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