nursing 211 psych
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| role of nurse: ethical and legal implications- we need to understand what | the implications associated with the administration of psychotropic meds
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| neurotransmitters: they are what; where are the chemicals stored; what runs through the neuron; the electrical impulse stimulates what; | chemicals; in the axon terminals of the presynaptic neuron; an electrical impulse; the neuron to release neurotransmitters
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| neurotransmitters: where are the neurotransmitters released into; what determines whether or not another electrical impulse is generated | the synaptic cleft; the synaptic cleft
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| how do psychotropics work: receptors- they are molecules that are situated where; they are the binding sites for what; | on the cell membrane; neurotransmitters
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| neurotransmitters: dopamine: aka; these influence what; too much causes what; too little causes what; what old meds increase it; what new meds effect it | DA; emotional behavior; mania; parkisonium s/s flat effect; thorazine, Haldol; abilify, Seroquel, zyprexa
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| neurotransmitters: norepinephrine: aka; what secretes this; this is secreted in response to what; when we do not have enough what med do we take; | NE; the adrenal glands; stress; SNRI;
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| neurotransmitters: acetycholine- aka; what nervous system is this located; this gets inadvertently blocked with what; when this is blocked with other meds this is called what | Ach; peripheral and central; others meds; anticholinergic effect
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| neurotransmitters: serotonin- aka; this effects what; not enough causes what; too much causes what; some meds can cause ___ syndrome; what is tx for serotonin syndrome; | 5-HT; sleep arousal, pain, perception, libido, apetite; depressed; psychosis; serotonin syndrome; reduce meds
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| neurotransmitters: GABA- this inhbits what; what promotes it; | the CNS; ETOH and benzos
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| how psychotropics work: antidepressents- they block what; MAOIs prevents the metabolism of what | reuptake of neurotransmitters; neurotransmitters
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| how psychotropics work: antipsychotics- they block what; where are these blocked | dopamine; in the post synaptic site;
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| how psychotropics work: benzodiazepines- this facilitates the transmission of ___; examples; | GABA; Ativan, xanax
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| how psychotropics work: psychostimulants- ex of illegal; ex of legal; this increases the release of what | meth; Adderall, ridalin; neurotransmitters
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| background assessment data for antianxiety agents: indication for them; what is the action for them; who are they contraindicated in; | anxiety disorders, anxiety s/s, acute alcohol withdrawal, skeletal muscle spasms, convulsive disorders, status epilepticus, preoperative sedation; depression of the CNS; known hypersensitivity, in combo with CNS depres, preg/lactation, glaucoma, coma,
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| background assessment data for antianxiety agents: indication for them: who should we use these catiously with; teach what; what are nrsg dx; are they for long term use | elderly, debilitated clients, clients with renal or hepatic dysfunction, hx of ETOH, depressed or suicidal; how sedating they can be; risk for injury; no
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| background assessment data for antidepressents: indications; | dysrythmic disorders, major depression,depression associated with organic disease, ETOH;
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| background assessment data for antidepressents: action- they increase the concentration of what in the body; how do they increase these; | norepi an serotonin; by blocking their reuptake by the neurons or by inhibiting the release of monoamine oxide
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| background assessment data for antidepressents: action- what meds block the reuptake by the neuron; what meds inhibit the release of monoamine oxidase | tricyclics, tetracyclics, SSRIs; MAOIs
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| background assessment data for antidepressents: why is there a black box warning for suicidal idiations | the med can life pt out of depression at first just enough to act out suicide before the med is at the maxed potential
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| serotonin reuptake inhibitors: name them; these block the reuptake of what; what is the major side effects; | Prozac, Zoloft, luvox, celexa, Lexapro; serotonin; serotonin syndrome;
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| serotonin syndrome: what happens to temp; what happens to bp; what happens to consciousness; what happens to muscles; what is med tx; | increases; increases; confusion, halluncinations, agitation, drowsiness; rigid, hyperflexia; periactin or cyproheptidine
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| SNRI: what is the dual action; examples of them; what med can also be used for chronic pain; what med is also used for metapausal hot flashes | blocks both serotonin and norepi; Effexor, Cymbalta, pristiq; Cymbalta; pristiq
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| MAO inhibitors: what are the examples; what are the diet restrictions; why is there diet restriction; why is med not given much | monoamine oxidase, tyramine; cant have aged cheese, red wine, hard salami; tyramine effects if these foods are eaten causing a pounding Ha and increased BP; bc the diet restrictions are hard to maintain
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| MAO inhibitors: why does position need to be moved slowly; why is it lethal in overdose;examples | due to risk for hypotension; bc it changes QT interval; clomipramine(anafranil), imipramine(tofranil), amitriptyline (Elavil), nortriptyline(pamelor), desipramine(desyrel)
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| mood stabilizing agents: indications; examples; what is action of lithium; there is a very narrow window of what for lithium | prevention and tx of manic episodes associated with bipolar disorder; lithium carbonate; changes electrical conduction, enhances uptake of norepi; therapy
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| mood stabilizing agents: lithium- this is toxic to what, what concurrent med do we need to be careful with | kidneys, diuretics
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| mood stabilizing agents: other examples; | clonazepam, carbamazepine, valproic acid, lamotrigine, gabapentin, topitamate, verapamil, variousantipsuchotic;
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| antipsychoics: examples; indications; | abilify, invega, zyprexa, clozaril, geodan, Risperdal; treatment of acute and chronic psychoses, selected agents are also used in the tx of bipolar mania, intractable hiccups, control of tics in tourettes;
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| antipsychoics: action; | unknown but thought to block postsynaptic dopamine receptors in the basal ganglia, hypothalamus, limbic system, brainstem, medulla;
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| EPS: what are s/s of this; what med is given to treat these s/s | dystonia-spasms, muscle tightening, pseudo-parkinsonism, akathisia, tardive dyskinesia; Cogentin, Benadryl, Ativan, artane, akineton, Inderal, symmetrel,
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