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Psychiatric Medications Review - Psych Mental Health Nursing - generic names

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Question
Answer
Atypical antipsychotics   Clozaril, Risperidal, Seroquel, Zyprexa, Abilify, Geodon, Invega, Latuda, Saphris, Fanapt  
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Anti-Manic & Mood Stabilizing Drugs   Lithium, Depakote, Lamictal, Tegretol, Trileptal  
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Tricyclic Antidepressants   Anfranil, Elavil, Norpramin, Pamelor, Sinequan, Tofranil,Vivactil  
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SSRIs   Prozac, Paxil, Celexa, Zoloft, Luvox, Lexapro, St. John's Wort  
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MAOIs   Marplan, Nardil, Parnate, EMSAM-Patch  
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SNRI   Effexor, Pristiq, Cymbalta  
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Benzodiazepines/ Anxiolytics   Ativan, Klonopin, Librium, Tranxene, Valium, Xanax  
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other compounds   Wellbutrin  
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Typical Antipsychotics   Haldol, Mellaril, Prolixin, Stelazine, Thorazine, Moban, Loxitane, Serentil, Trilafon,  
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EPS Side Effect Treatment Agents   Artane, Benadryl, Cogentin, Symmetrel  
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Non-Benzodiazepine- Anxiolytics   Buspar, Inderal, Kava-Kava, Vistaril  
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Hypnotics & Herbals   Ambien, Desyrel, Lunesta, Melatonin, Restoril, Valerian, Sonata, Rozerem  
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Substance Abuse Related Drugs   Antabuse, Campral, Catapress, Methadone, Suboxone, Topamax  
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CNS Stimulants- ADHD Treatment   Adderall, Focalin, Ritalin, Strattera, Vyvanse  
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Nursing Interventions for Atypical Antipsychotics   Blood Pressure Checks, BMI measurements, blood glucose, lipids, monitor for hyperglycemia, assess for sedation or hypotension  
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Atypical Antipsychotics Side Effects   risk of metabolic syndrome, increased weight, blood glucose, triglycerides, hypotension, sedation, dizziness  
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Tricyclic Antidepressants Side Effects   dizziness, drowsiness, diarrhea, dry mouth, urinary retention, and orthostatic hypotension serious adverse reactions are paralytic ileus, acute renal failure, hypertension, and hypertensive crisis, depending on the specific product.  
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Tricyclic Antidepressants Nursing Interventions   Blood Pressure, pulse, Monitor laboratory studies, weight increase, appetite increase, mental status, mood, sensorium, affect, suicidal tendencies,Urinary retention, constipation  
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Which medication is indicated for Parkinson's dementia (mild to moderate)   Rivastigime  
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Which medication is FDA indicated for Parkinson's disease psychosis?   Pimavanserin (Nuplazid)  
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What is the MOST effective treatment for Parkinson's?   Levodopa/Carbidopa (Sinemet)  
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What is an unpleasant side effect of amantadine (Symmetrel)?   Confusion/memory problems  
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What two neurotransmitters are regulated in Parkinson's disease with anitcholinergics?   Dopamine and Acetylcholine  
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Which medication can be used in all stages of Alzeheimer's   Donepezil (Aricept)  
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Should galantamine (Razadyne) be used with renal impairment?   Should be used with caution in those with renal and hepatic impairment.  
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What is the MOA of memantine (Namenda)   NMDA glutamate receptor  
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What is the Aricept/Namenda combination medication   Namzaric  
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Are there any FDA approved medications for dementia related behavioral distrubances?   No, everything is off-label.  
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What test is required prior to starting Nuedexta?   ECG  
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Which medication is FDA approved for anorexia nervosa   No FDA medication approved; can use SSRIs and antipsychotics off label for the treatment of comorbid depression/anxiety/mood  
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Which medication is FDA approved for bulimia   Fluoxetine (Prozac) 60-80mg daily  
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Which medication is FDA approved for binge eating disorder?   Lisadexamfetamine (Vyvanse).  
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Can you use Vyvanse in those with hyperthyroidism?   No, contraindicated in hyperthyroidism and glaucoma  
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What two medications are used for alcohol abstinence   acomprosate (Campral) and disulfiram (Antabuse)  
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How long should a client be abstinent of alcohol before starting disulfiram (antabuse)?   at least 12 hours from last drink  
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Should a person with ESRD be prescribed acomprosate (Campral)   No, this medication is contraindicated in renal impairment  
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What two medications are used for etoh dependence?   Nalmefene (Selincro) and Naltrexone (Vivitrol)  
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What two class of medications are used for etoh withdrawal?   Benzodiazepines and alpha 2 agonist  
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What can happen when methadone (Dolophine) is mixed with other CNS depressants?   Death  
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What medical issues are contraindicated with methadone (Dolophine) use?   Respiratory depression, acute or severe bronchial asthma, gastrointestinal obstruction including a paralytic ileus  
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What is the MOA of buprenorphine (Suboxone)?   Suboxone is an opioid partial agonist that binds to opiate receptors, preventing exogenous opioids from binding.  
