Podcast
Questions and Answers
Which receptor type does Buspirone primarily bind to?
Which receptor type does Buspirone primarily bind to?
- Serotonin and dopamine receptors (correct)
- Norepinephrine receptors
- GABA receptors
- Acetylcholine receptors
Why is Buspirone unsuitable for PRN (as needed) usage?
Why is Buspirone unsuitable for PRN (as needed) usage?
- It causes immediate sedation.
- It has a high risk of dependency.
- Its antianxiety effects develop slowly, taking 2-4 weeks for full effect. (correct)
- It has a rapid onset of action but short duration.
Which of the following is a major disadvantage of Buspirone compared to other anxiolytics?
Which of the following is a major disadvantage of Buspirone compared to other anxiolytics?
- Rapid development of tolerance
- Slow onset of antianxiety effects (correct)
- Significant risk of respiratory depression
- High potential for misuse
Which food/beverage is contraindicated with Buspirone due to potential increase in its effects?
Which food/beverage is contraindicated with Buspirone due to potential increase in its effects?
A client taking Buspirone reports dizziness and lightheadedness. What is the most appropriate nursing education?
A client taking Buspirone reports dizziness and lightheadedness. What is the most appropriate nursing education?
What is the primary mechanism of action for Fluoxetine (SSRIs) in treating depression?
What is the primary mechanism of action for Fluoxetine (SSRIs) in treating depression?
How long might it take for a client to experience the full therapeutic effects of Fluoxetine after starting treatment?
How long might it take for a client to experience the full therapeutic effects of Fluoxetine after starting treatment?
A client on Fluoxetine reports experiencing sexual dysfunction. Which intervention should the nurse suggest first?
A client on Fluoxetine reports experiencing sexual dysfunction. Which intervention should the nurse suggest first?
Which adverse effect requires immediate monitoring when initiating Fluoxetine therapy, especially in young adults?
Which adverse effect requires immediate monitoring when initiating Fluoxetine therapy, especially in young adults?
A client taking Fluoxetine concurrently with NSAIDs should be monitored for what?
A client taking Fluoxetine concurrently with NSAIDs should be monitored for what?
Why is it important to avoid the use of MAOIs with Fluoxetine?
Why is it important to avoid the use of MAOIs with Fluoxetine?
Bupropion inhibits the reuptake of which neurotransmitters?
Bupropion inhibits the reuptake of which neurotransmitters?
What is a significant precaution to consider when administering Amitriptyline to a hospitalized client?
What is a significant precaution to consider when administering Amitriptyline to a hospitalized client?
A client taking Amitriptyline reports dry mouth, constipation, and blurred vision. Which intervention is appropriate?
A client taking Amitriptyline reports dry mouth, constipation, and blurred vision. Which intervention is appropriate?
What potentially life-threatening toxicity should a nurse monitor for in a client taking Amitriptyline?
What potentially life-threatening toxicity should a nurse monitor for in a client taking Amitriptyline?
A client is prescribed Phenelzine. What dietary restriction is most important for this client?
A client is prescribed Phenelzine. What dietary restriction is most important for this client?
Concurrent use of over-the-counter decongestants is most likely to cause adverse effects with which of the following medications?
Concurrent use of over-the-counter decongestants is most likely to cause adverse effects with which of the following medications?
For a client taking lithium, which of the following instructions is most important to prevent lithium toxicity?
For a client taking lithium, which of the following instructions is most important to prevent lithium toxicity?
A client on lithium therapy exhibits coarse tremors, confusion, and ongoing gastrointestinal distress. What does this indicate?
A client on lithium therapy exhibits coarse tremors, confusion, and ongoing gastrointestinal distress. What does this indicate?
Imagine encountering a client presenting with extreme polyuria of dilute urine, tinnitus, and involuntary movements while on lithium therapy. The client's lithium level reads 2.3 mEq/L. Which immediate intervention might the healthcare provider prescribe, considering the spectrum of lithium toxicity management?
Imagine encountering a client presenting with extreme polyuria of dilute urine, tinnitus, and involuntary movements while on lithium therapy. The client's lithium level reads 2.3 mEq/L. Which immediate intervention might the healthcare provider prescribe, considering the spectrum of lithium toxicity management?
What is the primary reason Buspirone is administered on a scheduled basis rather than as needed (PRN)?
What is the primary reason Buspirone is administered on a scheduled basis rather than as needed (PRN)?
A client taking buspirone reports intermittent headaches. What should the nurse include in the client education?
A client taking buspirone reports intermittent headaches. What should the nurse include in the client education?
A client with both anxiety and a history of hepatic impairment is prescribed buspirone. What adjustment to the medication regimen should the nurse anticipate?
A client with both anxiety and a history of hepatic impairment is prescribed buspirone. What adjustment to the medication regimen should the nurse anticipate?
A client taking Fluoxetine reports experiencing insomnia since starting their medication. What recommendations should the nurse provide to help manage this side effect?
A client taking Fluoxetine reports experiencing insomnia since starting their medication. What recommendations should the nurse provide to help manage this side effect?
Which of the following findings requires immediate intervention for a client who recently started fluoxetine?
Which of the following findings requires immediate intervention for a client who recently started fluoxetine?
