Pregunta 1
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SSRIs with MAOIs or multiple SSRIs at once causes this
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serotonin syndrom
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hyptertensive crisis
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clozapine (Clozaril), olanzapine (Zyprexa) & resperidone (Risperdal) are
Pregunta 3
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haloperidol (Haldol) can cause
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Hypertensive crisis
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Serotonin Syndrome
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coma
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Extra pyramidal symptoms
Pregunta 4
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MAOIs with decongestants/ cold medicines can cause
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Hypertensive crisis
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Extra pyramidal symptoms
-
Serotonin Syndrome
Pregunta 5
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triazolam (Halcion) & flurazepam (Dalmane)
Pregunta 6
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fluoxetine (Prozac) & Sertraline (Zoloft) are
Pregunta 7
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imipramine (Tofranil) & amitryptiline (Elavil) are
Pregunta 8
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Lithium & depakote are
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Mood stabilizers
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Atypical antipsychotics
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Tricyclics
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Anti-anxiety agents
Pregunta 9
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chlorpromazine (Thorazine) & thiothixine (Navane) are
Pregunta 10
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lorazepam (Ativan) & alprazolam (Xanax)
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Mood stabilizers
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Atypical antipsychotics
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Tricyclics
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Anti-anxiety agents
Pregunta 11
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benztropine (Cogentin) & trihexyphenidyl (Artane) are
Pregunta 12
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secobarbital (Seconal) & Pentobarbital (Nembutal) are
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Atypical antipsychotics
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Mood stabilizers
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Barbiturates
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Anti-anxiety agents
Pregunta 13
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A decrease in serotonin can result in anxiety.
Pregunta 14
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Lithium carbonate can cause extrapyramidal symptoms.
Pregunta 15
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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.
Pregunta 16
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Extrapyramidal symptoms are caused by the blockage of norepinephrine at the synapse.
Pregunta 17
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Routine blood levels are taken on a client using haloperidol (Haldol).
Pregunta 18
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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.
Pregunta 19
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St. John’s Wort herbal medication has shown qualities of being an antidepressant; however, more clinical trials are needed.
Pregunta 20
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Fluoxetine (Prozac) is given at bedtime.
Pregunta 21
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Loarazepam is preferred over diazepam for short procedures or situations because the half-life is shorter.
Pregunta 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.
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Tricyclics have more sedating and anticholinergic effects than the SSRIs.
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SSRIs work faster to achieve a therapeutic response than the tricyclics (days as opposed to 2 weeks).
Pregunta 23
Pregunta
Which of the following is a potential prescribed drug of abuse, often in the elderly?
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Carbamazepine (Tegretol) for sleep
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Haloperidol (Haldol) for sleep
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Alprazolam (Xanax) for anxiety
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Risperadone (Risperdal) for confusion
Pregunta 24
Pregunta
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.”
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Call the MD, report the symptoms as likely EPS, and administer
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Give more haloperidol (Haldol) PRN
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Suggest a warm shower to relax (accompanied to prevent a fall)
Pregunta 25
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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
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lab draws for blood levels and diet
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diet, exercise, and sexual activity
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diet, exercise and lactation because weight gain is eminent
Pregunta 26
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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.
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signs and symptoms of early toxicity verses side effects (weight gain is common)
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the importance of taking the medicine and working with the doctor to find a comfortable therapeutic level – instead of self-stopping the medication.
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all the above
Pregunta 27
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Which electrolyte are you most concerned with when a client is taking Lithium?
Pregunta 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
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Call rapid response because it is likely neuroleptic malignant syndrome
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Call rapid response because it is likely an impending stroke
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Call rapid response because it is likely sepsis
Pregunta 29
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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?
