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psych med info
nursing 211
| Question | Answer |
|---|---|
| typical antipsychotics: name them; is there a high or low risk for ESP; most have mod anticholinergic effect, but what one has low risk for anticholinergic effect; what is the action | thorazine (chlorpromazine), prolixin (fluphenazine), mellaril (thioridazine), Haldol (haloperidol); high; Haldol; dopamine receptor antagonist; |
| typical antipsychotics: why should I&O be assessed; who is at highest risk for urinary retention; what should be administered for ESP; why should EKG be assessed | risk for urinary retention; elderly; Cogentin; due to risk for cardiotoxicity |
| what scale is used to assess ESP | AIMs |
| typical antipsychotics: what should we teach for anticholinergic side effect; with Haldol what labs should be drawn periodically; | sugarless gum or candy, 2-3 liters of fluid/day, high fiber diet, sunscreem rise slowly; liver; |
| atypical antipsychotics: they effect dopamine; do they effect serotonin; name them | yes; yes; Risperdal, clozaril, Seroquel, zyprexa,geodon,abilify, |
| typical antipsychotics: what type can be long acting and given every 3-4 weeks IM if necessary | Haldol and prolixin |
| what are the s/s of the anticholinergic effect | dry mouth, blurred vision, constipation, urinary retention, photosensitivity, postural hypotension, sedation |
| what does EPS stand for | extrapyramidal symptoms |
| atypical antipsychotics: what one can be injected as an adjunct to lithium therapy; these commonly cause increased or decreased wt; what often happens to BP; what one do we need to monitor for cataracts; what one can cause agranulocytosis; | risperadol; increased; postural hypotension; seroqual; risperodol, clozaril, |
| atypical antipsychotics: is ESP low or high with these; what one can be combined with clozaril or Haldol; what one should we monitor WBCs; why are WBCs monitored with this; | low; risperodol; clozaril; causes neutropenia; |
| atypical antipsychotics: clozaril- at what wbc count should it be held; what s/s of neutropenia should pt be taught to monitor and report; what substance can pt not take while on this; | if <3000; sore throat, fever; ETOH; |
| atypical antipsychotics: all of these are a serotonin-dopamine ___; what one is not that but instead a serotonin-dopamine __; | antagonist; modulator |
| atypical antipsychotics: what ones cause high sedation; what ones have insulin resistance; what ones often have anticholinergic effects; | Seroquel, zyprexa; zyprexa, risperadol; Geodon, clozaril, abilify; |
| atypical antipsychotics: Seroquel- what hypo gland can these exasterbate; why do eyes need to be checked; why is fasting BG checkd; why are extreme temps avoided; what substance can they not consume | the thyroid- increase hypothyroidism; pt at risk for cataracts; pt at risk for insulin resistance; due to hypothyroid; ETOH |
| atypical antipsychotics: what ones lower the seizure threshold; what ones cause cardiotoxicity; with cardiotoxicity what test should be done periodically | Seroquel and zyprexa; zyprexa and risperdol; EKG |
| atypical antipsychotics: risperdol- teach what about how long it takes to reach peek effectivenenss | 1-2 weeks |
| Cogentin:what is this used for; this restores the balance of ___ and ___ in the CNS: what are the 2 common side effects; what should be monitored on pt at all times when taking psychotropics; | EPS;dopamine and acetylcholine; anticholinergic and orthostatic hypotension; EPS; |
| with the anticholinergic effects what needs to be taught in regards to diet | increase fluids and fibers |
| antiparkinson's meds: name the one; this increases the release of what; what are side effects; dose should be managed how; | symmetrel; dopamine; dizzy, confusion, ortho hypotension; taper the dose |
| mood stabilizing drugs: what is the common one; what is the uncommon class of drugs that help to stabilize mood; name the anticonvulsants; | lithium; anticonvulsants; depalote,trilepta;,Topamax; |
| mood stabilizing drugs: lithium- this enhances the reuptake of what 2 things; what happens to wt; what happens to thyroid; where is there pain; what happens to muscles; what happens to BP; what happens to ht electricity; | norepi and serotonin; increases; decreases function; HA; fine tremors; hypotension; arrhythmias; |
