Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/107

Click to flip

107 Cards in this Set

  • Front
  • Back
Short-acting Benzodiazepines
Lorazepam (Ativan); Aprazolam (Xanax); Oxazepam (Serax)
Oxazepam (Serax)
Short-acting benzodiazepine cleared through the kidneys; Dose mg/day = 30-60
Aprazolam (Xanax)
Short-acting benzodiazepine; Dose mg/day = 0.25 - 4.0
Long-acting Benzodiazepines
Diazepam (Valium); Chlordiazepoxide (Librium)
Diazepam (Valium)
Long-acting benzodiazepine; Dose mg/day = 4-30
Chlordiazepoxide (Librium)
Long-acting benzodiazepine; Dose mg/day = 30-60
ETOH detox medications
diazepam (Valium); lorazepam (Ativan); oxazepam (Serax); carbamazepine (Tegretol);Thiamine; Magnesium; Antabuse; naltrexone (Revia)
Effects of diazepam (Valium) in ETOH detox
raises seizure threshold; IM less effective than PO, erratic release from fat stores
Effects of lorazepam (Ativan) in ETOH detox
short acting, use with liver damage (because does not metabolize through the liver)
Effects of oxazepam (Serax) in ETOH detox
cleared through the kidneys; use with liver failure
Effects of carbamazepine (Tegretol) in ETOH detox
Use for hx of multiple withdrawals; prevents kindling effect in limbic system
Effects of Thiamin in ETOH detox / dosage
Replenish liver stores. give for 10 days, 100 mg/day
Effects of magnesium on ETOH detox
Low Mg will contribute to DT's; Give IM or IV for 3 days when indicated.
Effects of Antabuse
for chronic ETOH dependence relapse; someone else should administer; stops the breakdown of acetaldehyde: Drinking, using OTC meds or mouthwash with alcohol in them or cologne can lead to hypertensive crisis.
Effects of naltexone (Revia) in ETOH detox
Blocks opiate receptors and relieves craving. Discontinue before surgery or opiate analgesics won't work
Anti-anxiety medications
benzodiazepines; busprone (BuSpar); hydroxyzine (Vistaril); propanolol (Inderol); Antidepressants
Uses for Busprone (BuSpar) / Dose mg/day =
Anti-anxiety; non-addictive; for longer term use; Do not use PRN. Also used in dementia. Dose = 15-80 mg/day
Uses for hydroxyzine (Vistaril) / Dose mg/day =
Anti-anxiety med. Dose = 200-400 mg/day
Uses for propanolol (Inderol); Drug class
Anti-anxiety; Drug class beta-blocker/anti-HTN
Uses for antidepressants in anti-anxiety tx
used selectively to treat panic, phobias, OCD, PTSD
Psychopharmacology for Mania; Meds =
Lithium; Mood Stabilizers/anticonvulsants
Lithium - description
A naturally occurring salt used for tx of mania
Lithium theraputic level
0.4 - 1.0 meq/L;
Theraputic level very close to toxic level
Considerations when Lithium is used
Kidney function must be normal, with fluid intake at 3 liters/day; Blood draws every 2 weeks; sx lag 2 weeks after theraputic level reached; cut dose in half during depressive episodes
Early signs of lithium toxicity
Nausea, vomiting, diarrhea, thirst, slurred speech, muscle weakness
Interventions for early signs of lithium toxicity
At less than 1.5 mEq/L, Withhold drug, draw blood level, re-evaluate dose
Advanced signs of Lithium toxicity
Coarse hand tremor; persistent GI upset; mental confusion; Muscle hyper-irritability; EEG changes; uncoordination
