Unit I - Pharmacology & Cognition Flashcards
1
Q
3 Types of Anti Depressants
A
- Tricyclic
- MAOI
- SSRI
2
Q
Tricyclic Anti Depressants
A
Blocks the absorption of serotonin
- Nopramin
- Elavil
- Anafranil
- Tofranil
- Anticholinergic S/S - dry mouth, urine retention, constipation, blurred vision, tachycardia, excess perspiration
- Weight gain
- Extreme caution in asthma patient, cardiovascular/GI disorders, alcoholism, shizophrenia and bipolar disorders
3
Q
MAOI
A
Increases # of neurotransmitters by inhibiting reabsorption
- Nardil
- Parnate
- Avoid tyramine in food and beverages - can cause hypertensive crisis
- Aged foods - cheese, beer, pizza, wine, salami
- Low safety margin - used for patients who don’t respond to SSRI and TCA
4
Q
Selective Serotonin Reuptake Inhibitors
A
Inhibits serotonin
- Prozac
- Paxil
- Zoloft
- Break between MAOI and SSRI
- Wait two weeks after stopping MAOI, before starting SSRI
5
Q
Atypical Anti-Depressants
A
- Wellbutrin
- Effects activity of NE and DA
- Use cautiously in patients with seizure disorders
- Lowers seizure threshold
- Effexor
- Available in immediate or XR form
6
Q
Traditional Antipsychotics
A
- Kills all dopamine overload
- Sedates patient
- Causes gynocomastia
- Avoid alcohol, drugs, caffeine, smoking
- Photosensitivity
- Anticholinergive S/S
- Haldol
- Thorazin
- Prolixin
- Navane
7
Q
Atypical Antipsychotics
A
- Current meds of choice for psychotic disorders
- Generally treat negative and positive symptoms
- Geodone
- Risperdal
- Use sunscreen, prevent photosensitivity
- Avoid extreme temp
- Itching/srash, decreased libido, dysmenorrhea, rhinitis, cough
- Abilify
- Tachycardia, fever, sedation, headache, N/V, parkinsonism
- Zypyrexa
- Oral disintegrating tablets contain aspartame
- Agranulocytosis, ambylopia, increased liver enzymes
8
Q
Clozapine
(Clazaril)
A
- No class
- Treats schizophrenia
- Used when schizo is unresponsive to standard therapy with other anti-psychotics
- Reduces suicidal behavior
- S/S - DASHN
- Drooling
- AGRANULOCYTOSIS - wipes out immune system, why you need weekly blood tests
- Sedation
- Hypotension (orthostatic)
- Not for dementia patients
9
Q
Anxiolitics
A
- Think benzo’s.
- Treats anxiety disorders
- Habit forming, OD can be fatal
- Used for short term, can be addictive
- Valium
- Xanax
- Ativan
- Kloponin
- Others - Versed, Restoril, Serax
10
Q
Mood Stabilizers
A
- Treats bipolar/unipolar disorders
- Bipolar patient with anti depressant takes a mood stabilizer at the same time to prevent manic episode
- Don’t change diet or decrease fluid intake
- No alcohol, OTC, prescription meds or herbs w.o. notifying HCP
- Lithium
- Depakote
- Carbamazepin
- Trileptal
11
Q
Anticholinergics
A
- Block acetylcholine
- Dry mouth/nose/throat, constipation, drowsiness, blurred vision, constipation, memory loss
- Given for negative effects of antipsychotics
- Cogentin
- Artane
- Benadryl
12
Q
Medication s/s r/t Antipsychotics
A
- Akathisia
- Tardive Dyskinesia
- Acute Dystonia
- Neuroleptic Malignant Syndrome
13
Q
Akathisia
A
- Restless leg syndrome
- Involuntary movement of lower legs
- Uncontrollable
- Urge/need to move legs to prevent unpleasant sensations
14
Q
Tardive Dyskinesia
A
- Caused by longterm use of neuroleptic meds (Haldol, Thorazine)
- Involuntary movements of tongue, lip, face, trunk, extremities
- Permanent, no treatment
15
Q
Acute Dystonia
A
- Sustained muscular spasms
- Abnormal postures
- Treatment - IM Anticholinergics
16
Q
NMS
A
- Idiosyncratic reaction to neuroleptic meds
- Fever, muscle rigifity, altered LOC, autonomic dysfunction
- ANS regulates unconscious body functions, including HR, temp, BP, and GI secretion
- Treatment - take pt off meds
17
Q
Disorganized Schizophrenia
A
- Thoughts, behavior, speech is inappropriate, doesn’t make sense
- Babble, socially isolated, doesn’t make sense
18
Q
Catatonic Schizophrenia
A
- Physical immobility to move or speak
- Unaware of surroundings
- So engaged in their mind, they can’t come out
- Completely unable to move or speak
- Catatonic stupor - wacy flexibility, can mold into a position and they stay there
19
Q
Residual Schizophrenia
A
- Patient does not display prominent symptoms
- Hallucinations/delusions present but s/s significantly diminished
- Patient is under control
20
Q
Paranoid Schizophrenia
A
- Loss of touch with reality
- Delusions not based on reality
- Can lead to suicidal and violent behaviors
- (tinfoil head)
21
Q
Cognition
A
Complicated process by which an individual learns, stores, retrieves, and uses information
22
Q
Negative Symptoms of Schizophrenia
A
- Inexpressive facial expressions
- Monotone, monosyllabic speech
- Few gestures
- Lack of interest in world/people
- Can’t feel pleasure
- Absent of normal emotion and social sensitivity
23
Q
Positive Symptoms of Schizophrenia
A
- Hallucinations
- Delusions
- Exaggerations and distortions of normal perceptions and thinking
24
Q
Meds to Treat Schizophrenia
A
- Traditional antipsychotic
- Atypical antipsychotic
- Intensive case management
25
Q
Dementia
A
- Progressive
- Loss of cognitive function
- S/S similar to delirium
- Changes in memory, judgment
- Decreased ability to calculate numbers, abstract reasoning, problem solving
26
Q
Common Causes of Dementia
A
- Amyloid plaques and neurofibrillary tangles
- CVA and cardiovascular problems
- Nerve cell degeneration
27
Q
Dementia Treatment
A
- Pharmacologic
- Behavior mod
- Assist with ADLS
- Safety measures
- Liquid nutrition, feeding tubes
- Frequent repositioning
- 24 hr nursing care
28
Q
Delirum
A
- Temporary
- Confusion
- Radpily altering mental states
- Disorientation
- Personality changes
29
Q
Factors That Can Cause Delirium
A
- Infection
- Meds (antihistamines, anticholinergics, benzos)
- Anesthesia
- Electrolyte imbalance
- Pain
- Sleep disturbances
- Underlying dementia (dx or not dx’d)
30
Q
Treatment of Delirium
A
- Treat underlying cause
- Find age related causes (UTI, med toxicity)
- Look for alcohol/drug use in younger adult or adolescent population
- Vitamin and nutrition
- Seizure precautions
