Studied by 7 people
Looks like no one added any tags here yet for you.
What are 3 non-pharmacological methods to treat psychotic disorders?
bio feedback
relaxation techniques
cognitive behavioural therapy
What kind of antipsychotics have the most risk of extrapyramidal symptoms?
1st generation antipsychotics, ‘typical’
What type of antipsychotic has fewer side effects?
2nd and 3rd generation antipsychotics, ‘atypical’
What do atypical antipsychotics increase the risk for?
Increased risk for type 2 diabetes
What are examples of extrapyramidal symptoms? (4)
Acute dystonias
Akathisia
Pseudoparkinsonism
Tardive dyskinesia
What would the symptoms of lip smacking, worm-like movements of the tongue, uncontrolled chewing and grimacing indicate when taking antipsychotics?
Tardive dyskinesia
What would the symptoms of tremor, muscle rigidity, and stooped posture indicate when taking antipsychotics?
Pseudoparkinsonism
What would the symptoms of inability to rest and relax, and pacing indicate when taking antipsychotics?
Akathisia
What would the symptoms of muscle spasms of the face, tongue, neck, and back indicate when taking antipsychotics?
Acute dystonia
What would the symptoms of dry mouth, tachycardia, and blurred vision indicate when taking antipsychotics?
Anticholinergic effects
What would the symptoms of high fever, confusion, muscle rigidity, and high serum creatine kinase indicate when taking antipsychotics?
Neuroleptic malignant syndrome
How to the atypical antipsychotics Phenothiazines work?
They interrupt dopamine + serotonin pathways in the brain
What type of antipsychotic works best for positive symptoms?
Typical, or 1st generation antipsychotics
What type of antipsychotic treats both positive and negative symptoms?
Atypical antipsychotics
What are adverse effects of atypical antipsychotics? (4)
Weight gain
Decreased libido
Osteoporosis
Change in glucose metabolism (if diabetic watch sugars)
What do anxiolytics affect?
works on the CNS
What are 4 classes of CNS depressants used to treat anxiety?
Antidepressants
Benzodiazepines
Nonbenzodiazepine anxiolytics
Barbiturates
What is rebound insomnia?
Insomnia caused by discontinuation of a long-used sedative drug
What is electroencephalogram (EEG)?
A tool for diagnosing sleep disorders, seizure activity, depression, and dementia
What are indications for the use of benzodiazepines? (5)
Insomnia caused by anxiety.
Seziure disorders.
Alcohol withdrawal.
Central muscle relaxation.
Induction agent in anesthesia.
What is the mechanism of action for benzodiazepines?
Binds to GABA receptor-chloride channel molecule, which intensifies the effects of GABA
What are adverse effects of benzodiazepines? (3)
Drowsiness
Dizziness
Respiratory depression
Why are barbiturates rarely prescribed anymore?
Low therapeutic index, very easy to overdose
How long does it take for antidepressants to relieve anxiety symptoms?
4-6 weeks
What classes of antidepressants are used to reduce symptoms of anxiety? (4)
Tricyclic antidepressants (TCAs)
Monoamine oxidase inhibitors (MAOIs)
Selective serotonin reuptake inhibitors (SSRIs)
Atypical antidepressants
What are some side effects of SNRIs? (4)
Weight loss
Sexual dysfunction
Abnormal dreams
Constipation
Who cannot take tricyclic antidepressants (TCAs)?
Patients with heart block, arrhythmias, or history of heart attacks
What are side effects of tricylic antidepressants? (6)
Dry mouth
Blurred vision
Urine retention
Hypertension
Anticholinergic effects
Cardiac dysrhythmias
What should people taking monoamine oxidase inhibitors (MAOIs) avoid?
Foods containing tyramine (cheese, wine, pickled foods)
What are common adverse effects of monoamine oxidase inhibitors (MAOIs)? (3)
Orthostatic hypotension
Headache
Diarrhea
What are adverse effects of SSRIs? (6)
Sexual dysfunction
Nausea
Headache
Weight gain
Anxiety
Insomnia
What are sympathomimetic effects?
Cardiovascular side effects including tachycardia, hypertension, heart attack and stroke.
What antidepressant drug is contraindicated in patients who have seziures?
Wellbutrin (NDRI)
How do tricyclic antidepressants work?
Blocks the reuptake of norep
What is the mmechanism of action of MAO Inhibitors?
decreases the effectiveness of monoamine oxidase
What can occur if someone taking MAOIs eats food containing tyramine?
Hypertensive crisis
What is the mechanism of action of lithium?
Affects sodium transport across cell membranes
What is an adverse affect of lithium?
excessive loss of sodium
What is important to remember for patients taking lithium?
It has a narrow therapeutic index, so regular bloodwork is needed
What drugs are used to treat bipolar disorder? (3)
Lithium
Valproic acid (antiseziure drug)
Risperidone (atypical antipsychotic drug)
What is the mechanism of action for CNS stimulants for ADHD?
acts as a norepinephrine and dopamine reuptake inhibitor (NDRI)
What are adverse effects of CNS stimulants (4)
Insomnia
Weight loss
Nervousness
Anorexia
What is a non-stimulant drug used to treat ADHD?
