24

What are some of the adverse effects of Antipsychotics?

Answer 24

1) Neuroleptic malignant syndrome
2) extrapyramidal symptoms
3) Tardive dyskinesia
4) Dystonia
5) Akathisia

Question 25

What are the 2 major things that cause an interaction with Antipsychotics?

Answer 25

1) Antacids

2) Tanic Acids (found in grapes, tea and wine)

Question 26

Why are serum sodium levels important to know when administering lithium?

Answer 26

Because lithium toxicity is potentiated by the presence of hyponatremia and hypovolemia.