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Nursing 4 - Mental Health > Unit I - Pharmacology & Cognition > Flashcards

Unit I - Pharmacology & Cognition Flashcards

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1
Q

3 Types of Anti Depressants

A
  1. Tricyclic
  2. MAOI
  3. SSRI
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2
Q

Tricyclic Anti Depressants

A

Blocks the absorption of serotonin

  1. Nopramin
  2. Elavil
  3. Anafranil
  4. 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
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3
Q

MAOI

A

Increases # of neurotransmitters by inhibiting reabsorption

  1. Nardil
  2. 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
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4
Q

Selective Serotonin Reuptake Inhibitors

A

Inhibits serotonin

  1. Prozac
  2. Paxil
  3. Zoloft
  • Break between MAOI and SSRI
  • Wait two weeks after stopping MAOI, before starting SSRI
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5
Q

Atypical Anti-Depressants

A
  1. Wellbutrin
    • Effects activity of NE and DA
    • Use cautiously in patients with seizure disorders
    • Lowers seizure threshold
  2. Effexor
    • Available in immediate or XR form
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6
Q

Traditional Antipsychotics

A
  • Kills all dopamine overload
  • Sedates patient
  • Causes gynocomastia
  • Avoid alcohol, drugs, caffeine, smoking
  • Photosensitivity
  • Anticholinergive S/S
  1. Haldol
  2. Thorazin
  3. Prolixin
  4. Navane
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7
Q

Atypical Antipsychotics

A
  • Current meds of choice for psychotic disorders
  • Generally treat negative and positive symptoms
  1. Geodone
  2. Risperdal
    • Use sunscreen, prevent photosensitivity
    • Avoid extreme temp
    • Itching/srash, decreased libido, dysmenorrhea, rhinitis, cough
  3. Abilify
    • Tachycardia, fever, sedation, headache, N/V, parkinsonism
  4. Zypyrexa
    • Oral disintegrating tablets contain aspartame
    • Agranulocytosis, ambylopia, increased liver enzymes
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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
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9
Q

Anxiolitics

A
  • Think benzo’s.
  • Treats anxiety disorders
  • Habit forming, OD can be fatal
  • Used for short term, can be addictive
  1. Valium
  2. Xanax
  3. Ativan
  4. Kloponin
  5. Others - Versed, Restoril, Serax
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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
  1. Lithium
  2. Depakote
  3. Carbamazepin
  4. Trileptal
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11
Q

Anticholinergics

A
  • Block acetylcholine
  • Dry mouth/nose/throat, constipation, drowsiness, blurred vision, constipation, memory loss
  • Given for negative effects of antipsychotics
  1. Cogentin
  2. Artane
  3. Benadryl
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12
Q

Medication s/s r/t Antipsychotics

A
  1. Akathisia
  2. Tardive Dyskinesia
  3. Acute Dystonia
  4. Neuroleptic Malignant Syndrome
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13
Q

Akathisia

A
  • Restless leg syndrome
  • Involuntary movement of lower legs
  • Uncontrollable
  • Urge/need to move legs to prevent unpleasant sensations
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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
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15
Q

Acute Dystonia

A
  • Sustained muscular spasms
  • Abnormal postures
  • Treatment - IM Anticholinergics
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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
  1. Inexpressive facial expressions
  2. Monotone, monosyllabic speech
  3. Few gestures
  4. Lack of interest in world/people
  5. Can’t feel pleasure
  6. Absent of normal emotion and social sensitivity
23
Q

Positive Symptoms of Schizophrenia

A
  1. Hallucinations
  2. Delusions
  3. Exaggerations and distortions of normal perceptions and thinking
24
Q

Meds to Treat Schizophrenia

A
  1. Traditional antipsychotic
  2. Atypical antipsychotic
  3. 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
  1. Amyloid plaques and neurofibrillary tangles
  2. CVA and cardiovascular problems
  3. 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
  1. Infection
  2. Meds (antihistamines, anticholinergics, benzos)
  3. Anesthesia
  4. Electrolyte imbalance
  5. Pain
  6. Sleep disturbances
  7. Underlying dementia (dx or not dx’d)
30
Q

Treatment of Delirium

A
  1. Treat underlying cause
  2. Find age related causes (UTI, med toxicity)
  3. Look for alcohol/drug use in younger adult or adolescent population
  4. Vitamin and nutrition
  5. Seizure precautions

Nursing 4 - Mental Health (4 decks)

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