Antidepressants
Mood Stabilizers and Lab Values
Antipsychotics
Anxiolytics
Side Effects/Adverse Reactions
100

Venlafaxine and duloxetine are members of this drug class.

What are Selective Norepinephrine Reuptake Inhibitors

100

What important instructions must be adhered to when performing of bloodwork to measure Lithium levels?

Trough

Blood levels should be drawn 12 hours after the last dose.

100

What are examples of EPS

dystonias

parkinsonism

tardive dyskinesia 

100
Benzodiazepines are often used to manage withdrawal symptoms from this substance
What is alcohol.
100
There is an increased risk for agranulocytosis when taking this medication.
What is clozaril
200

What common supplement interacts with antidepressants and is therefore contraindicated?

St. Johns Wort

200

What must a nurse monitor for on a patient starting antieleptics?

suicide risk

200

What population is  antipsychotics absolutely contraindicated in?

elder adults with NCD

200
These drug classes are considered first line of treatment in anxiety disorderes
What are SSRIs and newer antidepressants.
200
Severe muscle rigidity, diaphoresis, labile pulse and blood pressure, stupor, coma, and death are the symptoms of this severe adverse reaction seen in antipsychotics.
What is neuroleptic malignant syndrome or NMS.
300

What is a patient at risk for if they suddenly stop taking their antidepressants, and what are 3 symptoms will they have?

The mnemonic FINISH summarizes the symptoms of antidepressant discontinuation syndrome: Flu-like symptoms (lethargy, fatigue, headache, achiness, sweating), Insomnia (with vivid dreams or nightmares), Nausea (sometimes vomiting), Imbalance (dizziness, vertigo, light-headedness), Sensory disturbances (“burning,” “tingling,” “electric-like” or “shock-like” sensations) and Hyperarousal (anxiety, irritability, agitation, aggression, mania, jerkiness).3

300
Patients should avoid consuming this when taking a mood stabilizer or anticonvulsant.
What is alcohol.
300

What does DRESS stand for? and what medication is this reaction seen in?

drug reaction with eosinophilia and systemic symptoms

olanzapine 

300

These classes of drugs are used off label to treat anxiety through the blocking of peripheral or central nonadrenergic activity.

What are beta blockers and alpha 2 receptor agonists (propranolol and clonidine).

300
There is an increase risk of seizures with this antidepressant.
What is bupropion (wellbutrin).
400
A client must avoid foods that are high in Tyramine when taking a medication from this drug class.
What are Monoamine Oxidase Inhibitors (MAOIs).
400

Why must a nurse conduct an integumentary assessment in a patient taking neuroleptic medications?

Risk of 

Stevens-Johnson syndrome (especially with lamotrigine and carbamazepine)

This toxic skin necrolysis can be life threatening

400

Second generation antipsychotics, in addition to acting on the dopamine receptors, also have an effect on the neurotransmitter  ___________________, causing improvement in ________ and __________, which are negative symptoms in schizophrenia. 

Second-generation antipsychotics, in addition to acting on the dopamine receptors, also have an effect on the neurotransmitter serotonin (5-HT), causing improvement in affect and social withdrawal, which are negative symptoms in schizophrenia.

400

The FDA added a boxed warning (its strongest warning) related to the serious risks and possible death associated with combining benzodiazepines with this substance

opioid pain medications or opioid cough medications

400
Tricyclic antidepressants (nortriptyline, amytriptyline, doxepin, etc.) commonly cause these side effects.
What are drowsiness, low blood pressure, dry mouth, urinary retention.
500

List 5 signs of serotonin syndrome

  • Agitation or restlessness.
  • Insomnia.
  • Confusion.
  • Rapid heart rate and high blood pressure.
  • Dilated pupils.
  • Loss of muscle coordination or twitching muscles.
  • High blood pressure.
  • Muscle rigidity.
500
This is the target serum lithium level for acute mania.
What is 1.0-1.5
500

What is the difference between akinesia and akathisia?

Akinesia: Absence or impairment in voluntary movement.

■  Akathisia: Continuous restlessness and fidgeting, or akathisia, occurs most often in women and may manifest 50 to 60 days after therapy begins. Combining atypical antipsychotics has demonstrated a three-fold risk for developing akathisia compared with monotherapy with a single second generation antipsychotic (Berna et al., 2015).

500

What type of effect can cause anxiety, agitation, hallucinations, irritability, and insomnia in patients taking benzodiazepines?

Paradoxical excitement/paradoxical effect

500
Tongue protrusion, lip smacking, choreiform movements, chewing are symptoms of this side effect, seen at times in patients taking conventional antipsychotics.
What is tardive dyskinesia.
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