5Th Quarter Psych Part 4

Front 1

What are the four broad classifications of psychopharmacology

Back 1

Anxiolytics

Antidepressants

Anti Mania

Antipsychotics

Front 2

Name a prototype drug for anxiolytics

Back 2

Xanax AKA alprazolam

Front 3

First-generation antipsychotic medications are referred to as this. Second-generation antipsychotic medications are also known as this.

Back 3

First generation AKA typical

Second generation AKA atypical

Front 4

These antipsychotic medications often have a longer half-life and can be given Depo

Back 4

Typical, first generation antipsychotics

Front 5

These antipsychotics often have a shorter half-life and are beginning to be able to be given Depo

Back 5

2nd generation, atypical antipsychotics

Front 6

Antipsychotic with a 3-day half life

Back 6

Haldol

Front 7

Antipsychotic with a 30 hour half life

Back 7

Risperidone

Front 8

many psychiatric medications are given orally and some are given parenterally, usually by IM route. Only rarely are they given by IV or Sub-Q.

Back 8

True

Front 9

The time that it takes for plasma concentrations of a drug to decrease to half of an initial value

Back 9

Half life

Front 10

Most psychiatric drugs act on the central nervous system and must therefore leave the bloodstream to enter the interstitial fluid, the cerebrospinal fluid and or the cells of the brain. This makes it difficult for some medications to do this

Back 10

Cross the Blood-brain barrier

Front 11

Most psychiatric drugs have their effect either because they bind to a specific brain receptor or because they have an effect on one or more brain neurotransmitter systems

Back 11

True

Front 12

This group of drugs are administered to control the symptoms of psychosis such as hallucinations and bizarre paranoid behaviors.

Back 12

Antipsychotic drugs

Front 13

These drugs calm the patient without sedation or reduction in alertness

Back 13

Antipsychotic drugs

Front 14

Since many medically induced psychotic states are transient, treatment may not be necessary for brief or mild psychosis.

Back 14

True

Front 15

The major psychotic disorders, schizophrenia and manic depressive psychosis respond well to antipsychotics

Back 15

True

Front 16

Symptoms for which these medication treatments are used include hallucinations, delusions and disorganized thought processes including paranoia

Back 16

Antipsychotics

Front 17

Negative symptoms of schizophrenia respond well to classical antipsychotics

Back 17

False, negative symptoms of schizophrenia do not respond to classical antipsychotics

Front 18

This anti-psychotic medication has been shown to be significantly more effective than other atypical antipsychotics and is used for treatment of?

Back 18

Refractory schizophrenia

Front 19

The term neuroleptic is an older term for antipsychotic

Back 19

True

Front 20

Second generation antipsychotics have different and often fewer side effects than first generation, and they are often considerably more costly

Back 20

True

Front 21

This anti-psychotic medication May effectively treat psychotic clients not helped by classical agents but it comes at the risk of occasional life-threatening bone marrow depression, and potential of some cardiac complications as well as dose-dependent lowering of seizure threshold

Back 21

Clozapine

Front 22

All of the currently available antipsychotic drugs are well absorbed when given orally or by IM injection. Injection typically produces significant clinical effects within 15 to 30 minutes whereas oral Administration may take this long

Back 22

1 to 4 hours

Front 23

Some first-generation antipsychotic drugs such as fluphenazine and Haldol all have been specifically formulated to have a very long duration of action. These long-acting drugs are given by injection only and are manufactured in a preparation of drug dissolved in sesame oil. The sesame oil slows the diffusion of the drug into adjacent muscle and as a consequence absorption is significantly delayed

Back 23

Depot method

Front 24

This second-generation antipsychotic is now marketed in an injectable form using microspheres rather than sesame oil

Back 24

Risperidone

Front 25

All of these class of drugs bind to brain dopamine receptors and probably as a result of that binding produce a degree of indifference to both external and internal stressful stimuli

Back 25

Antipsychotics

Front 26

Indifference produced from these medications is associated with relatively little sedation or inhibition of pain responses and leads to a calming effect without reducing alertness or sensitivity to pain

Back 26

Antipsychotics

Front 27

Dependency does not occur with antipsychotic medications but clients should typically taper their use of these medications rather than stopped abruptly.

