Psych Drugs etc.

  1. What type of antidepressant is Tofranil?
  2. What neurotransmitter systems does Tofranil work on?

    What does this do?
    Serotonin & norepinephrine

    Creates anticholinergic effects
  3. What are 4 anticholinergic effects of Tofranil/imipramine?
    • Blurred vision
    • Dry Mouth
    • Orhto Static hypotension
    • constipation
  4. Some tricyclic antidepressants (TCA's) block what in the brain?

    This produces what symptom?
    H1 receptors

    Sleepiness & Tachycardia
  5. 3 major concerns of TCA's r/t cardiovascular system are?
    • arrythmias/dysrythmias
    • heartblock
    • MI
  6. Maximum effectiveness for Tofranil/imipramine (& all TCAs) is explerienced when?
    2-4 weeks
  7. Besides effects on cardio system, what are 4 other adverse reactions to Tofranil/imipramine?
    • ECG changes
    • Hypotension
    • Hallucinations
    • Paresthesia
  8. How is lithium carbonate/Eskalith classified?
    A mood stabilizer
  9. What is the action mechanism of lithium carbonate/Eskalith?
    • alters na+ transport in nerve and muscle cells
    • Shifts toward inter neuronal muscle or catacholines

    *specific action in mania is unknown
  10. What is the therapeutic range of lithium carbonate?

    Why is it important to maintain this range?
    • 0.5-1.5 mEq/L
    • higher levels @ risk to become toxic
  11. What are 2 dietary concerns when taking lithium carbonate?
    adequate intake of h2o and sodium Na+
  12. How ling does it take for symptom control to occur when taking lithium?
    10-21 days
  13. With long-term use of lithium what are the concerning effects?
    Development of thyroid, heart, kidney disorders
  14. What are adverse reactions to lithium?
    • Liver damage withing 1st 6 months
    • Life threatening pancreatitis
    • Clothing disorder
    • Slurred speech or anaphalaxys
  15. What is the classification of chlorpromazine/thorazine?
    1st generation antipsychotic
  16. What does chlorpromazine/thorazine act on (neuro system)?

    What effect does it have on a neurotransmitter system?
    Dopamine D2

    Blocks dopamine receptor sites
  17. Prolixin/fluphenazine what other drug is exactly alike?

    How so?
    Haldol/haloperidon & thorazine

    • 1st generation antipsychotic look for pseudoparkinsoniaisms
    • TD
    • NMS - AR
  18. A fatal adverse reaction for cholorpromazine/thorazine is what?

    What are the symptoms?
    NMS - neuroleptic malignant syndrome

    muscle rigidity with cog wheeling, hyperpyrexia, HTN, diaphoresis, tachycardia, incontenence
  19. What are the adverse reactions of chlorpromazine/thorazine?
    • agranulocytosis
    • hyperpirolactinemia (milk menstrual disturbances women, E.D. in men)
    • tachycardia
    • tardive dyskinesia
  20. What is the classification of Haldol/haloperidol?
    1st generation antypsychotic
  21. What neuro system does haloperidol/ haldol act on, and how does it do this?
    Dopamine D2

    blocks dopamine receptor sites
  22. taking haloperidol/haldol may cause s.e. that look like a neuroligical disease what?

    What are the s/s?

    s/s tardive dysk. & parkinsonisms
  23. What are adverse reactions to haliperidol/Haldol?
    • agranulocytosis
    • ECG changes
    • seizures
    • respiratory depression
  24. What category drug does atomoxetine/Strattera belong?

    Selective Norepinephrine Reuptake Inhibitor
  25. What is atomoetine/Stratta used for?

    How does it work?
    ADHD in kids and adults

    Blocks the reuptake of norepinephrine into the presynaptic neuron!
  26. What is the greatest risk when taking atomoxetine/Stratta?

