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115 Cards in this Set

  • Front
  • Back
positive symptoms are ______
observable
major drug categories for depression therapy
TCA
SSRI
SNRI
MAOI
ATYPICALS
suidice risks increase ______ with medications
initially
the test will contain what about drugs?
what is the action of drug categories
TCA's

action
ae
other use
blocks neuronal reuptake of noreepi/serotonin

intensify NE/serotonin

long half life

AE: cariotoxcity, sedation, hypotension, anticholinergiic effects

other uses:
neuropathic pain
insomnia
adhd
ocd
explain TCA's cardiotoxic effects
may cause bradycardia/tachycardia
if TCA mix with MAOI
HTN ensues
if TCA mix with other NE reputake inhibitor
tachycardia
manic epidsode
htn
SSRI

action
half life
AE
action
-intensifies transmission at synapses
-prolonged half life (one month to become effective)

AE:
sex dysfunction
weight gain
withdrawal
serotonin syndrome
EPS
bruxism
platelet dysfunction
hyponatremia
fatigue
serotonin syndrome:

clincal manifestations
highly agiated
sever hallucinations
hypothalmus over drive
-high fevers
-brain damage
-death
bruxism
ssri ae

grinding teeth

can lead to migraines

treat with mouth gaurds
EPS
extra pyramidal side effectts

ae of ssri
platelet dysfunction
ae of ssri

if going for sx, tell someone
weight gain for ssri tx
exercise and watch diet
ssri drug interactions
warfarin
maoi
tca
lithium
how ssri effects warfarin
probly have to increase dose
maoi+ssri= ______
serotonin syndrom
ssri+tca=______

what to do?
could increase tca level

decrease the tca dose
ssri+lithium=______

what to do?
higher lithium levels

decrease lithium dosage
lithium effect ______ and ______ levels
electrolyte and ion levels
why are ssri better than tca
they dont have carditoxic side effects

considered safer
S/NRI
effexof/cymbalta
S/NRI
deals with the aching of depression
why does depression hurt?
depression is a stressor. stress response kicks in and inflammatory phase happens
S/NRI
effexor/cymbalta

powerful blockade of norepinephrine and serotonin
MAOI

indications
atypical depression
bulimia
ocd
panic
MAOI

ae
cns stimulation
orthostatic hypotension
HTN crisis
MAO is
an enzyme in the liver that activates norepinephrine
MAOI effect are reverssible/irreversible
irreversible

monitor for htn crisis
MAOI pateints cant process this yogurt element
tyramine - protein
anxiety disorders

define
intense fear disproportionate to event
five subcategories of anxiety disorders
panic disorders
PTSD
gen anxiety disorder
social phobia
OCD
bipoolar disease

what is it?
diagnosis is made by level of mania a patient achieves
tx goals of bipolar
prevent mania

maintain stable emotion

control mania
how do we tx bipolar

3 categories
antidepresants
antipsychotics
mood stabilizers (lithium)
why give antipsychocits for bipolar
short term mood stabilizers
given when escalating to mania
what is a widely used mood stablizer
lithium
lithium you must maintain ______
levels

do regular checks
what could happen if li levels go to high
catatonic state

sit drooling
dont eat
dont move
who do we want on lithium?
someone who is compliant
lithium is good why?
because it does not sedate
usual antipsychotics for bipolar disease
seroquil (inexpensive)
geodon
abilify
respiradone
antiseizure meds can be used at ______ stabilizers
mood
antiseizure meds for mood stabalizers
valproic acid
lamictal
depakote
heres the issue with antiseizure meds

what to do
a lot can cause SJS

go easy and do good teaching
panic disorder

define
deblitating condition with multiple symptoms
parts of body where panic disorders manifest
neurologic
cardiac
resp
diaphoresis
nause/abd pain
psychological
why is GI effected by panic
^acid
decreased blood flow=cramps
etiology of panic disorders
genetic and major life stressor
panic diosrder interventions
behavioral therapy-extended time
psycholocal therapy-extended time
meds
-antidepressants
-ssri
one drug you wont see with panic disorders is______
wellbutrin
generalized anxiety disorder

define
ss
meds
excessive worry >6months

muscle tension
autonomic hyperactivity
exaggerated startle
concentration issues

benzo
buspirone
SSRI
b adrenergic blockers
what is excessive worry?
worry about real deal situations but you just give it more thought than it should be
obession is a ________
thought.