A client on fluoxetine is scheduled for surgery. Why is it crucial for the health care provider to be informed?
A client on fluoxetine is scheduled for surgery. Why is it crucial for the health care provider to be informed?
A client is prescribed bupropion for depression. Which of the following pre-existing conditions would be a contraindication for this medication?
A client is prescribed bupropion for depression. Which of the following pre-existing conditions would be a contraindication for this medication?
A client prescribed bupropion for seasonal affective disorder should be educated to take the medication at which time of year?
A client prescribed bupropion for seasonal affective disorder should be educated to take the medication at which time of year?
A client taking amitriptyline reports blurred vision. What is the physiological mechanism causing this effect?
A client taking amitriptyline reports blurred vision. What is the physiological mechanism causing this effect?
Prior to initiating amitriptyline, which diagnostic test is most important for the nurse to review?
Prior to initiating amitriptyline, which diagnostic test is most important for the nurse to review?
Which of the following interventions is crucial to teach a client taking amitriptyline to minimize the risk of orthostatic hypotension?
Which of the following interventions is crucial to teach a client taking amitriptyline to minimize the risk of orthostatic hypotension?
A nurse is caring for a client who is taking phenelzine for depression. Which of the following findings should be reported to the provider immediately?
A nurse is caring for a client who is taking phenelzine for depression. Which of the following findings should be reported to the provider immediately?
A client prescribed phenelzine should be instructed to avoid which of the following over-the-counter medications?
A client prescribed phenelzine should be instructed to avoid which of the following over-the-counter medications?
What is the rationale for the recommendation that clients taking MAOIs continue dietary restrictions for two weeks after discontinuing the medication?
What is the rationale for the recommendation that clients taking MAOIs continue dietary restrictions for two weeks after discontinuing the medication?
A client with bipolar disorder is prescribed lithium. Which of the following electrolyte imbalances can increase the risk of lithium toxicity?
A client with bipolar disorder is prescribed lithium. Which of the following electrolyte imbalances can increase the risk of lithium toxicity?
Which of the following is a crucial instruction for clients taking lithium to prevent toxicity?
Which of the following is a crucial instruction for clients taking lithium to prevent toxicity?
What is the expected effect of propranolol when administered to a client taking lithium?
What is the expected effect of propranolol when administered to a client taking lithium?
Which of the following medications is contraindicated with lithium?
Which of the following medications is contraindicated with lithium?
A client taking disulfiram for alcohol use disorder consumes a small amount of alcohol at a party. What reaction should the nurse educate the client about?
A client taking disulfiram for alcohol use disorder consumes a small amount of alcohol at a party. What reaction should the nurse educate the client about?
Why is it essential for a client taking disulfiram to wear a medical alert bracelet?
Why is it essential for a client taking disulfiram to wear a medical alert bracelet?
A nurse is providing discharge education to a client who is starting naltrexone for alcohol use disorder. What should the nurse include in the teaching?
A nurse is providing discharge education to a client who is starting naltrexone for alcohol use disorder. What should the nurse include in the teaching?
A client is prescribed acamprosate for alcohol abstinence. What is the primary action of this medication?
A client is prescribed acamprosate for alcohol abstinence. What is the primary action of this medication?
Why is methadone used in the treatment of opioid dependence?
Why is methadone used in the treatment of opioid dependence?
What is the rationale for using clonidine during opioid withdrawal?
What is the rationale for using clonidine during opioid withdrawal?
A client is prescribed buprenorphine for opioid use disorder. What information should the nurse include in client education?
A client is prescribed buprenorphine for opioid use disorder. What information should the nurse include in client education?
A client is prescribed varenicline to aid in smoking cessation. Which of the following is important to report to the provider?
A client is prescribed varenicline to aid in smoking cessation. Which of the following is important to report to the provider?
A client is starting nicotine replacement therapy. What should the nurse emphasize in the education?
A client is starting nicotine replacement therapy. What should the nurse emphasize in the education?
A client with open-angle glaucoma is prescribed timolol eye drops. The nurse recognizes that this medication reduces intraocular pressure (IOP) by which mechanism?
A client with open-angle glaucoma is prescribed timolol eye drops. The nurse recognizes that this medication reduces intraocular pressure (IOP) by which mechanism?
A client with asthma is prescribed eye drops containing a beta-adrenergic blocker. What is an important nursing consideration?
A client with asthma is prescribed eye drops containing a beta-adrenergic blocker. What is an important nursing consideration?
A client is prescribed latanoprost eye drops for glaucoma. What should the client be taught regarding potential side effects?
A client is prescribed latanoprost eye drops for glaucoma. What should the client be taught regarding potential side effects?
After instilling eye drops, what action should the nurse take to prevent systemic absorption?
After instilling eye drops, what action should the nurse take to prevent systemic absorption?
A client is prescribed ciprofloxacin plus hydrocortisone otic drops for otitis externa. The client reports dizziness after instilling the drops. What should the nurse instruct the client to do?
A client is prescribed ciprofloxacin plus hydrocortisone otic drops for otitis externa. The client reports dizziness after instilling the drops. What should the nurse instruct the client to do?