Back 27

True

Front 28

While second generation antipsychotics also have an effect on dopamine receptors they differ from first-generation drugs in also acting at receptors for this

Back 28

Serotonin

Front 29

Because antipsychotic drugs are most commonly metabolized by the liver other medications that affect the rate of hepatic drug detoxification may have an effect on anti-psychotic drug excretion

Back 29

True

Front 30

This medication may increase antipsychotic effects and lead to increased side effects

Back 30

Cimetidine, Tagamet

Front 31

The interaction between antipsychotics and cimetidine is particularly Troublesome since cimetidine is widely promoted for dyspepsia and is available without prescription

Back 31

True

Front 32

Anticonvulsant medications such as carbamazepine also called Tegretol, used either for seizure control or for mood stabilization, May lower plasma concentrations of antipsychotics

Back 32

True

Front 33

Very high levels of this may worsen psychosis despite antipsychotic Administration

Back 33

Caffeine

Front 34

These over the counter medications especially in gel forms May decrease oral anti-psychotic drug absorption and should not be administered within 4 hours of an antipsychotic dose

Back 34

Antacids

Front 35

Antipsychotics are excreted in breastmilk so that breastfeeding is contraindicated when these medications must be used following delivery

Back 35

True

Front 36

Potentially Troublesome side effects of these antipsychotics include constipation, dry mouth, blurred vision, postural hypotension, urinary hesitancy or retention and, sedation

Back 36

First generation antipsychotics

Front 37

Side effects from these antipsychotics vary among agents but weight gain has proven among the most Troublesome complications

Back 37

Second generation antipsychotics

Front 38

These two antipsychotics seem to be the worst offenders in terms of weight gain, lipids and risk for diabetes

Back 38

Olanzapine and clozapine

Front 39

These antipsychotics frequently produce a variety of movement disorders including akathisia, dystonia, drug-induced parkinsonism and tardive dyskinesia

Back 39

First generation antipsychotics

Front 40

Data suggest that atypical antipsychotics generally cause movement disorders less frequently than first generation antipsychotics

Back 40

True

Front 41

A black box warning associated with sudden death in the use of these medications in the elderly treated for dementia related psychosis has been placed

Back 41

Antipsychotics

Front 42

These medications are used mostly for schizophrenia however we are seeing an increase in other usage such as with bipolar, autism irritability, Tourette's syndrome and severe refractory behavioral problems

Back 42

Antipsychotics

Front 43

Some of these medications are used for positive symptoms While others have been developed in use for both positive and negative symptoms

Back 43

Antipsychotics

Front 44

Remember psychosis is different than schizophrenia, psychosis is this kind of disorder.

Back 44

Emotional disorder

Front 45

These individuals are often depressed and Confused, have insomnia and are neglectful of self. Approach must be appropriate, not like everyone else.

Back 45

Antipsychotics

Front 46

Head to toe assessment and mmse prior to medication ordering, include assessment for suicidal ideation

Back 46

Antipsychotics

Front 47

These medications interact with alcohol, antihypertensives, opioids, levodopa, thiazides and Tegretol

Back 47

Antipsychotics

Front 48

Antidepressants, antileptics, hypnotics, antihistamines, antipsychotics, anxiolytics

Back 48

Help with sleep

Front 49

Caffeine, cardio medications, steroids, antimannics,

Back 49

Don't help with sleep

Front 50

How do I lower the risk of death with patients who have dementia

Back 50

Do not give antipsychotics

Front 51

Before giving medications in psychopharmacology it is important to do Baseline for later comparison. Then at least every 3 months check blood pressure, BCG, EKG and lipids

Back 51

True

Front 52

Ssris as well as SSNIs are usually quite safe but do have this common side effect

Back 52

Sexual side effects in 50%

Front 53

With these disorders the amygdala is malfunctioning, as we age atrophy and volume depletion occur

Back 53

Anxiety disorders

Front 54

Related to cognitive issues such as how one perceives a situation

Back 54

Anxiety

Front 55

Drugs for treating mood disorders are used either to treat depressed mood with this medication or to treat Mania with these medications

Back 55

Antidepressants

Mood stabilizers

Front 56

Medication is an attempt to balance mood and decrease episodes

Back 56

Anti manic treatments

Front 57

Triad of treatment drugs for anti manic

Back 57

Antidepressants, antipsychotics and or mood stabilizers

Front 58

Minimize symptoms, reduce cycling and help prevent recurrence

Back 58

Mood stabilizers

Front 59

Three principally used medications for anti manic

Back 59

Lithium, Depakote, Tegretol

Front 60

In acute situations of mania what are we trying to affect

Back 60

Euphoria, psychosis, cycling

Front 61

In ACUTE situations of depression what are we trying to affect

Back 61

Profound sadness. In this instance never use antidepressants alone they can be added later after a mood stabilizer

Front 62

With anti manic therapy long-term prevention is to achieve balance. What therapy is preferred here

Back 62

Mono therapy

Front 63

Adhere to diet

Stay on medication

Report SE: GI, sedation, confusion, weight gain, cardiac

Sometimes we only treat the Mania!

