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Psych/Neuro Rx (Exam 6, Pharm 112)
ANS, Anxiety, Isomnia, Psych meds, and Neuro meds
23
Nursing
Undergraduate 2
11/14/2010

Additional Nursing Flashcards

 


 

Cards

Term

 

 

Anxiolytics

+

Sleep Aide

Classes

Definition

 

Antidepresants

 

Benzodiazapines

 

Barbiturates

 

NonBenzo/NonBarbituate CNS depressants

Term

 

 

 

 

lorazepam (Ativan)

 

Definition
  • Class: Sedative-Hypnotic
  • Potentiates effects of GABA
  • Half life= 10-20 hours
  • anxiolytic and preanestisia Rx
  • IV; monitor for 5-15min after giving
  • Category D
  • contraindicated for: narrow angle glaucoma, psychosis, depression
  • avoid using for pain
  • OD= Romazicon- Benzo antagonist
Term

 

 

zolpidem (Ambien)

Definition
  • Class: Sedative-Hypnotic
  • GABA mediated CNS depression in the limbic, thalmic, and hypothalmic areas
  • Meant for short term insomnia mngt (7-10 days)
  • Rapid onset
  • Category B (Contraindicated for lactation)
  • Interaction= Phenothiazines augment CNS depression
  • half life= 1.7-2.5hours
  • duration= 6-8 hours

 

 

Term

 

 

 

 

phenytoin (Dilantin)

Definition

Class: Hydantoin

Unlike Barbituates low abuse risk

Narrow therapeutic range (10-20mcg/ml)

Metabolized differently=inividualized doses

Effective agaist all Sz except; absence Sz

Not compatible w/ many RX

flush lines w/ any dextrose poducts= risk for emboli

Use IV line w/ filter when infusing

Soft tissue irritant-avoid hand sites

Category D

Cand cause: Bradycardia, V-Fib, Hypotesion, and Hyperglycemia

 

 

 

 

 

Term

 

 

 

valproic acid (Depakote)

Definition

class: Valproate (anti-Sz)

Less side effects than Dilantin

DOC for tonic-clonic, partial and absense Sz.

also used for BPD

GI iritant, doNOT mix w/ carbonated soda=immediate release of Rx and risk for oral tissue damage

Preganancy D

Contraindicated for Liver Disease, Pancreatitis, Bleeding Dysfunction, or Metabolic disorders

Can cause Hyponatremia

 

 

 

Term

 

 

 

luminal (Phenobarbitol)

Definition

Class: Barbiturate (schedule II Rx)

Half-life= 2-6 days Duratrion= 6-10hrs PO, 4-10hrs IV

Can increase increased sensitivity to pain

Side effects:

Drowsiness

Addiction

Vitamin D deficiency (folate, B,and B12)

Resp Depression

CNS Depression

Coma/Death

Increases metabolism of othe Rx= Reduced effectiveness

 

Term

 

 

 

Parkinson's Triad

Definition

 

Tremors

 

Bradykenisis

(Slowed ability to start and continue movements)

 

Rigidity

Term

 

 

 

 

carbidopa-levodopa (Sinemet)

Definition

Class= Dopamenergic

Restores extrapyrimidal dopamine

carbidopa prevents enzymatic breakdown-helps levodopa across blood brain barrier

Can take up to 6mo to see therapeutic effects

Abrupt withdrawal= risk for parkinsonism crisis or NMS

Side effects:

Orthostatic Hypotension (common)

Involunatry movements

Fatigue

Insomnia

Dry Mouth

Blurred Vision

Loss of Appetite

Urinary Retention

Dyskenisia

Severe Depression

N/V

Palpations/Dysrhythmia

*TCAs decrease efficacy and increase postural hypotension

Do NOT take w/ MAO (risk for HTN crisis)

Anti-HTN meds= risk for Hypostension

*Pyridoxine reverses effects of L-dopa

Contraindiated for nrrow angle glaucoma

 

 

Term

 

 

 

 

NMS

Definition

 

