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NR566 - Advanced Pharmacology for Care of the Family > Week 7 - Psychiatric Diagnoses and Treatments > Flashcards

Week 7 - Psychiatric Diagnoses and Treatments Flashcards

1
Q

Memantine

What is this drug used for and what do you do if someone has an elevated creatinine clearance?

A

Memantine is used for moderate/severe Alzheimer’s Disease

With an elevated creatinine clearance rate dose should be reduced.

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2
Q

What is the first line treatment for panic disorder?

A

SSRIS (fluoxetine, paroxetine, sertraline)
+ Cognitive behavioral therapy

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3
Q

What is first line treatment for performance anxiety?

A

Beta blockers - propranolol

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4
Q

What is the first line treatment for Generalized Anxiety Disorder?

A

Nondrug therapy
* Supportive therapy
* Cognitive behavioral therapy
* Biofeedback
* Relaxation training

Drug therapy
* SSRIs & SNRIs
o Venlafaxine (SNRI)
o Duloxetine (SNRI)
o Paroxetine
o escitalopram
* buspirone
o buspar

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5
Q

What are the treatment options for Depression?

A
  • Pharmacotherapy
  • depression specific pscyhotherapy
  • somatic therapies
    • electroconvulsive therapy
    • transcranial magnetic stimulation
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6
Q

What treatment options are appropriate if first depression drug isn’t working?

A
  • Increase dosage
  • Switch to another drug in the same class
  • Switch to another drug in a different class
  • Add a second drug (like an atypical antidepressant)
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7
Q

How long do depression medications take to become effective?

A

4-8 weeks to assess for efficacy

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8
Q

What is the biggest risk with antidepressants?

A

All pose a risk for suicide

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9
Q

What is the first line treatment for sleep disturbances?

A

Benzodiazepines
- Diazepam
- Lorazepam
- Alprazolam
- Triazolam
Newer benzodiazepine receptor agonists
- Zolpidem
- Zaleplon
- eszopiclone

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10
Q

Which sleep med would help patients fall asleep if they don’t have trouble staying asleep?

A
  • Ramelteon
  • Zaleplon
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11
Q

What is the therapeutic drug level for lithium?

A

0.6-0.8mEq/L

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12
Q

What is the most significant drug interaction for lithium?

A

NSAIDS increase lithium levels by 60%

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13
Q

What are some common adverse reactions with first generation antipsychotics?

A
  • Tardive dyskinesia (twisting, writhing movements)
  • Dry mouth
  • Constipation
  • Urinary retention
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14
Q

What patient teaching should be given with first generation antipsychotics?

A
  • Drugs may take a few weeks for full effectiveness
  • Avoid alcohol, narcotics and other CNS depressants
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15
Q

What are the major drug interactions for SSRIs?

A
  • Antiplatelet
  • Anticoagulants
  • MAOIs
  • Lithium
  • TCAs
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16
Q

What baseline data is needed when prescribing SSRIs?

A

Serum sodium in older adults and patients on diuretic therapy

17
Q

What are common adverse effects of SSRIs?

A
  • Anxiety
  • CNS stimulation
  • Headache
  • Insomnia
  • Nausea
  • Nervousness
  • Weight gain
18
Q

What strategies can be used to minimize the adverse effects of SSRIs?

A
  • Stop MAOIs at least 14 days before starting an SSRI
  • Use caution with TCAs, lithium, antiplatelets, anticoagulants
19
Q

What baseline data is needed when prescribing SNRIs?

A

Serum sodium in older patients and those taking diuretics

20
Q

What strategies can be used to prevent adverse effects when prescribing SNRIs?

A
  • Contraindicated with MAOIs (withdraw MAOI 14 days prior to starting an SNRI)
  • Use in caution with TCA and SSRI
  • Withdraw venlafaxine 7 days prior to starting MAOI
  • Taper dose if stopping to avoid withdrawal.
21
Q

What baseline data is needed to prescribe tricyclic antidepressants?

A

ECG especially for patients with dysrhythmias or those over 40

22
Q

What patient education is needed when prescribing TCAs?

A
  • Move slowly to reduce risk of falling due to orthostatic hypotension
23
Q

What baseline data is needed to prescribe MAOIs?

A

Blood pressure

24
Q

What patient education is needed when prescribing MAOIs?

A

Foods high in tyramine and symptoms of hypersensitivity crisis (nausea, vomiting profuse sweating, severe headache)

25
Q

What dietary restrictions are needed for patients taking MAOIs?

A

Avoid tyramine containing foods to reduce the risk of hypertensive crisis

26
Q

Name some benzodiazepines

A
  • Lorazepam
  • diazepam
  • aprazolam
27
Q

Name some benzodiazepine-like drugs

A
  • Saleplon
  • Eszopiclone
  • Zolpidem
28
Q

What type of drug is Ramelteon?

A

A melatonin receptor agonist.

29
Q

What are symptoms of serotonin withdrawal?

A
  • Dizziness
  • Headache
  • Nausea
  • Sensory disturbances
  • Tremor
  • Anxiety
  • dysphoria

NR566 - Advanced Pharmacology for Care of the Family (8 decks)

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