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Psychiatric Pharmacology
Medication Exam
194
Nursing
Undergraduate 4
04/29/2014

Additional Nursing Flashcards

 


 

Cards

Term
Types of Antidepressants
Definition
TCAs SNRIs SSRIs MAOIs Atypical
Term
Action of TCAs
Definition
Serotonin, norepinephrine and others
Term
Education for TCAs
Definition
Do not take with alcohol
Term
Labs with TCAs
Definition
Levels of the medication (especially if taking with other antidepressants) Liver function if risk factors
Term
Side effects of TCAs
Definition
Tremor, twitching, paresthesias, ataxia, weight gain, sedation, orthostatic hypotension. Anticholinergic effects: dry mouth, blurred vision, constipation, urinary hesitation/retention, hypotension
Term
Anticholinergic Side effects of TCAs
Definition
Dry mouth, blurred vision, constipation, urinary hesitation/retention, hypotension
Term
Adverse effects of TCAs
Definition
Palpitations, tachycardia, convulsions
Term
Contraindications with TCAs
Definition
Following an MI or severe cardiac conduction disease, Pregnancy and lactation, avoid alcohol
Term
TCAs Use with Caution
Definition
If: elderly or debilitated use a smaller dose; Persons with hepatic, renal or cardiac insufficiency; psychotic persons may cause mania; persons with a history of seizures
Term
TCA Drugs
Definition

Trimipramine, Imipramine, Desipramine,

Nortriptyline, Protriptyline, Amitriptyline, Protriptyline, Deoxepin

 

MINE

ptyLINE

DeoxePINE

Term
Action of SSRIs
Definition
Serotonin re-uptake inhibitors
Term
Education for SSRIs
Definition
Takes 4-6 weeks to take effect, possible sexual SE, take with food, tell prescriber about any herbal medications, if taking long term advise adequate calcium intake
Term
Labs associated with SSRIs
Definition
None needed, unless client on blood thinning medication
Term
Side Effects of SSRIs
Definition
Nausea,headache, shakiness, sleep disturbances, sweating, sexual dysfunction
Term
Citalopram & Paroxetine (SSRIs) Side Effects
Definition
Tiredness
Term
Adverse Effects of SSRIs
Definition
Serotonin Syndrome (Dry, Hot, Confused, Tremor)
Term
Contraindications of SSRIs
Definition
Concurrent use of MAOIs or St. John's Wort, hyponatremia (withhold dose)
Term
Use with Caution SSRIs
Definition
If: elderly start low and go slow, watch for suicidal ideation in children, on TCAs
Term
SSRI Drugs
Definition

Paroxetine, Sertraline, Fluoxetine, Fluvoxamine, Excitalopram, Citalopram

 

Paroxetine & Sertraline FLUw (x2) EXCITedly over a CITting PRAM

Term
Action of SNRIs
Definition
Selective NE reuptake inhibitor
Term
Teaching with SNRIs
Definition
Watch for withdrawl effects if suddenly stop; Dizziness and nausea can be severe
Term
Side Effects of SNRIs
Definition
N/V, fatigue, shakiness, dizziness, sweating, sexual side-effects
Term
Contraindications associated with SNRIs
Definition
Significant liver dysfunction or chronic alcohol use
Term
Use with Caution Considerations SNRIs
Definition
Use with caution in the elderly
Term
Use of SNRIs
Definition
Novel anti-depressant
Term
SNRI Drugs
Definition
Venlafaxine, Duloxetine, Desvenlafaxine
Term
Use of Mirtazapine
Definition

Novel anti-depressant

2nd line for ADHD

 

Is similar to TCA

Term
Use of Trazadone
Definition
Novel anti-depressant
Term
Use of Wellbutrin
Definition