Neurolyptic Malignant Syndrome

 

Muscle rigidity

Fever

autonomic instability

delirium

ass. w/ elevated creatnine phosphkinase (CPK)

 

Term

 

 

 

fluphenazine(Prolixin)

Definition

Class: Phenothiazine (typical anti-psychotic)

indication= acute/chronic pschosis

Action= alters effect of Dopamine in CNS (anticholergenic and anti-adrenegic blocking activity)

 

Can cause Tardive Dyskanisia

 

Term

 

 

phenothiazines

Definition

 

Prolixin

 

Thorazine

 

Phenazine

 

Mellaril

Term

 

 

 

 

phenothiazine side effects

Definition

Acute dystonia

Akathesia

Anticholergenic effects

Hypotension

Neurolyptic Malignant Syndrome

Parkinsonian

Sedation

Sexual Dysfunction

Tardive Dyskinesia

Term

 

 

Non-Phenothiazines

Definition

 

 

Haldol

Tarctan

Loxitane

Moban

Orap

Navene

Term

 

 

Non-phenothiazne Side effects

Definition

Sedation

 

Transient Drowsiness

 

Extrapyramidal effects

 

Tremors

 

Orthostatic Hypotension

Term

 

 

 

Meds used to Tx Anxiety

Definition

 Antidepressants

 

Anti-seizure

 

Antihypertensives

 

Antidysrhytmics

 

*Primary Rx= TCAs, MAOs, and SSRIs

Term

 

 

SSRIs

Definition

 

Selective Seratonin Reuptake Inhibitor

Safer

side effects: increased HR and HTN, N/V, Dry mouth, insomnia,

Sexual Dysfunction, fatigue, agitation

 

Term

 

 

 

Anticholinergic Effects

Definition

Are caused by drugs that block the action of acetylcholine. Acetylcholine is a neurotransmitter—a chemical messenger that helps nerve cells communicate.

 

 

Confusion, blurred vision, constipation, dry mouth, light-headedness, difficulty starting and continuing to urinate, and loss of bladder control.

Term

 

 

 

sertaline (Zoloft)

Definition

Class: SSRI

Tx for depression, anxiety, panic, and OCD

*Do NOT give with MAO or up to 14 days post d/c

Pregnancy C

 

Assess for suicidal idiation esp. in Teenagers

 

Avoid protein bound meds like Digoxin or Warifin= toxicity and bleeding

 

Term

 

 

 

imipramine (Tofranil)

Definition

Class: Tricyclic Antidepressant

Blocks reuptake of seratonin and norepinepherine

Used to Tx major depression, nocturnal enurisis in peds, and withdrawal of ETOH and Cocaine

Anticholinergic effects

Do NOT d/c abruptly

Category C

Side effects; Dysrythmia, heart-block, HTN, drowsiness, fatigue

 

Contraindicated for hear pts.

 

Term

 

 

phenelzine (Nardil)

Definition

Class: Monoamine oxidase inhibitor (MAO)

Action= irreversible inhibition of MAO

intensifies effects of norepinephrine in arenergic synapse

used only when other meds do not work

Effects may coninue for up to 2-3 weeks after d/c

Abrupt d/c= rebound hypertension

Category C

side effects; dry mouth, orthostatic hypotension, insomnia, loss of appetite, diarrhea, headache

Potentiates the effects of insulin

food containing tyrosine=severe HTN!!!

 

Term

 

 

 

Lithium

Definition

Class: Glutamate inhibitor; serotonin receptor antagonist

Action: stabilization of mood during manic phases of BPD

(has neither antimanic or antidepresant properties in ptsw/out BPD)

Therapeutic results seen in 2-3 weeks

Narrow therapeutic range (0.5-1.5)

Pregnancy D category

Diurectics increase the removal of Lithium by the kidneys

Adverse effects:

Dizziness

Fatigue

Short Term Memory

Increased Urination

N/V

Loss of Appetite

Dry Mouth

Muscle Weakness

 

*Salt free diet= reduces excretion of lithium

 

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