Psych E2
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| GABA | Neurotransmitter Regulates anxiety (decrease = anxiety)
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| Serotonin | Neurotransmitter regulates sleep, wakefulness, mood, delusions, hallucinations
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| Dopamine | Neurotransmitter regulates cognition, emotional responses, and motivation
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| Norepinephrine | Controls arousal, attention, mood, affect, anxiety, thinking, planning, and interpreting
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| Acetylcholine | Sleep & wakefulness (a/w Alzheimer)
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| Typical Antipsychotic Categories | Phenothiazine and NonPhenothiazines
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| Phenothiazine | Block NE
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| Phenothiazine Drugs | Aliphatic, Piperazines: Prolixin&Trilafon, Piperidine: Thioridazine (Mellaril)
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| NonPhenothiazine | Block Dopamine
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| NonPhenothiazine Drugs | Butyrophenone: Haloperidol(Haldol), Dibenzoxazepines, Dihydroindolone, Thioxanthene
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| Typical Antipsychotic EPS | Pseudoparkinsonism, acute dystopia, akithisia, tardive dyskinesia, NMS
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| Acute Dystonia | Spasms and upward eye movement
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| Tardive Dyskinesia | Protrusion/rolling of tongue, chewing motion, lip smacking
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| Pseudoparkinsonism | Rigidity, stooped posture, shuffling gait, tremors
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| Synopsis | Faulty release, reuptake, or elimination of neurotransmitters leads to an imbalance and develops mental disorders
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| Antitypical Antipsychotic Drugs | Clozapine (Clozaril), Riperdone (Risperdal), Olanzapine (Zyprexia), Quetiapine (Seroquel), Invega, Ziprasidone (Geodon)
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| Benzodiazepines | Lorazepam (Ativan) and BuSpar
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| Herbal Antidepressants | St. Johns Wort and Gingko Biloba
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| Antidepressant Categories | TCAs, SSRIs, Atypical, MAOIs, SNRI, Heterocyclic
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| Tricyclic Antidepressants (TCAs) | Elavil, Toframil, Surmontil,, Sinequin, Desiprmine, Nortriptyline, Protiptyline
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| Selective Serotonin Reuptake Inhibitors | Prozac, Luvox, Zoloft, Paxil, Celexia, Lexapro
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| Atypical Antidepressants | Ascendin, Wellbutrin, Ludiomil, Serzone, Desyrel, Remeron, Effexor
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| Monamine Oxidase Inhibitors | Parnate, Marplan, Nardil
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| SNRI | Selective NE Reuptake Inhibitor
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| Heterocyclic | Affects serotonin, dopamine, NE
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| Mood Stabilizers | Lithium, Anticonvulsants, Atypical Antipsychotics, Benzodiazepines, Calcium Channel Blockers, Antidepressants
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| Anticonvulsants | Carbamazepine (Tegretol), Depakote, Lamictal, Zyprexia, Geodon, Abilify
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| Alternative Uses for Antidepressants | Dysthmia, schizophrenia, eating disorders, anxiety disorders, migraines, chronic pain, and sleep disorders
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| Serotonin Syndrome | Too much serotonin in the CNS
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| Symptoms of Serotonin Syndrome | Muscle twitches, tremor, confusion, disorientation, spasms, and shivering
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| Symptoms of Serotonin Withdrawal | F- flu like symptoms & fatigue
I - insomnia
N - nausea
I - imbalance/dizziness
S - sensory disturbances
H - hyperarousal (anxiety/agitation)
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| TCAs | Increases serotonin and norepinephrine
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| MAOIs | Increase NE, serotonin, and dopamine
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| Side Effects of MAOIs | Elevated BP
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| Avoid with MAOIs | Tyramine foods (chocolate, coffee, bananas, dairy, cheese, beer, wine, soy)
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| Pharmacokinetics | how body affects a drug
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| Absorption | how drug moved into blood stream from site of administration
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| Distribution | how much drug is moved into various body tissues
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| Metabolism | How drug is altered into active and inactive parts
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| Elimination | how much of drug is removed from body
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| Bioavailability | How much reaches systemic circulation unchanged
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| Half-Life | Time it takes for dose amount of drug in body to decrease by 50%
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| Steady State | Plasma drug concentration remains constant between doses (equilibrium between ingestion and excretion)
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| Enzyme | protein that catalyzes 1 or more biochemical reactions
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| Agonist | Drug that stimulates receptor to open its channel
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| Antagonist | drug that blocks the receptor from opening
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| Therapeutic Index | measure of safety and toxicity of a drug
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| Therapeutic Effect | Desired interaction
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| Synergistic Effect | drug interaction whose effects are greater than if given alone
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| Augmentation | Addition of another class of meds to supplement effectiveness of primary med
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| Pharmacodynamics | Effects of drug on body
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| Pyschopharmacogenetics | deals with genetic and environmental factors that control or influence psychotropic drug metabolizing systems
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| Antipsychotics | Block dopamine
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| Atypical Antipsychotics | Block dopamine and serotonin
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| Antidepressants | Increase NE and Serotonin
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| Cholinesterase (ChE) Inhibitors | Increases acetylcholine
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| Benzodiazepines | Enhance GABA effects
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| Traditional/Typical Antipsychotic Target | + Symptoms (Hallucinations, delusions, paranoia, disordered thinking)
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| Atypical Antipsychotics Target | + and - Symptoms (blunt affect, decreased social interaction, lack of motivation)
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| Phenothiazine Nursing Care | Photosensitivity: sunscreen/clothing
Constipation: Increase fiber and exercise
Dry Mouth: Ice or sugar free candy
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| Akathisia | Can't remain still (rule out anxiety or agitation)
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| Anticholinergics | Artane and Benztropine (Cogentin)
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| Clozapine (Clozaril) Warnings | Agranulocytosis, seizures, myocarditis, cv &respiratory effects, and increased mortality in elderly patients with dementia
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| AIMS | Abnormal Involuntary Movement Scale (detects presence of tardive dyskinesia)
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| Lithium | Naturally occurring salt, first line tx for acute mania clients
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| Lithium reduces what symptoms | Elation, grandiosity, expansiveness, flight of ideas, irritability, manipulativeness, anxiety
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| Lithium Side Effects | Weight gain, tremors, acne, hypothyroidism, n&v, diarrhea, cramps
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| Lithium Mechanism of Action | Increase salt intake = decrease lithium (low levels)
Decrease salt intake = increase lithium (toxicity)
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| Bipolar Drugs | Valporic Acid (Depakene), Valproate (Depacon), Depakote
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| Anticonvulsant Side Effects | Dizziness, double vision, headache, Stevens Johnson Syndrom, Agranulocytosis
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| Why benzodiazepines given for bipolar | Treats agitation, insomnia, and anxiety
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| Calcium Channel Blocker Drugs | Calan, Isoptin, Adalat, Procardia, Nimotop
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| Calcium Channel Blockers Use | Bipolar clients with HTN, arrhythmias, pregnancy
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| Side Effects of Calcium Channel Blockers | Dizziness, headache, nausea, arrhythmias, hepatotoxicity, and syncope
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| Short Term Acute Mania Tx | Zyprexa. Abilify, Geoden (Atypical Antipsychotics)
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| Cholinesterase Inhibitor Drugs | Razadyne, Aricept, Exelon, Cognex
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