A client is diagnosed with otitis externa. The nurse provides education on preventing recurrence, including which of the following?
A client is diagnosed with otitis externa. The nurse provides education on preventing recurrence, including which of the following?
Which of the following best describes how buspirone differs from benzodiazepines in the treatment of anxiety disorders?
Which of the following best describes how buspirone differs from benzodiazepines in the treatment of anxiety disorders?
A client taking fluoxetine exhibits which of the following signs and symptoms that suggest serotonin syndrome?
A client taking fluoxetine exhibits which of the following signs and symptoms that suggest serotonin syndrome?
Concurrent use of tricyclic antidepressants (TCAs) with which of the following herbal supplements increases the risk of serotonin syndrome?
Concurrent use of tricyclic antidepressants (TCAs) with which of the following herbal supplements increases the risk of serotonin syndrome?
Which of the following medications, when used concurrently with MAOIs, is most likely to cause a hypertensive crisis?
Which of the following medications, when used concurrently with MAOIs, is most likely to cause a hypertensive crisis?
What is the underlying mechanism by which lithium exerts its mood-stabilizing effects in clients with bipolar disorder?
What is the underlying mechanism by which lithium exerts its mood-stabilizing effects in clients with bipolar disorder?
A client with a history of heavy alcohol use is admitted for detoxification. However, it is discovered that they also take MAOIs for depression. No one told the admitting provider about the MAOIs. Which medication is absolutely contraindicated for this client due to the risk of severe adverse reactions?
A client with a history of heavy alcohol use is admitted for detoxification. However, it is discovered that they also take MAOIs for depression. No one told the admitting provider about the MAOIs. Which medication is absolutely contraindicated for this client due to the risk of severe adverse reactions?
Which assessment finding would contraindicate utilizing topical ciprofloxacin plus hydrocortisone otic drops to a client experiencing pain, edema, and erythema of the external auditory canal?
Which assessment finding would contraindicate utilizing topical ciprofloxacin plus hydrocortisone otic drops to a client experiencing pain, edema, and erythema of the external auditory canal?
A client has been prescribed buspirone for anxiety. What is the MOST important instruction to provide regarding its onset of action?
A client has been prescribed buspirone for anxiety. What is the MOST important instruction to provide regarding its onset of action?
Which of the following herbal supplements should a client taking buspirone AVOID due to the risk of serotonin syndrome?
Which of the following herbal supplements should a client taking buspirone AVOID due to the risk of serotonin syndrome?
A client taking buspirone reports persistent gastrointestinal distress. What should the nurse recommend to minimize this side effect?
A client taking buspirone reports persistent gastrointestinal distress. What should the nurse recommend to minimize this side effect?
What is the MOST significant concern when buspirone is administered to a client currently taking a monoamine oxidase inhibitor (MAOI)?
What is the MOST significant concern when buspirone is administered to a client currently taking a monoamine oxidase inhibitor (MAOI)?
A client newly prescribed fluoxetine reports feeling more energetic but still feels depressed. Which statement is the MOST appropriate for the nurse to make?
A client newly prescribed fluoxetine reports feeling more energetic but still feels depressed. Which statement is the MOST appropriate for the nurse to make?
Which of the following instructions should a nurse provide a client who is starting fluoxetine to minimize sleep disturbances?
Which of the following instructions should a nurse provide a client who is starting fluoxetine to minimize sleep disturbances?
A client on fluoxetine reports increased bruising. Which concurrent medication is MOST likely contributing to this adverse effect?
A client on fluoxetine reports increased bruising. Which concurrent medication is MOST likely contributing to this adverse effect?
A client is prescribed fluoxetine. What is the MINIMUM time that should pass after discontinuing fluoxetine before initiating an MAOI?
A client is prescribed fluoxetine. What is the MINIMUM time that should pass after discontinuing fluoxetine before initiating an MAOI?
Which of the following findings necessitates immediate intervention in a client who recently started Fluoxetine?
Which of the following findings necessitates immediate intervention in a client who recently started Fluoxetine?
A client taking bupropion reports experiencing frequent headaches. What should the nurse recommend?
A client taking bupropion reports experiencing frequent headaches. What should the nurse recommend?
Bupropion is contraindicated in clients with which of the following pre-existing conditions?
Bupropion is contraindicated in clients with which of the following pre-existing conditions?
For a client taking bupropion to prevent seasonal affective disorder (SAD), when should the nurse instruct the client to BEGIN taking the medication?
For a client taking bupropion to prevent seasonal affective disorder (SAD), when should the nurse instruct the client to BEGIN taking the medication?
A client taking amitriptyline reports increased daytime sleepiness. What should the nurse advise?
A client taking amitriptyline reports increased daytime sleepiness. What should the nurse advise?
Prior to initiating amitriptyline, which assessment is MOST crucial for the nurse to perform?
Prior to initiating amitriptyline, which assessment is MOST crucial for the nurse to perform?
Which common side effect should the nurse include in the education of a client taking amitriptyline?
Which common side effect should the nurse include in the education of a client taking amitriptyline?
Which of the following over-the-counter medications should a client taking phenelzine be instructed to AVOID?
Which of the following over-the-counter medications should a client taking phenelzine be instructed to AVOID?