Might add antipsychotics

Back 63

What the Patient needs to know about anti manic treatment

Front 64

These medications affect lithium

Back 64

Diuretics

Front 65

These medications affect antieleptics

Back 65

Tylenol and ssris

Front 66

Take same time each day with food

Back 66

Lithium

Front 67

Diet is important! Thyroid and kidney abnormalities are an issue

Back 67

Lithium

Front 68

What is the therapeutic range and half life of lithium

Back 68

.6 to 1.2

Half-Life 24 hours

Front 69

Hydration is important

Back 69

Lithium

Front 70

These are known to cause lithium toxicity

Back 70

Thiazide diuretics, ACE inhibitors and NSAIDs

Front 71

Often replaced with lamotrigine

Back 71

Lithium

Front 72

These side effects of lithium should be reported immediately

Back 72

Tremors, confusion and excessive tiredness

Front 73

3 antieleptic medications

Back 73

Lamotrigine/ Lamictal

Valproic acid / Depakote

Carbamazepine / Tegretol

Front 74

BP maintenance, depression, seizures, migraines

Back 74

Lamotrigine / Lamictal

Front 75

N / V, tremor, Vision issues , HA, Steven Johnson syndrome

Back 75

Side effects of Lamotrigine / Lamictal

Front 76

Take with water, breaking the pills is okay, do not double up

Back 76

Lamotrigine / Lamictal

Front 77

You might lose your hair

Back 77

Valproic acid / Depakote

Front 78

Take with food, do not open or Crush, no milk or colas with this medication

Back 78

Valproic acid / Depakote

Front 79

N / V, tremor, Vision issues, headache, Steven Johnson syndrome

Back 79

Carbamazepine / Tegretol

Front 80

Take with food and at night

Back 80

Carbamazepine / Tegretol

Front 81

Used in extreme Mania with lithium

Back 81

Antipsychotics with mood disorder

Front 82

Remember sleep, eat and hydrate

Back 82

Antipsychotics with mood disorder

Front 83

Speak clearly, calmly and quietly. If they are hearing voices try to get them to listen to you not them

Back 83

Schizophrenia

Front 84

Depression of the central nervous system, few actions outside of this

Back 84

Anti-anxiety medication

Front 85

Affect our stress response and cortisol, reducing anxiety in the limbic system

Back 85

Anti-anxiety medication

Front 86

Alters Gaba receptors, they work on Gaba

Back 86

Anti-anxiety medication

Front 87

Intensify the effects of Gaba increasing relaxation

Back 87

Benzos

Front 88

Quickly absorbed in less than 30 minutes and cross the blood-brain barrier fast

Back 88

Anti-anxiety medication

Front 89

These decrease norepinephrine and dopamine levels

Back 89

Anti-anxiety medications

Front 90

Short time anxiety use

Back 90

Benzos

Front 91

Insomnia, agitation, severe grief, severe panic, seizures

Back 91

Uses for benzos

Front 92

This combination of medications is deadly

Back 92

Benzos and opiates

Front 93

Three medications for anxiety that are not benzos

Back 93

Buspirone / Gabapentin / pregabalin

Front 94

Zolpidem / Lunesta

Back 94

Hypnotics used in treatment of anxiety

Front 95

Psychological dependence, psychomotor impairment

Back 95

negatives of anti-anxiety meds

Front 96

Dizziness, decreased blood pressure, depressed respirations

Back 96

Side effects of benzos

Front 97

Dependence on medication

Back 97

Side effects of benzos

Front 98

Dysfunction of liver

Back 98

Side effects of benzos

Front 99

Dyscrasias of the blood

Back 99

Side effects of benzos

Front 100

Rise slowly / dangle

Back 100

Education for benzos

Front 101

Avoid Alcohol and Other CNS depressants

Back 101

Education with benzos

Front 102

Avoid psychomotor activities

Back 102

Education with benzos

Front 103

Advice to wear medical alert bracelet

Back 103

Education with benzos

Front 104

May interact with tricyclics, calcium channel blockers, anti-epileptics, antipsychotics, ssris , antifungals, antibiotics, oral contraceptives