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Risperidone (Risperdal)
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Diazepam (Valium)
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Sertaline (Zoloft)
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Amitriptyline (Elavil)
Pregunta 30
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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
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decreasing her dress size- weight gain
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hypotension and falls- yes, orthostatic hypotension
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sexually transmitted disease- sexual side effects
Pregunta 31
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Ativan is an anti anxiety that is give which ways
Pregunta 32
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Riperdal is an antipsychotic that is given
Pregunta 33
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Prozac is an antidepressant that is given
Pregunta 34
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Ritalin is a CNS stimulant that is given
Pregunta 35
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Haldol is an antipsychotic that is given
Pregunta 36
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Xanax is an anti anxiety that is given
Pregunta 37
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antidepressant
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antianxiety
Pregunta 38
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risperdal is a(n)
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CNS stimulant
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antipsychotic
Pregunta 39
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antianxiety
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antidepressant
Pregunta 40
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CNS stimulant
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antianxiety
Pregunta 41
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antidepressant
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antipsychotic
Pregunta 42
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Tegretol is a(n)
Pregunta 43
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Tegretol can only be given IM
Pregunta 44
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SSRI
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Mood Stabilizing Drug
Pregunta 45
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Lithium a drug used for anticonvulsant and bipolar disorder can only be given PO
Pregunta 46
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Thorazine is a(n)
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antiemetic
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mood stabilizer
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antipsychotic
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SSRI
Pregunta 47
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Thorazine can be given
Pregunta 48
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Seroquel is an anti anxiety
Pregunta 49
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Seroquel is given IM
Pregunta 50
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antidepressant and MAOI
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SSRI
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Tricylic antidepressant
Pregunta 51
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Marplan is given for depression and is given PO
Pregunta 52
Pregunta 53
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Buspar is given for the management of anxiety and is administered PO
Pregunta 54
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Zoloft is given for major depressive disorder, panic disorder and OCD. It is a(n)
Pregunta 55
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Zoloft is a SSRI that is given IM
Pregunta 56
Pregunta 57
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The tricyclic antidepressant Elavil is given SC
Pregunta 58
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Fluphenazine is a(n)
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antianxiety
-
antipsychotic
Pregunta 59
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Fluphenazine an antipsychotic is given
Pregunta 60
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An antipsychotic/mood stabilizer given for schizophrenia and acute manic disorder is
Pregunta 61
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Zyprexa is given for bipolar I and is given
Pregunta 62
Pregunta 63
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Paxil is administered PO
Pregunta 64
Pregunta 65
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Ambien is given for insomnia and is administered
Pregunta 66
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Haloperidol (Haldol) is what drug classification?
Pregunta 67
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How is Haloperidol (Haldol) administered?
Pregunta 68
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What is the range of dose for Haloperidol (Haldol)
Pregunta 69
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Side effects to monitor for Haloperidol (Haldol) are
Pregunta 70
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Side effects of Haloperidol (Haldol) are QT prolongation and increased prolactin
Pregunta 71
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Describe how Haloperidol (Haldol) is used for rapid tranquilization in emergencies?
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IV for sedation
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IM for sedation
Pregunta 72
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Risperidone (Risperdal) is what drug classification?
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Atypical antipsychotic
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Mood stabilizing
Pregunta 73
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Risperidone (Risperdal) is administered
Pregunta 74
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standard dose for Risperidone (Risperdal) is PO 1 mg twice daily
Pregunta 75
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A standard dose for 2 Risperidone (Risperdal) is 45mg IM every 4 weeks
Pregunta 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
Pregunta 77
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a patient can breastfeed on Risperidone (Risperdal)
Pregunta 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
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less expensive to administer
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have fewer motor side effects
-
They may also improve cognitive function
Pregunta 79
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Fluoxetine (Prozac) is a SSRI antidepressant
Pregunta 80
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Fluoxetine (Prozac) is administered IV at night
Pregunta 81
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What is the standard dose of Fluoxetine (Prozac)?
Pregunta 82
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Side effects of Fluoxetine (Prozac) include
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anxiety and insomnia
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agitation and akathisia
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weight gain and nausea
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sexual dysfunction
Pregunta 83
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Fluoxetine (Prozac) is contraindicated in all but which of the following
Pregunta 84
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Lithium carbonate is a mood stabilizer
Pregunta 85
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How is lithium carbonate administered
Pregunta 86
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What is the standard dose for lithium carbonate
Pregunta 87
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What would a nurse teach a patient receiving lithium carbonate
Pregunta 88
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EPS symptoms are drug-induced movement disorders
Pregunta 89
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EPS symptoms are drug-induced movement disorders that include
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Pseudoparkinsonism: difficulty speaking or swallowing, loss of balance control, pill rolling of hands, mask-like face, shuffling gait, rigidity, tremors
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Akasthisia: restlessness or desire to keep moving
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Tardive dyskinesia: uncontrolled rhythmic movement of mouth, face and extremities.
