week 4 questions Flashcards
What do you do in the case of acute dystonia?
Bonus: which gen is more likely to cause this?
Administer diphenhyramine
1st gen is more likely to cause this
What to do in case of Parkinsonism?
Bonus: which gen?
administer anticholinergic med
1st
What constitutes “extra pyrimidal” side effects?
acute dystonia = face spasms
akathisia = restlessness
Parkinsonism
Explain tardive dyskinesia
difficulty speaking and chewing –> slow wormlike movements of mouth
late in therapy and untreatable
1st gen
Side effects of 1st gen vs 2nd gen antipsychotics
1st gen: extrapyrimidal side effects and prolactin elevation
2nd gen: agranulocytosis, anticholinergic, CYP3A4 metabolism
caveot: not exclusive, just more likely
What is neuroleptic malignant syndrome and how do you treat it?
rigidity, fever, and autonomic inability that happens with some psych meds
treat with dantrolene, IV fluids, and stop psych med
mild abstinence syndrome
happens when antipsychs are abruptly withdrawn
causes restlessness, insomnia, GI distress, and sweating
diagnosing schizophrenia
decrease in self care
1 month of active phase symptom
6 month of continuous signs of disturbance
who SHOULDN’T take SSRIs?
patient with history of suicide attempt
what is serotonin syndrome
happens when 2 meds affecting reuptake of serotonin are taken at same time
***DONT TAKE SSRI AND MAOI W/IN 5 WEEKS
delirium, tachycardia, hyperreflexia, agitation, tramors, hyperthermia, seizures, dysrhythmias, DIC
Types of drugs to treat BPD
mood stabilizers = lithium, diva sodium, carbamazepine
antipsychotics
antidepressants
Things to be cautious ab with lithium
small therapeutic range
short half life
can’t be excreted if not enough sodium
Too musch = GI issues, tremors, hypothyroidism, renal issues
What do BPD ppl have to consider before getting pregnant?
they can’t be on lithium
lithium drug interactions
no diuretics
no NSAIDs
no Anticholinergics
What are benzos approved for? also what is their class?
they’re sedative hypnotics
used for seizures, sleep, and anxiety
Unique pros of benzos
don’t suppress REM
don’t increase metabolism of other drugs
Good for etoh withdrawal
What to do in a benzo OD
give Flumazenil –> careful bc it causes withdrawal
What can’t you ingest with benzos?
grapefruit and any other CNS depressors
Which sedative/hynotic DOES NOT cause CNS depression
Ramelteon
Barbituates mech of action
intensify GABA in brainstem
what to do when barbiturate OD
airway
fluids
pressor support
activated charcoal
Amphetamine mech of action
release NE and dopamine
Amphetamine tolerance, dependence, and abuse
Tolerance: eventually tolerat mood elevation, appetite suppression, and cardiovascular stimulation
Abstinence syndrome with abrupt withdrawal
can be abused bc of euphoria
Amphetemine adverse effects
CNS stimulation
weight loss
CV effects
psychosis
