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SSRIs with MAOIs or multiple SSRIs at once causes this
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serotonin syndrom
-
hyptertensive crisis
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clozapine (Clozaril), olanzapine (Zyprexa) & resperidone (Risperdal) are
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haloperidol (Haldol) can cause
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Hypertensive crisis
-
Serotonin Syndrome
-
coma
-
Extra pyramidal symptoms
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MAOIs with decongestants/ cold medicines can cause
Antworten
-
Hypertensive crisis
-
Extra pyramidal symptoms
-
Serotonin Syndrome
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triazolam (Halcion) & flurazepam (Dalmane)
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fluoxetine (Prozac) & Sertraline (Zoloft) are
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imipramine (Tofranil) & amitryptiline (Elavil) are
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Lithium & depakote are
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Mood stabilizers
-
Atypical antipsychotics
-
Tricyclics
-
Anti-anxiety agents
Frage 9
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chlorpromazine (Thorazine) & thiothixine (Navane) are
Frage 10
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lorazepam (Ativan) & alprazolam (Xanax)
Antworten
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Mood stabilizers
-
Atypical antipsychotics
-
Tricyclics
-
Anti-anxiety agents
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benztropine (Cogentin) & trihexyphenidyl (Artane) are
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secobarbital (Seconal) & Pentobarbital (Nembutal) are
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Atypical antipsychotics
-
Mood stabilizers
-
Barbiturates
-
Anti-anxiety agents
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A decrease in serotonin can result in anxiety.
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Lithium carbonate can cause extrapyramidal symptoms.
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Children with ADHD respond atypically to Methylphenidate (Ritalin) than children without the diagnosis – instead of stimulation they calm and can focus.
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Extrapyramidal symptoms are caused by the blockage of norepinephrine at the synapse.
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Routine blood levels are taken on a client using haloperidol (Haldol).
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Eating aged cheese and minimal red wine is acceptable for clients taking Lithium carbonate but not those taking an MAO inhibitor.
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St. John’s Wort herbal medication has shown qualities of being an antidepressant; however, more clinical trials are needed.
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Fluoxetine (Prozac) is given at bedtime.
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Loarazepam is preferred over diazepam for short procedures or situations because the half-life is shorter.
Frage 22
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You will see more SSRIs used as a front-line drug of choice over the older tricyclics. Why?
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Clients can more easily overdose with the tricyclics because of cardiac involvement.
-
Tricyclics have more sedating and anticholinergic effects than the SSRIs.
-
SSRIs work faster to achieve a therapeutic response than the tricyclics (days as opposed to 2 weeks).
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Which of the following is a potential prescribed drug of abuse, often in the elderly?
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Carbamazepine (Tegretol) for sleep
-
Haloperidol (Haldol) for sleep
-
Alprazolam (Xanax) for anxiety
-
Risperadone (Risperdal) for confusion
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You receive a client to your floor from the ER after having received a large dose of Haldol. He is sleepy but begins to complain of being stiff and feels restless inside. What would you do?
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Call “Rapid Response.”
-
Call the MD, report the symptoms as likely EPS, and administer
-
Give more haloperidol (Haldol) PRN
-
Suggest a warm shower to relax (accompanied to prevent a fall)
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Your client has been ordered phenelzine (Nardil). What special patient-family teaching do you need to address?
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diet, use of other medications (over the counter ie cold meds), and blood pressure
-
lab draws for blood levels and diet
-
diet, exercise, and sexual activity
-
diet, exercise and lactation because weight gain is eminent
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Sarah has bipolar illness and begins taking Lithium. In your teaching, what is important to cover?
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the need for periodic blood levels because the therapeutic range is close to the mild toxicity range.
-
signs and symptoms of early toxicity verses side effects (weight gain is common)
-
the importance of taking the medicine and working with the doctor to find a comfortable therapeutic level – instead of self-stopping the medication.
-
all the above
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Which electrolyte are you most concerned with when a client is taking Lithium?
Frage 28
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Harry Potter is on the mental health unit because of hallucinations of Hogwarts, flying brooms and witches. He begins to become confused and disoriented, has decreasing loss of consciousness rapidly, holds himself stiff, and is very warm to touch. You take his vitals and he has high BP, and temperature of 103.2 F. What are you most concerned he has?