A client taking phenelzine reports a severe headache. What is the nurse's priority action?
A client taking phenelzine reports a severe headache. What is the nurse's priority action?
A client taking phenelzine abruptly starts exhibiting anxiety, agitation, and mania. What is the nurse's priority action?
A client taking phenelzine abruptly starts exhibiting anxiety, agitation, and mania. What is the nurse's priority action?
Why is it critical for clients taking MAOIs to maintain dietary restrictions for two weeks after discontinuing the medication?
Why is it critical for clients taking MAOIs to maintain dietary restrictions for two weeks after discontinuing the medication?
Which of the following findings in a client taking lithium requires immediate intervention?
Which of the following findings in a client taking lithium requires immediate intervention?
A client on lithium therapy has a lithium level of 2.1 mEq/L. What is the priority nursing intervention?
A client on lithium therapy has a lithium level of 2.1 mEq/L. What is the priority nursing intervention?
What instruction is MOST important for clients taking lithium to prevent toxicity?
What instruction is MOST important for clients taking lithium to prevent toxicity?
Which medication used concurrently with lithium can increase the risk of lithium toxicity?
Which medication used concurrently with lithium can increase the risk of lithium toxicity?
A client taking disulfiram consumes alcohol. What effects should the nurse educate the client about?
A client taking disulfiram consumes alcohol. What effects should the nurse educate the client about?
Besides avoiding alcohol, what ADDITIONAL precaution should the nurse emphasize for clients taking disulfiram?
Besides avoiding alcohol, what ADDITIONAL precaution should the nurse emphasize for clients taking disulfiram?
A client is prescribed Buprenorphine for opioid use disorder. Which of the following indicates successful client education?
A client is prescribed Buprenorphine for opioid use disorder. Which of the following indicates successful client education?
A client taking naltrexone for alcohol use disorder should be educated about which intended effect of the medication?
A client taking naltrexone for alcohol use disorder should be educated about which intended effect of the medication?
What is the primary action of acamprosate in treating alcohol use disorder?
What is the primary action of acamprosate in treating alcohol use disorder?
What is the primary purpose of using clonidine during opioid withdrawal?
What is the primary purpose of using clonidine during opioid withdrawal?
A client is prescribed varenicline to aid in smoking cessation and reports new-onset depression. What is the nurse's BEST action?
A client is prescribed varenicline to aid in smoking cessation and reports new-onset depression. What is the nurse's BEST action?
The nurse is providing education to a client starting nicotine replacement therapy. What should the nurse include?
The nurse is providing education to a client starting nicotine replacement therapy. What should the nurse include?
A client with open-angle glaucoma is prescribed timolol eye drops. How does this medication reduce intraocular pressure (IOP)?
A client with open-angle glaucoma is prescribed timolol eye drops. How does this medication reduce intraocular pressure (IOP)?
What should be taught to a client prescribed latanoprost eye drops for glaucoma?
What should be taught to a client prescribed latanoprost eye drops for glaucoma?
Which instruction is MOST important for a client using ciprofloxacin plus hydrocortisone otic drops who reports dizziness after instillation?
Which instruction is MOST important for a client using ciprofloxacin plus hydrocortisone otic drops who reports dizziness after instillation?
A client diagnosed with otitis externa should be educated on which of the following?
A client diagnosed with otitis externa should be educated on which of the following?
Imagine a patient who has been on fluoxetine for years suddenly develops high fever ($>40^\circ$ C), severe muscle rigidity, and fluctuating blood pressure. Initial labs are remarkable for a CK of 20,000 U/L. What life-threatening condition has likely developed, and what is the MOST critical immediate intervention?
Imagine a patient who has been on fluoxetine for years suddenly develops high fever ($>40^\circ$ C), severe muscle rigidity, and fluctuating blood pressure. Initial labs are remarkable for a CK of 20,000 U/L. What life-threatening condition has likely developed, and what is the MOST critical immediate intervention?
Due to its interaction with CYP2D6, concomitant use of fluoxetine with which of the following medications has the HIGHEST risk of leading to drug-induced long QT syndrome and Torsades de Pointes, particularly in individuals with pre-existing cardiac conditions?
Due to its interaction with CYP2D6, concomitant use of fluoxetine with which of the following medications has the HIGHEST risk of leading to drug-induced long QT syndrome and Torsades de Pointes, particularly in individuals with pre-existing cardiac conditions?
A client is prescribed buspirone for anxiety. Which instruction regarding alcohol consumption is MOST accurate?
A client is prescribed buspirone for anxiety. Which instruction regarding alcohol consumption is MOST accurate?
A client on fluoxetine reports increased anxiety and restlessness. What should the nurse recommend FIRST?
A client on fluoxetine reports increased anxiety and restlessness. What should the nurse recommend FIRST?
A client is starting bupropion for depression. Which statement is MOST important for the nurse to include in the education?
A client is starting bupropion for depression. Which statement is MOST important for the nurse to include in the education?
A client taking amitriptyline reports constipation. Which dietary recommendation is MOST appropriate?
A client taking amitriptyline reports constipation. Which dietary recommendation is MOST appropriate?
Which outcome indicates effective teaching for a client prescribed phenelzine?