someons says "i cant get this thought out of my head"
compusions are ________
acts

i have to wash my hands 3 times before i can walk out the door
ocd is often confused with ________ or ________
adhd or defiance
s/s ocd
contiuous repitition of acts or thoughts regardless of environment
interventions for ocd
behavioral and cognitive therapy
SSRIs and TCAs
social phobias are aka

define
social anxiety disorder

irrational and persistent fear of negative reception by other people
outcomes of social phobias
interferes with routine activities like school, jobs, appts
social phobia interventions
behavior and cognitive therpies
ssris
benzo
mao
b adrenergic blockers
PTSD

define
result of a traumatic event causing immediate fear helplessness or horror
PTSD marker
re experiencing event
avoidacne of reminders
persistent hypervigilance
PTSD interventions
psychotherapy
SSRI (paxil/zoloft)
benzos

mech action

indications

long term AE
potential gaba
fast to cross BBB
metab is liver
dont depress CNS

sever anxiety attack
alcohol/drugs withdraw
ICU environment
good to help maintain sleep
(however, it is drug induced sleep)
used to get people through colonoscopies

long term use can insight quiet delrium
dosing with benzos
start low
common benzos
valium-longest acting
xanax
ativan
versed

all have amnesic properties
________ has the best anterograde amnesia properites
versed
how do you reverse benzo?
romazecon
cognition
processing of sensory input
rem sleep
rapid eye movement
vivid dreams
loss of muscle movement

hard to arouse these people
circadian rhythms
light levels
suprachiasmatic nucleus
-hypothalamus
anterior ptuitary
non 24 hour sleep wake syndrome
circadian disorder
those who cant tell light from dark

blind
brain tumors
sbi
jet lag syndrom
circadian disorder

no synchrondy
shift work sleep disorder
cicadian disorder

might achieve rm sleep but wont stay in it long
how to manage shift worker syndrome
control the environment you sleep in
delayed sleep phase cycle
circadian disorder

inability to go to bed at night but cant wake up in the morning
advanced sleep phase syndrome
circadian disorder

cant keep awake at 7pm
but wake up at 3am
insomnias

dx
sleep diary
environment
chem/meds
actigraphy
polysomnography
insomnia

interventions
treat cause
psychotherapy
meds
night terrors
nightmares with children
happens first part of the night
elderly pt loose _____
rem sleep and all kinds of things cause it
what percent of sleep is stage one?
5%
what percent of sleep is stage two?
50%
sleep stage two

eeg/wakeability
eeg spikes
easy to wake them
what percent is stage 3 of sleep
10-20%
what percent is REM sleep?
1/4th
how long do most benzodiazapine last
about 4 hours
what is the first choice of drugs for sleep issues
benzodiazepines
talk about benzodiazepines and tolerance
occurs after 2 weeks
may cause rebound insomnia
non benzo hypnotics
zolpidem
zaleplon
eszopiclone
ramelteon
triazolam
drug for sleep
rapid onset
short duration
zaleplon
drug good for middle of night waking as duration is short
no am drowsiness
ramelteon
melatonin agonist
rapid onset
short duration
trazodone
sedating antidepressant
good for pt using stimulating antidepressant meds
AE: hypotension, impotence
antihistamines AE
tolerance
am drowsiness
narcolepsy definition
abnormal sleep issues related to neurotransmitters in the hypothalamus

hypocretin 1 and hypocretin 2
narcolepsy s/s
daytime sleepiness
disturbed nocturnal sleep
muscle weakness
hallucinations
sleep paralysis
how to dx narcolepsy
sleep lab studies
narcolepsy interventions
stimulats:
methylphenidate
methamphetamine
modafini

TCAs

environmental controls
movement disorders define
occur in non rem sleep and are disruptive
two types of movement related sleep disorders
periodic limb movement disorder
relsteless leg syndrome
PLMD
periodic limb movement disorder

repetitive movment of big two with flexion of ankle, knee, hip

unknown etiology
RLS
urgency to move limbs w/ or w/out sensation

etiology: genetics, spinal cord lesions, meds, iron defic

meds: levadopa, dopamine agonists, antiseizure meds, benzos, opiods
sleep apnea s/s
snoring
insomnia
morning headaches
excessive sleepiness
polycythemia
sexual disfuction
congitive changes
systemic htn
how is polycythemia r/t sleep apnea
polycythemia is over production of RBC

sleep apnea causes chronic low levels of oxygen, body responds with more RBC

could cause clots
how to dx sleep apnea
sleep studies and history
interventions for sleep apnea
weight loss
med change
dental appliance
cpap
bipap
ncpap
difference between cpap/bipap
continuous positive airway pressure to blow past obstruction

bipap has two settings, and works on ventilation
nightmares define
dreams that activate the sympathetic nervous system
when do night terrors and sleep walking happen?
stage two
parasomnia interventions
control sleep environment
meds
benzos
-diazepam
-clonazepam

TCA
sleep disorders in children
sleep terror
confusional arousal
sleep walking
discuss sleep terrors
happens in first half of night sleep
effect 2-4yr
they cant tell you they had a bad dream
their eyes are open
sympathetic nervous system activated
how to treat kids and sleep disorders
make sure they get their naps