Term
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Definition
chronic
disordered thinking
reduced ability to comprehend reality
positive symptoms - exaggeration of normal behavior; hallucinations, mania
negative symptoms - depression of normal behavior; withdrawal, depression, catatonic states
**cause: perhaps excess dopamine
- inhibit dopamine for tx |
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Term
| First generation antipsychotics - Neuroleptics |
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Definition
cause mvmt assoc'd adverse rxns bc impact on NS impedes dopamine, NE, histamine
chlorpromazine (thorazine), haloperidol (haldol)
MOA: block Rs including dopamine2 in brain
USES: schizo
initial effects 1-2 days
substantial effects 2-4 wks |
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Term
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Definition
extrapyrimidal symptoms - mvmt related SE; include...
- acute dystonia - spasm of face, back, neck; medical emergency; tx w/anticholinergic (benadryl)
- parkinsonism - like parkinson's; tx w/anticholinergic (benadryl)
- akathisia - can't stop moving; have to get up and walk; tx w/anticholinergic (benadryl)
tardive dyskinesia - no tx |
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Term
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Definition
neuroleptic malignant syndrome - rigid, boardlike, ledpipe rigidity; MM are contracting so body temp rises; medical emergency, pts can die
anticholinergic effects - dry mouth, constipation, drying everything out, ortho HoTN (bc blocked adrenergic Rs), sedation (bc blocked histamine Rs)
neuroendocrine effects - since dopamine blocks prolactin, and since we block dopamine w/these drugs, we have increased prolactin = increased milk prod, gynecomastia
seizures - decreases seizure threshold
sexual dysfxn - depresses libido; noncompliance bc this
dermatologic effects - some meds can cause dermatitis when you touch it
agranulocytosis - WBCs; w/o, pt is at increased risk for infection; watch WBC counts
dysrhythmias - prolonged QT |
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Term
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Definition
anticholinergic drugs - intensified effects
CNS depressants - intensified effects
Levodopa - used to tx parkinson's; impeded |
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Term
| Second generation antipsychotics - Atypical antipsychotics |
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Definition
olanzapine (zyprexa)
ziprasidone (geodon)
less likely to cause EPS, TD |
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Term
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Definition
USES: schizo, agitation in schizo, bipolar, acute mania of bipolar
blocks Rs for serotonin, dopamine, histamine, ACH, NE
SE: wt gain -> diabetes, dyslipidemia |
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Term
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Definition
USES: schizo, bipolar
blocks Rs for dopamine, histamine, alpha-adrenergic
blocks reuptake of serotonin and NE
AE: somnolence, ortho HoTN, rash
- low risk of wt gain, diabetes, dyslipidemia
prolongs QT interval = risk for dysrhythmias |
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Term
| TCAs - amitriptyline (elavil) |
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Definition
block neuronal reuptake of NE, serotonin
USES: depression, bipolar
AE: ortho HoTN (bc adrenergic blockade), anticholinergic effects, diaphoresis, sedation, cardiac tox, seizures, hypomania (increased activity, excitation), toxic to NS - ppl can OD -> death
SUICIDE RISK |
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Term
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Definition
MAOIs
sympathomimetics - Epi/NE work better when given w/TCA
anticholinergics
CNS depressants - intensified effects
Toxicity - no anecdote; must pump stomach, give tar/coal; something to make them throw up |
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Term
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Definition
most desired
selectively inhibit serotonin reuptake
escitalopram (lexapro)
sertraline (zoloft)
fluoxetine (prozac) |
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Term
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Definition
most widely used
selective inhibition of serotonin reuptake, CNS excitation
may take a while for body to adapt and take effect!!
USES: depression, bipolar, OCD, panic disorder, bulimia, PMDD
AE: sexual dysfxn, wt gain
INTRXNS: MAOIs - HTN crisis
warfarin - monitor PT/INR, can be inc'd effects
TCAs, Lithium - inc'd effects
Lexapro and Zoloft very similar |
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Term
| SNRIs - desvenlafaxine (pristiq) |
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Definition
block reuptake of serotonin and NE - giving more energy
USES: major depression
AE: nausea, HA, dizziness, insomnia, diarrhea, dry mouth, sweating, constipation, ED, dec'd libido
NO risk of tox |
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Term
| MAOIs - phenelzine (nardil) |
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Definition
2nd/3rd choice of tx bc so many food/drug intrxns
MAO - enzyme that converts NE, serotonin, & dopamine into inactive products; inactivates tyramine in foods
- tyramine promotes NE release = inc'd BP/HR
- foods w/tyramine - avocados, overripe bananas, aged/dried meat/fish, cheeses, chianti wine
USES: atypical depression, bulimia nervosa, OCD
AE: CNS stim, ortho HoTN, HTN crisis w/tyramine |
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Term
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Definition
indirect acting sympathomimetics - ephedrine, amphetamine = HTN crisis
TCAs - HTN crisis risk
Antihypertensives - can lower BP
Meperidine (demerol) - can cause inc'd body temp (hyperpyrexia) |
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Term
| Atypical antidepressants (atypical bc its a stimulant) - bupropion (welbutrin) |
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Definition
stimulant = inc'd HR, BP, metabolism; dec'd appetite; insomnia
stimulate to lose wt; inc'd sexual desires - tx hypoactive sexual desires
USES: major depression, prevention of seasonal affective disorder, counteract sexual dysfxn in pts taking SSRIs, hypoactive sexual desire disorder
AE: seizures, agitation, HA, dry mouth, constipation, wt loss, GI upset, dizziness, tremor, insomnia, blurred vision, tachycardia
INTRXNS: MAOIs - HTN crisis |
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Term
| drugs for bipolar disorder |
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Definition
aripirazole (abilify)
lithium |
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Term
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Definition
USE: bipolar
plasma levels: keep < 1.5 mEq/L
maintain btwn 0.4-1.0 mEq/L
TOX can cause death
AE: GI effects, tremor, polyuria, renal tox, goiter/hypothyroidism (impairs iodine secretion = no thyroid hormone); teratogenesis
Inhibits ADH - causes massive amts of urine = polyuria |
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Term
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Definition
diuretics - increase plasma lithium levels
NSAIDS - increase plasma lithium levels
anticholinergics - massive urine production, hesitancy |
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Term
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Definition
benzodiazepines
diazepam (valium)
lorazepam (ativan)
alprazolam (xanax) |
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Term
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Definition
CNS depressant
reduce anxiety
promote sleep
MM relaxation
IV - can cause HoTN, cardiac arrest, CNS depression
MOA: potentiate GABA |
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Term
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Definition
USES: anxiety, insomnia, seizures
AE: CNS depression, anterograde amnesia, paradoxical effects, respiratory depression, ABUSE, teratogens
INTRXNS: CNS depressants
risk for tolerance and physical dependence |
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Term
| ADHD - CNS stimulant - amphetamine (adderall XR) |
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Definition
promotes release of NE
USES: ADHD, narcolepsy, obesity
AE: CNS stim, wt loss, CV effects, psychosis, inc'd BP/HR
*give in AM, record pts wt
looks like paranoia/paranoid schizophrenia |
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Term
| methylphenidate (ritalin) - CNS stimulant |
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Definition
promotes NE release
increases BP/HR
AE: insomnia, reduced appetite, emotional lability |
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Term
| atomoxetine (strattera) - non-stimulant |
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Definition
no potential for abuse
1-3 wks
selective inhibitor of NE reuptake
AE: suicidal thinking in children, growth retardation, severe liver injury
INTRXNS: MAOIs - HTN crisis |
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