| mood stabilizing drugs: lithium toxicity s/s- does pt sweat more or less; what happens to urination at first and then later; what happens to thirst; GI s/s; what happens to speech; what happens to sedation | more; increases then decreases; increases; N/V; slurred; drowsy to coma to death |
| mood stabilizing drugs: lithium- what is therapeutic level; what is acute level; what is toxic level; how long does med take to stabilize mood; teach what in diet; | 0.6-1.2; 1-1.5; <1.5; 1-2 weeks; do not restrict sodium, 2-3 liter fluid/day; |
| mood stabilizing drugs: anticonvulsants- what happens to blood components; what lab is elevated besides bleed times; what to teach; are they more or less sedated | there is a prolonged bleed time; liver enzymes; draw serum blood levels;more |
| stimulants: name them; what ones are a CNS stimulant; is the action of Strattera; | Ritalin, Adderall, Provigil, concerta, strattera; ritilan, Adderall, Provigil, concerta; SNRI increases norepinephrine; |
| stimulants: what are they used for; does wt increase or decrease with these; is apetite increased or decreased; what are GI issues; is there insomnia or increased sedation; does the SNRI or stimulants cause anemia and leukopenia | ADHD, narcolepsy; decreased; decreased; GI upset; insomnia; stimulants |
| stimulants: what one causes mood swings; do SNRIs or stimulants cause dry mouth; at what age group does growth retardation occur; | Strattera; stimulants; in children; |
| stimulants: teach what in regards to meals; who should we monitor growth; when should it be given during the day; what blood levels should be tested; what one has risk for suicidal dependancies; | eat 6-8 small meals; children; in the AM; CBC, liver enzymes; strattera |
| stimulants: what one do we need to assess for dependency; what one could have risk to be sold on the street; in regards to liver enzymes what should we teach; | stimulants; stimulants; pt to monitor for yellowing of the eyes |
| antianxieties: what are the classifications | benzodiazephines, beta blockers, msic, |
| antianxieties: benzos- name them; is it fast or slow acting; is it for short or long term anxiety; what is the action; | Xanax, Ativan, Librium, klonopin; fast; short term; potentiates GABA: |
| antianxieties: benzos side effects- what can happen to BP; is pt more or less sedated; over time pt can have a ___ to drug; can pt become more or less depressed with this; effects are increased by what substances; | ortho BP; more; tolerance; depressed; narcs, barbituaites, ETOH, cimetidine, disulfirm; |
| antianxieties: benzos- who should not get these; what to teach in regards to driving; what to teach about changing positions; what type of use causes withdrawal effects; what drugs decrease effects | pregnant or lactating; caution- or no driving; rise slowly; long term use; nicotine & caffeine |
| antianxieties: beta blockers- name them; how do these help anxiety; how do they help the somatic effects | atenolol, metoprolol, nadolol, Inderal; they treat the somatic effects of anxiety; by vasodilation |
| antianxieties: beta blockers side effects: what happens to BP; what can happen to HR: what syndrome can it cause; what happens GI; if given with clonidine what can happen | orthostatic BP; bradycardia; WPW syndrome; N/V; paradoxical htn |
| antianxieties: beta blockers side effects- where is pain; when to check BP; what body system assessment should be done; what is serious adverse effect to these; who should not take these; should they be taken with meals or on an empty stomach; | HA; when lying and standing;cardiac; bronchospasms; asthmatics; with meal |
| antianxieties: misc- what is the one misc one; it is a ____ and ___ antagonist; are there anticolinergic side effects; where is there pain; what is HR; | buspar; serotonin and dopamine; yes; chest; increasedl |
| antianxieties: misc- who should not get it; what VS should be monitored; at risk for increased or decreased seizures | pregnant, lactating; HR; increased |
| hypnotics: name them; what are these used for; are they for short or long term use; what does it do to CNS; | ambien, sonata; sleep aid; short; depress it; |
| hypnotics: side effects- is there a potential for dependency; is there a risk for overdose; what happens to GI; we should be catious with combo with what other meds; what assessment should be done; | yes; yes ; upset; other psychotropics; suicide assessment; |
| hypnotics: what substances can they not take while on this; what contract needs to be made | OTC drugs and etoh; suicide |
| anti-depressents: name the classes; | tri-cyclics, tetracyclics, SNRIs, SSRIs, MAO inhibitors, |
