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Questions and Answers
Which of the following are manifestations of MAOI overdose?
Which of the following are manifestations of MAOI overdose?
Serotonin syndrome can occur with the use of SSRIs alongside MAOIs.
Serotonin syndrome can occur with the use of SSRIs alongside MAOIs.
True
What is the primary treatment for MAOI overdose?
What is the primary treatment for MAOI overdose?
Hemodialysis and supportive measures
Foods high in __________ should be avoided when taking MAOIs.
Foods high in __________ should be avoided when taking MAOIs.
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Match the following drug interactions with their potential outcomes:
Match the following drug interactions with their potential outcomes:
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Which drug is classified as a phenylbutylpiperidine?
Which drug is classified as a phenylbutylpiperidine?
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Fluphenazine is considered a low potency antipsychotic drug.
Fluphenazine is considered a low potency antipsychotic drug.
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Name one antipsychotic drug that is classified as a benzisoxazole.
Name one antipsychotic drug that is classified as a benzisoxazole.
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Chlorpromazine is a member of the __________ group of antipsychotic drugs.
Chlorpromazine is a member of the __________ group of antipsychotic drugs.
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Match the following drug classes with their respective examples:
Match the following drug classes with their respective examples:
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What side effect is strongly associated with Haloperidol?
What side effect is strongly associated with Haloperidol?
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What is the primary mechanism of action for first-generation antipsychotic drugs?
What is the primary mechanism of action for first-generation antipsychotic drugs?
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Which of the following is NOT a contraindication for thiazide diuretics?
Which of the following is NOT a contraindication for thiazide diuretics?
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Lithium is safe to use in children under age 6.
Lithium is safe to use in children under age 6.
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What condition is associated with long-term use of lithium?
What condition is associated with long-term use of lithium?
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The maintenance serum level for lithium should be between _______ mEq/L.
The maintenance serum level for lithium should be between _______ mEq/L.
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Which of the following is an acceptable adverse effect of lithium treatment in the range of 1.0-1.5 mEq/L?
Which of the following is an acceptable adverse effect of lithium treatment in the range of 1.0-1.5 mEq/L?
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Match the following lithium serum levels with their associated effects:
Match the following lithium serum levels with their associated effects:
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Decreased bone density has been observed in adults using lithium.
Decreased bone density has been observed in adults using lithium.
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Name one medication that can be used in combination with lithium for acute mania.
Name one medication that can be used in combination with lithium for acute mania.
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Nursing considerations for lithium administration include monitoring electrolyte levels, particularly _______.
Nursing considerations for lithium administration include monitoring electrolyte levels, particularly _______.
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What is a black box warning associated with all antidepressant drugs?
What is a black box warning associated with all antidepressant drugs?
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The risk of suicide from antidepressants is highest in older age groups.
The risk of suicide from antidepressants is highest in older age groups.
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Name one type of first-generation antidepressant.
Name one type of first-generation antidepressant.
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The second generation of antidepressants includes _____ reuptake inhibitors.
The second generation of antidepressants includes _____ reuptake inhibitors.
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Match the following antidepressant drug categories with their examples:
Match the following antidepressant drug categories with their examples:
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Which generation of antidepressants includes serotonin-norepinephrine reuptake inhibitors?
Which generation of antidepressants includes serotonin-norepinephrine reuptake inhibitors?
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Close monitoring is necessary during the first few weeks of antidepressant treatment.
Close monitoring is necessary during the first few weeks of antidepressant treatment.
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What should clinicians do concerning patients with depression?
What should clinicians do concerning patients with depression?
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The risk of suicide decreases in _____ age groups.
The risk of suicide decreases in _____ age groups.
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Which of the following is NOT a type of first-generation antidepressant?
Which of the following is NOT a type of first-generation antidepressant?
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What is a common indication for the use of clomipramine?
What is a common indication for the use of clomipramine?
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Tricyclic antidepressants are typically the first choice for treating depression.
