Mental Med Quiz

psychopharm medication quiz

therapeutic range for lithium

0.6-1.2 during active phase or 0.8-1.2

agranulocytosis and Clozaril (clozapine)

clozapine suppresses bone marrow and can cause neutropenia (low WBC)

signs of lithium toxicity

confusion, hyperirritability of muscles, sedation, coarse hand tremor

ataxia, blurred vision, clonic movements, seizures

convulsions, fever, cardiac arrhythmias, coma

neuroleptic malignant syndrome

caused by excessive dopamine depletion

muscle rigidity, elevated temp, altered mental status, diaphoresis

stop offending meds, transfer to critical care, order brain scan → reduce body temp, protect muscles, iv fluids, cardiac monitoring

side effects of conventional antipsycotics

dry mouth

urinary retention and hesitancy

constipation

blurred vision

dry eyes

sexual dysfunction

anticholinergic toxicity

pseudoparkinsonism

acute dystonic reactions

akathisia

tardive dyskinesia

hypotension/orthostatic hypotension

tachycardia/irregular pulse

severe neutropenia

cholestatic jaundice

neuroleptic malignant syndrome (NMS)

metabolic syndrome

depot and decanoate preparations

long acting injectable (LAI)

for sustained release of medication over extended period

depot = into muscle or under skin for slow release from area into bloodstream

decanoate = specific type of depot formula (lipophilic side chain)

tricyclic antidepressants and cardiac toxicity / glaucoma

TCAs block sodium channels on heart → fatal secondary to cardiac conduction disturbances

contraindicated in recent MIs and glaucoma = anticholinergic effects makes pupils dilate which increases pressure

tyramine restrictions with monoamine oxidase inhibitors (MOAI)

foods with tyramine taken with MOAI can cause hypertensive crisis

ex: fermented meats, pizza, beer, yeast

S/S: flushed face, sudden increase BP, explosive occipital headache, palpitations, sweating, dilated pupils

side effects of Depakote (divalproex sodium) and therapeutic range

50 - 100 mcg/mL

sedation, weight gain, tremor, thrombocytopenia, pancreatitis, hepatic failure, nausea, weakness, indigestion, vomiting, dizziness

Lamictal (lamotrigine) side effects

for bipolar depression - inhibit sodium channels and modulates release of excitatory neurotransmitters

stevens johnsons syndrome, dizziness, headache, diplopia, ataxia, blurred vision, nausea, somnolence,

Effexor (venlafaxine) and BP issues

can raise blood pressure → contraindicated in high blood pressure pt

norepinephrine reuptake blockade = more norepinephrine = sympathetic nervous system = fight or flight

Wellbutrin (bupropion) and seizures

lowers seizure thresholds → cause neuronal hyperexcitability

Geodon (ziprasidone) and absorption

to be taken with a bigger meal with fat content in order to help the absorption and increase bioavailability bc it is lipid soluble

advantages of Abilify (aripiprazole) over other new gen antipsycotics

people tend to gain less weight

psychopharmacological effect of Narcan (naloxone)

narcan competes with heroin for receptors controlling respiration to prevent respiratory depression

what group of pt do we NOT want to prescribe benzodiazepines

pts with substance use disorders → additive effects

proper Ritalin (methylphenidate) admin in relation to sleep

given in morning → stimulant

no later than 4 pm

benzodiazepines used for

anti anxiety, hypnotic, anticonvulsant, amnestic, muscle relaxant → CNS depressant effects

prevent alcohol withdrawal symptoms

anticonvulsants and bipolar disorder related

anticonvulsant properties = alteration of electrical conductivity in membranes

→ membrane stabilizing effect = reduced mood swings in bipolar disorder

akathisia relates to antipsychotics

side effect of first gen antipsychotics → extrapyramidal side effects (EPS)

motor restlessness, rocking, pacing, inability to stand or sit still

Benzodiazepines

alprazolam (Xanax)

clonazepam (Klonopin)

diazepam (Valium)

lorazepam (Ativan)

SSRIs

fluoxetine (Prozac)

sertraline (Zoloft)

paroxetine (Paxil)

citalopram (Celexa)

escitalopram (Lexapro)

fluvoxamine (Luvox)

MAOIs

henelzine (Nardil)

tranylcypromine (Parnate)

mood stabilizers

lithium

valproate (Depakote)

lamotrigine (Lamicatal)

antipsychotics

clozapine (Clozaril)

aripiprazole (Abilify)

ziprasidone (Geodon)