Novel anti-depressant

ADHD

Term
Use of Mirtazepine
Definition

Novel anti-depressant

2nd line ADHD

Term
Action of the Novel Anti-depressants
Definition
NE, Serotonin, Dopamine and others
Term
Teaching with the Novel Anti-depressants
Definition
Watch for withdrawl effects if suddenly stopped; Dizziness and nausea can be severe
Term
Side Effects of Mirtazepine
Definition
Fatigue, shakiness, dizziness, drying effects
Term
Side effects of Wellbutrin
Definition
Shakiness, dizziness, sleep problems if taken at night, mood changes, tiredness
Term
Side Effects of Trazadone
Definition
Fatigue, nausea
Term
Use of MAOIs
Definition
Anti-depressant
Term
Action of MAOIs
Definition
Inhibit mono-oxidase enzyme from breaking down neuropeptides
Term
Education associated with MAOIs
Definition
No other anti-depressants for 2 weeks before or while on MAOI; Low-tyramine diet; Do not take Demerol
Term
Tyramine Containing Foods to Avoid while Taking MAOIs
Definition
Cheese, red wine, beer, smoked meats
Term
Side Effects of MAOIs
Definition
Dry mouth, dizziness, insomnia, nausea
Term
Contraindications Associated with MAOIs
Definition
Do not use with Demerol, Avoid Tyramine containing foods
Term
Adverse Effect of Eating High Amounts of Tyr with MAOIs
Definition
Hypertensive crisis
Term
Use of Benzodiazepines
Definition
Anti-anxiety
Term
Action of Benzodiazepines
Definition
Facilitate GABA causing muscle relaxation and reduction of seizures
Term
Education with Benzodiazepines
Definition
Avoid long-term use, risk of abuse and habituation, avoid use of motor vehicles, take as directed, avoid abrupt DC
Term
Special Considerations with Benzodiazepines
Definition
Monitor rate of use, refill rates and avoid letting the patient accumulate large amounts due to OD risk
Term
Side effects of Benzodiazepines
Definition
Fatigue, dizziness, headache, nausea, shakiness, falls, slowed reaction time
Term
Adverse Effects of Benzodiazepines
Definition
Respiratory depression, respiratory arrest if taken with other sedating medications, seizure if abruptly DCed
Term
Contraindications with Benzodiazepines
Definition
Active substance abuse
Term
Use with Caution Considerations of Benzodiazepines
Definition
Caution if using other sedating medications and substance abuse
Term
Use of Buspirone
Definition
Novel anti-anxiety
Term
Action of Buspirone
Definition
GABA agonist
Term
Side Effects of Buspirone
Definition
Dizziness, flushing, nausea
Term
Use with Caution Associated with Buspirone
Definition
If using other sedating medicaitons
Term
Use of Hydroxyzine Pamoate
Definition
Novel anti-anxiety
Term
Action of Hydroxyzine Pamoate
Definition
Anti-histamine with anti-anxiety properties
Term
Teaching with Hydroxyzine Pamoate
Definition
Avoid driving until effects known
Term
Side Effects of Hydroxyzine Pamoate
Definition
Dry mouth, constipation
Term
Use with Caution Considerations of Hydroxyzine Pamoate
Definition
Use with caution if taking other sedating medications
Term
Name the Major Categories of Mood Stabilizers
Definition
Anti-psychotics (Typical, Clozaril, Atypical), Anti-Seizure, Lithium
Term
Use of the Typical Anti-Psychotics
Definition
Anti-psychotic, mood stabilization
Term
Action of Typical Anti-Psychotics
Definition
Dopamine blockade
Term
Teaching with Typical Anti-Psychotics
Definition
Use sun block, take adequate fluids to avoid dehydration, watch for involuntary movements, eat healthy, blood sugar risks, 4-6 weeks for full benefit
Term
Labs Associated with Typical Anti-Psychotics
Definition
Blood sugars, lipid profile
Term
Toxicity of Typical Anti-Psychotics
Definition
Very safe
Term
Which Typical Anti-Psychotics have depot preparations available?
Definition
Halodol decanoate, Fluphenzine decanoate are dosed every 2-4 weeks
Term
Side Effects of Typical Anti-Psychotics
Definition

EPS: dystonia, parkinsonism (akathesia and akinesia), tardive dyskinesia

NMS (Hot, rigid, confused, diaphoretic)