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-
Call rapid response because it is likely serotonin syndrome
-
Call rapid response because it is likely neuroleptic malignant syndrome
-
Call rapid response because it is likely an impending stroke
-
Call rapid response because it is likely sepsis
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Nicole, aged 30, is in the intensive outpatient program because of depressive symptoms with mild suicidal ideation. Which is the safest antidepressant for her?
Antworten
-
Risperidone (Risperdal)
-
Diazepam (Valium)
-
Sertaline (Zoloft)
-
Amitriptyline (Elavil)
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Marian, aged 68, has been started on Risperdal for agitation and delusions. What is she at risk for?
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-
hypertension- QT prolongation is a AE not SE
-
decreasing her dress size- weight gain
-
hypotension and falls- yes, orthostatic hypotension
-
sexually transmitted disease- sexual side effects
Frage 31
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Ativan is an anti anxiety that is give which ways
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Riperdal is an antipsychotic that is given
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Prozac is an antidepressant that is given
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Ritalin is a CNS stimulant that is given
Frage 35
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Haldol is an antipsychotic that is given
Frage 36
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Xanax is an anti anxiety that is given
Frage 37
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antidepressant
-
antianxiety
Frage 38
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-
CNS stimulant
-
antipsychotic
Frage 39
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-
antianxiety
-
antidepressant
Frage 40
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-
CNS stimulant
-
antianxiety
Frage 41
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-
antidepressant
-
antipsychotic
Frage 42
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Tegretol can only be given IM
Frage 44
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SSRI
-
Mood Stabilizing Drug
Frage 45
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Lithium a drug used for anticonvulsant and bipolar disorder can only be given PO
Frage 46
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-
antiemetic
-
mood stabilizer
-
antipsychotic
-
SSRI
Frage 47
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Thorazine can be given
Frage 48
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Seroquel is an anti anxiety
Frage 49
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Seroquel is given IM
Frage 50
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-
antidepressant and MAOI
-
SSRI
-
Tricylic antidepressant
Frage 51
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Marplan is given for depression and is given PO
Frage 52
Frage 53
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Buspar is given for the management of anxiety and is administered PO
Frage 54
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Zoloft is given for major depressive disorder, panic disorder and OCD. It is a(n)
Frage 55
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Zoloft is a SSRI that is given IM
Frage 56
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The tricyclic antidepressant Elavil is given SC
Frage 58
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Fluphenazine is a(n)
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-
antianxiety
-
antipsychotic
Frage 59
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Fluphenazine an antipsychotic is given
Frage 60
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An antipsychotic/mood stabilizer given for schizophrenia and acute manic disorder is
Frage 61
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Zyprexa is given for bipolar I and is given
Frage 62
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Paxil is administered PO
Frage 64
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Ambien is given for insomnia and is administered
Frage 66
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Haloperidol (Haldol) is what drug classification?
Frage 67
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How is Haloperidol (Haldol) administered?
Frage 68
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What is the range of dose for Haloperidol (Haldol)
Frage 69
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Side effects to monitor for Haloperidol (Haldol) are
Frage 70
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Side effects of Haloperidol (Haldol) are QT prolongation and increased prolactin
Frage 71
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Describe how Haloperidol (Haldol) is used for rapid tranquilization in emergencies?
Antworten
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IV for sedation
-
IM for sedation
Frage 72
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Risperidone (Risperdal) is what drug classification?
Antworten
-
Atypical antipsychotic
-
Mood stabilizing
Frage 73
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Risperidone (Risperdal) is administered
Frage 74
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standard dose for Risperidone (Risperdal) is PO 1 mg twice daily
Frage 75
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A standard dose for 2 Risperidone (Risperdal) is 45mg IM every 4 weeks
Frage 76
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Side effects of Risperidone (Risperdal) include
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Less sedation and fewer EPS, weight gain/metabolic syndrome, sexual side effects
-
QT prolongation, increased prolactin
Frage 77
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a patient can breastfeed on Risperidone (Risperdal)
Frage 78
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Risperidone (Risperdal) is preferred over older antipsychotics because
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Targets the negative symptoms of schizophrenia as well as the positive and
-
less expensive to administer
-
have fewer motor side effects
-
They may also improve cognitive function
Frage 79
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Fluoxetine (Prozac) is a SSRI antidepressant
Frage 80
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Fluoxetine (Prozac) is administered IV at night
Frage 81
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What is the standard dose of Fluoxetine (Prozac)?