Tricyclic antidepressants are typically the first choice for treating depression.
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What is the primary mechanism of action of tricyclic antidepressants?
What is the primary mechanism of action of tricyclic antidepressants?
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Tricyclic antidepressants are named for their three ______ found in their chemical structure.
Tricyclic antidepressants are named for their three ______ found in their chemical structure.
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Match the tricyclic antidepressants with their brand names:
Match the tricyclic antidepressants with their brand names:
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Which of the following is a contraindication for using tricyclic antidepressants?
Which of the following is a contraindication for using tricyclic antidepressants?
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Tricyclic antidepressants have a rapid onset of action, typically within a few days.
Tricyclic antidepressants have a rapid onset of action, typically within a few days.
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What is a common adverse effect of tricyclic antidepressants?
What is a common adverse effect of tricyclic antidepressants?
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Tricyclic antidepressant overdose primarily affects the ______ and ______ systems.
Tricyclic antidepressant overdose primarily affects the ______ and ______ systems.
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In the case of tricyclic antidepressant overdose, what is a common treatment approach?
In the case of tricyclic antidepressant overdose, what is a common treatment approach?
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Study Notes
Psychotherapeutic Drugs
- Psychotherapeutic drugs, also called psychotropics, alter mental and emotional processes.
- Current theories suggest neurotransmitter imbalances are key in many disorders, diagnosed according to DSM-V criteria.
- Drugs are often used to treat mental health conditions by blocking or stimulating neurotransmitter release, but need to be combined with non-pharmacological treatments like counseling.
- The goal is to improve quality of life, social and occupational functioning, and ability to carry out ADLs.
- Some drugs initially approved for one condition might later be approved for treating other conditions.
- Children and older adults are more sensitive to drugs and at a higher risk of adverse effects.
- Response to medication varies between patients and often requires a trial-and-error approach to find what works.
- Stigma and fear of adverse effects may prevent patients from accepting and adhering to treatment.
Antipsychotic Drugs (Neuroleptics)
- Used to treat psychosis associated with schizophrenia (positive symptoms).
- They also treat severe mania, bipolar disorder, autism, and other medical conditions.
- These drugs, like antipsychotics, are effective in reducing schizophrenic symptoms such as visual hallucinations, auditory hallucinations, delusions, and disorganized behavior.
- Two main generations of antipsychotic drugs exist: the first (conventional) generation, and the second (atypical) generation.
- 1st generation antipsychotics include Phenothiazines (Chlorpromazine, Fluphenazine), Thioxanthenes (Thiothixene), and Phenylbutylpiperidines (Haloperidol).
- 2nd generation antipsychotics include Dibenzodiazepines (Clozapine, Olanzapine, Risperidone), and Benzisoxazoles (Quetiapine, Aripiprazole).
Antipsychotic Drugs – GEN 1
- Conventional antipsychotics primarily block dopamine receptors in the brain and decrease overall dopamine concentration.
- They also influence brain stem activity, leading to anti-anxiety effects and potentially antiemetic effects on the GIT through vagus nerve inhibition.
- Side effects include hypotension and sedative effects, as well as a higher risk of extrapyramidal symptoms (EPS)
- Phenothiazines such as Chlorpromazine, Fluphenazine, and Perphenazine are categorized by their “azine” suffix in their generic name.
- Thiothixene is in a different class (Thioxanthenes), similar enough phenothiazines in terms of potency and extrapyramidal side effects.
- Phenylbutylpiperidines like Haloperidol and Pimozide are structurally different but also associated with a higher risk of extrapyramidal side effects (EPS).
- Admin considerations include gradual tapering of the drug.
Antipsychotic Drugs – GEN 2
- Atypical antipsychotics, more potent, target both dopamine and serotonin receptors.
- They generally have lower risks of EPS compared to 1st-generation antipsychotics.
- Dibenzodiazepines like Clozapine, Olanzapine, Quetiapine, block receptors in the limbic system, as well as serotonin and histamine receptors.