    How would the RN recognize this?
    Liver damage

    • -dark urine
    • -URQ tenderness
    • -jaundice
    • -pruritis
    • -flu like symptoms
  27. What category of drug is Buprenorphine & naloxone (suboxone)?
    opiod analgesic
  28. What are 4 A/R of selgiline/Emsam
    • Hallucination
    • gambling/sexual urges
    • melanoma
    • abdominal pain
  29. How would and RN recognize parkinsonisms?
    • pill rolling tremor
    • mask like face
    • stooped posture
    • shuffling gate
    • arms not swinging w/walk
    • bradykinesia
  30. What category of drugs does Parnate/ trancypromine belong to?
    Monoamine oxidase inhibitors
  31. What neuro transmitter systems does Parnate/tranylcypromine work on?
    • serotonin
    • dompamine & epinephrine
  32. buprenorphine alone can be used for what?

    Also, buprenorphine alone and in combo with naloxone can be used for what?
    • Pain
    • Opiod detox
  33. How would an RN know the s/s of withdrawal?
    • rhinorrea
    • diaphoresis
    • muscle pain
    • abd. cramps
    • dilated pupils
    • panic/insomnia
  34. When using buprenorphine & naloxone for withdrawal/detox what route is usually given?
  35. What is the greatest danger of buprennorphine & naloxone?

    If this occurs, what is the antedote?
    respiratory depression

  36. What are the A.R. of buprenorphine and naloxone?
    • Resp. depression
    • anaphalaxis
    • physiological dependence
  37. What is the drug classification of clozapine/ Clozaril?

    What does the drug act on? How?
    2nd generation

    Acts on dopamine D2 and D4, and seratonin neuro systems.  By blocking both seratonin and dopamine receptor sites.
  38. Like Haldol & Prolixin what s/e and a/r can Clozapril/clozapine have?
    s/e tardive dyskinesias - pseudoparkinsonisms

    a/r NMS
  39. Exactly how does Parnate/tranylcypromine work on the neuro systems?
    inactivates MAO-A which inactivates dopamine in the brain & MAO-B which inactivates norepinephrine & serotonin, increasing all SAID transmitters.
  40. What is the most serious a/r to Parnate/tranylcypromine & what is caused by?
    hypertensive crisis

    Parnate/tranycypromine prevents dreakdown of tyramine in the liver stimulating intense vasoconstriction
  41. Because of risk of a serious a/r to Parnate what do patinet need to avoid?

    Give 4 examples.
    Tyramine in food

    • aged cheese
    • wines & beer
    • processed meats
    • fova beans
  42. What are 4 a/r other than hypertensive crisis that can occur with Parnate/trancypromine?
    • seizures
    • arrhythmias
    • agranulocytosis
    • thrombocytopenia
  43. What is unique about selegiline/Emsam?
    (name 2)
    delivered by transdermal patch

    can maintain regular diet, does not require tyramine restricted diet, if dose is <6mg per 24 hours. MAOI
  44. How would and RN recognize Tardive dyskinesia?
    • lip smacking
    • licking
    • puffing
    • tongue thrust
    • spastic facial distortion
    • jerking movements
  45. The fatal a/r with haloperidol/Haldol is?
    NMS (neuroleptic malignant syndrome)
  46. How would and RN recogniz NMS?

    What would the RN do if they observed these signs?
    • hyperpyrexia
    • muscle rigidity w/ cog wheeling
    • HTN/hypotension
    • tachy
    • incontinent

    Hold med and call MD ASAP.
  47. What are the 4 most important patient teachings when taking selgiline/Emsam?
    • -watch for HTN crisis symptoms
    • -change positions slowly
    • -get periodic skin checks
    • -advise doctor if new urge to gamble or sexual desire intensifies
  48. When taking chlorpromazine/Thorazine, what is the collective term for movement side effects?

