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70 Cards in this Set
- Front
- Back
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What is the action of SSRI's
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Blocks the reuptake of serotonin leaving it in the synapse longer which prolongs it's effects on the body.
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What are the typical side effects of SSRI's?
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Agitation, insomnia, headach, nausea and vomiting, sexual dysfunction, and hyponatremia.
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hyponatremia?
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Hyponatremia is a metabolic condition in which there is not enough sodium (salt) in the body fluids outside the cells. (Electrolight imbalance)
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What are the trade names of the SSRI's?
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Celexa, Lexapro, Luvox, Prozac, Paxil, Zoloft. (6)
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Special notes about SSRI's include...
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First line of treatment for Major Depression. Risk of lethal OD low,
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Describe the action of a SNRI's?
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Blocks the reuptake of serotonin and norepinephrine letting it stay in the synapse longer.
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What are the major warnings of SSRI's?
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Discontinuation syndrome- dizzyness, insomina, nervousness, irritability, nausea, and agitation - may occur with abrupt withdrawal (taper slowly). Contraindicted in MAOI's.
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What are the trade names of SNRI's?
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Effexor, Cymbalta
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What are some special notes about SNRI'a
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Effexor is a popular 2nd choice after SSRI's. Cymbalta has the advantage of decreasing neuropathic pain.
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What are the side effects of SNRI's?
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Hypertension (venlafaxine), nausea, insomnia, dry mouth, sweating, agitation, headache, sexual dysfunction.
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What are the major warnings for SNRI's?
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Monitor blood pressure with effexor, especially at higher doses and with a history of hypertension. Discontinuation syndrome. Contraindicated in MAOI's.
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What is the action of a NDRI?
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Blocks the reuptake of norepinephrine and dopamine.
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What is the trade name of the NDRI?
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Wellbutrin
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What special notes are considered when taking Wellbutrin?
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Stimulant action may reduce appetite. May increase sexual desire. Used as an aid to quit smoking.
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What are the side effects of NDRI?
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Agitation, insomnia, headache, nausea and vomiting, seizures (0.4%)
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What are the major warnings for NDRI's?
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Contraindicated in people taking MAOI's. High doses increase seizure risk, especially in peole who are predisposed to them.
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What is the trade name for a SNDI?
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Remeron
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What is the action of a SNDI?
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Blocks alpha 1 -adrenergic receptors that normally inhibit norepinephrine and serotonin.
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What are some notes about SNDI's
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Antidepressant effects equal SSRI's and may occur faster.
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What are the side effects of SNDIs?
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Weight gain, sedation, dizziness, headache; sexual dysfunction is rare.
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What are the major warnings for SNDIs?
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Drug-induced somnolence (Sleepiness) exaggerated by alcohol, benzodiazepines, and other CNS depressants. Contraindicated in people taking MAOIs.
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What are the two TCAs to know for test?
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Elavil, Tofranil
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What does a TCA do to the body? (Action)
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Inhibits the reuptake of serotonin and norepinephrine. Antagonizes adrenergic, histamineric and muscarinic receptors.
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What are the special notes to know about TCAs?
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Therapeutic effects similar to SSRIs, but side effects are more prominent. May work better in melancholic depression TCAs can worsen many cardiac and medical conditions.
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What are the side effects of TCAs?
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Dry mouth, constipation, urinary retention, blurred vision, orthostatic hypotension, cardiac toxicity.
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What are the major warnings for TCAs?
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Lethal in OD. Use cautiously in older adults and those with cardiac disorders, elevated intraocular pressure, urinary retention, hyperthyroidism, seizure disorders, and liver or kidney dysfunction. Contraindicated in MAOIs.
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What are the MAOIs?
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Nardil, EMSAM, Parnate
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What is the action of an MAOI?
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Inhibits the enzyme monamine oxidase, which normally breaks down neurotransmitters, including serotonin and norepinephrine.
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Special notes about MAOIs?
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Efficacy similar to other antidepressants, but dietary restrictions and potential drug interactions make this drug less desirable.
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Side effects of MAOI's?
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Insomnia, nausea, agitation, and confusion. Potential for hypertensive crises or serotonin syndrome with concurrent use of other anti-depressants.
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What are the major warnings for MAOI's?
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Contraindicated in people taking other antidepressants. Tyramine-rich food could bring about a hypertensive crisis. Many other drug interactions.
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What are the Adverse Effects to MAOI's?
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Hypotension; sedation, weekness, fatigue; Insomnia; changes in cardiac rhythem; Muscle cramps; Anorgasmia or sexual impotence; Urinary hesitancy or constipation; Weight gain.
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What are the toxic effects of MAOI's?
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Severe headache; Tachycardia, palpitations; Hypertension; Nausea and vomiting.
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SSRI's are used for what Medical condition?
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Depression
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SNRI's are used for what medical condition?
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Depression and neuropathic pain.
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NDRI's are used for what medical condition?
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Depression or smoking cessation.