Signs of severe lithium toxicity
Ataxia; blurred vision; oliguria; severe hypotension; seizures; stupor; coma to cardiac arrhythmia; circulatory collapse; death
Interventions for severe lithium toxicity / Blood level
Blood level 2.0 or higher
No know antidote. Hemodialysis may be necessary
Uses for carbamazepine (Tegretol)
Anticonvulsant effective in tx of mania and aggression
Considerations when using carbamazepine (Tegretol)
Monitor blood levels first 8 weeks
Side effects of carbamazepine (Tegretol)
Sedation; diplopia; uncoordination; agranulocytosis; aplastic anemia
Uses for valporic acid (Depakote)
Anticonvulsant effective in mania and aggression
Considerations when using valporic acid (Depakote)
Monitor liver functions
Side effects of valporic acid (Depakote)
Tremors; GI upset; wt. gain; alopecia; hepatitis
Tricyclic antidepressants (TCA)
Amitryptyline (Elavil); Doxepine (Sinequan)
Second Generation (Atypical) antidepressants
Maprotyline (Ludiomil); Desyrel (Trazadone)
SSRI: Selective Serotonin Re-uptake Inhibitors
Fluoxetine (Prozac); Sertraline (Zoloft)
Important drug interaction consideration with SSRI's and SSNRI's
FATAL W/ MAOI'S
SSNRI: Selective Serotonin/Norepinephrine Re-uptake Inhibitors
Venlafixine (Effexor)
Side-effects for amitryptyline (Elavil) / Sedation; cardiac conduction abnormalities; 3;Anticholenergic; Orthostatic hypotension = rated from 0-3; 1=low, 2=moderate, 3=high
sedation = 3; cardiac conduction abnormalities = 3; anticholinergic = 3; orthostatic hypotension = 2
Side-effects for doxepine (Sinequan) / Sedation; cardiac conduction abnormalities;Anticholinergic; Orthostatic hypotension = rated from 0-3; 1=low, 2=moderate, 3=high
sedation = 2; cardiac conduction abnormalities = 0;anticholinergic = 1; orthostatic hypotension = 1
Side-effects for maprotyline (Ludiomil) / Sedation; cardiac conduction abnormalities;Anticholinergic; Orthostatic hypotension = rated from 0-3; 1=low, 2=moderate, 3=high
sedation = 2; cardiac conduction abnormalities = 2;anticholinergic = 3; orthostatic hypotension = 1
Side-effects for desyrel (Trazadone) / Sedation; cardiac conduction abnormalities;Anticholinergic; Orthostatic hypotension = rated from 0-3; 1=low, 2=moderate, 3=high
sedation = 3; cardiac conduction abnormalities = 0;anticholinergic = 0; orthostatic hypotension = 2
Side-effects for fluoxetine (Prozac) / Sedation; cardiac conduction abnormalities;Anticholinergic; Orthostatic hypotension = rated from 0-3; 1=low, 2=moderate, 3=high
sedation = 0; cardiac conduction abnormalities = 0;anticholinergic = 1; orthostatic hypotension = 1
Side-effects for sertraline (Zoloft) / Sedation; cardiac conduction abnormalities;Anticholinergic; Orthostatic hypotension = rated from 0-3; 1=low, 2=moderate, 3=high
Sedation = 0;cardiac conduction abnormalities = 1; Anticholinergic = 1 ;Orthostatic hypotension = 1
Side-effects for venlafixine (Effexor) / Sedation; cardiac conduction abnormalities;Anticholinergic; Orthostatic hypotension = rated from 0-3; 1=low, 2=moderate, 3=high
Sedation = 1; cardiac conduction abnormalities = 0;Anticholinergic = 1 ;Orthostatic hypotension = 0