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Dystonia: muscle spasms, twisting motions, twitching, inability to move eyes, weakness of arms and legs
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tenitus: rigidity of muscles
Pregunta 90
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What are the 5 rights
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right dose amount
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right route
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right time
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right patient
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right consent form
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right drug
Pregunta 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
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norepinephrine
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dopamine
Pregunta 92
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The neurotransmitter that helps regulate attention, behavior, and body temperature; decreased in depression
Pregunta 93
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Medications that need routine blood levels to monitor for therapeutic range and toxicity
Pregunta 94
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Most anti-anxiety agents enhance the inhibitory effect of this neurotransmitter
Pregunta 95
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The antidepressant medications administered in the morning
Pregunta 96
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The antidepressant medications administered at bedtime
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mood stabilizers
-
tricyclics (TCAx)
Pregunta 97
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The average time frame for therapeutic results of the antidepressants
Pregunta 98
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The 3 most common medications used for bi-polar disorder
Pregunta 99
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The types of antidepressant medications that present the highest risk for overdose
Pregunta 100
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The most common medication used for rapid tranquilization of a patient with psychotic symptoms
Pregunta 101
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The new class of antipsychotics that have fewer motor side effects (EPS) but are more expensive
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typical antipsychotics
-
atypical antipsychotics
Pregunta 102
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The abnormal motor side effects common with the typical or standard antipsychotics
Pregunta 103
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Two medications that can be administered in a long-acting injectable
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Haldol Deconoate
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quetiapine (Seroquel)
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Risperdal Consta
Pregunta 104
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The permanent extrapyramidal side effect
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tardive dyskinesia
-
serotonin syndrome
Pregunta 105
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The nurse suggests low calorie hard candies and sips of water
Intervention for what?
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nursing intervention for the anticholinergic, dry mouth
-
nursing intervention for the anticholinergic, hypoglycemia
Pregunta 106
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Adequate fluid intake, daily exercise, and high fiber foods
Intervention for what?
Pregunta 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
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hypertension
-
orthostatic hypotension
Pregunta 108
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The common medication combination (2 drugs) given to an agitated and psychotic person in the ER
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Haldol and Ativan
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Xanex and Proxac
Pregunta 109
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The 2 roles of the nurse when treating a mental health patient with psychotropics
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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)
Pregunta 110
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The benzodiazepine that has a shorter half life than valium and is often used in treatment of alcohol withdrawal
Pregunta 111
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The type of antidepressant medication that requires the patient to eat a special diet to avoid a hypertensive crisis
Pregunta 112
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The illness with signs & symptoms of :
Confusion to coma
Hyperthermia
Hyperreflexia
Labile BP & HR
Myoclonus & tremor
Pregunta 113
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The illness with signs & symptoms of :
Muscle ridgidity
Hyperthermia
Tachycardia
Diaphoresis
Labile BP
Respiratory distress – hypoxia
Renal failure
Pregunta 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
Pregunta 115
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What is used in ALL nursing departments & settings
Pregunta 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
Pregunta 117
Pregunta
Most psychotropic medication affect neurotransmitters in one of several ways. Mark all that apply.
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Block NTs from entering receptor site on postsynaptic neuron
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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
Pregunta 118
Pregunta
There are two types of antipsychotic medication typical and atypical
Pregunta 119
Pregunta
Which of the following 2 medications were the first generation of treatment for psychosis including hallucinations and delusions
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Haldol
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Clozaril
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Thorazine
-
Abilify
Pregunta 120
Pregunta
The Atypical Psychotics or the second generation are medications developed more recently that address similar symptoms. These medications include
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Clozaril
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Olanzapine
-
Risperidone
-
Abilify
-
Thorazine
Pregunta 121
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Serious medical complications for antipsychotics include
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Tardivea dyskinesia
-
serotonin syndrome
Pregunta 122
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Antipsychotics have a Black-Box Warning for
Pregunta 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
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serotonin
-
epinephrine
-
dopamine
Pregunta 124
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MOA of Typical antipsychotics
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blocks dopamine receptors
-
reduce dopamine transmission
-
decreases concentration of dopamine
Pregunta 125
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Which antipsychotics have fewer EPS but are no less sedating
Pregunta 126
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The weight gain from these drugs can be as much as 40lbs per month in worst case scenario
Pregunta 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
Respuesta
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Prozac
-
Haldol
-
Clozaril
-
Lorazepam
Pregunta 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
Pregunta 129
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These drugs target the negative symptoms of schizophrenia as well as the positive and have fewer motor side effects.