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SNDI's are used for what medical condition?
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Depression
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TCA's are used for what medical condition?
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Depression
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Lithium is used for what medical condition?
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Bipolar
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What is the therapeutic range of Lithium?
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0.6-1.2 mEq/L
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What are the normal side effects of Lithium?
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fine hand tremor, polyuria, mild thirst, mild nausea, mild weight gain.
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What are the early signs of lithium toxicity?
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Nausea, vomiting, diarrhea, thirst, polyuria, lethargy, slurred speech, muscle weakness, and fine hand tremor.
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What are the advanced signs of toxicity?
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Coarse hand tremor, persistent gastrointestinal upset, mental confusion, muscle hyperirritability, electroencephalographic changes, incoordination, sedation.
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What are the severe symptoms of lithium toxicity?
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Ataxia, confusion, large output of dilute urine, serious electroencephalographic changes, blurred vision, clonic movements, seizures, stupor, severe hypotension, coma; death is usually secondary to pulmonary complications. Convulsions, oliguria, and death can occur.
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Tegretol and Depakene/Depakote are classified as what?
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Anticonvulsants
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Tegretol and Depakene/Depakote have what type of action on the body
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Slows down the electrical impulses (conduction) within the neurons.
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Tegretol and Depakene/Depakote are indicated for what medical condition?
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Acute mainia, depression maintenance.
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Special notes related to Tegretol?
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Requires regular blood levels (6-8 mg/L) as well as Liver panel. Works best in Rapid Cycling episodes.
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Special notes regarding Depakene/Depakote?
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Levels need to be monitored (50-100 mcg/ml). Check liver enzymes. Works well in Rapid Cycling, Mixed Episodes and Multiple Episodes.
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What are the 3 antipsychotics used for Bipolar disease?
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Zyprexa, Seroquel, Abilify
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Why are antipsychotics used in Bipolar?
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Used to control hyperactivity and aggression. They take effect sooner than lithium and help prevent exhausiton, coronary collapse, and death.
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What effects need to be watched when taking Lamictal?
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Life threatening rash that may indicate Stevens Johnsom Syndrome.
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What are the Anticonvulsants indicated for bipolar disease?
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Sepakene, Depakote, Tegretol, Lamictal, Neurontin, Topamax, Klonopin, Ativan.
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What antianxiety medications are indicated for bipolar disease?
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Klonopin, Ativan.
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Special notes regarding the medications Neurontin and Topamax?
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May be used in rapid cycling and in clients refractory to other medications.
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Indications for use of Klonopin and Ativan in bipolar disease?
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use in acute mania to reduce psychomotor agitation.
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Four of the current drugs available for Alzheimer's disease are _____, _____, ______, & _____.
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Aricept, Exelon (a patch), Razadyne & Namenda
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Cholinesterase inhibitors work by?
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They work by preventing the breakdown of acetylcholine – a neurotransmitter important for memory- thereby increase it's availability at cholinergic synapses. This neurotransmitter is deficient in Alzheimer’s. By increasing its availability clients experience improvement in their cognition and behavior.
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What are the indications for Cholinesterase Inhibitors?
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Modestly improves cognition, behavior, function, Slows disease progression. Used for early to moderate stages of Alzheimers; 6-12 months
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N-Methyl-D-Aspartate Antagonists work by
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Normalizes levels of glutamate, which in excessive quantities contributes to neurodegeneration.
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Aricept Side Effects?
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Nausea, vomiting, loss of appetite and increased frequency of bowel movements. Used at All stages
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Razadyne Side Effects?
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Nausea, vomiting, loss of appetite and increased frequency of bowel movements. Used to treat Mild to moderate
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Namenda Side Effects?
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Headache, constipation, confusion and dizziness.Used to treat Moderate to severe cases of Alzheimers
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Exelon Side Effects?
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Nausea, vomiting, loss of appetite and increased frequency of bowel movements. Used to treat Mild to moderate Alzheimers.
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What are the symptoms of Serotonin Syndrome?
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Hyperactivity of restlessness; Tachycardia---> cardiovascular shock; Fever--->Hyperpyrexia; elevated blood pressure; Altered mental states (delirium); Irrationality, mood swings, hostility; Seizures--->status epilepticus; myoclonus, incoordination, tonic rigidity; Abdominal pain, diarrhea, bloating; Apnea--->Death.
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Name the Cholinesterase Inhibitors?
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Aricept, Exelon, Razadyne.
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Name the NMDA antagonist?
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Namenda
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What is the indications for NMDA?
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Treatment of moderate to severe Alzheimer's disease. No evidence that it modifies underlying disease.
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Medications used to limit Alcohol withdrawl symptoms?
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Benzodiazepines & Clonidine; Naltrexone; Campral; Topamax; Antabuse.
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Medications used to limit Opiate withdrawl symptoms?
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Mehtadone; Levo-alpha-acetylmethadol; Naltrexone; clonidine; buprenophine
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