Which outcome indicates effective teaching for a client prescribed phenelzine?
Which laboratory value requires immediate notification to the provider for a client on lithium?
Which laboratory value requires immediate notification to the provider for a client on lithium?
A client taking disulfiram wants to use an alcohol-based hand sanitizer. What information should the nurse provide?
A client taking disulfiram wants to use an alcohol-based hand sanitizer. What information should the nurse provide?
A client with opioid use disorder is prescribed clonidine for withdrawal symptoms. What is the primary purpose of this medication?
A client with opioid use disorder is prescribed clonidine for withdrawal symptoms. What is the primary purpose of this medication?
A client taking varenicline to quit smoking reports new-onset depression. What action should the nurse take FIRST?
A client taking varenicline to quit smoking reports new-onset depression. What action should the nurse take FIRST?
A client with glaucoma is prescribed timolol eye drops. Which pre-existing condition would be MOST concerning?
A client with glaucoma is prescribed timolol eye drops. Which pre-existing condition would be MOST concerning?
A client is prescribed ciprofloxacin plus hydrocortisone otic drops. What instruction is MOST important?
A client is prescribed ciprofloxacin plus hydrocortisone otic drops. What instruction is MOST important?
A client on MAOIs is scheduled for elective surgery. What is the MOST critical consideration regarding anesthesia?
A client on MAOIs is scheduled for elective surgery. What is the MOST critical consideration regarding anesthesia?
A client taking lithium develops persistent vomiting and diarrhea. Recognizing the risk for toxicity, the nurse anticipates which MOST important intervention?
A client taking lithium develops persistent vomiting and diarrhea. Recognizing the risk for toxicity, the nurse anticipates which MOST important intervention?
A client on fluoxetine is also prescribed warfarin. Which assessment finding is MOST critical for the nurse to monitor?
A client on fluoxetine is also prescribed warfarin. Which assessment finding is MOST critical for the nurse to monitor?
A client taking buspirone regularly reports consuming grapefruit juice. Why is this concerning, and what education should the nurse provide?
A client taking buspirone regularly reports consuming grapefruit juice. Why is this concerning, and what education should the nurse provide?
Flashcards
Buspirone - Pharm action
Buspirone - Pharm action
Binds to serotonin and dopamine receptors; dependency is less likely compared to other anxiolytics; doesn't cause sedation or potentiate other CNS depressants; carries no misuse risk.
Buspirone - Therapeutic Uses
Buspirone - Therapeutic Uses
Panic disorder, social anxiety disorder, obsessive-compulsive and related disorders, trauma and stressor-related disorders (PTSD), generalized anxiety disorder (GAD), bruxism.
Fluoxetine - Pharm action
Fluoxetine - Pharm action
Selectively block serotonin reuptake in the synaptic space, intensifying serotonin's effects; considered first-line treatment for depression.
Fluoxetine - Therapeutic uses
Fluoxetine - Therapeutic uses
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Bupropion - Pharm action
Bupropion - Pharm action
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Bupropion - Adverse effects
Bupropion - Adverse effects
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Amitriptyline - Pharm action
Amitriptyline - Pharm action
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Amitriptyline - Therapeutic uses
Amitriptyline - Therapeutic uses
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Phenelzine - Pharm action
Phenelzine - Pharm action
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Phenelzine - Therapeutic uses
Phenelzine - Therapeutic uses
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Lithium - Pharm action
Lithium - Pharm action
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Lithium - Medication Effectiveness
Lithium - Medication Effectiveness
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Disulfiram - Pharm action
Disulfiram - Pharm action
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Methadone Substitution - Pharm action
Methadone Substitution - Pharm action
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Buprenorphine - Pharm action
Buprenorphine - Pharm action
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Varenicline - Pharm action
Varenicline - Pharm action
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Timolol - Pharm action
Timolol - Pharm action
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Timolol - Nursing Administration
Timolol - Nursing Administration
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Ciprofloxacin plus hydrocortisone otic drops - Pharm action
Ciprofloxacin plus hydrocortisone otic drops - Pharm action
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Ciprofloxacin plus hydrocortisone otic drops - Nursing Administration
Ciprofloxacin plus hydrocortisone otic drops - Nursing Administration
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Buspirone - Important teaching
Buspirone - Important teaching
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Buspirone - Main complications
Buspirone - Main complications
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Buspirone - Contraindicated substances
Buspirone - Contraindicated substances
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SSRIs - Sexual dysfunction
SSRIs - Sexual dysfunction
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SSRIs - CNS Stimulation
SSRIs - CNS Stimulation
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SSRIs - Neuroleptic Malignant Syndrome
SSRIs - Neuroleptic Malignant Syndrome
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SSRIs - Serotonin Syndrome
SSRIs - Serotonin Syndrome
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SSRIs - Withdrawal syndrome
SSRIs - Withdrawal syndrome
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SSRIs - Bruxism
SSRIs - Bruxism
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SSRIs - Drug Interactions
SSRIs - Drug Interactions
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Common SSRIs
Common SSRIs
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Important SSRI Teaching
Important SSRI Teaching
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Bupropion for Seasonal Depression
Bupropion for Seasonal Depression
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TCAs - Orthostatic Hypotension
TCAs - Orthostatic Hypotension
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TCAs - Anticholinergic effects
TCAs - Anticholinergic effects
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TCAs - Toxicity
TCAs - Toxicity
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TCAs and suicide risk
TCAs and suicide risk
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TCAs - Drug interactions
TCAs - Drug interactions
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TCAs - Monitor for toxicity by...
