Psychotherapies Flashcards

1
Q

What is the main drug used for anxiety?

A

Lorazepam (benzodiazepine)

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2
Q

Benzodiazepines mechanism of action:

A

Enhance the effects of GABA resulting in reduced neuronal excitability and depress CNS activity.

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3
Q

What is the main adverse effect of BZDs?

A

Decreased CNS activity (drowsiness, loss of coordination, dizziness, confusion)

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4
Q

What is the prototype of SSRIs used for depression?

A

Sertraline

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5
Q

What is the advantage of SSRIs over TCAs and MAOIs?

A

they cause less effect on the cardiovascular system

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6
Q

What are the 2 major side effects of SSRIs?

A

weight gain and sexual dysfunction

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7
Q

What is the prototype of SNRIs used for depression?

A

Venlafaxine

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8
Q

Which drugs are considered 2nd line for the treatment of depression?

A

TCAs

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9
Q

What are two examples of TCAs used for depression ?

A

Amitriptyline and Imipramine

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10
Q

Low doses of amitriptyline can be used for?

A

palliative (neuropathic) pain and migraine prevention

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11
Q

TCAs block both….?

A

serotonin and NE reuptake

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12
Q

which TCA is used for childhood enuresis?

A

Imipramine

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13
Q

some of the adverse effects of TCAs (sedation, confusion and motor incoordination) will wear off in?

A

1-2 weeks

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14
Q

TCAs have _______ effects

A

anticholinergic

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15
Q

what are the anticholinergic effects of TCAs?

A

blurred vision, constipation, urinary retention, dry mouth and tachycardia

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16
Q

What is the most dangerous adverse effect of TCAs?

A

dysrhythmias

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17
Q

Are TCAs lethal in overdose?

A

yes, 70-80% of people die before reaching the hospital

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18
Q

What can you do for a TCA overdose?

A

there is no antidote for acute toxicity, but you can give activated charcoal to decrease drug absorption

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19
Q

Which antidepressants are used when depression is not responsive to other drugs?

A

MAOIs

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20
Q

What is the cheese effect?

A

a hypertensive crisis that occurs when MAOIs are taken with tyramine

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21
Q

What is the most common side effect of MAOIs?

A

orthostatic hypotension

22
Q

What must happen if a patient is switching from an SSRI to an MAOI?

A

there must be a 2-5 week wash out (drug free) period in between

23
Q

how long must the diet restriction be maintained when quitting MAOIs?

A

for 2 weeks

24
Q

the nurse should inform clients that it may take up to _______ to see therapeutic effects

25
What is considered first line treatment for bipolar disorder?
Lithium
26
what is important to note about lithium?
it has a very narrow therapeutic range
27
Serum levels of lithium should range between?
0.4 to 0.5 mmol/L and less than 1.5 mmol/L
28
When does lithium toxicity occur?
when serum lithium levels are more than 1.5 mmol/L
29
What is a sign of lithium toxicity?
CNS effects
30
Which drugs used for epilepsy are also used in bipolar disorder?
valproate and carbamazepine
31
what is the hallmark of psychosis?
loss of contact with reality
32
Antipsychotics are always used with?
caution
33
What is an example of a first generation antipsychotic?
chlorpromazine (largactil)
34
What is an example of a second generation antipsychotic?
Clozapine
35
All typical antipsychotics are?
dopamine receptor antagonists
36
What is the most serious adverse effect of typical antipsychotics?
motor disturbances (EPS)
37
Why do atypical antipsychotics have less motor disturbances?
they have less effect on DA receptors than typical antipsychotics
38
What is a serious adverse effect of clozapine?
agranulocytosis
39
SSRIs have _______ properties
stimulant
40
TCAs can cause?
sedation
41
What is the most common adverse effect of TCAs?
Orthostatic Hypotension
42
All antidepressants initially increase the risk for?
Suicide. All patients should be monitored for worsening mood and signs of suicidal ideation.
43
In patients with bipolar disorder, SSRIs should not be used alone because?
the can induce mania
44
when serum sodium level is reduced...?
lithium excretion is also reduced, and lithium accumulates
45
Lithium levels above ____ should be reported
1.5 mEq/L
46
What is a safe analgesic to use with lithium?
Aspirin (ASA)
47
Why shouldn't NSAIDS be used with lithium?
they can increase lithium levels by up to 60%
48
Can diuretics be used with lithium?
No, diuretics can increase lithium levels by reducing the serum sodium level
49
Can Benadryl be used with lithium?
Diphenhydramine has anticholinergic properties and can aggravate lithium-induced polyuria by causing urinary hesitancy.
50
Early lithium toxicity is evidenced by
diarrhea, anorexia, muscle weakness, nausea, vomiting, tremors, slurred speech, and drowsiness. Later signs include blurred vision, seizures, trembling, confusion, and ataxia.