Pharm II Exam 1

sedation

what is the main adverse effect of benzodiazepines?

fatigue, sleepiness, dizziness

what are the signs of CNS depression

paradoxical

what type of reaction can be seen as an adverse reaction with benzodiazepines

makes them hyper

paradoxical reaction in children when taking benzodiazepines

short

is benzodiazepines administered for short or long periods of time

PO, IV, or IM

how can benzodiazepines be administered

respiratory rate

what should definitely be monitored with benzodiazepines

slowly 5 mg/min

how should benzodiazepines be administered by IV

flumazenil

what is the antidote to benzodiazpeines

benzodiazepine receptor antagonist

what is flumazenil

diazepam and alprazolam

what are 2 examples of benzodiazepines

buspirone

what is an example of a non-benzodiazepine

2-4 weeks

how long does it take buspirone to reach therapeutic level

long

is buspirone administered for short or long periods of time

insomnia, anxiety, and restlessness

what are some paradoxical effects of buspirone

GI upset, headache, dizziness, lightheadedness

side effects of buspirone

GABA

what does benzodiazepine inhibit the effect of

non-benzodiazepines

bind to seratonin and dopamine receptors, increases norepinephrine metabilism

no

do non-benzodiazepines interact with other CNS depressants

food

what should you take non-benzodiazepines with

grapefruit juice

what should you avoid taking with non-benzodiazepines

very addictive

why are benzodiazepines not used long term

decreased LOC, reduced muscle contraction, respiratory depression, death

what could happen if benzodiazepines are taken with other CNS depressants

caffeine, cold meds, appetite suppressants, alcohol

what should a pt be told to avoid when taking benzodiazepines

tapered

should benzodiazepines be tapered or can it be stopped abruptly

depression

associated with an imbalance of neurotransmitters in regions of the brain associated with focused attention and emotion, sensory processing, and arousal

selective seratonin reuptake inhibitors

what does SSRI stand for

Prozac

example of an SSRI

amitriptyline

example of TCAs

Tricyclic antidepressants

what does TCA stand for

Monoamine oxidase inhibitors

what does MAOIs stand for

serotonin-norepinephrine reuptake inhibitors

what does SNRIs stand for

Nardil

what is an example of an MAOI

Effexor XR

what is an example of SNRIs

Wellbutrin

what is an example of an atypical antidepressants

SSRIs, MAOIs, TCAs, SNRIs, Atypical antidepressants

what are the types of drugs that are taken for depression

1 to 4 weeks

about how long do antidepressants take to reach therapeutic effect

insomnia, orthostatic hypotension, anticholinergic effects, weight gain

common side effects of antidepressants

morning

what time of the day should antidepressants be taken

dry mouth, constipation, urinary retention, blurred vision

what are exampels of anticholinergic effects

St.John's Wart

never mix SSRIs with ____

antidepressants

don't mix MAOI with _____

potential for increased suicidal ideation and aggression

black box warning for antidepressants

TCAs

blocks the reuptake of norepinephrine and serotonin

people with cardiovascular issues

TCAs are containdicated for what group of people

CNS depression and photophobia

side effects of TCAs

toxicity

adverse reactions of TCAs

dysrhythmias, mental confusion, agitation, seizures

signs of toxicity with TCAs

bedtime

when should TCAs be taken

activities that require mental alertness

what should patients taking TCAs avoid

maintain fiber and fluid intake

how should a patient try and stop anticholinergic effects

SSRIs

selectively blocks reuptake of serotonin

insomnia, nervousness

signs of CNS excitation

tapering

what helps SSRI discontinuation syndrome

sexual dysfunction, weight gain, insomnia, bruxism, hyponatremia

side effects of SSRI

grinding of teeth

what is bruxism

water rention -- weight gain

what is hyponatremia

sweaty, hot, fever

what does the second S stand for with serotonin syndrome

rigid muscles, restlessness, agitation

what does the second R stand for with serotonin syndrome

increased heart rate

what does the second I stand for with serotonin syndrome

CNS symptoms, psychological symptoms, vivid dreams

signs of SSRI discontinuation syndrome

SSRIs

SNRIs have all the similar side effects to ___

any foods containing tyramine

what foods should you avoid when taking MAOIs

aged cheese, smoked meats, avocados, figs, bananas, smoked and cured fish, soy sauce, some beer and red wine, pickled products

what are some examples of thyramine-rich foods

MAOIs

there is a massive hypertensive crisis risk with ____

2 weeks prior and 2 weeks after med started/stopped

when should tyramine be avoided when taking MAOIs

calcium, antacids, acetaminophen, NSAIDs, other antidepressants

what other drugs to avoid when taking MAOIs

suicide

there is an increased _____ risk when taking MAOIs, especially in children, adolsecents, and young adults

morning

what time should atypical antidepresants be taken

patients with seizure disorders

what are atypical antidepressants contraindicated for

lithium carbonate

most common mood stabilizer used

mania

what does lithium carbonate particularly help with

confusion, lethargy, slurred speech, increased reflexes, seizures

whta are the signs of toxicity of lithium carbonate

sodium intake

lithium carbonate is very sensitive to ____

fine hand tremors, anorexia, weight gain, find hand tremors, renal toxicity

what are some of the side effects of litium carbonate

dehydration

what could cause an issue with sodium intake while on lithium carbonate

food or milk

what should lithium carbonate be administered with

jaundice

what to look out for with taking valproic acid

depakote, depacon, depakene

types of valproic acid

weakness, facial edema, anorexia, vomiting, jaundice

signs of hepatotoxicity with vaproic acid

bleeding and bruising

thrombocytopenia

low platlelet count

what is thrombocytopenia caused by

carbonated drinks

what should you not mix valproic acid with

liver function and CBC

what lab results should be monitored for a patient on valproic acid

acute dystonia, akathisia, secondary parkinsonism, tardive dyskinesia

examples of extrapyramidal symptoms

acute dystonia

severe painful spasms of the neck and body

akathisia

restlessness and unconftrolable need for constant motion

secondary parkinsonism

muslce rigidity, tremors, and sluggish movements

tardive dyskinesia

writhing movements of the tongue and neck

extrapyramidal symptoms, anticholinergic effects, hypotension, neuroleptic malignant syndrome, sedation, sexual dysfunction

side effects of chlorpromazine

chlorpromazine

example of traditional antipsychotics

beta blocker

antidote to akathisia

dyphenhydramine

antidote to acute dystonia

anticholinergic

antidote to parkinsonism

benzodiazepine

antidote to tardive dyskinesia

fever and rigid muscles

signs of neuroleptic malignant syndrome

pre diabetics or type 2 diabetics

what is risperdal contraindicated for

CNS depression, weight gain, metabolic syndrome

adverse reactions of risperdal

increase exercise and monitor blood glucose

interventions for risperdal

low fat, low carb diet

what should the nutrition of someone on risperdal include