    What are they?
    EPS - Extra Pyramidial Symptom

    • acute dystonia - (involuntary muscular contractions)
    • akathisia - restlessness
  49. Besides EPS what other a/r can occur with Buspar?
    CHF, MI, anger/aggression, paresthesia
  50. Is Buspar used long term or short term?
  51. Buspar differs from short term anxiolytic medications in what way?
    Not addictive
  52. What drug category is lorazepam?
  53. What neurotransmitter system do benzos act on?
  54. How do benzos act on the GABA neuro system?
    They "enhance" the GABA neuro system which creates a "depressed" effect
  55. When does a patient notice the effects of lorazepam?
    30-60 minutes
  56. Lorazepam is potentially ______, sudden cesation could result in the worst case scenario of _______?

    Statis epilepticus
  57. What is the most important patient teaching for Paxil patients?
    • -Do not double your dose
    • -Watch for suicidal thoughts
    • -Avoid alcohol & CNS depressants
    • -Don't take while pregnant
  58. What are 4 common side effects of Wellbutrin?
    • Dry mouth
    • Nausea
    • Vomitting
    • HA
  59. What are 4 patient teaching points for Wellbutrin?
    • -Do not double missed dose or take more than prescribed
    • -What for sucidality
    • -Unused shell may pass in stool
    • -Use sunscreen causes photosensitivity
  60. What are 4 common s/e of tofranil/imiprmine?
    • drowsiness
    • fatigue
    • constipation
    • dry mouth
  61. Most important patient teaching for Tofranil/imipramine are?
    • -Don't drive until acclimated
    • -avoid alcohol
    • -call 911 if you experience angina
    • -call MD if suicidal
    • -Don't double dose
  62. What are 4 common side effects of Parnate/trancypromine?
    • Othostatic hypotension
    • insomnia
    • edema
    • HA
    • diarrhea
  63. What are 4 patient teachings important to share with patients taking Parnate/trancypromine?
    • -Go to hospital if severe HA
    • -Monitor b/p for first 6 weeks
    • -Avoid all meds, vitamins, supplements until pharmacist okays
    • -Maintain tyramine free diet for 2 weeks after med cessation
  64. What are common s/e of selegiline/Emsam?
    • confusion
    • dizziness
    • fainting
    • vivid dreams
  65. What are the common side effects of chlorpromazine/thorazine?
    • Photosensitivity
    • Constipation
    • Blurred vision
    • Dry mouth
  66. What are 4 most important patient teaching ops for someone on chlorpromazine/Thorazine?
    • -Report signs of EPS, NMS, or TD
    • -Change positions slowly
    • -Avoid alcohol
    • -Don't go in the sun w/o sunscreen or protective clothing

    **Females may cause false+ pregnancy test
  67. What drug category is Ritalin/methylphenidate?

    What is it primarily used for?

    ADHD- especially in children
  68. What are the 4 most important patient teaching opportunities with lithium/Eskalith?
    • -Take missed tab within 6 hours if on multi-dose or as soon as remembered if on single dose.
    • -Do not stop abruptly
    • -Call MD is severe n/v occur
  69. What are common s/e of fluphenazine/Prolixin?
    • Extrapyramidal reactions
    • Photosensitivity
    • Anorexia
    • Dry mouth
  70. What are common side effects of benztropine/cogentin?
    • Blurred vision
    • Dry eyes
    • Dry mouth
    • constipation
  71. What are the common s/e of lithium?
    • Thinning of hair
    • itching skin
    • loss of appetite
    • stomach pain
  72. What are the 4 a/r for Wellbutrin
    • suicidal thoughts
    • HTN
    • arrhythmias
    • hallucinations
  73. A significant a/r with Wellbutrin used with other antidepressants?
  74. One seriour a/r that may occur with Paxil, especially if combined with another anti-depressant or st. Johns Wart is?
    Serotonin syndrome
  75. What are the symptoms of Serotonin syndrome?
    • Abd. pain
    • Diarrhea
    • Sweating
    • Fever
    • Tachycardia
    • Increased BP
  76. What are some a/r of Paxil?
    • NMS (neuroleptic malignant syndrome)
    • suicidal thoughts
    • mental depression
    • pruitis
  77. Wellbutrin is unique among antidepressants because it effect the_______ & ______ neurotransmitter systems.  It doe not effect the ________ neurotransmitter system.
    Dopamine & norepinephrine