Frage 82
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Side effects of Fluoxetine (Prozac) include
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anxiety and insomnia
-
agitation and akathisia
-
weight gain and nausea
-
sexual dysfunction
Frage 83
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Fluoxetine (Prozac) is contraindicated in all but which of the following
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Lithium carbonate is a mood stabilizer
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How is lithium carbonate administered
Frage 86
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What is the standard dose for lithium carbonate
Frage 87
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What would a nurse teach a patient receiving lithium carbonate
Frage 88
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EPS symptoms are drug-induced movement disorders
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EPS symptoms are drug-induced movement disorders that include
Antworten
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Pseudoparkinsonism: difficulty speaking or swallowing, loss of balance control, pill rolling of hands, mask-like face, shuffling gait, rigidity, tremors
-
Akasthisia: restlessness or desire to keep moving
-
Tardive dyskinesia: uncontrolled rhythmic movement of mouth, face and extremities.
-
Dystonia: muscle spasms, twisting motions, twitching, inability to move eyes, weakness of arms and legs
-
tenitus: rigidity of muscles
Frage 90
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What are the 5 rights
Antworten
-
right dose amount
-
right route
-
right time
-
right patient
-
right consent form
-
right drug
Frage 91
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The neurotransmitter that is increased in the disease of schizophrenia – hence the antipsychotics block the receptors
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-
epinephrine
-
norepinephrine
-
dopamine
Frage 92
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The neurotransmitter that helps regulate attention, behavior, and body temperature; decreased in depression
Frage 93
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Medications that need routine blood levels to monitor for therapeutic range and toxicity
Frage 94
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Most anti-anxiety agents enhance the inhibitory effect of this neurotransmitter
Frage 95
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The antidepressant medications administered in the morning
Frage 96
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The antidepressant medications administered at bedtime
Antworten
-
mood stabilizers
-
tricyclics (TCAx)
Frage 97
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The average time frame for therapeutic results of the antidepressants
Frage 98
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The 3 most common medications used for bi-polar disorder
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The types of antidepressant medications that present the highest risk for overdose
Frage 100
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The most common medication used for rapid tranquilization of a patient with psychotic symptoms
Frage 101
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The new class of antipsychotics that have fewer motor side effects (EPS) but are more expensive
Antworten
-
typical antipsychotics
-
atypical antipsychotics
Frage 102
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The abnormal motor side effects common with the typical or standard antipsychotics
Frage 103
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Two medications that can be administered in a long-acting injectable
Antworten
-
Haldol Deconoate
-
quetiapine (Seroquel)
-
Risperdal Consta
Frage 104
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The permanent extrapyramidal side effect
Antworten
-
tardive dyskinesia
-
serotonin syndrome
Frage 105
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The nurse suggests low calorie hard candies and sips of water
Intervention for what?
Antworten
-
nursing intervention for the anticholinergic, dry mouth
-
nursing intervention for the anticholinergic, hypoglycemia
Frage 106
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Adequate fluid intake, daily exercise, and high fiber foods
Intervention for what?
Frage 107
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Instructing the patient to move slowly from lying to sitting to standing, especially in the morning and in the Elderly.