TCAs - Monitor for toxicity by...
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MAOIs - CNS Stimulation
MAOIs - CNS Stimulation
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MAOIs - Hypertensive Crisis
MAOIs - Hypertensive Crisis
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MAOIs - Tyramine-rich foods
MAOIs - Tyramine-rich foods
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Disulfiram - Length of affect
Disulfiram - Length of affect
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Acamprosate - Pharm action
Acamprosate - Pharm action
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Clonidine - Education
Clonidine - Education
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Buprenorphine - Benefit
Buprenorphine - Benefit
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Bupropion - Nursing action
Bupropion - Nursing action
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Varenicline - Patient education
Varenicline - Patient education
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Nicotine Replacement Therapy - Pharm action
Nicotine Replacement Therapy - Pharm action
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Ciprofloxacin plus hydrocortisone otic drops - complications and assessment
Ciprofloxacin plus hydrocortisone otic drops - complications and assessment
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Study Notes
Buspirone - Atypical Anxiolytic
- The mechanism of action for this medication is unknown
- It binds to serotonin and dopamine receptors
- Dependency is less likely compared to other anxiolytics
- Does not result in sedation or potentiate CNS depressants and has no misuse risk
- Antianxiety effects develop slowly, requiring a week for initial responses and 2-4 weeks for full effect
- Because of its slow action, it is taken on a schedule and not suitable for PRN use
- Treats panic disorder, social anxiety disorder, obsessive-compulsive disorders, PTSD, generalized anxiety disorder (GAD), and bruxism
- Complications include dizziness, nausea, headache, lightheadedness, and agitation, which can be limited by taking it with food and avoiding driving
- Other complications include constipation managed by increasing fiber and fluids, and suicidal ideation, requiring monitoring for depression and suicidal thoughts
- Contraindicated during pregnancy and lactation
- Use caution with older adults and clients with liver or renal dysfunction
- Contraindicated with MAOI antidepressants or within 14 days of discontinuing MAOIs to avoid hypertensive crisis
- Interactions with erythromycin, ketoconazole, St. John's wort, and grapefruit juice can increase its effects
- Clients should avoid antimicrobials and herbal preparations with St. John's wort and SAMe due to serotonin syndrome risk
- Avoid grapefruit juice
- Shows therapeutic benefits for anxiety, even up to a year, despite being labeled for short-term use
- Take the med with meals to prevent GI irritation
- Effects take 1-4 weeks, taken regularly, and tolerance, dependence, or withdrawal are not a problem
Fluoxetine - Selective Serotonin Reuptake Inhibitors (SSRIs)
- Selectively blocks serotonin reuptake, intensifying serotonin effects, considered first-line for depression, and takes 1-3 weeks to work
- Treats major depression, obsessive-compulsive, bulimia, premenstrual dysphoric, panic, post-traumatic stress, generalized anxiety, and bipolar disorders
- Causes sexual dysfunction like anorgasmia, impotence, and decreased libido
- Manageable by notifying provider, lowering dosage, discontinuing temporarily, and using adjunct meds like sildenafil or buspirone
- Bupropion has fewer sexual dysfunction adverse effects
- Causes CNS stimulation like insomnia, agitation, and anxiety
- Mitigated by notifying the provider, lowering the dose, taking it in the morning, avoiding caffeine, and using relaxation techniques
- Monitor fever, respiratory distress, and tachycardia for Neuroleptic Malignant Syndrome
- Monitor suicidal tendencies, especially during early therapy, with higher risk in those 24 or younger
- Monitor for Torsades De Pointes
- Weight loss in early therapy can be followed by weight gain, so monitor and encourage regular exercise and a balanced diet
- Serotonin syndrome can occur 2-72 hours after starting treatment and can be lethal
- Symptoms include confusion, agitation, poor concentration, hostility, disorientation, delirium, seizures, unstable blood pressure, diaphoresis, fever, incoordination, hyperreflexia, tremors, nausea, vomiting, diarrhea, abdominal pain, coma and anxiety
- Manage symptoms, provide serotonin-receptor blockade, manage muscle rigidity, use cooling blankets, anticonvulsants, artificial ventilation, and withhold medication
- Withdrawal syndrome causes headache, nausea, visual disturbances, anxiety, dizziness, and tremors, managed by tapering the dose gradually
- Can cause hyponatremia, especially in older adults on diuretics
- Monitor rash, sleepiness, faintness, and lightheadedness
- Changing antidepressants or adding low-dose buspirone can decrease bruxism
- Avoid during late pregnancy due to risk of pulmonary hypertension in the newborn
- Considered safe during lactation
- Contraindicated with MAOIs or TCAs and needs a 2-week washout before MAOI
- Use caution with liver/kidney disease, cardiac disease, seizures, diabetes, ulcers, and GI bleeding
- TCAs, MAOIs, and St. John’s wort increase serotonin syndrome risk
- MAOIs require 14 days wash out, or five weeks if from fluoxetine
- Avoid TCAs and St. John’s wort together due to bleeding risk
