Test 2

Question 1

Treatment challenges

Answer 1

Treating from above & below
Medication adherence
Self-medication

Question 2

3 Medication options

Answer 2

Lithium
Antiepileptic medications
Atypical antipsychotics

Question 3

Benefits of Lithium

Answer 3

Highly effective
Treats from above or below
Lowers suicide risk

Question 4

Problem with lithium?

Answer 4

Narrow therapeutic window.

Question 5

Lithium levels should be:

Answer 5

Less than 1.5 mEq/L

Question 6

Normal SE of Lithium

Answer 6

Mild nausea
Fine hand tremors
Polyuria or polydipsia
Weight gain

Question 7

Early Signs of Toxicity [ACNE] :

Answer 7

Ataxia
Coarse hand tremors
N/V/D
Ears ringing

Question 8

Pt teaching for Lithium:

Answer 8

Take with food to decrease GI upset
Maintain adequate fluid & salt intake
Avoid strenuous exercise
Signs of toxicity

Question 9

What does a brand new nurse need to know about lithium?

Answer 9

Low salt levels and water loss leads to lithium toxicity
Know the early sign of toxicity
Levels should not be more than 1.5

Question 10

Anxioltics: Benzos Common Uses

Answer 10

Anxiety disorders
Sleep disorders
Muscle spasms
Seizure disorders
Alcohol withdrawal

Question 11

Benzo Drugs to know.

Answer 11

Alprazolam - short duration & quick onset
Clonazepam- long onset & duration
Diazepam
Chlordiazepoxide
Lorazepam

Question 12

Benzos MOA:

Answer 12

Help GABA work better

Work on the same receptor as alcohol

Question 13

Benzos SE:

Answer 13

Ataxia
Sedation
Impaired Memory

Question 14

Benzo Precautions:

Answer 14

Elderly
Liver dz.
Drug Abuse history

Question 15

High yield concepts on Benzos:

Answer 15

Benzos are for short term use only
Never combine Benzos with alcohol
Do not quit Benzos abruptly
Flumazenil is the antidote for benzo overdose.

Question 16

Buspirone MOA

Answer 16

Binds strongly to 5HT receptors and loosely to DA receptors

Question 17

Advantages of Buspirone

Answer 17

No abouse potential
Not a CNA depressant
No major withdrawal issues

Question 18

Disadvantage of Buspirone

Answer 18

Takes much longer to work (weeks)

Question 19

Pts must avoid what when taking Buspirone ?

Answer 19

Grapefruit juice.

Question 20

High yield concepts Busprione :

Answer 20

Non-addicitve
It takes several weeks to reach full effect
Avoid grapefruit juice

Question 21

Antipsychotics: FGA (typical) drugs

Answer 21

Haloperidol

Chlorpromazine

Question 22

FGAs Common uses:

Answer 22

Schizophrenia
Agitation/ aggression
N/V
Intractable hiccups

Question 23

Schizo symptoms

Answer 23

Positive: hallucinations, delusions, disorganized speech & bizarre behavior
Negative: affective flattering, alogical, abolition, anhedonia, and social isolation

Question 24

FGAs MOA:

Answer 24

Block DA receptors in the brain

Question 25

Dopamine pathways:

Answer 25

Mesolimbic Mesocortical Nigrostriatal Tuberoinfundibular

Question 26

SE of FGAs

Answer 26

``` Anticholinergic effects Orthostatic hypotension Sedation Neuroendocrine effects Photosensitivity ```

Question 27

EPS

Answer 27

Acute dystonia Akathisia Parkisonism Tardive dyskinesia

Question 28

Neuroleptic Malignant Syndrome

Answer 28

``` Fever Elevated WBC & CPK Vital signs unstable Encephalopathy Rigidity (lead pipe) ```

Question 29

High yield concepts FGAs

Answer 29

``` They work by blocking DA Lots of serious SE Notorious fir causing EPS Dont treat EPS with an antipsychotic Know the S/S of NMS Watch out for orthostatic hypotension Wear sunscreen ```

Question 30

SGAs (atypical) drugs

Answer 30

Clozapine Risperidone Olanzapine Aripiprazole

Question 31

SGAs common uses:

Answer 31

Schizo Bipolar disorder Dementia w psychotic features

Question 32

SGAs MOA:

Answer 32

``` Block DA(2) & 5HT(2a) receptors in the brain. Decrease of DA in areas with too much & increases it in areas with too-little at least that's the theory ```

Question 33

Comparison to FGAs

Answer 33

Lower risk of EPS Really high risk of metabolic syndrome Super expensive Probably equally effective

Question 34

Metabolic syndrome

Answer 34

Central obesity Hypertension High BS Dyslipidemia

Question 35

Clozapine

Answer 35

Highly effective Can cause agranulocytosis Requires weekly monitoring (WBCs) Report signs of infection immediately

Question 36

High Yield concepts for SGAs

Answer 36

Lower risk for EPD High risk for metabolic syndrome Watch for sings of infection if a client is taking clozapine Watch for sings of NMS (can occur in FGA/SGA)