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psych med info

nursing 211

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