Routinely checking BP for this
Antworten
-
hypertension
-
orthostatic hypotension
Frage 108
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The common medication combination (2 drugs) given to an agitated and psychotic person in the ER
Antworten
-
Haldol and Ativan
-
Xanex and Proxac
Frage 109
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The 2 roles of the nurse when treating a mental health patient with psychotropics
Antworten
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Provider of direct patient care
(administer meds, assess effectiveness, monitor for side effects)
-
Educator
(of purpose, maintenance & side effects)
-
notify HCP
(report all noticeable signs of psychotropics)
Frage 110
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The benzodiazepine that has a shorter half life than valium and is often used in treatment of alcohol withdrawal
Frage 111
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The type of antidepressant medication that requires the patient to eat a special diet to avoid a hypertensive crisis
Frage 112
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The illness with signs & symptoms of :
Confusion to coma
Hyperthermia
Hyperreflexia
Labile BP & HR
Myoclonus & tremor
Frage 113
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The illness with signs & symptoms of :
Muscle ridgidity
Hyperthermia
Tachycardia
Diaphoresis
Labile BP
Respiratory distress – hypoxia
Renal failure
Frage 114
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The condition with signs & symptoms of :
Coarse hand tremor
Mental confusion
Hyperirritability of muscles
Drowsiness
Incoordination to ataxia
ECG changes and arrythmias
Blurred vision
Seizures
Frage 115
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What is used in ALL nursing departments & settings
Frage 116
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When neurons are stimulated or depolarized they release neurotransmitters. Each neurotransmitter has site-specific receptors that can receive it. This is called
Frage 117
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Most psychotropic medication affect neurotransmitters in one of several ways. Mark all that apply.
Antworten
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Block NTs from entering receptor site on postsynaptic neuron
-
Accelerates the synaptic transmission
-
Prevent destruction of NTs at synapse by interfering with enzymes at synapse
-
Inhibit reuptake/recycling NTs by presynaptic neuron
-
Enhance the release or inhibit the release
Frage 118
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There are two types of antipsychotic medication typical and atypical
Frage 119
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Which of the following 2 medications were the first generation of treatment for psychosis including hallucinations and delusions
Antworten
-
Haldol
-
Clozaril
-
Thorazine
-
Abilify
Frage 120
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The Atypical Psychotics or the second generation are medications developed more recently that address similar symptoms. These medications include
Antworten
-
Clozaril
-
Olanzapine
-
Risperidone
-
Abilify
-
Thorazine
Frage 121
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Serious medical complications for antipsychotics include
Antworten
-
Tardivea dyskinesia
-
serotonin syndrome
Frage 122
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Antipsychotics have a Black-Box Warning for
Frage 123
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Schizophrenia (positive symptoms), acute mania, psychotic depression, drug-induced psychosis, other psychotic symptoms (these symptoms are associated with elevated concentrations of
Antworten
-
serotonin
-
epinephrine
-
dopamine
Frage 124
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MOA of Typical antipsychotics
Antworten
-
blocks dopamine receptors
-
reduce dopamine transmission
-
decreases concentration of dopamine
Frage 125
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Which antipsychotics have fewer EPS but are no less sedating
Frage 126
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The weight gain from these drugs can be as much as 40lbs per month in worst case scenario
Frage 127
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Which atypical antipsychotic has a risk of agranulocytosis or a serious drop in granulated WBCs due to suppression of the bone marrow
Antworten
-
Prozac
-
Haldol
-
Clozaril
-
Lorazepam
Frage 128
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Atypical antipsychotics are use to treat schizophrenia, treatment of acute mania associated with bipolar disorder, some uses for augmentation of antidepressant
Frage 129
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These drugs target the negative symptoms of schizophrenia as well as the positive and have fewer motor side effects.
Antworten
-
Typical antipsychotics
-
Atypical antipsychotics
Frage 130
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These drugs are known as serotonin-dopamine antagonists because they have more 5-Ht2 effects to D2 receptor blockade. They may also improve cognitive function.
