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MH701 Safety

Exam 1 Review

exam(

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100% correct

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Which neurotransmitters are most theorized when decreased lead to depression and anxiety? - answer Norepinephrine and Serotonin The difference in the daignosis of dysthymia vs. MDD is dysthymia must present for how long? - answer 2 years-Someone with dysthymia has that "everything is just ok", nothings great everyday mood. Struggle with

when last happy. MDD patient has a 2 week period of depression with symptoms of trouble sleeping, appetite, insight, guilt, concetration, pleasure, suicidal thoughts. MDD they remember being happy, not always sad and angry. A non-addictive and non habit forming alternative for the use in treating anxiety? - answer Buspirone or Buspar-Take everyday, 2 times/day to see the most effect 4-6 weeks. Good add-on to antidepressant and also good for children. Substance to avoid when taking MAOIs and why? - answer Tyramine and hypertensive crisis-Hardly seen in practice and used for last resort. Causes very high pressure. Tyramine items such as hotdogs, processed meat, sausage, pepperoni, chocolate, avocodoes, guac, raisins, bananas, yeasts, swiss cheese, blue cheese, wine, beer, alcohol, aged cheese. What SSRI has a shorter half-life and most often need to be weened to prevent issues

with discontinuation? - answer Paroxetine of Paxil-Pt. needs to be monitored due to days they will feel great or a low drop in their mood because of the half-life. Have a hard time discontinuing, have more anxiety, dizzy feeling. Paxil causes weight gain and sexual S/E. What class of antidepressants is more lethal in an overdose? - answer TCAs-MOre lethal, SSRIs are safer. TCAs conducton of heart issues such as EKG changes and more drying. What is a patient likely to exhibit if they suddenly stop taking Venlafaxine (Effexor)? - answer Discontinuation Syndrome-A rebound effect, feel worse than before starting the drug. Dizziness, blurry, nausea, cloudy feeling. Can feel a difference in 2-3 days. Educate patient on this if they are non- compliant. Must slowly ween off medication, so they do not have the effects. SSRI that can often interact with many OTC and prescription drugs? - answer Fluvoxamine-Interacts with OTC cold

medications ie. sudafed, decongestat. Educate patients on the possible risks involved. What antidepressant is contraindicated with seizure disorders, anorexia, and bulemia? - answer Buproprion (Wellbutrin)-Do not want to overstimulate the brain, causing a seizure; with eating disorders electrolytes are out of balance and predisposed to having a seizure. This med actually helps to DECREASE appetite. First-line treatment for depression and anxiety? - answer SSRIs-More tolerable and lower risks of S/E. Headache and N/V are common for the first 5 days of taking med. Potentially life-threatening syndrome that is precipitated by the use of serotonergic drugs? - answer Serotonin Syndrome-Test reflexes-hyperreflexia early symptom is very loose stool/diarrhea. Stp med see if symptom resolves. Will see fever, blood pressure issues, diarrhea, shaking. Mindful of dosage

when taking 2 x SSRIs and with taking Tramadol. Which of the following OTCs should avoided with concurrently taking a SSRI medication? - answer St. Johns Wort or SAMe Why is there a black box warning on antidepressants about suicide in child and adolescents? - answer Brain is not fully developed until 25 years, uncertain brain reactions. Does NOT cause suicidal thoughts. Short acting Benzos often used in elderly with dementia or PRN use? - answer Lorazepam (Ativan)-More tolerable in the elderly, less fall risk. Clonazepam and Diazepam are LONG acting. Abruptly stopping a benzodiazepine can lead to? - answer Seizure-CNS depressant, Benzos work to depress the brain, nerves, excitability. Associated with abuse/addiction, when taken longer than 4 months. The brain tries to fight its way back from the

depression of the benzos to have feeling again. Benzos are for short term or an as needed PRN prescription. Patient on Lithium reveals she was recently started on Naproxen for pain daily. Your response? - answer Naproxen can increase Lithium levels. Which of the following is considered a short- acting Benzodiazepine? - answer Lorazepam (Ativan) Beta-blocker used for anxiety, restlessness, and agitation? - answer Propranolol or Inderol-5 mg-10 mg used 2-3 times/day as needed for anxiety. Wonderful for social anxiety, used for anticipatory anxiety situation, stage presentations. Can be given 20-30 minutes before. Anxiety about being in places or situation from which escape might be difficult? - answer Agoraphobia-May be afraind to leave

home. Can have panic with or without. Panic- 1 month of worrying. Anxious patient struggles with weight, which of following meds more likely to worsen this issue? - answer Valproic Acid or Depakote. Bruproprion (Wellbutrin) and Fluoetine (Prozac) can aid in weight loss Exposure to trauma, negative mood, irritability, sleep issues, flashbacks lasting 3 days to 1 month. - answer Acute Stress Disorder-Will be within 1 month, happened recently, will be PTSD. If severe case, will be getting worse after 1 month. Medication believed to block effects of adrenaline and suppress nightmares? - answer Prazosin or minipress-1 mg-2 mg starting dose. Old BP medication. Monitor BP. Guafacine and Mirtazepine can also be used for nightmares. Patient who is stable complains of decreased sex drive from Sertraline, possible solution? -

answer add-on Buproprion (Wellbutrin)-Hits the Dopamine, pleasure chemical. Can help with orgasm issues, drive, erectile issues. Tetracyclic antidepressant that can help with sleep, appetite stimulation, and nightmares?