Others: Sedation, weight gain

Term
Adverse Effects of Typical Anti-Psychotics
Definition
EPS Symptoms: dystonia, parkinsonism, akathesia, akinesia
Term
Contraindications Associated with Typical Anti-Psychotics
Definition
CNS depression, blood dyscrasias, Parkinson's; liver, renal, or cardiac insufficiency; seizures, preggers
Term
Use with Caution Considerations with Typical Anti-Psychotics
Definition
Use with caution in patients with QT interval prolonged, and other drugs that may do this (Celexa, Omeprazole)
Term
Use of Clozapine
Definition
Newer atypical anti-psychotic and mood stabilizer
Term
Action of Clozapine
Definition
dopamine blockade
Term
Teaching with Clozapine
Definition
Patient must have labs taken weekly, biweekly, then monthly for the time on the medication
Term
Labs Associated with Clozapine
Definition
CBC to check for agranulocytosis
Term
Side Effects of Clozapine
Definition
Drooling, m. stiffness, drying, fatigue, orthostatic hypotension, weight gain, cholesterol and blood sugar elevation
Term
Caution when Using Clorapine
Definition
Other agents that prolong QT interval
Term
Use of 2nd Generation Anti-psychotics
Definition
Anti-psychotic and mood stabilization
Term
Action of 2nd Generation Anti-psychotics
Definition
Block Dopamine receptors in a unique way; less permanent binding of Seratonin
Term
Teaching with 2nd Generation Anti-psychotics
Definition
Eat a healthy diet, risk high blood sugar and cholesterol, CV risks in the elderly (Black Box)
Term
Black box warning with 2nd Generation Anti-psychotics
Definition
CV risk in the elderly
Term
Labs with 2nd Generation Anti-psychotics
Definition
Liver function tests, lipid profile, blood sugar at baseline and periodically, baseline ECG
Term
What is the risk for movement disorders with 2nd Generation Anti-psychotics
Definition
Low
Term
Side Effects of 2nd Generation Anti-psychotics
Definition
Sedation, dizziness, hypotension, drying effects, constipation, weight gain, high cholesterol, gynomastica
Term
Adverse Effects of 2nd Generation Anti-psychotics
Definition
EPS, NMS, DM
Term
Side Effect of Quetiapine
Definition
Cataracts
Term
Side Effects of Olanzapine (atypical anti-psychotic)
Definition
Worst offender for wight gain and DM
Term
Uses of Anti-seizure medications
Definition
Anti-seizure and mood stabilization
Term
Action of Anti-seizure medications
Definition
GABA
Term
Education with Anti-seizure medications
Definition
Healthy diet to avoid increased weight, avoid missing a dose, takes 4-6 weeks for full effect
Term
Teaching with Depakote (Anti-seizure drug)
Definition
Need regular liver and CBC labs
Term
Teaching with Carbmezapine (Anti-seizure drug)
Definition
Need regular liver and CBC labs
Term
Labs with Depakote (anti-seizure drug)
Definition
CBC, liver function baseline and periodically; serum Depakote periodically
Term
Labs with Carbmezapine (anti-seizure drug)
Definition
CBC and liver function baseline and periodically
Term
Side effects of Anti-seizure medications
Definition
Fatigue,nausea, dizziness
Term
Side Effects of Depakote (anti-seizure drug)
Definition
Fatigue, hair loss, nausea, dizziness
Term
Side effects of Lamotrigine (anti-seizure drug)
Definition
Fatigue, rash, nausea, dizziness
Term
Side effects of Topiramate (anti-seizure drug)
Definition
Fatigue, nausea, cognitive blunting, dizziness
Term
Contraindications with Depakote (anti-seizure drug)
Definition
History of liver problems or pancreatitis
Term
Use of Lithium
Definition
Mood stabilizer
Term
Teaching with Lithium
Definition
Avoid dehydration, use sunscreen, if changing the amount of salt in the diet the dose of Li may need to also be altered, as Na levels go down Li levels go up, toxicity risk, eat a health diet to avoid weight gain
Term
Labs with Lithium
Definition
TSH, Cr, BUN, electrolytes at baseline and every 6 months
Term
Target Serum [Lithium]
Definition
0.5-1.2 mmol/L; although usually kept low 0.5-0.8 mmol/L to lower toxicity risk
Term
Signs and Symptoms of Lithium Toxicity
Definition
Nausea, vomiting, decreased cognition, confusion. lethargy
Term
Side Effects of Lithium
Definition
Tiredness, dizziness, weight gain, edema, diarrhea, hand tremor, muscle weakness, metallic taste, polydipsia, polyuria, concentration issues
Term
Use Lithium Cautiously
Definition
If: dehydrated or using diuretics, thyroid disease is present, patient is taking other mood stabilizers
Term
Categories of Psychostimulants
Definition
Methyphenidate Family, Dextroamphetamine Family, Wakefullness promoting, Non-Stimulants
Term
Uses of the Methylphenidates
Definition

