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74 Cards in this Set
- Front
- Back
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What do SEDATIVE agents do?.
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calm, reduce anxiety.
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What do HYPNOTIC agents do?
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Induce drowsyness & promote sleep.
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What do anxiolytics do?
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Reduce anxiety.
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What may trigger ACUTE ANXIETY DISORDER?
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Illness, separation from loved ones, anticipation of stressful evengts. May resolve in wks or months w/o tx.
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What meds are used to tx ACUTE ANXIETY DISORDER?
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BENDODIAZEPINES. (short term relief for more severe acute anxiety)
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Describe PANIC DISORDER.
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Acute episodes of severe anxiety. Marked psychologic & psychologi sxs.
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What meds do you tx panic disorders with?
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Benzos (ALPRAZOLAM, CLONAZEPAM)
SSRI antidepressants (SETRALINE) |
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Define PHOBIC DISORDER.
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Specific, social or agoraphobia.
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Meds for PHOBIC DISORDERS?
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BENZOS(acute relief, enables pts to more easily benefit fr psychotherapy)
ANTIDEPRESSANTS(most effective long-term for social & agoraphobia) PROPANOLOL(stage freight, acute situational, or performance anxiety) |
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Define OCD.
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OBSESSIONS(recurrent or persistant thoughts or impulses) COMPULSIONS(repetitive behaviors in response to obsessions)
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How do you tx OCD?
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Antidepressants & psychotherapy.
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Define GENERALIZED ANXIETY DISORDER.
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chronic worry, apprehension concerning future events.
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How do you tx Gen Anxiety disorder?
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Benzos(for acute sxs, bridge to psychotherapy.
BUSPIRONE(chronic anxiety, non-sedating) SSRI(Citalopram, Fluoxetine, Setraline) |
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What is the cause for PTSD?
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Exposure to traumatic events.
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How do you Tx PTSD?
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SSRIs & Benzos(startle response, flashbacks)
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Indications for Benzos.
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Anxiety, insomnia, muscle spasm, seizure disorder & spasticity.
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Name the Benzos.
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Alprazolam, Diazepam, Lorazepam, Midazolam.
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Alprazolam, a benzo used for?
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Anxiety, panic. Requires high dose. May cause seizures if stopped suddenly.
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Diazepam (a benzo) use for?
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Anxiety, prevent alcohol detox seizures, spasms, spasticity.
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Lorazepam (benzo) use?
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Best for elderly pts. Anxiety, seisures.
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Midazolam (benzo) use?
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Anesthetic for pts undergoing endoscopy, xray, minor sx.
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How do you tx acute anxiety disorder?
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Benzos.
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Tx for Panic disorder?
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Benzos & SSRIs.
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Tx of OCD?
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Antidepressants & psychotherapy.
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Tx for phobic disorder?
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Psychoterapy & Benzos
(propanolol for stage fright) |
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Tx of Generalized anxiety?
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Benzos & SSRIs.
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TX PTSD?
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SSRIs & Benzos.
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Sedative.
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Calms, reduces anxiety.
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Hypnotic.
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Induce dorwsiness, promotes sleep.
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Anxiolytic.
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Reduces anxiety.
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If Benzos & ETOH mix?
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Greater resp depression, coma, death.
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Why is Zolpidem, a newer Benzo better for the treatment of insomnia?
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It doesn't affect sleep architecture & it doesn't have as much tolerance or dependence.
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Advantages of Buspirone compared to Benzos for Anxiety.
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Non-sedating, zero tolerance, zero dependence.
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Disadvantages of Buspirone compared to benzos in treating anxiety?
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Effects not felt for 3-4 wks.
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Positive symptoms of Schizophrenia.
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Agitatitions, hallucinations, delusions, disorganized speech, disorganized thinking & insomnia.
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Negative symptoms of Schizophrenia.
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apathy, affect flattening, lack of motivation, anhedonia, poverty of speech (alogia), social isolation.
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Older "typical" antipsychotic qualities.
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Greater EPSs, sedation and anticholinergic (chlorpromazine), orthostatic hypotension,↑ serum prolactin, Poikilothermy.
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New "atypical" antipsychotic qualities.
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Lower EPS, more sedating & anticholinergic (clozapine), orthostatic hypotension, agranulocytosis, arrythmias, wt gain.
Better at treating NEGATIVE sxs found in Schizos (apathy) |
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Which of the new "atypical" antipsychotics has more side effects than the rest of them?