- Can displace warfarin, increasing bleeding risk, so monitor PT/INR levels
- Fluoxetine can increase tricyclic antidepressants and lithium levels, so avoid concurrent use
- Suppresses platelet aggregation, increasing bleeding risk with NSAIDs, so monitor for bleeding
- Names in common: Citalopram, Escitalopram, paroxetine, sertraline, fluvoxamine, Venlafaxine, Desvenlafaxine, Duloxetine
- Avoid MAOIs, obtain baseline sodium levels for older adults on diuretics, take in the morning, take with food, and are known to causes sexual adverse effects
Bupropion - Atypical Antidepressant
- Acts by inhibiting norepinephrine and dopamine uptake
- Treats depression, major depressive disorder, seasonal affective disorder
- Prescribed when clients cannot tolerate sexual dysfunction from SSRIs and SNRIs
- Aids smoking cessation, prevents seasonal pattern depression, and can be used for attention-deficit disorder
- Causes headache, dry mouth, GI distress, constipation, increased heart rate, hypertension, restlessness, and insomnia
- Effects are managed by observing and notifying the provider, sipping fluids, and increasing dietary fiber
- Causes nausea, vomiting, anorexia, and weight loss, so monitor weight and food intake
- Can cause seizures, so use only when benefit outweighs fetal risk and be cautious in clients with renal/hepatic impairment
- MAOIs are contraindicated and require a 2-week washout
- Do not use with MAOIs
- If used for seasonal pattern depression, start in autumn and taper off in spring
Amitriptyline - Tricyclic Antidepressants (TCAs)
- Blocks norepinephrine and serotonin reuptake, intensifying neurotransmitter effects with action taking 10-14 days
- Treats depression and depressive episodes of bipolar disorder
- Used for neuropathic pain, fibromyalgia, anxiety, obsessive-compulsive, insomnia, ADHD, and bipolar disorder
- Causes orthostatic hypotension, managed by monitoring BP/HR, advising position changes, and avoiding dehydration, also need to monitor the client for suicidal tendencies
- Causes anticholinergic effects like dry mouth, blurred vision, photophobia, urinary issues, constipation, and tachycardia
- Mitigate by chewing gum, sipping water, wearing sunglasses, increasing fiber and fluids, and voiding before taking medication
- Causes sedation, which decreases over time, so avoid hazardous activities and take at bedtime
- Toxicity from cholinergic blockade and cardiac issues can cause dysrhythmias, confusion, agitation, seizures, coma, and death
- Obtain baseline ECG, monitor vital signs, and notify the provider of toxicity
- Decreases seizure threshold requiring seizure monitoring
- Monitor sweating
- Use only if benefit outweighs fetal risk during pregnancy
- Avoid with lactating clients as it causes sedation in infants
- Contraindicated with seizure disorders, coronary artery disease, diabetes, liver/kidney/respiratory disorders
- Also contraindicated with urinary retention, angle-closure glaucoma, benign prostatic hyperplasia, and hyperthyroidism
- Suicide risk clients should receive a 1-week supply due to the lethality of toxic doses
- Concurrent use with MAOIs or St. John's wort leads to serotonin syndrome, avoid concurrent use
- Concurrent use of MAOIs can cause severe hypertension, avoid concurrent use
- Antihistamines and other anticholinergics cause additive anticholinergic effects, avoid concurrent use
- Increased effects of epinephrine and dopamine occur, avoid concurrent use
- TCAs decrease effects of ephedrine and amphetamine, avoid concurrent use
- Alcohol, benzodiazepines, opioids, and antihistamines cause additive CNS depression, avoid other CNS depressants
- Needs toxicity monitoring by cardiac dysrhythmias
- Administer at bedtime for sedation and orthostatic fall risk, and monitor "cheeking" due to high toxicity risk
Phenelzine - Monoamine Oxidase Inhibitors (MAOIs)
- Medications block MAOI enzymes, increasing neurotransmitters, and requires diet and medication restrictions due to tyramine
- Affects take 2-4 weeks, with food/drug interactions and adverse effects
- Treats depression, bulimia, panic, social anxiety, generalized anxiety, obsessive-compulsive, and posttraumatic stress disorder
- Causes CNS stimulation, anxiety, agitation, mania, or hypomania, notify provider immediately of any effects
- It causes orthostatic hypotension, so monitor BP/HR and instruct clients to change positions slowly
- Hypertensive crisis can result from dietary tyramine, possibly leading to stroke, with severe hypertension and changes in HR
- Administer Phentolamine IV or nifedipine
- Needs continuous cardiac monitoring and respiratory support
- Causes local rash with transdermal patch
- Choose a clean, dry area, apply glucocorticoid, avoid hairy/irritated/callous areas, and wash hands after
- Contraindicated in clients with pheochromocytoma, heart failure, cardiovascular/cerebral vascular disease, and severe renal insufficiency
- Diabetes and seizure disorders clients should use caution
- Transdermal selegiline is contraindicated with carbamazepine or oxcarbazepine due to increased MAOI levels
- Interacts with indirect sympathomimetics, causing norepinephrine release and hypertensive crisis
- Tricyclic antidepressants and SSRIs require caution
- Antihypertensives, leads to an additive hypotensive effect, so monitor BP and manage dosages
- Avoid meperidine, use a different analgesic
- Tyramine causes hypertensive crisis, headaches, nausea, heart rate, and blood pressure
- The MAOI transdermal patch has a low tyramine sensitivity
- Diet instructions including labels for any manifestations.