ADHD

Inattention r/t autism

Term
Action of the Methylphenidates
Definition
Dopamine and NE reuptake inhibitors
Term
Teaching with Methylphenidates
Definition
Monitor for appropriate gains in height and weight, encourage adequate caloric intake, take medication with food
Term
Labs with Methylphenidates
Definition
CBC and WBC periodically to monitor for blood dycrasias
Term
Side Effects of Methylphenidates
Definition
Anorexia, weight loss, lack of expected weight and height gains, shakiness, dizziness, elevations of BP, flattening effect
Term
Adverse Effects of Methylphenidates
Definition
Palpitations
Term
Contraindications with Methylphenidates
Definition
CV problems, hypertrophic cardiomyopathy, arrythmias, current abuse and/addiction
Term
Caution with Methylphenidates
Definition
If HTN, ED, abuse potential, abuse/addiction history
Term
Uses of Dextroamphetamines
Definition

ADHD

Inattention r/t autism

Term
Action of Dextroamphetamines
Definition
Dopamine and NE reuptake inhibitors
Term
Teaching with Dextroamphetamines
Definition
Monitor for appropriate gains in weight and height, encourage adequate calories, take medication with food
Term
Labs with Dextroamphetamines
Definition
CBC and WBC periodically to check for blood dyscrasias
Term
Side effects of Dextroamphetamines
Definition
Anorexia, lack of expected weight and/or height gains, shakiness, dizziness, elevations of BP
Term
Adverse Reactions of Dextroamphetamines
Definition
Palpitations
Term
Contraindications of Dextroamphetamines
Definition
CV problems, hypertrophic cardiomyopathy, arrythmias, current abuse/addiction
Term
Use with Caution with Dextroamphetamines
Definition
If HTN, ED, abuse potential, history of abuse/addiction
Term
Dextroamphetamines Medications
Definition
Dextroamphetamine, Amphetamine, Lixdexamfetamine
Term
Non-stimulant drugs used to improve attention and focus
Definition
Atomexetine, Wellbutrin, Guanfacine & Clonidine (anti-HTN)
Term
Uses of Non-stimulant Attention Span Improvers
Definition

ADHD

Inattention r/t autism

Term
Action of Non-stimulant Attention Improvers
Definition
NE
Term
Teaching with Non-stimulant Attention Improvers
Definition
Take for 4-6 weeks for full benefit, take daily
Term

Labs with Non-stimulant Attention Improvers

 