  78. What is the optimum effect time period of Paxil?
    2-4 Weeks

    Its believed Paxil stimulates growth of new neurons/receptors
  79. How does Paxil work?
    It effects the serotonin neurotransmitter system by blocking the reuptake of serotonin in the presynaptic cleft
  80. What drug category does Paxil belong to?
    SSRI (depression) (also used for anxiety disorder)
  81. What a/r can happen with clozapine/clozaril?
    • ventricular arrythmias
    • cardiac arrest
    • leukopenia
    • T.D.
  82. What a/r is clozapine/Clozaril more likely to have, unlike haliperidol & fluphenazine?

    What must the patient do to prevent this?

    Weekly blood draw to check ANC & WBC
  83. What are 4 common s/e of lorazepam?
    • Drowsiness
    • Dizziness
    • Lethargy
    • Confusion
  84. What are the top 4 patient teachings for lrazepam?
    • Don't combine w/ alcohol or sedatives
    • Taper off use
    • Don't use if pregnant
    • Don't drive while taking this med
  85. Where in the brain does Ritalin/methylphenidate work?
    Pre-frontal cortex
  86. When does Buspar reach its maximum effectiveness?
    3-6 weeks
  87. What are 4 s/e of Buspar?
    • dizziness
    • tachycardia
    • nausea
    • blurred vision
  88. For Buspar, what are the most important patient teaching points?
    • Don't eat grapefruit
    • Don't drink alcohol
    • Take @ same time each day: either always with food or always without
    • Tell MD about all meds including vitamins & supplements
  89. What are the most important patient teaching for someone taking atomoxetine/Stratta
    • Don't take more than prescribed dose in 24 hour period
    • Take missed dose ASAP
    • Call MD upon s/s of liver problems
    • Never share your meds
  90. What a/r can occur with atomoxetine/Strattera?
    • Suicidal thoughts
    • Allergic reaction anaphalaxis
    • Angioneurotic edema
    • Severe liver problems
  91. What is a potentia a/r that could occur due to dopamine and serotonin neurotransmitter interuption in Buspar?

    Excitatory Post Synaptic Potential
  92. Buspar is unique because it has a mild agonist effect on what neurotransmitter system?
  93. What neurotransmitter system does Buspar work primarily on?
  94. What is Buspar used for?
  95. Whar are important patient teachings for someone taking benztropine/Cogentin?
    • Call MD if rapid heart beat
    • Decreases perspiration-pt. at risk of overheating
    • Change position slowly due to ortho hypertension
    • Do no drink alcohol
  96. What is the drug classification of benztropine/Cogentin?
    anti-parkinson, anticholinergic agent
  97. What is benztropine/Cogentin used to treat?

    Extrapyramidal symptoms
  98. How does benztropine/Cogentin work?

    How long does it take to work?
    Blocks cholinergic activity in CNS, prolonging dopamine activity

    immediately or 2-3 days
  99. Long term use of benztropine/Cogentin in conjunction with an antipsycotic, predisposes a patient to develop what?
    Tardive dyskinesia
  100. What are a/r of benztropint/Cogentin?
    • Hallucinations
    • Depression
    • Arrhythmias
    • Sudden weakness
  101. What are potential a/r of lorazepam?
    • Apnea
    • Cardiac arrest
    • Hypotension
    • Respiratory depression
  102. If statis epilepticus is not controlled the result could be _______
    This can also be a result of using lorazepam with______?

  103. How is Prolixin/fluphenazine administered?

    What form does it come in?
    med is mixed in sesame oil-deconate

    given z track
  104. How long does a Prolixin/fluphenazine injection last?
    2-4 weeks
  105. What are the a/r to Prolixin/fluphenazine?
    • EPS
    • Agranulocytosis
    • Thrombocytopenia
    • Death
Card Set
Psych Drugs etc.
Psych Drugs etc.