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How long must a client be clean before starting naltrexone (Vivitrol)?   The client must be opioid free for 7-10 days before starting treatment and must be confirmed by drug screens  
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What are all the forms of NRT?   Gum, Patch, Nasal Spray, and Inhaler.  
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What part of the brain is thought to be involved with ADHD?   Prefrontal Cortex  
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Which neurotransmitters are involved with ADHD?   Dopamine and norepinephrine  
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What measure tools are used in diagnosing ADHD?   Connors and Vanderbilt  
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What are the types of ADHD?   Combined, predominately inattentive, and predominately hyperactive-impulsive  
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Symptoms of impulsivity appear to involve which area of the brain?   Orbitofrontal cortex  
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What is the mechanism of actions of stimulants?   Increasing norepinephrine and dopamine by blocking reuptake  
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What part of family medical history is extremely important before prescribing stimulants?   Cardiac disease history  
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What medical condition is contraindicated with stimulant use?   Glaucoma  
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What can delay peak action of stimulants for 2-3 hours?   Taking the stimulant dose with food  
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What test and vitals are important to monitor with stimulants   ECG, BP, height, weight  
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What medical conditions are amphetamine used in caution with?   Hepatic and cardiac impairments  
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Which medication condition is contraindicated with use of Vyvanse?   Hyperthyroidism  
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What labs should be monitored periodically with Vyvanse?   CBC, platelets, and LFTs  
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People that lose their appetite for dinner may benefit from which two stimulant options?   Metadate CD and Ritalin LA  
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What is a rare side effect of methylphenidates?   Priapism  
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Which SNRI is FDA approved for ADHD ages 6 and older?   Straterra  
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How long can it take for Strattera to be effective?   2-3 months  
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What is the MOA of clonidine?   Alpha 2 agonist but also norepinephrine receptor agonist  
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Which enzyme metabolizes guanfacine?   CYP450 3A4  
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Which antipsychotic is FDA indicated for Autism related irritability ages 5-16?   Risperdal  
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What is designed to provide guidelines in prescribing high risk medications in the elderly?   Beers criteria  
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How does a practitioner decide on medications in pregnancy?   Risk vs benefit discussion  
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What is recommended to supplement with Lamictal if taken when pregnant?   Extra folic acid  
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What is lithium levels so important to monitor frequently in pregnancy?   Due to fluid shifts  
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What the “D”s in the D approach in deprescribing?   Diagnosis, dangerous, dosages, duplicate, deficient, desire, and duration  
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Which SSRI is FDA indicated for bulimia nervosa?   fluoxetine (Prozac)  
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Which two SSRIs are FDA approved for treating children with MDD?   i. Escitalopram (Lexapro) 12 and up, ii. Fluoxetine (Prozac) 8 and up  
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Which SSRI is not FDA approved for MDD or depression?   Fluvoxamine (Luvox) (OCD)  
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Which SSRI should be dosed at night due to sedation?   Paroxetine (Paxil), long 1/2 life life  
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Which SSRIs are FDA indicated for PMDD? There are 3 of them.   i. Fluoxetine (Prozac), ii. Paroxetine (Paxil), and iii. Sertraline (Zoloft)  
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Which enzyme does Duloxetine (Cymbalta) inhibit? And can you remember from week one what other substance inhibits this exact enzyme.   CYP450 1A2 and the substance is cigarettes (nicotine)  
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Which SNRI is indicated for MDD and neuropathic pain?   Duloxetine (Cymbalta)  
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What OTC medication can reduce clearance of Venlafaxine (Effexor)?   Cimetidine (Tagamet HB)  
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What vital signs should be assessed before initation of Levomilnacipran (Fetzima)?   i. Heart rate and ii. blood pressure  
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Which SNRI is not FDA indicated for mental illness disorders?   Milnacipran (Savella)  
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Which antidepressant is contraindicated with epilepsy or eating disorders?   Buproprion (Wellbutrin)  
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Which class of antidepressants are known for a three ring structure?   TCA’s  
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What is the biggest concern with prescribing TCA’s to a suicidal client?   Overdose, this should be not given to a suicidal client if you can avoid, but if necessary, no more than a weeks supply should be considered; only takes 7x normal dose for OD; bicarbonate is needed to reverse  
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What ingredient in food should be avoided in those taking a MAOI?   Tyramine  
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Which OTC class of medications should be avoided with MAOIs?   Cold medicines  
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Which pain medication can increase risk for seizures in those taking antidepressants?   Tramadol (Ultram)  
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Which populations require a lower recommended starting dose of antidepressants?   i. Elderly and ii. children  
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What is the black box warning for antidepressants?   May increase risk of suicidality, especially in young adults  
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What are symptoms of serotonin syndrome?   i. Shivering, ii. Hyper-reflexia/ myoclonus iii. Increased temperatures, iv. Vital sign instability, v. Encephalopathy/altered LOC, vi. Restlessness, vii. Sweating  
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How many days must the client wait after discontinuation of a MAOI before starting a SSRI?   14 days  
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What labs are necessary prior to starting Carbamazepine (Tegretol)?   i. CBC, ii. LFTs, iii. kidney and iv. thyroid function.  