Considerations for maprotyline (Ludiomil)
Toxic in OD
Considerations for doxepine (Sinequan)
Toxic in OD; anxiety and depression
Considerations for sertraline (Zoloft)
+ insomnia
Considerations for venlafixine (Effexor)
MAOI- fatal rx
Dose ranges for amitryptyline (Elavil)
50 - 150 mg per day; max dose 300 mg/day
Dose ranges for doxepine (Sinequan)
50-150 mg/day; max dose 100-200 mg/day
Dose ranges for maprotyline (Ludiomil)
50-150 mg/day; max dose 225 mg/day
Dose ranges for desyrel (Trazadone)
150 mg/day; max dose 400-600 mg/day
Dose ranges for fluoxetine (Prozac)
20 mg/day; max dose 80 mg/day
Dose ranges for sertraline (Zoloft)
50 mg/day; max dose 200 mg/day
dose ranges for venlafixine (Effexor)
75 mg/day; max dose 375 mg/day
3 antipsychotic classes
Phenothiazines; Butyrophenones; Atypical Antipsychotics
Phenothiazines
Chlorpromazine (Thorazine); Thioridazine (Mellaril); Fluphenazine (Prolixin)
Butyrophenones
Haloperidol (Halidol);
Atypical Antipsychotics
Clozapine (Clozaril); Respiridone (Resperidal); Olanzapine (Zyprexia)
dosage for chlorpromazine (thorazine) ~ acute/maintainence
Acute = 200-1600 mg/day; Maintenence = 50-800 mg/day
dosage for thioridazine (Mellaril) ~ acute/maintainence ~
Route
Acute = 200-600 mg/day; Maintenence = 50-800 mg/day ~
Route = PO
dosage for Fluphenazine (Prolixin) ~ acute/maintainence ~
Route
Acute = 2.5 - 20 mg/day; Maintenence = 2-40 mg/day
Butyrophenones
Haloperidol (Halidol);
Atypical Antipsychotics
Clozapine (Clozaril); Respiridone (Resperidal); Olanzapine (Zyprexia)
dosage for chlorpromazine (thorazine) ~ acute/maintainence
Acute = 200-1600 mg/day; Maintenence = 50-800 mg/day
dosage for thioridazine (Mellaril) ~ acute/maintainence ~
Route
Acute = 200-600 mg/day; Maintenence = 50-800 mg/day ~
Route = PO
dosage for Fluphenazine (Prolixin) ~ acute/maintainence ~
Route
Acute = 2.5 - 20 mg/day; Maintenence = 2-40 mg/day
dosage for haloperidol(Halidol) ~ acute/maintainence ~
Route
Acute dose = 5-50 mg/day; maintenance = 1-15 mg/day;
route = PO; IM; Decanoate, 25 mg z-track IM q 4 weeks
dosage for respiridone (Resperidal) ~ acute/maintainence ~
Acute dose = (not given) mg/day; maintenance = 4-6 mg/day;
dosage for clozapine (Clozaril) ~ acute/maintainence ~
Acute dose = 300-900 mg/day; maintenance = 200-400 mg/day;
dosage for Olanzapine (Zyprexia) ~ acute/maintainence ~
Acute dose = 10-20 mg/day; maintenance = 12.5 - 29 mg/day;
Indications and side effect for chlorpromazine (Thorazine)
Lowers seizure threshold; Photosensitivity; stopping suddenly and restarting can cause "thorazine shuffle" which is permanent
Side effect of thioridazine (Mellaril)
may lengthen QT interval; Possible torsades de pontes
what medications are long-acting in oil
Decanoates ~ specifically fluphenazine (Prolixin) and haloperidol (Halidol)
Side effects of clozapine (Clozaril)
Agranulocytosis; Seizures; blood dyscrasias
Side effects of respiridone (Respiridal)
Insomnia; agitation; wt. gain
Side effects of olanzapine (Zyprexia)
Agitation; insomnia; interacts w/ antidepressants
Phenothiazines used to treat...
positive sx; lower dose in elderly
Atypical antipsychotics used to treat...
