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Questions and Answers
What is the primary mechanism of action for tricyclic antidepressants?
What is the primary mechanism of action for tricyclic antidepressants?
Which of the following is a common adverse effect associated with tricyclic antidepressants?
Which of the following is a common adverse effect associated with tricyclic antidepressants?
In the context of overdose management with tricyclic antidepressants, what is the first step to decrease drug absorption?
In the context of overdose management with tricyclic antidepressants, what is the first step to decrease drug absorption?
Which of these is NOT a common indication for tricyclic antidepressants?
Which of these is NOT a common indication for tricyclic antidepressants?
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Why are tricyclic antidepressants considered second line drugs for depression?
Why are tricyclic antidepressants considered second line drugs for depression?
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Which of the following is a common therapeutic outcome associated with the use of anxiolytics?
Which of the following is a common therapeutic outcome associated with the use of anxiolytics?
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A patient taking antidepressants would most likely demonstrate which of these?
A patient taking antidepressants would most likely demonstrate which of these?
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What is the therapeutic level range for lithium, measured in mmol/L?
What is the therapeutic level range for lithium, measured in mmol/L?
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Which of these is a primary therapeutic goal when administering antipsychotics?
Which of these is a primary therapeutic goal when administering antipsychotics?
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A patient with an acute exacerbation of major depressive disorder (MDD) with suicidal ideation and insomnia would likely benefit most from medication in which class?
A patient with an acute exacerbation of major depressive disorder (MDD) with suicidal ideation and insomnia would likely benefit most from medication in which class?
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Which of these is a hallmark characteristic of a psychotic disorder?
Which of these is a hallmark characteristic of a psychotic disorder?
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Which type of psychotherapeutic drug is primarily used to reduce anxiety by decreasing overactivity in the central nervous system?
Which type of psychotherapeutic drug is primarily used to reduce anxiety by decreasing overactivity in the central nervous system?
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Which of the following is a common adverse effect associated with benzodiazepine use?
Which of the following is a common adverse effect associated with benzodiazepine use?
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What is a primary risk associated with combining benzodiazepines with alcohol or other CNS depressants?
What is a primary risk associated with combining benzodiazepines with alcohol or other CNS depressants?
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Which of the following is a unique characteristic of buspirone (BuSpar®) compared to benzodiazepines?
Which of the following is a unique characteristic of buspirone (BuSpar®) compared to benzodiazepines?
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A patient is prescribed alprazolam (Xanax®). For which condition is this medication most used?
A patient is prescribed alprazolam (Xanax®). For which condition is this medication most used?
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Which of the following is a consideration when prescribing diazepam (Valium) to a patient?
Which of the following is a consideration when prescribing diazepam (Valium) to a patient?
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What is commonly used to reverse the effects of a benzodiazepine overdose?
What is commonly used to reverse the effects of a benzodiazepine overdose?
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Why should older adult patients be closely monitored while taking antianxiety medications?
Why should older adult patients be closely monitored while taking antianxiety medications?
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What is a crucial instruction to provide to patients starting antidepressant therapy regarding therapeutic effects?
What is a crucial instruction to provide to patients starting antidepressant therapy regarding therapeutic effects?
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Why might tricyclic antidepressants need to be weaned off before surgery?
Why might tricyclic antidepressants need to be weaned off before surgery?
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What should be taught to patients and families when MAOIs are prescribed?
What should be taught to patients and families when MAOIs are prescribed?
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What is an important consideration when administering antipsychotic medications to minimize gastrointestinal discomfort?
What is an important consideration when administering antipsychotic medications to minimize gastrointestinal discomfort?
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Which drug interaction poses the greatest risk of serotonin syndrome?
Which drug interaction poses the greatest risk of serotonin syndrome?
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Concurrent use of MAOIs is contraindicated in patients taking which of the following?
Concurrent use of MAOIs is contraindicated in patients taking which of the following?
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A patient starting fluoxetine should be monitored for which of the following possible side effects?
A patient starting fluoxetine should be monitored for which of the following possible side effects?
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What is the primary mechanism of action for conventional antipsychotic drugs?
What is the primary mechanism of action for conventional antipsychotic drugs?
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Which of the following is classified as a first-generation antipsychotic drug?
Which of the following is classified as a first-generation antipsychotic drug?
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Which symptom type of schizophrenia do most antipsychotics have the greatest efficacy in improving?
Which symptom type of schizophrenia do most antipsychotics have the greatest efficacy in improving?
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A clinician is treating a patient who experiences both the positive and negative symptoms of schizophrenia. Which class of antipsychotics may be the most effective?
A clinician is treating a patient who experiences both the positive and negative symptoms of schizophrenia. Which class of antipsychotics may be the most effective?