| anti-depressents: tri-cyclics- name them; this increases ____ & ___ reuptake; | Elavil; serotonin and norepi reuptake; |
| anti-depressents: tri-cyclics- is there anticholinergic effects; what happens to BP; what happens to the heart; what happens to wt; is there photosensitivity; is there and increase or decrease of suicide risk; | yes; ortho HTP; cardiac arrhythmias; wt gain; yes; increase; |
| anti-depressents: tri-cyclics- do they increase or sedation; what body system should be assessed; is there high or low potential for overdose; what should be limited; what to teach in regards to diet; | increase it; cardiac; high; quantity available to pt; increase fluids and fiber; |
| anti-depressents: tri-cyclics- what time a day should they be taken; encourage increased what; what substance should not be taken while on Elavil; teach to be cauitious while ___ | at HS; exersice; ETOH; driving |
| anti-depressents: tetracyclics- name them; this increases ___ and ___; there is an increase in ____ risk as depression lifts; how long does it take until it works | trazadone, remeron; serotonin and norepi; suicide; 7-14 days; |
| anti-depressents: tetracyclics- are there anticholinergic effects; is there photosensitivity; what are ht issues; is wt gained or lost; what happens to BP; | yes; yes; cardiac arrhythmias; gained; ortho hypo; |
| anti-depressents: tetracyclics- what contract needs to be made; b/c of photosensitivity what is teaching; is the risk for seizures increased or decreased; is there an immediate or delayed onset to improved mood; | no suicide; wear sunscreen; increased; delayed; |
| anti-depressents: tetracyclics- what to teach about diet; encourage pt to wear ___ when in sun | increase fiber and fluids; sunscreen |
| anti-depressents: SNRis- what 2 neurotransmitters do they increase; name them; | serotonin and norepi; Effexor (venlafaxine), Cymbalta, pristiq; |
| anti-depressents: SNRis- side effects: what happens to bp; are there anticholinergic issues; what meds should it not be taken with b/c it will increase bleeding risks; what herbal should not be taken with these; | HTN; yes; aSA, NSAIDS; st. John's wart; |
| anti-depressents: what one is a misc one; what is action of wellbutrin; does wellbutrin increase or decrease the seizure threshold; increased sedation or insomnia with wellbutrin; do these pt become more or less agitated and restless; | wellbutrin; increased norepi and dopamine; lwoers it; insomnia; more; |
| anti-depressents: wellbutrin- with dosing how should they be dosed apart; what substance should not be taken with this | q8h; ETOH |
| anti-depressents: SSRIs- name them; these block the reuptake of what; the blocking of the reuptake of serotonin does what; what arethe 2 uses; | Prozac, celexa, serotonin; increases the available serotonin at receptor site; anti-anxiey and anti-depressant; |
| anti-depressents: SSRIs- there is an increased risk for what as depression lifts; what one increases blood levels of statins; what other meds do they potentiate; what med on the list of SSRIs does not potentiate others | suicide; Prozac; other meds that use the same enzyme- serotonin; celexa |
| anti-depressents: SSRIs- increased sedation or insomnia; decreased or increased weight; what serious side effect can these cause | insomnia; decreased; serotonin syndrome |
| serotonin syndrome: what is temp; what is BP; what is HR; what happens to muscle tone; what happens to CNS | high; high; high; rigid; coma and then death; |
| anti-depressents: SSRIs- what should we always assess for; in what doses- high or low do they decrease anxiety; what kind of warning does it have; why is it given with food; what to teach about stopping med; what one is the only one FDA approved for kids | s/s serotonin syndrome; low; black box; to prevent naseua; never stop abruptly; prozac |
| MAO inhibitors: name them; what enzyme does it inhibit; the inhibition of monoamine increases what neurotransmitters; they cannot be taken with what | nardil; monoamine oxidase; norepinephrine, dopamine, serotonin; other psychotropics |
| MAO inhibitors: it needs how long before it can be taken after the dc of another med; what is wash out time; what in regards to diet; when does hypertensive crisis occur with these meds; | 2-5 weeks; time needs to remove other med from system; tyramine free; with ingestion of tyramine foods, narcotics, general anesthesia; |