- Restrictions last 2 weeks with medication discontinuation
- Vasopressors and caffeine can cause hypertension, so avoid foods with with them
- General anesthetics should not be used 10-14 days near operations
- Inform adherence to the regimens, the therapeutic effects arrive in 1-3 weeks, full therapeutic in 2-3 months
- Suicide risks must be assessed always on antidepressants
- Give lists of tyramine-rich foods
- Indicates there has been verbal improvement of mood, increased hoping, able to perform ADLs Improved sleeping/eating has happened, and increased interactions with peers
- The drugs: Isocarboxazid, Tranylcypromine, Selegiline (transdermal patch)
- Meds administered to establish regular levels that must maintain therapy, for relapse occurs due to that.
- Resolved in 6 months but can repeat past a year
Lithium Carbonate - Mood Stabilizer
- Produces neurochemical changes, including serotonin receptor blockade, decreases atrophy and increases growth
- Treats bipolar disorder
- Controls mania episodes and prevents mania/depression
- Causes GI Distress, Nausea, diarrhea, abdominal pain transient
- Fine hand tremors interferes skills may be stress
- Beta blocking to adjust the lower dose/divided doses
- Report of tremors of report increased for what of tremors are a sign of toxicity
- Polyuria and thirst mild/use diuretic and spirolactone
- Fluid intake of 1500 for all the maintenance
- Incline to proper diet with the weight gain
- The low dosage for renal failure is needed
- Is hypo for kidney goiter or the hypothyroidism of baseline with its levels
- Levothyroxine to monitor levels
- Bradycardia/hypotension and fluid for electrolytes
- Toxicity below its below with the NVM and list out
Lithium Toxicity Adverse Effects
- Level is below it to get the manifest of speech
Lithium Early Indications
- The L2 M is GI/NVM with course tremors to show dose
- The toxicity severe indications extreme polyuria leading to problems for more tests done
- Toxicity severe high levels
- Not as reproductive for cautions as thyroid but it need s carefulness
Severe Toxicity
- The kidney and levels should be noted and for how NA is to prevent and avoid using for the interactions should be checked throughout
Lithium Nursing Administration
- Levels may take more frequent when needed and to have less for lithiums in an acute setting is needed. This is shown during therapy.
- Maintain tests needed and to report the findings
Disulfiram, Naltrexone, Acamprosate
- Disulfiram creates a behavioral with all of the interactions listed
- Can result in respiratory problems if done that way
- Naltrexone is a opioid antagonist, and Acamprostae decreases all other feelings
- All monitored by the action for heptoxicity.
- It should to avoid ingestion of it, and for some problems to take action.
Methadone, Clonidine, Buprenorphine
- For clients going through the physical dependency, it will remove all the substances.
- Used for long-term maintenance.
- The Clonidine assists with all the symptoms
- Buprenorphine is known to prevent things from with the client
- A 3 B has this with some drugs for the long-term effect.
Opioid Withdrawal
- Maintain dosages for the results
- Have basic vitals
- Not that one needs to tell results to provider
- Doses can be tapered slowly for the with drawls of participation.
Varencline
- For help when it came to nicotine and it can cause actions
- By avoiding client and the help of any actions when it comes to therapy.
Nicotine Therapy
- These are some products to help that by listing off several action for actions when there is an education for effects.
Timolol, Betaxolol, Brimonidine, Latanoprost, Acetazolamide - Beta-adrenergic Blockers
- Beta-blockers decrease intraocular pressure by decreasing aqueous humor production
- Primarily used topically for POAG and can be combined with other medications to lower IOP
- Transient stinging discomfort that resolves
- Occasional conjunctivitis, blurred vision, photophobia, and dry eyes, with systemic effects impacting the heart and lungs with bradycardia and shortness
- Overdosing can lead to systemic effects and monitor for the bradycardia.
- Not safe to use when pregnant and use lowest dose when lactating
- Beta2 blockers are not okay to use for the chronic respiratory as a AV
Beta Blockers
- Can increase effects to notify
- Monitor for diabetic patients and that it happens to have a low drop rate done that way.
- Instill drops gently to avoid infection.
Ciprofloxacin plus Hydrocortisone Otic Drops
- In hydro can act to help effect that is needed to help
- It helps treat otitis externa
- Rash can ask if allergies exists to fluoroquinolone or steroids, for that action is a needed form.
- The client should place the side in the exact fashion for proper treatment.
- Have pain when moving the ear, and prevent certain diseases.
- The cotton needs drying for the drainage.
- Avoid putting foreign objects such as cotton swabs and to not cause damage.
- Drying canal action and to prevent drainage damage.
- Avoid wearing earplugs.
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