Respuesta
-
Typical antipsychotics
-
Atypical antipsychotics
Pregunta 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.
Respuesta
-
typical antipsychotic
-
Atypical antipsychotic
Pregunta 131
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Atypical antipsychotic have which side effects
Pregunta 132
Pregunta
What is the psychiatric emergency related to atypical antipsychotics
Pregunta 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
Pregunta 134
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Symptoms of neuroleptic malignant syndrome include
Pregunta 135
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Treatment for Neuroleptic Malignant Syndrome include
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Haldol
-
Parlodel
-
dantrium
-
life support
Pregunta 136
Pregunta
types of antidepressants include
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SSRIs
-
SNRIs
-
TCA
-
Atypical antipsychotics
-
MAOIs
-
typical antipsychotics
Pregunta 137
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Antidepressants are used to treat major depression, panic disorder and other anxiety disorders including psychotic depression
Pregunta 138
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Interact with the monoamine neurotransmitter systems in the brain, particularly the neurotransmitters
Pregunta 139
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Antidepressants have a Black Box Warning for increased risk of suicide in
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adolescents
-
elderly
-
women
Pregunta 140
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Contraindications for antidepressants include
Pregunta 141
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Psychiatric syndrome of antidepressants include
Pregunta 142
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Serotonin syndrome occurs from excessive serotoninergic activity this can occur because
Pregunta 143
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manifestations of serotonin syndrome include confusion to coma, hypothermia, labile BP/HR and
Pregunta 144
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Atypical or novel antidepressants MOA differ structurally and seem to work with less defined mechanisms than the other antidepressants
Pregunta 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.
Pregunta 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
Respuesta
-
acetylcholine
-
dopamine
-
epinephrine
Pregunta 147
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An important patient teaching for trip-cyclic antidepressants is to use caution when getting up or driving and
Respuesta
-
to take in the morning
-
to take in the evening
Pregunta 148
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Side effects of Tri-cyclic antidepressants are anticholinergic which include
Pregunta 149
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Nursing interventions for tri-cyclic antidepressants include section, weight gain, tachycardia, sexual dysfunction and
Respuesta
-
orthostatic hypotension
-
hypertension
Pregunta 150
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Contraindications of tri-cyclic antidepressants include suicide due to the overdose risk
Pregunta 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.
Respuesta
-
atypical antidepressants
-
mood stabilizers
-
MAO inhibitors
Pregunta 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
Respuesta
-
dopamine
-
norepinephrine
-
epinephrine
-
serotonin
Pregunta 153
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Side effects of MAO inhibitors include sedation, insomnia, dry mouth, orthostatic hypotension, sexual dysfunction and
Pregunta 154
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Psychotic emergency of MAO inhibitors are
Respuesta
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serotonin syndrome
-
hypertensive crisis
Pregunta 155
Pregunta
Hypertensive crisis occurs because excessive tyramine or sympathomimetic drugs and example of this is
Respuesta
-
OTC allergy medication
-
OTC cold medicine
Pregunta 156
Pregunta
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
Pregunta 157
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Mood stabilizers drugs include
Pregunta 158
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Mood stabilizing drugs are use to treat anxiety
Pregunta 159
Pregunta
Which drug was the first drug specific Bipolar Disorder (manic depression)Replaced in the 1980’s with usage of the anticonvulsants.