Antworten
-
typical antipsychotic
-
Atypical antipsychotic
Frage 131
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Atypical antipsychotic have which side effects
Frage 132
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What is the psychiatric emergency related to atypical antipsychotics
Frage 133
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Serotonin syndrome is poorly understood and is believed to be an abrupt and drastic reduction in dopaminergic activity, high mortality
Frage 134
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Symptoms of neuroleptic malignant syndrome include
Frage 135
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Treatment for Neuroleptic Malignant Syndrome include
Antworten
-
Haldol
-
Parlodel
-
dantrium
-
life support
Frage 136
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types of antidepressants include
Antworten
-
SSRIs
-
SNRIs
-
TCA
-
Atypical antipsychotics
-
MAOIs
-
typical antipsychotics
Frage 137
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Antidepressants are used to treat major depression, panic disorder and other anxiety disorders including psychotic depression
Frage 138
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Interact with the monoamine neurotransmitter systems in the brain, particularly the neurotransmitters
Frage 139
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Antidepressants have a Black Box Warning for increased risk of suicide in
Antworten
-
adolescents
-
elderly
-
women
Frage 140
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Contraindications for antidepressants include
Frage 141
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Psychiatric syndrome of antidepressants include
Frage 142
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Serotonin syndrome occurs from excessive serotoninergic activity this can occur because
Frage 143
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manifestations of serotonin syndrome include confusion to coma, hypothermia, labile BP/HR and
Frage 144
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Atypical or novel antidepressants MOA differ structurally and seem to work with less defined mechanisms than the other antidepressants
Frage 145
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Atypical or novel antidepressants are the oldest drugs for depression but are not used as much because of side effects.
Frage 146
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MOA of ti-cyclic antidepressants block the presynaptic re-uptake of neurotransmitters (norephinephrine & serotonin). Result is increased norephinephrine in the synapse. TCA’s block the muscarinic receptors that bind______________________ – result is anticholinergic effects.
Could also use for shingles cause blocks neurotransmitter
Antworten
-
acetylcholine
-
dopamine
-
epinephrine
Frage 147
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An important patient teaching for trip-cyclic antidepressants is to use caution when getting up or driving and
Antworten
-
to take in the morning
-
to take in the evening
Frage 148
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Side effects of Tri-cyclic antidepressants are anticholinergic which include
Frage 149
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Nursing interventions for tri-cyclic antidepressants include section, weight gain, tachycardia, sexual dysfunction and
Antworten
-
orthostatic hypotension
-
hypertension
Frage 150
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Contraindications of tri-cyclic antidepressants include suicide due to the overdose risk
Frage 151
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These are older drugs, along with the TCA’s. They are rarely used and usually a last choice for treatment of major depression. They require high compliance in lifestyle diet from the patient.
Antworten
-
atypical antidepressants
-
mood stabilizers
-
MAO inhibitors
Frage 152
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MAO inhibitors MOA: inhibition of MAO enzyme system result in which neurotransmitters not being broken down so there are higher levels
Antworten
-
dopamine
-
norepinephrine
-
epinephrine
-
serotonin
Frage 153
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Side effects of MAO inhibitors include sedation, insomnia, dry mouth, orthostatic hypotension, sexual dysfunction and
Frage 154
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Psychotic emergency of MAO inhibitors are
Antworten
-
serotonin syndrome
-
hypertensive crisis
Frage 155
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Hypertensive crisis occurs because excessive tyramine or sympathomimetic drugs and example of this is
Antworten
-
OTC allergy medication
-
OTC cold medicine
Frage 156
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Which drug do you need to teach patients to avoid tyramine foods such as (aged cheeses, aged meats, beer and wine, sauerkraut, soy sauce) as well as sympathomimetic drugs
Frage 157
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Mood stabilizers drugs include
Frage 158
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Mood stabilizing drugs are use to treat anxiety
Frage 159
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Which drug was the first drug specific Bipolar Disorder (manic depression)Replaced in the 1980’s with usage of the anticonvulsants.
Antworten
-
Depakote
-
Lamictal
-
Lithium carbonate
Frage 160
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Which is true regarding lithium carbonate MOA:
Frage 161
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Lithium Carbonate has the most narrow therapeutic index of all psychotropic medications
Frage 162
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Lithium carbonate has a black box warning that can occur even when doses close to a therapeutic range
Frage 163
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Side effects of lithium carbonate include nausea, diarrhea anorexia and
Antworten
-
fine hand tremors
-
blurred vision
-
dry mouth
Frage 164
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Nursing interventions for Lithium Carbonate include fatigue, weight gain, acne, cardiac (non-therapeutic levels) and
Antworten
-
polydipsia and poyuria
-
night sweats and terrors
Frage 165
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Patient teaching for Lithium Carbonate include taking with food, avoid alcohol and NSAIDS, ensuring the HCP of all other meds and having monthly blood levels drawn _______ hours after last dose. (maintain therapeutic levels between 0.5–1.5 mEq/L)
Frage 166
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Adverse effects of Lithium Carbonate include long term kidney and thyroid disease, lithium toxicity and
Antworten
-
blurred vision
-
harm to a fetus
Frage 167
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therapeutic level for lithium carbonate are
Antworten
-
0.5-1.5 mEq/L
-
1.5-2 mEq/L
-
2-2.5 mEq/L
Frage 168
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1.5–2 mEq/L are what levels for lithium carbonate and can cause coarse hand tremors, ECG change and persistent GI upsets
Frage 169
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2-2.5 mEq/L is what level for lithium carbonate and can cause ataxia, serious ECG changes, large dilute urine output and fatalities secondary to pulmonary complications?