Definition
Regular liver function tests
Term
Side Effects of Non-stimulant Attention Improvers
Definition
Stomach upset, nausea, fatigue
Term
Side Effects of Atomexetine (Non-stimulant Attention Improver)
Definition
Nausea, fatigue, shakiness, hypotension
Term
Side effects of Guanfacine and Clonidine (Non-stimulant Attention Improver)
Definition
Nausea, fatigue, hypotension
Term
Adverse Effects of Atomexetine (Non-stimulant Attention Improver)
Definition
Palpitations
Term
Caution with Guanfacine and Clonidine (Non-stimulant Attention Improvers)
Definition
If has low BP
Term
Uses of Wakefullness Promoting Drugs: Modafinil
Definition
ADHD
Term
Action of Wakefullness Promoting: Modafinil
Definition
Not fully known
Term
Teaching with Wakefullness Promoting: Modafinil
Definition
Similar to pxycho-stimulants but side effects are milder
Term
Side effects of Wakefullness Promoting: Modafinil
Definition
Shakiness, insomnia if taken during the day, nausea, headache
Term
Caution with Wakefullness Promoting: Modafinil
Definition
If HTN
Term
Drugs Used as Anti-Alcohol Agents
Definition
Disulfiram, Naltrexone, Acamprostae, Topiramate, Neurontin
Term
Labs for Anatabuse (anti-alcohol agent)
Definition
Liver function and CBC
Term
Reaction to Alcohol if on Anatabuse (anti-alcohol agent)
Definition
Flushing, nausea, thirst, abdominal pain, chest pain, dizziness, fast breathing, vomiting, fainting, confusion
Term
Side Effects of Disulfram (anti-alcohol agent)
Definition
Drowsiness, headache, metallic or garlic taste in mouth, nausea, mood problems, loss of appetite
Term
Adverse Effects of Disulfram (anti-alcohol agent)
Definition
Blurred vision, changes in color vision, dark urine, numbness or tingling of the arms/legs, seizures, vomiting, weakness, yellowing of the eyes/skin
Term
Contraindications with Disulfram (anti-alcohol agent)
Definition
metronidazole or an alcohol-containing medicine (protease inhibitors, cough syrups), severe heart disease, alcohol use
Term
Caution with Disulfiram (anti-alcohol agent)
Definition
If on anticoagulants, benzodiazepines, isoniazid, phenytoin, chance of pregnancy
Term
Action of Naltrexone (anti-alcohol/narcotics drug)
Definition
Opioid blocking agent
Term
Education with Naltrexone (anti-alcohol drug)
Definition
3-4 weeks for full effect, use caution when operating machinery, will not get sick if they use alcohol
Term
Side Effects of Naltrexone (anti-alcohol drug)
Definition
Fatigue, strange feelings, asthenia, nausea
Term
Contraindications with Naltrexone (anti-alcohol drug)
Definition
Chronic opioid use makes this medication ineffective
Term
Caution with Naltrexone (anti-alcohol drug)
Definition
If liver dysfunction
Term
Action of Acamprostae (anti-alcohol agent)
Definition
GABA analogue
Term
Education with Acamprostae (anti-alcohol agent)
Definition
Takes 4-6 weeks for full effect, will not get ill if use alcohol, caution when operating machinery
Term
Side Effects of Acamprostae (anti-alcohol agent)
Definition
Diarrhea, insomnia, mood changes, anorexia, pain, flatulence, nausea, dizziness, pruritis, dry mouth, paresthesia, sweating
Term
Contraindications with Acamprostae (anti-alcohol agent)
Definition
Severe renal impairment
Term
Anti-Dementia Categories
Definition
Cholinesterase inhibitors, NMDA Receptor antagonists
Term
Side effects of Cholinesterase Inhibitors
Definition
N/V, diarrhea, weight loss, fatigue/sleepiness, insomnia, loss of appetite, muscle cramps, abnormal dreams, dizziness, fainting, frequent urination, headache, pain, increased gastric acid, HTN
Term
Adverse Effects of Cholinesterase Inhibitors
Definition
Generalized convulsions, bladder outflow obstruction, syncopal episodes
Term
Contraindications with Cholinesterase Inhibitors
Definition
Anesthesia
Term
Caution with Cholinesterase Inhibitors
Definition
If history of asthma or COPD
Term
Teaching with NMDA Receptor Agonist: Memantadine
Definition
4-6 weeks for benefit
Term
labs with NMDA Receptor Agonist: Memantadine
Definition
Kidney and liver
Term
Considerations with NMDA Receptor Agonist: Memantadine
Definition
Work dose up slowly
Term
Side Effects of NMDA Receptor Agonist: Memantadine
Definition
Dizziness, headache, constipation, confusion, HTN, coughing, somnolence, vomiting, back pain, diarrhea
Term
Adverse Effects of NMDA Receptor Agonist: Memantadine
Definition
Hallucinations
Term
Caution with NMDA Receptor Agonist: Memantadine
Definition
If using Amantadine, ketamine, dextromethorphan, urinary alkalinizers; drugs renally eliminated: HCTZ, triameterene, metformin, quinidine, nicotine
Term
Benzodiazepine Drugs
Definition

Lorazapam, Diazepam, Clonzapam, Alprozolam, Oxazepam, Clorzepate

 