Norepinephrine reuptake inhibitors (NRIs)
What are the symptoms of hyperthyroidism? (5)
hyperactivity
insomnia
heat intolerance
fatigue
increased appetite but weight loss
What are the symptoms of hypothyroidism? (5)
hypothermia
decreased appetite but weight gain
dry skin + hair
fatigue
constipation
What is the pharmacologic treatment for hyperthyroidism? (2)
Antithyroid medications
Beta-blockers
What is the pharmacologic treatment for hypothyroidism?
Medications that replace thyroid hormone, like Levothyroxine
What is the treatment for thyroid storm?
thyroid storm = extreme case of hyperthyroidism
treatment = cooling, NO aspirin, fluid replacement
What is a goiter?
Enlarged thyroid gland
What is myxedema?
A life threatening complication of long untreated hypothyroidism
In primary thyroid disorders, what part is dysfunctional?
Thyroid
In secondary thyroid disorders, what part is dysfunctional?
Pituitary
In tertiary thyroid disorders, what part is dysfunctional?
Hypothalmus
What is the function of the pancreas?
Keeps blood glucose within normal range
What are the physiological actions of insulin? (3)
Promotes entry of glucose into cells
Provides storage of glucose
Inhibits breakdown of fat and glycogen
What is the cause of type 1 diabetes mellitus?
Caused by absolute lack of insulin secretion due to autoimmune destruction of pancreatic islet cells
What type of insulin is rapid acting?
Lispro / Humalog
What type of insulin has prolonged action?
Glargine / Lantus
How long does it take for rapid acting insulin to take effect?
10 - 20 mins
How long does it take for long acting insulin to take effect?
30 mins - 4 hours
How long does rapid acting insulin last?
3 - 5 hours
How long does long acting insulin last?
16 - 24 hours
When is rapid acting insulin usually administered?
At the start of a meal
When is short acting insulin usually administered?
30 - 60 mins before a meal
What is the preferred site for insulin injection?
Abdomen
What type of insulin can be used intravenously?
Regular insulin
What is the safest way to give insulin?
Insulin pen
What are signs and symptoms of hypoglycemia? (5)
sweating
tachycardia
confusion
drowsiness
convulsions
Which drugs can raise blood glucose levels? (4)
Phenytoin
NSAIDs
Diuretics
Corticosteroids
Which drugs can lower blood glucose levels? (3)
Lithium
ACE inhibitors
Beta-blockers
What is type 2 diabetes?
Pancreas can secrete some insulin, but the insulin receptors have become resistant
How do oral anti-diabetic medications treat type 2 diabetes?
Lowers blood glucose
What are the classes of oral anti-diabetic drugs? (6)
Sulfonylureas
Biguanides
Alpha-glucosidase inhibitors
Thiazolidinediones
Meglitinides
Incretin enhancers
How do sulfonylureas treat type 2 diabetes?
stimulates the release of insulin from pancreatic islet cells
What are adverse effects of sulfonylureas? (3)
Hypoglycemia
Weight gain
hepatotoxicity
Why are biguanides usually the first line of therapy for type 2 diabetes?
Do not cause weight gain and hypoglycemia
What is the only drug in the biguanide class?
Metformin
How do biguanides treat type 2 diabetes?
Decreases hepatic production of glucose and reduces insulin resistance
What are some side effects of biguanides? (2)
Usually GI related, like diarrhea and nausea
What is important to remember about biguanides?
Stop medication if getting IV dyes for radiological study
What is a rare and fatal adverse effect of biguanides?
Lactic acidosis
What is the onset of Metformin?
less than 1 hour
What is the duration of Metformin?
12 hours
How do alpha-glucosidase inhibitors treat type 2 diabetes?
Blocks enzymes in the small intestine that break down complex carbs
How do thiazolidinediones treat type 2 diabetes?
Reduce blood glucose by decreasing insulin resistance and inhibiting hepatic gluconeogenesis
How long does it take for thiazolidinediones to work optimally?
3-2 months
What are the common adverse effects of thiazolidinediones? (3)
fluid retention
headache
weight gain
How do meglitinides treat type 2 diabetes?
act by stimulating the release of insulin from pancreatic islet cells
How long is the duration of action for meglitinides?
2 - 4 hours
What is the most common adverse effect for meglitinides?
Hypoglycemia
How do incretin enhancers treat type 2 diabetes?
Mimic effects of incretins- hormones released into the blood by intestine in response to food to signal insulin secretion and stop glucagon production
What is nociceptive pain?
Pain caused by tissue damage
What is neuropathic pain?
Pain from damage to nerve cells
What is breakthrough pain?
Persistant pain that has been aggravated
What are clinical manifestations of pain? (4)
Increased BP, HR, and RR
Diaphoresis
Pallor
Dialated pupils
How does Acetaminophen treat pain?
Inhibits synthesis of prostoglandins
What is the difference between NSAIDs and Acetaminophen?
NSAIDs have anti-inflammatory properties, where Acetaminophen does not
What is the antidote to Acetaminophen?
Acetylcysteine
How do salicylates (Aspirin) treat pain?
Reduces the production of prostoglandins
What is important to remember about Aspirin?
Children should not take Aspirin due to the risk of Reye’s syndrome
Note 
Flashcard (175)