| MAO inhibitors: side effects- wt increase or decrease; what happens to BG; what happens to BP; possible increase or decrease of seizure activity; sedation/coma yes or no; insomnia yes or no; | increase; decreases; high BP; increase; sedation/coma; yes |
| MAO inhibitors: teach what about diet;what are tyramine foods; what other substance to avoid | tyramine free diet; aged cheeses, smoked/processed meats, red wines, yeast, fava beans, avacodoes, bananas; OTC meds |
| addiction dependence withdrawal: name the drug; this is an opiod agonist or antagonist; this is a partial ____; | suboxone; antagonist; agonist-antagonist; |
| suboxone: this increases pressure where; does it suppress or stimulate CNS; what meds should it not be taken with; how should it be taken; when should it be started after lat opiod use | IOP-intraocular pressure; suppress; benzos or delirium tx; dissolve under tongue and do not swallow; 4 hrs after |
| SSRIs do what psychologically; tricyclic antidepressants do what psychologically; MAOis do what; | reduces depression, controls anxiety, controls obsessions; reduces depression, relieves severe pain, prevents panic attacks; reduces depression and controls anxiey |
| SNRIs and Effexor do what; wellbutrin does what; | reduce depression and can relieve pain of neuropathy, relieves anxiety; reduces depression and can aid is smoking cessation and decreases s/s of ADHD |
| typical antipsychotics can provide relief from irretractable __ | hiccups |
| what ones are used to relievepsychosis | typical and atypical antipsychosis |
| antianxiety: def paradoxical excitement; what is tx of this;decreased effect occurs with the consumes ofwhat substances | client develops s/s opposite of the meds desired effects; withhold drug and notify physician; cigarettes and ETOH |
| antianxiety: what med has the longest delayed onset; what med is not recommended for the delayed onset bc of the long effectiveness | buspar; buspar |
| fatal reactions can occur when SSRIs are in combo with what | MAOIs |
| discontinuation syndrome of antidepressants: what is it; s/s of this; | this is abrupt withdrawal of SSRIs,effexor; dizziness, lethargy, HA, N, |
| what is tx of serotonin syndrome | discontinue med immediate, MD to order conjuctive therapy |
| what should pt not drink while taking antidepressant therapy | ETOH |
| trazadone can cause what | inappropriate or prolonged penile erection |
| why is wellbutrin taken in divided doses; what to teach if pt misses a dose of wellbutrin | to decrease the risk of seizures; do not double up on meds if dose is missed |
| besides blood levels what are s/s of lithium toxicity | blurred vision, N/v, tinnitus, severe diarrhea, tremmors, dilute urine, mental confusion, giddiness, serious: MIs, arrhythmias |
| lithium: similar in chemical makeup to what; it competes in body to what substance; so if sodium intake is reduced what happens to lithium in body; what should daily intake of sodium be | sodium; sodium; lithium is reabsorbed since it is similar in sodium and it can increase the possibility of toxicity; adequate with fluids; |
| use of antipsychotics with ___ and ___ increase CNS depression | ETOH and CNS depressents |
| typical antipsychotics: they can do what to the electrical components of the heart; can they lower or increase the seizure threshhold | prolong the QT interval; lower it; |
| antipsychotics (all): what hormonal issues occur; what happens to wt; k | decreased libido; increases |
| antipsychotics: what one has an extremely high risk of causing seizures at high doses; what one can cause extreme risk for agranulocytosis | clozaril; clozaril |
| before initiation of clozaril what lab should be done | WBCs and absolute neutrophil count |
| neuroleptic malignant syndrome: does this occur in typical or atypical antipsychotics; when can it occur during drug therapy; s/s; | atypical; with onset of drug or even years afterwards; severe parkinsonian muscle rigidity, super high temp 107 deg, high pulse, high rr, bp fluctuates, rapid deteriation of mental status; |
| Atypical antipsychotics: what can happen to BG; they are not approved in the tx of whom and thus hold a black boxed warning for that; | increases and can cause DM also increased wt; dementia psychosis in the elderly |
| MAOIs: when not in hypertensive crisis, what is a common side effect in regards to BP | ortho hypotension; |
| Tardive dyskinesia: is this a long term or short term effect of taking antipsychotics | long term side effect |
Created by:
jmkettel
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