Respuesta
-
Depakote
-
Lamictal
-
Lithium carbonate
Pregunta 160
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Which is true regarding lithium carbonate MOA:
Pregunta 161
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Lithium Carbonate has the most narrow therapeutic index of all psychotropic medications
Pregunta 162
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Lithium carbonate has a black box warning that can occur even when doses close to a therapeutic range
Pregunta 163
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Side effects of lithium carbonate include nausea, diarrhea anorexia and
Respuesta
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fine hand tremors
-
blurred vision
-
dry mouth
Pregunta 164
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Nursing interventions for Lithium Carbonate include fatigue, weight gain, acne, cardiac (non-therapeutic levels) and
Respuesta
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polydipsia and poyuria
-
night sweats and terrors
Pregunta 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)
Pregunta 166
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Adverse effects of Lithium Carbonate include long term kidney and thyroid disease, lithium toxicity and
Respuesta
-
blurred vision
-
harm to a fetus
Pregunta 167
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therapeutic level for lithium carbonate are
Respuesta
-
0.5-1.5 mEq/L
-
1.5-2 mEq/L
-
2-2.5 mEq/L
Pregunta 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
Pregunta 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?
Pregunta 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.
Pregunta 171
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Interventions for anticonvulsants include
Respuesta
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frequent rests
-
therapy animals
-
periodic blood levels
Pregunta 172
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Anticonvulsant medications carry MANY Black Box warnings. Among them:
Pregunta 173
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Anticonvulsant medications carry MANY Black Box warnings. The one that is a psychiatric emergency is
Pregunta 174
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Side effects of anticonvulsants include sedation, dizziness, blurred vision, dry mouth, nausea, heartburn, muscle tremors and
Pregunta 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
Pregunta 176
Pregunta
Adverse effects of anticonvulsants include Stevens-Johnson syndrome, evere stomach pain, bruising, jaundice (pancreatitis, liver involvement, thrombocytopenia) and potential harm to a fetus from
Pregunta 177
Pregunta
Which medications are used to treat anxiety disorders, PTSD, alcohol withdrawal
Pregunta 178
Pregunta
Anxiolytics include
Respuesta
-
Depakote
-
benzodiazepines
-
buspirone (BuSpar)
Pregunta 179
Pregunta
This is the MOA for which drug:
Moderate the actions of GABA, increases the receptor responsiveness to GABA
Respuesta
-
anticonvulsants
-
anxiolytics
-
antidepressants
Pregunta 180
Pregunta
side effects of anxiolytics include sedation, drowsiness, poor concentration, impaired memory, cloudy sensations and
Pregunta 181
Pregunta
Patient teaching for anxiolytics include use caution while driving due to slower reflexes, avoid alcohol and
Pregunta 182
Pregunta
Antianxietys and Anxiolytics have very similar side effects and patient teachings
Pregunta 183
Pregunta
CNS stimulate drugs are used to manage which of the following
Respuesta
-
ADHD
-
narcolepsy
-
autism
-
diabetes
Pregunta 184
Pregunta
The MOA of CNS stimulate drugs is stimulate brain function, increasing release of neurotransmitters (norepinephrine & dopamine)and blocking re-uptake. Reduces action of _______.
Pregunta 185
Pregunta
CNS stimulants are at extreme risk for...
Respuesta
-
respiratory depression
-
abuse and dependence
Pregunta 186
Pregunta
Side effects for CNS stimulates include anorexia, nausea, irritability and
Pregunta 187
Pregunta
Patient teaching for CNS stimulants include long-term use can cause dependency, tolerance develops and
Respuesta
-
taking before meals
-
taking after meals
Pregunta 188
Pregunta
For this drug patients learn when they need to take the med.
Example: to focus on school work, cognitive tasks; drug holiday on weekends
Respuesta
-
anti-anxiety
-
CNS stimulate
Pregunta 189
Pregunta
cognitive enhancers work on neurons are destroyed and this lowers the available ____________ for nervous system transmission. (dementia for example)
Respuesta
-
dopamine
-
acetyocholine
-
GABA
Pregunta 190
Pregunta
Cognitve enhancers are used for Alzheimers disease, with their MOA lowering acetylcholine. Examples of these drugs include
Pregunta 191
Pregunta
cognitive enhancers work by blocking the enzyme acetylcholinesterase and make available more of the neurotransmitter, ___________________
Respuesta
-
dopamine
-
acetylcholine
-
GABA
Pregunta 192
Pregunta
For cognitive enhancers it is important to note in patient teachings that the medication does not reverse the disease process and