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If taking Lamotrigine (Lamictal) what is the most deadly side effect? And how many days can a patient miss before starting back at initial dosing?   i. Stevens Johnson Syndrome. ii. 5 days or more must restart at initial dosing.  
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What is the therapeutic range for lithium?   i. 0.6-1.2mEq/L  
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What are symptoms of severe lithium toxicity?   i. Hyperthermia, ii. hypotension, iii. seizures, iv. renal failure, v. coma, vi. death  
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What is the therapeutic range for Valproate (Depakote)?   50-125ug/mL  
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Which neurotransmitter is directly related to Alzheimer's and impaired memory?   Acetylcholine  
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Which amino acid has excitatory properties, and an increase presents as bipolar affective disorder?   Glutamate  
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Which neurotransmitter reduces arousal, aggression, and anxiety?   GABA  
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Which neurotransmitter is related to extrapyramidal side effects and prolactin dysregulation?   Dopamine  
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Which neurotransmitter is related to depression and anxiety and is found in the brain as well as the GI system?   Serotonin  
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What is the outermost layer of the cerebrum?   Cerebral Cortex  
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What is the largest part of the brain?   Cerebrum  
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What is the newest identified lobe of the brain?   Insula  
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Wrinkled ball of tissue that helps coordinate movement?   Cerebellum  
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Name the three parts of the brainstem   i. Midbrain, ii. medulla oblongata, and iii. pons  
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Thinking, planning, organizing, problems solving, and short-term memory are in which lobe?   Frontal  
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Temperature, taste, touch, and movement are process in which lobe of the brain?   Parietal  
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Which brain lobe process primarily vision and has been linked to visual hallucinations?   Occipital  
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Which lobe of the brain processes memories, integrating them with sensations of taste, sound, sight, and touch?   Temporal  
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Which lobe of the brain is associated with conscious desires and decodes bodily states?   Insula  
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What structure processes all incoming information except for smell?   Thalamus “Hal”.  
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Which structure of the brain processes smell and attaches emotions to stimuli?   Amygdala “Amy"  
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What structure of the brain functions as the library/google, memory center?   Hippocampus “Campus”  
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Which structure is the hormone monitor and tells others which hormones are needed?   Hypothalamus ”little Hal” –he is bossy!  
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What structure is considered the danger protector and stimulates hormones?   i. Pituitary gland and ii. basal ganglia “bee gees”  
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Molecular changes produced by a drug when binding to receptor site is termed?   Drug action  
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What are the route, absorption, distribution, binding, inactivation, and excretion considered?   Factors of drug action  
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What is the pharmacokinetic parameter that is defined as the time for the drug concentration in the plasma to be reduced by 50%?   Half life  
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What is calculated by adding 4-5 half life’s of a medication?   Steady state  
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What is a common enzyme family that break down hormones and medications?   PYC450  
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Which benzodiazepine is FDA indicated for Generalized Anxiety Disorder and Panic Disorder?   Alprazolam (Xanax)  
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Which enzyme most commonly metabolizes benzodiazepines?   CYP450 3A4  
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Benzodiazepines should not be tapered any faster than 3 day increments with specific dose reduction. True or False   True  
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Benzodiazepines are habit forming. True/False   true  
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5. There are safer options for the treatment of anxiety, especially in those with a history of drug abuse, compared to benzodiazepines. True or False   true  
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Insomnia is common in those with mental illness. True/False   true  
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Which stage of sleep does the body temperature decrease?   stage 2  
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What class of insomnia medications are known to cause sleep driving?   Hypnotics  
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Which hypnotic is only FDA approved for short term insomnia?   Zaleplan (Sonata)  
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What is the mechanism of action for Ramelteon (Rozerem)?   Ramelteon (Rozerem) is a melatonin receptor agonist.  
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Which receptor/neurotransmitter is related to EPS?   Dopamine, D4  
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How do we know if a side effect is related to the medication prescribed?   a. Practitioners should be aware of the receptor the drug binds to and of the possibility of the client exhibiting those side effects relating to that receptor.  
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Which antipsychotics are associated with the least side effects?   Atypical antipsychotics  
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Which atypical antipsychotics could be passed in a bowel movement by the patient intact?   Paliperidone (Invega)  
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What aspect of client care would indicate the need of a long-acting injection?   History non-compliance  
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NMS is common. True/False   False  
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NMS is life threatening. True/False   True  
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What is the first thing the practitioner should do with the medications if NMS is suspected?   Discontinue the antipsychotic  
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Should NMS be treated outpatient?   No, medical support is necessary  
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NMS only happens in the first few days of starting antipsychotics. True/False   FAlse  
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In order to minimize side effects, practitioners should avoid multiple simultaneous medication changes. True/False   True  
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What can help sweating with antidepressants?   Clonidine (Catapress) or Benztropine (Cogentin)  
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What is bruxism?   Bruxism is involuntary grinding and gnashing of teeth  
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What class of medications treat acute dystonia?   Anticholinergics  
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What medication works for priapism?   None, priapism requires an emergency room visit  
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