• answer Mirtazepine-Montor weight for heavier child. A patient with schizophrenia complains of constant auditory hallucinations, what neurotransmitter is associated with this? - answer Dopamine-Too much dopamine or overstimulation of the brain. Heightens positive symptoms that we do not want. ie. hallucinations, delusions. ADHD is too little Dopamine. Which neurotransmitters are most theorized when decreased lead to depression and anxiety? - answer Norepinephrine and Serotonin The difference in the daignosis of dysthymia vs. MDD is dysthymia must present for how long? - answer 2 years-Someone with dysthymia has that "everything is just ok",

nothings great everyday mood. Struggle with when last happy. MDD patient has a 2 week period of depression with symptoms of trouble sleeping, appetite, insight, guilt, concetration, pleasure, suicidal thoughts. MDD they remember being happy, not always sad and angry. A non-addictive and non habit forming alternative for the use in treating anxiety? - answer Buspirone or Buspar-Take everyday, 2 times/day to see the most effect 4-6 weeks. Good add-on to antidepressant and also good for children. Substance to avoid when taking MAOIs and why? - answer Tyramine and hypertensive crisis-Hardly seen in practice and used for last resort. Causes very high pressure. Tyramine items such as hotdogs, processed meat, sausage, pepperoni, chocolate, avocodoes, guac, raisins, bananas, yeasts, swiss cheese, blue cheese, wine, beer, alcohol, aged cheese.

What SSRI has a shorter half-life and most often need to be weened to prevent issues with discontinuation? - answer Paroxetine of Paxil-Pt. needs to be monitored due to days they will feel great or a low drop in their mood because of the half-life. Have a hard time discontinuing, have more anxiety, dizzy feeling. Paxil causes weight gain and sexual S/E. What class of antidepressants is more lethal in an overdose? - answer TCAs-MOre lethal, SSRIs are safer. TCAs conducton of heart issues such as EKG changes and more drying. What is a patient likely to exhibit if they suddenly stop taking Venlafaxine (Effexor)? - answer Discontinuation Syndrome-A rebound effect, feel worse than before starting the drug. Dizziness, blurry, nausea, cloudy feeling. Can feel a difference in 2-3 days. Educate patient on this if they are non- compliant. Must slowly ween off medication, so they do not have the effects.

SSRI that can often interact with many OTC and prescription drugs? - answer Fluvoxamine-Interacts with OTC cold medications ie. sudafed, decongestat. Educate patients on the possible risks involved. What antidepressant is contraindicated with seizure disorders, anorexia, and bulemia? - answer Buproprion (Wellbutrin)-Do not want to overstimulate the brain, causing a seizure; with eating disorders electrolytes are out of balance and predisposed to having a seizure. This med actually helps to DECREASE appetite. First-line treatment for depression and anxiety? - answer SSRIs-More tolerable and lower risks of S/E. Headache and N/V are common for the first 5 days of taking med. Potentially life-threatening syndrome that is precipitated by the use of serotonergic drugs? - answer Serotonin Syndrome-Test reflexes-hyperreflexia early symptom is very loose stool/diarrhea. Stp med see if symptom

resolves. Will see fever, blood pressure issues, diarrhea, shaking. Mindful of dosage when taking 2 x SSRIs and with taking Tramadol. Which of the following OTCs should avoided with concurrently taking a SSRI medication? - answer St. Johns Wort or SAMe Why is there a black box warning on antidepressants about suicide in child and adolescents? - answer Brain is not fully developed until 25 years, uncertain brain reactions. Does NOT cause suicidal thoughts. Short acting Benzos often used in elderly with dementia or PRN use? - answer Lorazepam (Ativan)-More tolerable in the elderly, less fall risk. Clonazepam and Diazepam are LONG acting. Abruptly stopping a benzodiazepine can lead to? - answer Seizure-CNS depressant, Benzos work to depress the brain, nerves, excitability. Associated with abuse/addiction,

when taken longer than 4 months. The brain tries to fight its way back from the depression of the benzos to have feeling again. Benzos are for short term or an as needed PRN prescription. Patient on Lithium reveals she was recently started on Naproxen for pain daily. Your response? - answer Naproxen can increase Lithium levels. Which of the following is considered a short- acting Benzodiazepine? - answer Lorazepam (Ativan) Beta-blocker used for anxiety, restlessness, and agitation? - answer Propranolol or Inderol-5 mg-10 mg used 2-3 times/day as needed for anxiety. Wonderful for social anxiety, used for anticipatory anxiety situation, stage presentations. Can be given 20-30 minutes before. Anxiety about being in places or situation from which escape might be difficult? -

answer Agoraphobia-May be afraind to leave home. Can have panic with or without. Panic- 1 month of worrying. Anxious patient struggles with weight, which of following meds more likely to worsen this issue? - answer Valproic Acid or Depakote. Bruproprion (Wellbutrin) and Fluoetine (Prozac) can aid in weight loss Exposure to trauma, negative mood, irritability, sleep issues, flashbacks lasting 3 days to 1 month. - answer Acute Stress Disorder-Will be within 1 month, happened recently, will be PTSD. If severe case, will be getting worse after 1 month. Medication believed to block effects of adrenaline and suppress nightmares? - answer Prazosin or minipress-1 mg-2 mg starting dose. Old BP medication. Monitor BP. Guafacine and Mirtazepine can also be used for nightmares.

Patient who is stable complains of decreased sex drive from Sertraline, possible solution? - answer add-on Buproprion (Wellbutrin)-Hits the Dopamine, pleasure chemical. Can help with orgasm issues, drive, erectile issues. Tetracyclic antidepressant that can help with sleep, appetite stimulation, and nightmares?

• answer Mirtazepine-Montor weight for heavier child. A patient with schizophrenia complains of constant auditory hallucinations, what neurotransmitter is associated with this? - answer Dopamine-Too much dopamine or overstimulation of the brain. Heightens positive symptoms that we do not want. ie. hallucinations, delusions. ADHD is too little Dopamine.