-pam & Clorzepate

Term
Typical Low Potency Antipsychotics
Definition
Chloropromazine, Thioridazine
Term
High Potency Typical Antipsychotics
Definition
Fluphenazine, Thiothixene, Halperidol, Trifluoperazine, Loxipine, Perphenazine
Term
Atypical Antipsychotics
Definition
Clozapine, Risperidone, Olanzapine, Quetiapine, Ziprasidone, Aripipazole, Paliperidone, Asenapin, Lurasidone HCl
Term
Adverse Effects of Clozapine
Definition
Hyperprolactinemia, new onset DM, agranulocytosis, cardiac arrhythmias
Term
Anti-Seizure Drugs
Definition
Depakote, Carbmezapine, Oxcarbazepine, Lamotrigine, Topiramate, Gabapentin
Term
Methyphenidate Drugs
Definition
Methylphenidate (Ritalin, Concerta), Dexmethylphenidate
Term
Use of Naltrexone and Topiramate
Definition
Decrease alcohol cravings
Term
Use of Acamprostae
Definition
Alcohol use
Term
Use of Disulfiram
Definition
Prevents alcohol use
Term
Use of Methadone
Definition
Heroin withdrawl
Term
Use of LAAM
Definition
Alternative to methadone; for heroin withdrawl
Term
Clonidine + Naltrexone Use
Definition
Suppresses opioid withdrawl symptoms
Term
Use of Buprenorphine
Definition
Opioid addiction
Term
Action of Memantine
Definition
Regulates glutimate via NMDA antagonism
Term
Actetylcholinesterase Inhibitors Drugs
Definition
Donepezil, Tacrine, Rivastigmine, Galantamine
Term
Drugs Used to Treat EPS Symptoms
Definition

Diphenhydramine: antihistamine

Beztropine, Trihexyphenidyl, Procyclidine, Biperiden: anticholinergics

Amantadine: dopaminergic agonist

Term
S/S of NMS
Definition
Fever, agitation, muscle rigidity, tachycardia, tremor
Term
Medications Used to Treat Anorexia Nervosa
Definition

SSRIs: Especially Fluoxetine bc it reduces obsessive symptoms when the pt is at a maintanence weight

Chloropromazine (1st generation anti-psychotic)

Olanzapine (atypical anti-psychotic) improves mood, decreases obsessive behavior and decreases resistance to weight gain 

 

Term
Drugs Used to Treat Anger
Definition

Haloperidol when uncontrolled agitation present

SSRIs

Propanolol (beta-adrenergic blocker): reduces SNS S/S

Lithium

Anti-anxiety drugs: Benzodiazapines

Term
Drugs Used to Treat OCD
Definition

Only used with anxiety is so high the patient may harm themselves.

SSRIs

Sometimes TCAs

Lithium: for severe symptoms

Haloperidol/Quetiapine: severe symptoms

Term
Drugs Used to for GAD
Definition

Benzodiazepines: short-term

Buspirone

SSRIs

Sometimes TCAs

Term
Drugs Used to Treat PTSD
Definition

Sertraline: for sleep

Minipress: anti-HTN useful in reducing nightmares

Term
Drugs Used to Treat Bipolar Disorder
Definition

Anti-psychotics

Anti-siezure

Lithium

 

2nd Line: Anti-depressants

benzodiazepines  (agitation, mania)

Sleep medications

 

Term
Drugs Used to Treat Autism & Aspergers
Definition

Used to treat behavioral symptoms

Aripiprazole: when behavior interferes with progress

Psychostimulants: for inattentiveness

Term
Drugs Used to treat ADHD
Definition

Psychostimulants: Atomoxetine


2nd Line:

Wellbutrin

Clonidine

SNRIs

Term
Drugs Used to Tread ODD and Conduct Disorder
Definition

Atypical anti-psychotics: Risperidone, Aripiprazole

Anti-seizure: Depakote

Lithium

Underlying ADHD with anti-HTNs: Clonidine, Guanfacine

Term
Drugs Used to Treat Childhood OCD
Definition

Mostly SSRIs: Fluoxetine, sertraline, Citalopram

TCAs: Anafranil, Fluvoxamine, Mertazepine

SNRIs: Venlafaxine, Duloxetine

Anti-anxiety: Buspirone, Hydroxyzine, Benzodiazapines

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