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Besides psychosis, what is another indication for prochlorperazine?
Besides psychosis, what is another indication for prochlorperazine?
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Which of the following is a potentially life-threatening adverse effect associated with antipsychotic medications?
Which of the following is a potentially life-threatening adverse effect associated with antipsychotic medications?
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What is the primary mechanism of action that differentiates atypical antipsychotics from typical antipsychotics?
What is the primary mechanism of action that differentiates atypical antipsychotics from typical antipsychotics?
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Which medication is associated with a risk of blood dyscrasias as a notable adverse effect?
Which medication is associated with a risk of blood dyscrasias as a notable adverse effect?
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A patient on long-term antipsychotic therapy develops involuntary contractions of the oral and facial muscles, which of the following conditions would be the most likely diagnosis?
A patient on long-term antipsychotic therapy develops involuntary contractions of the oral and facial muscles, which of the following conditions would be the most likely diagnosis?
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Which of the following describes the extrapyramidal symptoms (EPS) associated with some antipsychotic drugs?
Which of the following describes the extrapyramidal symptoms (EPS) associated with some antipsychotic drugs?
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Which of the following is NOT a common symptom of neuroleptic malignant syndrome (NMS)?
Which of the following is NOT a common symptom of neuroleptic malignant syndrome (NMS)?
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A patient demonstrating restlessness and an inability to sit still is most likely experiencing which of the following?
A patient demonstrating restlessness and an inability to sit still is most likely experiencing which of the following?
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Which of the following best describes the reason haloperidol is useful for clients with schizophrenia who are nonadherent to their drug regimen?
Which of the following best describes the reason haloperidol is useful for clients with schizophrenia who are nonadherent to their drug regimen?
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Study Notes
Psychotherapeutics - Week 3
- The course is NUR 2403
- Housekeeping included questions from the previous week and a review of the quiz
- Glossary terms included: Dopamine hypothesis of psychosis, Dysregulation hypothesis of depression and mood, Permissive hypothesis of mood, Extrapyramidal Symptoms, Akathisia, Dystonias, Parkinson's traits, Tardive dyskinesia
- Anxiety is an unpleasant mental state with dread and fear. It can stem from anticipated or past experiences and can be an exaggerated response to negative situations
- Anxiety disorders include separation anxiety disorder, selective mutism, specific phobia, social anxiety disorder, panic disorder, panic attack, agoraphobia, generalized anxiety disorder, and substance- or medication-induced anxiety disorder
- Affective (mood) disorders involve changes in mood ranging from mania (abnormally pronounced emotions) to depression (abnormally reduced emotions). Some individuals experience both, known as bipolar disorder (BPD)
- Psychosis is a severe emotional disorder impairing mental function. Hallmarks include loss of contact with reality. Examples include schizophrenia, depressive, and drug-induced psychoses
- Psychotherapeutic drugs target anxiety, mood, and psychotic disorders
- Types of psychotherapeutic drugs include anxiolytics, mood-stabilizing drugs, antidepressants, and antipsychotic drugs
- Anxiolytic drugs reduce CNS activity to lessen anxiety. First-line drugs are antidepressants, and examples of benzodiazepines are alprazolam (Xanax®), diazepam (Valium®), and lorazepam (Ativan®). Buspirone (BuSpar®) is another type
- Adverse effects of benzodiazepines include decreased CNS activity, sedation, amnesia, hypotension, drowsiness, loss of coordination, dizziness, headaches, nausea, vomiting, and constipation
- Overdosing on benzodiazepines is dangerous if taken with other sedatives or alcohol. Flumazenil can reverse its effects
- Alcohol and CNS depressants taken with benzodiazepines cause additive CNS depression and even fatality.
- Alprazolam (Xanax) is primarily used as an anxiolytic for GAD, short-term relief of anxiety symptoms relating to panic disorder and depression
- Diazepam (Valium) treats anxiety, manages alcohol withdrawal, reverses status epilepticus, uses pre-surgery sedation, and aids in treating skeletal muscle spasms.
- Lorazepam (Ativan) is an intermediate-acting benzodiazepine beneficial for treating acutely agitated patients receiving IV or IM treatment or for mechanical ventilation treatment. It can treat, or prevent, alcohol withdrawal
- Buspirone hydrochloride is another miscellaneous anxiolytic with an unknown mechanism of action, often used on a scheduled basis. Adverse effects include paradoxical anxiety, blurred vision, dizziness, headache, and nausea
- Mood-stabilizing drugs include lithium carbonate and lithium citrate. Other drugs like benzodiazepines, antipsychotics, antiepileptic drugs, and dopamine receptor agonists are also used in combination with lithium
Antidepressants
- First-generation antidepressants include tricyclics, tetracyclics, and MAOIs.