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Clozapine. Less EPS, MORE sedation, more anticholinergic, More orthostatic hypotension.
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Tardive dyskinesia.
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W long use of antipsych. Abnormal oral & facial movements. tongue protrusion, lip smacking, abnormal limb & trukal movement.
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Akathisia.
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Motor restlessness. Feel compelled to move, shuffle ft, change positions, unable to sit quietly.
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Pseudo Parkinism.
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Like Parkinson's, rigidity, bradykinesia, tremor.
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Dystonia.
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Abnormal muscle tension in face & neck. Oculogyric crisis, tongue protrussion, torticollis (twisted & contracted neck muscles)
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Prolactin increase as SE of antipsychotics. also?
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Gynecomastia & menstrual irregularities.
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Poikilothermy, another SE of antipsychotic meds.
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Impaired hypothalamus to regulate temp. can lead to hypo or hyperthermia.
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High doses of Thioridazine can cause?
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Pigmentary retinopathy & cardiac toxicity.
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How do you treat Neuroepileptic Malignant Syndrome with? NMS
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DC causing drug, administer DANTROLENE. If pt needs more antipsychotics, use an "atypical."
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Characteristics of NMS?
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Elevated temp, ALOC, tachy, diaphoresis, tachypnea, urinary & fecal incotinence.
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Advantages of using "atypical" drugs over typical, for SCHIZOPHRENIA?
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Less EPS, more effect against negative symptoms.
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Indications for Amitriptyline, a TCA.?
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Depression.
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Adverse effects Amitriptyline?
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Sedation (give at bed time to use sedation to promote sleep), lower seizure threshold. OD: Widened QRS complex, arrythmias, tachy, hypotension.
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What can be seen with Amitriptyline OD?
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Cardiac arrythmia (wide QRS complex), hypotension, tachy, sedation, szs.
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Name the SSRIs? (CSF)
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Citalopram, Setraline, Fluoxetine.
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Indications for SSRIs? (Citalopam, Setraline, Fluoxetine)
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Depression, OCD, Anxiety disorders.
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Adverse effects of SSRIs? (Citalopram, setraline, Fluoxetine)
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Nervousness, dizziness, insomnia, male sexual dysfunction.
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Uses for Fluoxetine (prozac) an SSRI?
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Depression, anorexia, Bulemia.
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Adverse effects of Fluoxetine (prozac) an SSRI?
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Can impair Blood glucose levels in diabetics, SIADH (persistent hyponatremia, elev urine osmolality)
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Why is Setraline (SSRI) preferred for elderly pts?
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Because its elimination is not affected by aging.
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Why are SSRIs preferred over TCAs for depression & anxiety disorder?
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Less autonomic SEs, less sedation, much safer than TCAs if OD, seldom cause arrythmias, less seizures.
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Why are Monoamine Oxydase Inhibitors (MAOIs) lmtd to use as alternative therapy for depression?
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They have many potentially serious interactions with other drugs or foods (cheese, beer, meat fish). Effects not seen for wks.
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Other antidepressants? 2
(B, V) |
Bupropion, Venlafixine.
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Pros for Bupropion on the treatment of depression.
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Few anticholinergic SEs, very little sedation, rare CV SEs, rare sexual dysfunction.
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SEs of Bupropion an antidepressive?
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Can cause: Agitation, Insomnia, Nause, WT loss.
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Why is Velafixine a good choice for depression over SSRIs?
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Few autonomic, CV, SEs. Sedative.
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What phase is Lithuim for bipolar best at controlling, manic or depressive?
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MANIC. It has greater activity against mania.
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Adverse effects of Lithium.
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Drowsy, wt gain, fine hand tremor, polyuria, can cause hypothyroidism.
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What can elevated levels of serum Lithium lead to?
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Neurotoxicity & Cardiac toxicity leading to arrythmias.
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What are early signs of Lithium toxicity/OD?
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N, V,
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What effect do NSAIDS have on Lithium?
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Decreased clearance, elevated Lithium serum levels.
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What can mixing other drugs and Lithium cause?
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Neurotoxicity.
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What other drugs are alternatives to Lithium in treating Bipolar disorder?
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Antiepileptics. Carbamezapine & Valproate.
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Effects of Carbamezapine?
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Antimanic, antidepressant, fewer SEs.
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Effects of Valproate?
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Controls mania, or rapid manic/hypomanic cycling,
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Another Plus to Lithium?
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Not only controls manic episodes, it also is an antidepressant!
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