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antipsychotherpeutic
Ch. 17 Pharm
| Question | Answer |
|---|---|
| what are three main emotional disorders | anxiety affective disorders- moods psychoses- out of touch |
| what are 4 types of psychotherapeutic drugs | 1. antianxiety 2. antimanic 3. antidepressant 4. antipsychotic |
| What biochemicals can get out of balance in our body | GABA, ACh, Na, K, Mg |
| What are the 6 major anxiety disorders | OCD-obsessive compulsive disorder PTSD-postramautic stress disorder GAD-Generalized anxiety disorder Panic disorder Social Phobia Simply Phobia |
| Affective disorders(Mood) is what and what is an example | swing from mania to depression Bipolar |
| Psychosis and example | severe emotional disorder, can't do ADL's schizophrenia, drug induced psychoses |
| What is the biochemical imbalance therory | abnormal levels of endogenous chemical, neurotransmitters, in brain: Catecholamines: dopy, norepy Indolamines: serotonin, histamine, melatonin |
| What are some antianxiety drug categories | benzodiazepines, misc, barbituates, carbamates |
| What is a misc antianxiety drug | Buspirone(Buspar)- nonsedating, non habit forming, may interact with SSRI's, DON'T adm w/ MAOI's |
| Antianxiety drug indications | anxiety, insomnia, sedation, muscle spasms, seizure disorders, adjuncts in anesthesia, adjuvant for depression, alcohol withdrawal |
| What are some common benzodiazepines for antianxiety | diazepam(Valium) Lorazepam(Ativan) alprazolam(Xanax) Clonazepam(Klonopin) chlordiazepoxide(Librium) |
| One benzodiazepine that in injection only | midazolam(Versed) limited to surgical, invasive procedure |
| What should be noted when giving benzodiazepines | use lowest effective dose first habit forming, addictive |
| Adverse effects of benzodiazepines | hypotension, sedation, drowsy, dizzy, N/V, dry mouth, constipation |
| If overdose on benzodiazepine | Flumazenil |
| What is drug of choice for affective disorders, mood stabilizers and what is important to remember about dose | Lithium for mania narrow therapeutic window, maintain serum levels at 0.6-1.2mEg/L "L is 12th letter", take half |
| There are three hypothesis regarding depression and what causes it | 1. biogenic amine hypothesis- not enuf epy in dep. too much epy in mania 2. Permissive hypo- decr serotonin 3. Dysregulation hyp-failure to regulate catecholamine activity |
| What are the three categories of Antidepressants | tricyclic monoamine oxidase inhibitors (MAOIs) Newer-generation: SSRIs, 2nd/3rd generation |
| Tricyclic antidepressants act as 1st generation or 2nd | 2nd becuase SSRIs are 1st now, adjunct with 1st line drugs |
| What are the common tricyclics | amitriptyline(Elavil, Endep) doxepin(Senequan) imipramine(Tofranil) desipramine(Norpramin) nortriptyline(Aventyl, Pamelor) |
| What is MOA of tricyclics | block reuptake of neurotransmitters, accumulate in synapse space |
| What is the effect of blocking norepy What is effect of blocking serotonin reuptake | antidepressant, but also get tremors, tachy, others Serotonin: antidepressant, but also nausea, headache, anxiety, sex dysfx |
| What indications need tricyclics | depression, childhood enuresis(imipramine), OCD(clomipramine), trigeminal neuralgia |
| What are adverse effects of tricyclics | orthostatic hypotension, sedation, impotence, may need to be weaned before surgery |
| If overdose on tricyclics | lethal (70-80%) die No antidote, basic life support and manage seizures and dysrhythmias |
| What are MAOIs | 2nd line not treatment for cyclics, tyramine effect("cheese effect) |
| What are two MAOIs | phenelzine(Nardil) tranylcypromine(Parnate) |
| What is MOA of MAOIs | amines(dopy,norepy,serotonin) not broken down, so higher levels in brain, to relieve depressive sx |
| Main adverse effect wtih MAOIs | orthostatic hypotension |
| Over dose of MAOI | sx may not appear for 12 hrs, protect brain adn heart |
| When you have tyramine adn hypertensive crisis wtih MAOIs, what does that mean and what foods should you avoid | can lead to cerebral hemorrhage, stroke, coma, death Foods: aged/smoked cheese or meats, yeast extracts, red wines, fava beans |
| What is serotonin syndrome | concurrent use of MAOIs and SSRIs, if you switch to SSRI, must be 2-5 week "wash out" time b/n therapy |
| Newer generation antidepressants have what adv over others | 1st line drugs fewer advers effects, but take 4-6 weeks to reach effectiveness |
| What are some newer generation antidepressants | traxodone(Desyrel), buporpion(Wellbutrin) SSRIs: Prozac, Paxil, Zoloft, Luvox, Celexa, Lexapro, Effexor, Serzone, Remeron, Cymbalta, Pristiq |
| What is MOA of SSRIs | inhibit serotonin reuptake, no effect on norepy/dopy reuptake. Adv over tricyclics/MAOIs = no effect on cardio system |
| Indications for newer generation antidepressants | bipolar, depression, obesity, eating disorders, OCD, panic attacks, social anxiety, Myoclonus(muscle twitching), substance abuse |
| Adverse effects for newer generation antidepressants | CNS: insomnia Other: weight gain GI: N/D, constipation, dry mouth |
| What are ss of severe cases of serotonin syndrome | renal failure, rhabdomyolysis(muscle pain), intravascular coagulation(DIC)-bleeding out |
| Drug interactions of newer generation antidepressants | highly bound to plasma proteins, so more free drug inhibit cytochrome P-450 system(Liver), MAOIs |
| What are some antipsychotic drugs | Navane, Haldol, Moban, Loxitane, Phenothiazines-photosensitivity, shaking Atypical antipsychotics |
| what is MOA of antipsychotic drugs | block dopy receptors, so decr level in brain, tranquilizing effect |
| What are 2nd generation atypical antipsychotic drugs | "ine","one" clozapine(Clozaril), risperidone(Risperdal), olanzapine(Zyprexa), quetiapine(Seroquel), ziprasidone(Geodon), aripiprazole(Abilify), paliperidone(Invega) |
| what are indications for antipsychotics | bipolar, drug induced psychoses, schizophrenia, autism, tourette's, intractible hiccups |
| Adverse effects of antipsychotics | neuroleptic malignant syndrom(high fever, unstable BP extrapyramidal ss- acute dystonia, PD ss, Tardive dyskinesia |
| What herbal products are good antipyshotherapeutic drugs | St John's Wart, Ginseng |
| what are problems with St John's Wart | depression, anxiety, sleep disorders, nervousness interactions with MAOIs/SSRIs, tyramine foods |
| what are problems with ginseng | stress reduction may cause incr BP interact wtih anticoagulants, immunosuppressants, anticonvulsants, antidiabetic |
| What are some nursing implications with psychotherapeutic drugs | Assess LOC, make sure swallow drugs, dispense small amt to avoid suicide,caffeine and smoking decr antidepressants |
Created by:
palmerag
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