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NURS 804: Pharmacology > Unit 8: OVERVIEW (Depression, Anxiety, Psychosis, Bipolar, etc.) > Flashcards

Unit 8: OVERVIEW (Depression, Anxiety, Psychosis, Bipolar, etc.) Flashcards

1
Q

Drug Classes used to treat Depression

A

SSRIs (Selective Serotonin Reuptake Inhibitors)
TCAs (Trycyclic Antidepressants)
SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors)
SARIs (5-HT2 Antagonists)
Tetracyclic and Unicyclic Antidepressants
MAOIs

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2
Q

Advantages to SSRIs

A

very affordable (many on $4 list)

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3
Q

MOA of SSRIs

A

increase serotonin by blocking reuptake

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4
Q

SSRIs interact with MAOIs and can cause what major issue?

A

SEROTONIN SYNDROME

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5
Q

Important dosing note for SSRIs

A

DO NOT STOP abruptly; taper minimum of 2 weeks

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6
Q

What happens if SSRIs are abruptly stopped?

A

withdrawal syndrome

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7
Q

Side effects can happen with SSRIs; what do you need to tell patients?

A

hang in there; many side effects tend to go away

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8
Q

Name 7 SSRIs

A 
fluoxetine (Prozac)
paroxetine
sertraline (Zoloft)
citalopram (Celexa)
escitalopram (Lexapro)
fluvoxamine
vilazodone
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9
Q

How do the SNRIs work to treat depression?

A

block reuptake of serotonin & norepinephrine

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10
Q

Name 4 SNRIs used to treat depression

A

venlafaxine
desvenlafaxine
duloxetine
milnacipran

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11
Q

How do the TCAs work to treat depression?

A

block reuptake of biogenic amines, including serotonin and norepinephrine

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12
Q

Name 5 tertiary amine TCAs used to treat depression

A 
amitriptyline
clomipramine
doxepin
imipramine
trimipramine
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13
Q

Name 3 secondary amine TCAs used to treat depression

A

despiramine
nortriptyline
protriptyline

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14
Q

What antidepressant class can be fatal in overdoses, and why?

A

TCAs

due to arrhythmias or seizures

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15
Q

What happens with many TCAs and other drugs?

A

many drug-drug interactions increase the TCA concentration

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16
Q

Name the 1st, 2nd and 3rd line classes used to treat depression

A
  1. SSRIs
  2. SNRIs
  3. TCAs
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17
Q

Name 2 SARIs used to treat depression

A

trazodone (Desyrel)

nefazodone

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18
Q

How do the SARIs (5-HT2 Antagonists) work?

A

block of serotonin @ 5-HT2A receptors –>
antianxiety
antipsychotic
antidepressant

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19
Q

Name 2 tetracyclic and unicyclic antidepressants

A

bupropion

mirtazapine

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20
Q

Name 4 MAOIs used to treat depression

A

isocarboxazid
phenelzine
tranylcypromine
selegiline

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21
Q

MAOIs can interact with what drugs to cause a hypertensive crisis?

A

antidepressants
carbamazepine
levodopa

22
Q

MAOIs can interact with what drugs to cause serotonin syndrome?

A

dextromethorphan

antidepressants

23
Q

Why can MAOIs be fatal?

A

slow elimination

interaction with SSRI or tyramine-containing foods can cause a fatal hypertensive crisis

24
Q

What does tyramine do?

A

releases norepinephrine which increases BP and can cause arrhythmias

25
Q

What drug classes are used to treat insomnia and acute anxiety?

A 
barbitruates
benzodiazepines
benzodiazepine antagonists
hypnotics
5-HT Receptor Antagonists
26
Q

Define tolerance

A

reduced effect with repeated use of a drug; need higher doses for same effect

27
Q

Define cross-tolerance

A

person tolerant to 1 drug also tolerant to drugs in the same class

28
Q

Define dependance

A

s/sx of withdrawal when drug levels fall

29
Q

For what are barbiturates used?

A

anesthesia
insomnia
seizure disorders

30
Q

What barbiturate works within minutes and is used for anesthesia?

A

thiopental

31
Q

What barbiturates have a duration of action for hours?

A

pentobarbital
secobarbital
amobarbital

32
Q

What barbiturate has a duration of action for days?

A

phenobarbital

33
Q

Which benzodiazepines are more difficult to discontinue?

A

shorter-acting agents

34
Q

Name 2 short-acting benzodiazepines

A

midazolam

triazolam

35
Q

Name 2 intermediate-acting benzodiazepines

A

alprazolam (Xanax)

lorazepam (Ativan)

36
Q

Name 2 long-acting benzodiazepines

A

clonazepam (Klonipin)

diazepam (Valium)

37
Q

Name a 5-HT Receptor Antagonist used to treat anxiety

A

buspirone (Buspar)

38
Q

Name 3 hypnotics

A

zolpidem (Ambien)
zalepon
ezopiclone (Lunesta)

39
Q

What is the risk of using hypnotics in elderly patients?

A

delirium

40
Q

Name a benzodiazepine antagonist used for benzodiazepine overdose

A

flumazenil

41
Q

Of what should you be aware if you give flumazenil for a benzodiazepine overdose?

A

withdrawal symptoms in patients who are dependent on benzodiazepines

42
Q

Goal of Schizophrenia treatment

A

most drugs bind to dopamine receptors

want to keep dopamine available in the synapse so patients feel more euphoric/up

43
Q

Classes used to treat Schizophrenia

A

antipsychotic drugs
antischizophrenics
tranquilizers

44
Q

Typical antipsychotics can cause what irreversible side effect?

A

tardive dyskinesia

45
Q

Name some 1st generation typical antipsychotics

A 
chlorpromazine
fluphenazine
haloperidol
perphenazine
thoridazine
thiothixene
trifluoperazine
46
Q

Name some 2nd generation atypical antipsychotics

A 
ariprazole (Abilify)
clozapine (Clozaril)
olanzapine (Zyprexa)
quetiapine (Seroquel)
risperidone (Risperdal)
ziprasidone (Geodon)
47
Q

What atypical antispsychotic has a huge risk fo agranulocytosis and requires
WEEKLY BLOODWORK and
patients to be on a registry?

A

clozapine (Clozaril)

48
Q

Serious side effects of typical antipsychotics

A

QT prolongation
neuroepileptic malignant syndrome
extrapyramidal effects

49
Q

Which antipsychotics can cause QT prolongation?

A

ziprasidone (Geodon)

quetiapine (Seroquel)

50
Q

Which antipsychotics increase the risk of stroke?

A

risperidone

olanzapine

51
Q

What do you need to remember for all antipsychotics?

A

1 year to life

can cause withdrawal because they work on neurotransmitters –> taper on/off

NURS 804: Pharmacology (42 decks)

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