- Second-generation antidepressants include SSRIs like fluoxetine, sertraline, paroxetine, fluvoxamine, citalopram, and escitalopram, plus SNRIs such as duloxetine, desvenlafaxine, venlafaxine, and levomilnacipran.
- Therapy failure might require a different approach after 6 weeks at a proper dose. All classes have an increased risk of suicidal potential that must be monitored
- Tricyclic antidepressants have largely been replaced by SSRIs as first-line. Considered second line for patients who haven't responded to newer generation antidepressants. An example is amitriptyline.
- MOA of tricyclic antidepressants block reuptake of neurotransmitters to cause accumulation at nerve endings, potentially regulating malfunctioning neurons
- Indications for tricyclic antidepressants include neuropathic pain, insomnia, childhood enuresis, obsessive compulsive disorders, and anorexia
- Lethality for a tricyclic overdose is high; 70-80% die before reaching the hospital. Death results from CNS and cardiovascular system effects (seizures or dysrhythmias). Activated charcoal and alkalinizing urine help lower drug absorption. Basic life support is essential.
- Amitriptyline (Elavil) is one of the oldest and most widely used tricyclic antidepressants with indications in depression, insomnia and neuropathic pain.
- Mirtazapine (Remeron) is a tetracyclic antidepressant that promotes presynaptic release of serotonin and norepinephrine, including indications for depression, BPD, aiding sexual adverse affects for SSRI users, and as an appetite stimulant.
- Monoamine Oxidase Inhibitors (MAOIs) are nonselective, like phenelzine sulphate and tranylcypromine sulphate, or selective, like selegiline hydrochloride. They are typically rarely used to treat depression, but often used to treat Parkinson's disease.
- MAOIs pose a significant potential for hypertensive crisis when taken with tyramine, commonly found in aged cheeses, smoked/pickled/aged meats and fish, cured meats, yeast extracts, certain red wines, and many other foods
- Second generation antidepressants like trazodone, bupropion, and various SSRIs/SNRIs are known to manage depression, OCD, panic disorders, bipolar disorders, and even eating disorders
- Adverse effects for second generation antidepressants typically include anxiety, dizziness, drowsiness, insomnia and other similar effects.
- Commonly used SSRIs and SNRIs, include fluoxetine, sertraline, or duloxetine, may help with depressive symptoms and are used as treatments for generalized anxiety, certain pain concerns, and other related conditions
Antipsychotics
- Antipsychotics are used in managing drug-induced psychoses, schizophrenia, autism, extreme mania, BPD, treatment-resistant depression, and specific movement disorders (Tourette's Syndrome, nausea, etc)
- Conventional antipsychotics include phenothiazines.
- Second-generation antipsychotics are newer and have a better side effect profile. Examples include clozapine, risperidone, olanzapine, quetiapine, aripiprazole, paliperidone, asenapine, lurasidone, and ziprasidone.
- MOA of antipsychotics involves blocking dopamine receptors in the limbic system, basal ganglia, and areas related to emotion, cognition, and motor function, lowering dopamine levels for a tranquilizing effect in psychotic patients.
- Indications of antipsychotic drugs include psychotic illness, anxiety, and mood disorders. An example is prochlorperazine which can be used as an antiemetic medication
- Schizophrenia, characterized by positive symptoms like hallucinations, delusions, and disorganized thinking, and negative symptoms like apathy and social withdrawal, is often managed with antipsychotics
- Adverse effects of antipsychotic drugs include agranulocytosis, hemolytic anemia, drowsiness, Neuroleptic Malignant Syndrome (NMS), extrapyramidal symptoms (EPS), including pseudoparkinsonism, akathisia, acute dystonia, treated with benztropine and trihexyphenidyl, and tardive dyskinesia
- Atypical antipsychotics are designed with lower incidence of EPS, and tardive dyskinesia. Specific neurologic effects like involuntary movement disorders or tremors are addressed by specific medications in this category
Case Study
- Jane Gonzalez (28) was admitted with an acute exacerbation of major depressive disorder (MDD), characterized by suicidal ideation and insomnia.
General Information
- The pages displayed are likely from a lecture or presentation about psychotherapeutic drugs in relation to anxiety, mood, and psychotic disorders.
- Many specific conditions like bipolar disorder, OCD, depression, or eating disorders respond to various types of treatment as outlined in the study material
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Description
Test your knowledge on psychopharmacology with this quiz covering tricyclic antidepressants, anxiolytics, and antipsychotic medications. You'll explore mechanisms of action, adverse effects, and therapeutic goals. This quiz is designed for students in health sciences or related fields.