Frage 170
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____________________are used as mood stabilizers to treat mania in bipolar disorder. Lamictal and Depakote are used to treat bipolar depression. They are prescribed alone, with lithium, or with an antipsychotic drug to control mania.
Frage 171
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Interventions for anticonvulsants include
Antworten
-
frequent rests
-
therapy animals
-
periodic blood levels
Frage 172
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Anticonvulsant medications carry MANY Black Box warnings. Among them:
Frage 173
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Anticonvulsant medications carry MANY Black Box warnings. The one that is a psychiatric emergency is
Frage 174
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Side effects of anticonvulsants include sedation, dizziness, blurred vision, dry mouth, nausea, heartburn, muscle tremors and
Frage 175
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Patient teaching for anticonvulsants include impaired operation due to sedation, may require blood levels, notify MD immediately of rash and
Frage 176
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Adverse effects of anticonvulsants include Stevens-Johnson syndrome, evere stomach pain, bruising, jaundice (pancreatitis, liver involvement, thrombocytopenia) and potential harm to a fetus from
Frage 177
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Which medications are used to treat anxiety disorders, PTSD, alcohol withdrawal
Frage 178
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Anxiolytics include
Antworten
-
Depakote
-
benzodiazepines
-
buspirone (BuSpar)
Frage 179
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This is the MOA for which drug:
Moderate the actions of GABA, increases the receptor responsiveness to GABA
Antworten
-
anticonvulsants
-
anxiolytics
-
antidepressants
Frage 180
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side effects of anxiolytics include sedation, drowsiness, poor concentration, impaired memory, cloudy sensations and
Frage 181
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Patient teaching for anxiolytics include use caution while driving due to slower reflexes, avoid alcohol and
Frage 182
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Antianxietys and Anxiolytics have very similar side effects and patient teachings
Frage 183
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CNS stimulate drugs are used to manage which of the following
Antworten
-
ADHD
-
narcolepsy
-
autism
-
diabetes
Frage 184
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The MOA of CNS stimulate drugs is stimulate brain function, increasing release of neurotransmitters (norepinephrine & dopamine)and blocking re-uptake. Reduces action of _______.
Frage 185
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CNS stimulants are at extreme risk for...
Antworten
-
respiratory depression
-
abuse and dependence
Frage 186
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Side effects for CNS stimulates include anorexia, nausea, irritability and
Frage 187
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Patient teaching for CNS stimulants include long-term use can cause dependency, tolerance develops and
Antworten
-
taking before meals
-
taking after meals
Frage 188
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For this drug patients learn when they need to take the med.
Example: to focus on school work, cognitive tasks; drug holiday on weekends
Antworten
-
anti-anxiety
-
CNS stimulate
Frage 189
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cognitive enhancers work on neurons are destroyed and this lowers the available ____________ for nervous system transmission. (dementia for example)
Antworten
-
dopamine
-
acetyocholine
-
GABA
Frage 190
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Cognitve enhancers are used for Alzheimers disease, with their MOA lowering acetylcholine. Examples of these drugs include
Frage 191
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cognitive enhancers work by blocking the enzyme acetylcholinesterase and make available more of the neurotransmitter, ___________________
Antworten
-
dopamine
-
acetylcholine
-
GABA
Frage 192
Frage
For cognitive enhancers it is important to note in patient teachings that the medication does not reverse the disease process and