Back 104

Benzodiazepines

Front 105

7 food and supplement interactions with benzodiazepines

Back 105

Alcohol

Antacids

Food

Grapefruit juice

Nicotine

St John's Wort

Kava-kava

Front 106

5 types of patients who should not take benzodiazepines

Back 106

Substance abuse disorder

Sleep apnea

Hepatic disease

Elderly

Methadone or opiate use

Front 107

CBT is highly effective in this

Back 107

Anxiety

Front 108

No respiratory depression if taking alone, if combined with other CNS depressants there is a profound impact

Back 108

Benzos

Front 109

Major issue or minor issue, length of time and symptoms are imperative to diagnosis and prescribing in drug selection choices

Back 109

Antidepressants

Front 110

If minor medication is not always needed

Back 110

Antidepressants

Front 111

All antidepressants are effective with difference in side effects, cost and interactions

Back 111

True

Front 112

Monoamine neurotransmitters

Back 112

Serotonin and norepinephrine

Front 113

Five broad categories for antidepressants

Back 113

SSRI, Paxil

Snri, Effexor

Tricyclics, imipramine

MAOI inhibitors, phenelzine

Atypicals, buprion

Front 114

Step one in antidepressant medication therapy

Back 114

Ssris such as Prozac or Zoloft

Front 115

Chosen by symptoms, example if you have fatigue choose a CNS stimulant like Paxil

Back 115

Ssris

Front 116

Decreased libido, weight gain, bruxism

Back 116

SSRI

Front 117

Can be taken with or without food and they have a short half-life

Back 117

Ssris

Front 118

If insomnia is a problem take first thing in the morning

Back 118

SSRI

Front 119

Therapeutic effects may take 2 to 6 weeks

Back 119

Ssris

Front 120

Antacids, St John's Wort, Tagamet, Warfarin and maois

Back 120

Interact with ssris

Front 121

Step2 in antidepressant therapy

Back 121

Ssni such as effexor and Pristiq

Front 122

Take with or without food, short half-life, may cause blood pressure issues

Back 122

Ssni

Front 123

Ssris are better tolerated than these

Back 123

Ssni

Front 124

Small doses with big dangers

Back 124

Tricyclics

Front 125

Increased side effects of sedation, anticholinergic, orthostatic hypotension and cardiac toxicity if overdosed

Back 125

Tricyclics

Front 126

Lowers seizure threshold, long half-life

Back 126

Tricyclics

Front 127

Sometimes given for chronic pain, bipolar, chronic insomnia

Back 127

Tricyclics

Front 128

Interacts with multiple over the counter medications in a negative manner. Give one week at a time!

Back 128

Tricyclics

Front 129

Lethal dose can be 8 times the therapeutic dose versus ssris 30 therapeutic doses is non-lethal

Back 129

Tricyclics

Front 130

Second or third choice drug in depression

Back 130

MAOIs

Front 131

Can cause direct CNS stimulation and increased anxiety and even Mania

Back 131

Maois

Front 132

No additional medications of any kind should be given

Back 132

Maois

Front 133

Peripheral neuropathy, photosensitivity, agitation / anxiety / insomnia, decreased heart rate

Back 133

Maois

Front 134

Medical alert bracelet, risk for Falls

Back 134

Maois

Front 135

Seven food interactions with maois

Back 135

Sharp cheddar / aged Cheese's

Salami

Sauerkraut

Red wine and beers with yeast

Caviar

Fava beans

Avocados especially over ripe

Front 136

List an atypical antidepressant

Back 136

Wellbutrin

Front 137

Blocks dopamine and norepinephrine, is more of a stimulant

Back 137

Wellbutrin

Front 138

Given if the patient cannot tolerate ssris or SSNIs

Back 138

Wellbutrin

Front 139

Weight gain, cardiac concerns, cholesterol increase

Back 139

Wellbutrin

Front 140

Major uses for Wellbutrin

Back 140

Major depressive disorder and seasonal affective disorder

Front 141

Half-Life is one day can be taken with or without food

Back 141

Wellbutrin

Front 142

Caused by decay, pickling, fermentation of foods

Back 142

Tyramine

Front 143

The major excitatory neurotransmitter of the CNS

Back 143

Glutamate