Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
55 Cards in this Set
- Front
- Back
what is the moa of the typical antipsychotics?
|
block D2 receptors; also tends to block more peripheral dopamine rec
|
|
what are the side fx/nursing considerations for typical antipsychotics?
|
common side fx, delayed onset of action, prolactin inc, route of delivery
|
|
what is the moa for atypical antipsychotics?
|
block D2, 5-HT2 receptors
|
|
what are the side fx/nursing considerations for atypical antipsychotics?
|
wt gain, akathisia
|
|
what are the 4 receptors associated with "low-potency" antipsychotic action?
|
endocrine, muscarinic, histamine, alpha-adrenergic
|
|
what is potency a keyword for in antipsychotics?
|
SIDE EFFECTS
|
|
what are the 2 major classes of side fx assoc. w antipsychotics?
|
extrapyramidal (primary) | autonomic (anticholinergic, antiadrenergic)
|
|
what are some common concerns about admin antipsychotics?
|
cheeking, onset/duration of action, peripheral sidefx
|
|
what is akathisia?
|
inner restlessness, inability to sit still/be still. assoc w parkinsons, opioid withdrawal, and antipsychotic admin
|
|
which is the "dirty drug?"
|
olanzepine, blocks many diff. receptor types
|
|
typical antipsychotics, common ():
|
decanoate salt/fluphenazine, prochlorperazine, haloperidol, -azines
|
|
what is tardive dyskinesia?
|
most severe movement disorder, side fx of typical antipsychotics; non-reversible.
|
|
what characterizes tardive dyskinesia?
|
oral-facial dyskinesia and wide-spread choreoathetosis are characteristic
|
|
how do pt gain wt on typical antipsychotics?
|
hyperglycemia
|
|
impaired thermoregulation is a side fx of typical antipsychotics (T/F)
|
TRUE
|
|
what are contraindications for typical antipsychotics?
|
homeless pt, parkinsons
|
|
blocking dopamine has what side fx? (3)
|
dyskinesia, akathisia, tardive dyskinesia
|
|
blocking endocrine rec has what side fx? (3)
|
prolactin inc, menstrual changes, sexual dysfunction
|
|
blocking muscarinic rec has what side fx? (3)
|
blurry near vision, CI narrow-angle glaucoma, dec SLUDGE problems
|
|
blocking alpha rec has what side fx? (3)
|
orthostatic hypotension, lightheadedness, reflex tachy
|
|
atypical antipsychotics help with both pos and neg symptoms (T/F)
|
TRUE
|
|
atypical antipsychotics have a lower incidence of what?
|
motor side fx | weaker dopa side fx
|
|
what serious problems does clozapine have assoc?
|
fatal aplastic anemia | agranulocytosis
|
|
what are some common atypical antipsychotics?
|
clozapine, risperidone, olanzepine
|
|
clozapine
|
atypical antipsychotic, last resort drug
|
|
risperidone
|
atypical antipsychotic, more portent than haloperidol, has antichol side fx (but side fx profile better and less severe)
|
|
olanzepine
|
dirty drug; interacts with many rec types, produces many side fx | heavy sedation
|
|
atypical antipsychotics modify cardiac condition how?
|
mild prolonging QTc interval
|
|
what are the classes of rx for depression/mania?
|
SSRI, dopa reuptake blocker, MAOI, NE/5-HT reuptake blockers
|
|
what are the generic classes of affective disorders?
|
depression | elation | depression+elation
|
|
what are vegetative fx?
|
impaired sleep, energy and appetite.
|
|
which depressive fx recover first upon admin of antidepressant?
|
vegetative fx. WARNING: leads to suicidal pt now having the ability to act out their ideation.
|
|
fluoxetine
|
prozac; SSRI prototype, inhibits P450, very long DoA
|
|
side fx of fluoxetine
|
nausea, insomnia, nervousness, headache, anxiety; sexual problems
|
|
drug interactions w SSRIs
|
MAOIs, buspirone (counters sexual dysfunction), protein binding, enzyme metabolism
|
|
sertraline
|
SSRI; less potent than fluoxetine, inhibits P450 system
|
|
bupropion
|
dopa reuptake blocker; OoA 2-4 wks
|
|
who is bupropion for?
|
smokers, depressed pt who resistant to other antidepressants/can't tolerate side fx
|
|
venlefaxine
|
blocks reuptake of NE and 5-HT; side fx like SSRIs, can inc BP
|
|
duloxetine
|
blocks reuptake of NE and 5-HT; used for neuropathic and chronic pain; side fx: dizziness and fatigue
|
|
mirtazapine
|
blocks inhibitor NE rec (to the release of NE and 5-HT); has to be taken at bedtime as it is sedating, causes wt gain
|
|
amitriptyline
|
tricyclic antidepressant;
|
|
MoA of tricyclic antidepressants?
|
enhances activity of NE and 5-HT by inc avail at synapse; they vary in relative potency and ability to block reuptake of each
|
|
off-label uses of tricyclics?
|
childhood enuresis, agoraphobia
|
|
most serious side fx of tricyclics?
|
cardiac, orthostatic bp, arrhythmias, heart block, sedation, renal/hepatic impairment
|
|
drug interactions, tricyclics?
|
MAOIs (HTN crisis), CNS depressants (additive)
|
|
lethal dose for tricyclics (ct therapeutic dose)
|
10-30x normal dosage
|
|
serious side fx/complications for MAOIs
|
CNS hyperstim, low BP, anticholinergic fx, hepatic/hematological dysfunction
|
|
HTN crises occur with...
|
MAOIs + cough/cold/allergy/wt loss meds; CNS stims; TCAs
|
|
mania tx, prototype
|
lithium
|
|
lithium
|
peak serum 1-3 hrs; no fx until 5-10 days
|
|
what can modify lithium serum levels?
|
Na intake/elimination; red. Na intake or inc Na elim will prolong Li halflife
|
|
drug interactions with Li
|
anesthesia acts differently when on Li, diuretics dec HL, pancuronium fx prolonged by Li
|
|
complications with Li
|
narrow therapeutic range (0.6-1.5 mEq/L), toxic level (1.5-2.0 mEq/L)
|
|
lithium toxicity usually occurs in what pt... and how?
|
bipolar pt; they go off Li to stimulate a manic ep... then go back on when they feel out of control. (OoA takes 5-10 days.) So they overdose.
|