- Olanzapine and Quetiapine also block dopamine and serotonin receptors.
- Second-generation antipsychotic drugs like Risperidone and Aripiprazole primarily work by altering dopamine and serotonin levels.
Antipsychotic Drugs – CNS Adverse Events
- Extrapyramidal symptoms (EPS) are involuntary movements similar to Parkinson's disease.
- Types include Akathisia (restlessness), Tardive Dyskinesia (uncontrollable movements), and Acute Dystonia (muscle spasms).
- Neuroleptic malignant syndrome (NMS) is a life-threatening adverse effect characterized by muscle rigidity, altered thermoregulation, and autonomic instability, which can lead to serious complications, including coma.
- Treatment for EPS and NMS involves medication discontinuation, anticholinergic medication, or dopamine-replacing agents.
Antipsychotic Drugs – Other Adverse Effects
- Cardiovascular, gastrointestinal, endocrine, and skin side effects are possible, such as low white blood cell count and anemia.
- Orthostatic hypotension, weight gain, and gynecomastia are also potential side effects of antipsychotic medications.
- The use of antipsychotic drugs in individuals with preexisting heart conditions or who are on other medications may require careful monitoring for interaction.
Anxiety / Anxiolytic Drugs
- Benzodiazepines are commonly used anti-anxiety drugs. They enhance the effects of GABA, reducing CNS activity, causing an immediate effect on mood.
- Buspirone is an alternative that does not depress the CNS as much.
- Benzodiazepines exist as short, intermediate, and long acting forms.
- Only used for short-term conditions, but can be associated with tolerance.
- Anxiolytic drugs are not equally effective in all patients and sometimes have contradictory effects.
- Adverse effects include CNS depression, hypotension, and potential for dependence and addiction.
- Precautions should be taken regarding use in elderly, with liver or kidney disease, or in pregnancy.
Mood Stabilizer Drugs
- Lithium carbonate and lithium citrate are common mood stabilizers, primarily used in bipolar disorder.
- The mechanism of action for lithium is not fully understood, but it's thought to affect sodium ion transport and GABA function.
- Lithium is often administered to manage acute episodes or as a maintenance treatment.
- The drug must be taken regularly, to keep serum sodium levels normal, as it has a very narrow therapeutic range. This makes it highly toxic if not correctly administered.
- Lithium can cause significant side effects if levels are too high.
- Side effects can include tremors, confusion, and poor coordination.
Antidepressant Drugs
- Antidepressant drugs are often used for major depression and other mental health conditions.
- Two main generations exist: first generation include Tricyclic anti-depressants, MAOI, and Tetracyclic anti-depressants.
- Second generation (more recent) include SSRI (Selective Serotonin Reuptake Inhibitors).
- There is a black box warning for all types of antidepressants because suicide risk can be elevated when first starting treatment.
- Side effects include gastrointestinal effects, cardiac effects, and central nervous system effects.
Antidepressant Drugs - First Generation
- Tricyclic anti-depressants are named based on their three ring structures. They function by preventing the reuptake of important neurotransmitters, such as norepinephrine and serotonin.
- MAOIs prevent the breakdown of norepinephrine and serotonin, allowing these neurotransmitters to have a more pronounced effect.
- First generation drugs generally have more side effects than second generation drugs
Antidepressant Drugs - Second Generation
- SSRIs are generally considered safer and are well tolerated to treat various psychiatric conditions. They work by increasing serotonin levels in the brain.
- SNRIs work in a similar way but affect norepinephrine and serotonin instead of just serotonin.
- These newer kinds of medications are often used when the first generation antidepressants are not effective.
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Description
Test your knowledge on MAOI overdose, antipsychotic drugs, and their side effects with this comprehensive quiz. Questions cover drug interactions, classifications, and treatment strategies related to psychiatric medications. Perfect for students studying pharmacology or psychiatry.
