Mental Health Drugs

Front 1

What is the mechanism of action of tricyclic antidepressants?

Back 1

inhibit the reuptake of serotonin and NE

Front 2

What are tricyclic antidepressants used for?

Back 2

major depression, panic attacks, OCD

Front 3

What are the common s/e and a/e of tricyclic antidepressants?

Back 3

orthostatic hypotension
cardiac dysrhythmics
sedation
anticholinergic effects
weight gain
seizures
sexual dysfunction

Front 4

What are some important pt teaching for tricyclic antidepressants?

Back 4

several wks. or more for full effect
inform MD of intention to become pregnant

Front 5

What is the prototype for tricyclic antidepressants?

Back 5

Tofranil

Front 6

What is the mechanism of action of atypical antidepressants?

Back 6

inhibit serotonin and NE reabsorption and increase levels of serotonin, NE and dopamine in the central nervous system

Front 7

What are atypical antidepressants used for?

Back 7

major depression

Front 8

What are the common s/e and a/e of atypical antidepressants?

Back 8

anticholinergic effects, Stevens-Johnson syndrome, seizures, orthostatic hypotension

Front 9

What are the selective serotonin reuptake inhibitors mechanism of action?

Back 9

block the reuptake of serotonin into presynaptic nerve terminals

Front 10

What are SSIRs used for?

Back 10

depression, anxiety, OCD and panic attacks

Front 11

What are the common s/e and a/e of SSRIs?

Back 11

nausea, dry mouth, insomnia, somnolence, HA, nervousness, anxiety, GI disturbances, dizziness, anorexia, fatigue

Front 12

What are some important pt teaching for SSRIs?

Back 12

5 wks to reach full effect

Front 13

What is the protoype drug for SSRIs?

Back 13

Zoloft, Lexapro

Front 14

What are the monoamine oxidase inhibitors mechanism of action?

Back 14

limits the breakdown of NE, dopamine and serotonin in the CNS neurons

Front 15

What are MAOIs used for?

Back 15

depression

Front 16

What are the common s/e and a/e of MAOIs?

Back 16

anticholonergic effects, orthostatic hypotension, anorexia, resp. collapse, hypertensive crisis, circulating collapse

Front 17

What are some important pt teaching for MAOIs?

Back 17

avoid foods with tyramine
avoid caffeine

Front 18

What is the prototype drug for MAOIs?

Back 18

Nardil

Front 19

What are the benzodiapenes mechanism of action for anxiety and insomnia?

Back 19

bind to the GABA receptor and intensify it

Front 20

What are the common s/e and a/e of benzodiapenes?

Back 20

change in sleep patterns, paradoxial excitation, menstrual irregularities, Stevens-Johnson syndrome,

Front 21

What are some important pt teaching for benzodiapenes?

Back 21

avoid etoh or other CNS depressants
avoid caffeine, do not take if pregnant

Front 22

What is the prototype drug for benzodiapenes?

Back 22

Ativan

Front 23

What is the reversal agent of Ativan?

Back 23

Romazicon

Front 24

What is the mechanism of action of barbiturates?

Back 24

enhance the inhibitory mechanisms of GABA and directly mimic the actions of GABA

Front 25

What are barbiturates used for?

Back 25

sedation and insomnia

Front 26

What are the common s/e and a/e of barbiturates?

Back 26

CNS depression, hypotension, shock, bradycardia, respiratory depression, acute toxicity

Front 27

What are some important pt teaching for barbiturates?

Back 27

can decrease effectiveness of oral contraceptives
report s/s of bleeding
avoid etoh use
avoid taking gingko bilba

Front 28

What is the prototype drug for barbiturates?

Back 28

Phenobarbital

Front 29

What is the mechanism of action of phenothiazines?

Back 29

prevent dopamine and serotonin from occupying their receptor sites in certain regions of the brain

Front 30

What are phenothiazines used for?

Back 30

psychoses

Front 31

What are the common s/e and a/e of phenothiazines?

Back 31

anticholonergic effects, sexual dysfunction, menstrual disorders, extrapyramidal s/e, neuroepileptic malignant syndrome, CNS depression

Front 32

What are some important pt teaching for phenothiazines?

Back 32

report s/s of EPS or NMS
document each dose
do not stop taking

Front 33

What is the prototype drug for phenothiazines?

Back 33

Thorazine

Front 34

What is the prototype drug for nonphenothiazines?

Back 34

Haldol

Front 35

What is the mechanism of action of atypical antipsychotics?

Back 35

block dopamine receptors, serotonin and alpha-adrenergic receptors

Front 36

What are the common s/e and a/e of atypical antipsychotics?

Back 36

decreased libido, osteoporosis, impotence, alter glucose metabolism

Front 37

What are some important pt teaching for atypical antipsychotics?

Back 37

increase intake of fruits and veggies

Front 38

What is the prototype drug for atypical antipsychotics?

Back 38

Clozaril

Front 39

What is the reversal agent of Clozaril?

Back 39

charcoal w/ sorbitol

Front 40

What is rebound insomnia?

Back 40

occurs when a sedative drug is discontinued abruptly or after it has been taken for a long time; sleeplessness and symptoms of anxiety then become markedly worse

Front 41

What is behavioral insomnia?

Back 41

often attributed to stress caused by a hectic lifestyle or conflicts

Front 42

What is long-term insomnia?

Back 42

often caused by depression, manic disorders and chronic pain

Front 43

What is sleep debt?

Back 43

when clients are deprived of REM sleep; become frightened, irritable, paranoid, impaired judgment, and have a slow reaction time

Front 44

What are the physiological implications to lack of sleep?

Back 44

body cannot repair itself, brain cannot process and fill new info collected throughout the day, cannot regulate body temp, BP, hormone levels, and RR

Front 45

What is the relationship between suicide ideation and antidepressants?

Back 45

whenever a pt starts taking a antidepressant they start to feel good but not great which gives them the energy and motivation to commit suicide

Front 46

What are the contraindications to alprazolam therapy?

Back 46

acute narrow angle glaucoma
pregnancy

Front 47

What is Stevens-Johnson syndrome and which drugs can result in it?

Back 47

S/S: upper respiratory infection w/ chills, fever, and malaise
generalized blister like lesions
skin sloughing of 10% of body
extreme mania and suicidality
abdominal bleeding
atypical antidepressants
benzodiapenes

Front 48

What are extrapyramidal s/e?

Back 48

dystonias- severe muscle spasms
akathisia- inability to rest or relax
parkinsonism- tremor, muscles rigidity, stooped posture, shuffling gait
tardive dyskinesia- unusual tongue and face movements

Front 49

What is Serotonin syndrome?

Back 49

Serotonin accumulates in the body; S/S: confusion, anxiety, restlessness, HTN, tremors, sweating, hyperpyrexia, ataxia(unsteady gait), hyperthermia, muscle rigidity

Front 50

Discuss the interaction between foods containing tyramine and MAOIs.

Back 50

tyramine is usually degraded by MAO in the intestines but if pt is taking MAOIs tyramine enters the bloodstream in high amounts and displaces NE in presynaptic nerve terminals; sudden release of NE causing HTN

Front 51

Describe lithium toxicity.

Back 51

lithium acts like sodium in the body so conditions in which sodium is lost, excessive sweating or dehydration, can cause toxicity
S/S: vomiting, diarrhea, slurred speech, decreased coordination, drowsiness, muscle weakness, twitching