negative and positive sx
Monoamine Oxidase Inhibitors: MAOI's
Marplan; phenelzine (Nardil); tranylcypromine (Parnate); St John's Wort
Dose range for phenelazine (Nardil)
45-90 mg/day
Dose range for tranylcypromine (Parnate)
30
Side-effects for phenelzine (Nardil) / Sedation; Cardiac conduction; Anticholinergic; Orthostatic hypotension = rated from 0-3; 1=low, 2=moderate, 3=high
Sedation = 2
Cardiac conduction = 0
Anticholinergic = 0
Orthostatic hypotension =3
Side-effects for tranylcypromine (Parnate) / Sedation; Cardiac conduction; Anticholinergic; Orthostatic hypotension = rated from 0-3; 1=low, 2=moderate, 3=high
Sedation = 0
Cardiac conduction = 0
Anticholinergic = 0
Orthostatic hypotension =3
Important precaution for MAOI's
interact with Tyramine to yield hypertensive crisis
sx of hypertensive crisis
sever HA, stiff/sore neck, flushed, tachycardia, nosebleed, pupils dilate, chest pains, stroke, coma, death
tx for hypertensive crisis
treat as an emergency with IV regitine, oral chlorpromazine (Thorazine), IV Nifedipine
Drugs that interact with MAOI's
OTC meds for congestion; Antidepressants; Amine precursors (levodopa, L-tryptophan); Narcotics; Anesthetics; Sedatives (incl ETOH); anti-HTNs; Stimulants
Unsafe foods to eat with MAOI's ~ contain tyramine or other vasopressors~ (vegetable category)
avocados, fermented bean curd, fermented soybean paste, sauerkraut
Unsafe foods to eat with MAOI's ~ contain tyramine or other vasopressors~ (fruit category)
figs, bananas
Unsafe foods to eat with MAOI's ~ contain tyramine or other vasopressors~ (meat category)
fermented, smoked, aged meats/liver
Unsafe foods to eat with MAOI's ~ contain tyramine or other vasopressors~ (dairy category)
practically all cheeses
Unsafe foods to eat with MAOI's ~ contain tyramine or other vasopressors~ (yeast category)
yeast extract, but baked goods containing yeast are ok
Unsafe foods to eat with MAOI's ~ contain tyramine or other vasopressors~ (alcoholic beverages category)
some imported beers, Chianti
Unsafe foods to eat with MAOI's ~ contain tyramine or other vasopressors~ (Misc. category)
protein supplements, soups, shrimp paste, soy sauce, chocolate, fava beans, ginsing, caffeine (in large amounts
Antihypertensives (interact w/ MAOI's)
Methyldopa; guanethidine; resperpine
Important interaction warnine r/t MAOI's
DO NOT TAKE ANTIDEPRESANTS (TCA, SSRA, SSNRI) WITHIN 14 DAYS OF STOPPING MAOI'S
Side effects for chlorpromazine (Thorazine);
EPS; Anticholinergic; sedatation; hypotensive ~rated 1=low, 2=mod, 3=high
EPS = 2
Anticholinergic = 2
Sedative = 3
Hypotensive = 3
Side effects for thioridazine (Mellaril)
EPS; Anticholinergic; sedatation; hypotensive ~rated 1=low, 2=mod, 3=high
EPS =
Anticholinergic = 3
Sedative = 3
Hypotensive = 3
Side effects for fluphenazine (Prolixin)
EPS; Anticholinergic; sedatation; hypotensive ~rated 1=low, 2=mod, 3=high
EPS = 3
Anticholinergic = 1
Sedative = 1
Hypotensive = 1
Side effects for haloperidol (Halidol)
EPS; Anticholinergic; sedatation; hypotensive ~rated 1=low, 2=mod, 3=high
EPS = 3
Anticholinergic = 0
Sedative = 1
Hypotensive = 1
Side effects for clozapine (Clozaril);
EPS; Anticholinergic; sedatation; hypotensive ~rated 1=low, 2=mod, 3=high
EPS = 0
Anticholinergic = 0
Sedative = 1
Hypotensive = 1
Side effects for respiridone (Resperidal);
EPS; Anticholinergic; sedatation; hypotensive ~rated 1=low, 2=mod, 3=high
EPS = 1
Anticholinergic = 1
Sedative = 1
Hypotensive = 1
Side effects for olanzapine (Zyprexia);
EPS; Anticholinergic; sedatation; hypotensive ~rated 1=low, 2=mod, 3=high
EPS = 2
Anticholinergic = 2
Sedative = 3
Hypotensive = 3