NURS 660 Maryville |! |! |!
Exam 3 |! |!
Psychopharmacology |!
with precise answers |! |! |!
Sertraline (Zoloft) |! |!
Major Side Effects - Correct answer ✔insomnia, somnolence, HA, dry mouth,
|! |! |! |! |! |! |! |! |! |!
sex dysfunction, nausea & diarrhea
|! |! |! |! |!
Fluoxetine (Prozac) |! |!
Major Side Effect - Correct answer ✔Activating (UPPER); AGITATION,
|! |! |! |! |! |! |! |! |!
INSOMNIA, nausea, vomiting, sex dysfunction, GI, serotonin syndrome
|! |! |! |! |! |! |!
Paraoxetine (Paxil) |! |!
Major Side Effects - Correct answer ✔Anticholinergic (can't see, can't sleep,
|! |! |! |! |! |! |! |! |! |! |!
can't shit, can't spit), CYP2D6 inhibitor, increases TCA, phenothiazines, Type
|! |! |! |! |! |! |! |! |! |!
1C antiarrhythmics, weight gain, GI, sex dysfunction, insomnia, serotonin
|! |! |! |! |! |! |! |! |!
syndrome
,Lithium |!
Major Side Effects - Correct answer ✔increased thirst & urination, impaired
|! |! |! |! |! |! |! |! |! |! |!
concentration/memory, fatigue, tremor, weight gain. |! |! |! |! |!
Toxicity: cramps, v/d, kidney dysfunction, coarse tremor, confusion,
|! |! |! |! |! |! |! |!
irritability. Severe toxicity: seizures, coma, death.
|! |! |! |! |!
Fluvoxamine (Luvox) |! |!
Major Side Effects - Correct answer ✔nausea, vomiting, weight gain, sex
|! |! |! |! |! |! |! |! |! |! |!
dysfunction; BIG BBW for SI on this drug|! |! |! |! |! |! |!
Major side effects for sertraline, fluoxetine, paroxetine, and fluvoxamine
|! |! |! |! |! |! |! |! |!
(generals for all) |! |!
•Most side effects are immediate and go away with time - Correct answer
|! |! |! |! |! |! |! |! |! |! |! |! |!
✔sexual dysfunction (dose dependent- men: delayed ejaculation, ED; men
|! |! |! |! |! |! |! |! |!
and women: decreased sexual desire, anorgasmia)
|! |! |! |! |!
GI: decreased appetite, nausea, diarrhea, constipation, dry mouth
|! |! |! |! |! |! |!
Mostly CNS: insomnia, sedation, agitation, tremors, headache, dizziness
|! |! |! |! |! |! |!
,Autonomic: sweating |!
Bruising and rare bleeding |! |! |!
Rare hyponatremia (mostly in elderly)
|! |! |! |!
Rare hypotension
|!
SIADH
Weight gain |!
Rare: seizures, induction of mania, activation of suicidal ideation and
|! |! |! |! |! |! |! |! |! |!
behavior
Major side effects for sertraline, fluoxetine, paroxetine, and fluvoxamine
|! |! |! |! |! |! |! |! |!
(generals for all) r/t to increased serotonin - Correct answer ✔concentrations
|! |! |! |! |! |! |! |! |! |! |!
at serotonin receptors in parts of brain and body other than those that cause
|! |! |! |! |! |! |! |! |! |! |! |! |! |!
therapeutic actions (e.g. unwanted actions of serotonin in sleep centers
|! |! |! |! |! |! |! |! |! |!
causing insomnia or in gut causing diarrhea)
|! |! |! |! |! |!
can cause diminished dopamine release and might contribute to emotional
|! |! |! |! |! |! |! |! |! |!
flattening, cognitive slowing, and apathy in some patients
|! |! |! |! |! |! |!
, Major side effects for sertraline, fluoxetine, paroxetine, and fluvoxamine
|! |! |! |! |! |! |! |! |!
(generals for all) |! |!
Patients with diagnosed or undiagnosed bipolar or psychotic disorders -
|! |! |! |! |! |! |! |! |! |!
Correct answer ✔may be more vulnerable to CNS-activating actions of SSRIs
|! |! |! |! |! |! |! |! |! |!
Know major side effects for lithium (typically dose related) - Correct answer
|! |! |! |! |! |! |! |! |! |! |! |!
✔Ataxia, dysarthria, delirium, tremor, memory problems
|! |! |! |! |!
Polyuria, polydipsia (nephrogenic diabetes insipidus)
|! |! |! |!
Diarrhea, nausea |!
Weight gain |!
Euthyroid goiter or hypothyroid goiter, possibly with increased TSH and
|! |! |! |! |! |! |! |! |! |!
reduced thyroxine levels
|! |!
Acne, rash, alopecia
|! |!
Leukocytosis
Life Threatening: TOXICITY: TREMOR, ATAXIA, N/V/D, SEDATION, DI,
|! |! |! |! |! |! |! |!
INTESTINAL NEPHRITIS, T WAVE FLATTENING, SEIZURES |! |! |! |! |!
Exam 3 |! |!
Psychopharmacology |!
with precise answers |! |! |!
Sertraline (Zoloft) |! |!
Major Side Effects - Correct answer ✔insomnia, somnolence, HA, dry mouth,
|! |! |! |! |! |! |! |! |! |!
sex dysfunction, nausea & diarrhea
|! |! |! |! |!
Fluoxetine (Prozac) |! |!
Major Side Effect - Correct answer ✔Activating (UPPER); AGITATION,
|! |! |! |! |! |! |! |! |!
INSOMNIA, nausea, vomiting, sex dysfunction, GI, serotonin syndrome
|! |! |! |! |! |! |!
Paraoxetine (Paxil) |! |!
Major Side Effects - Correct answer ✔Anticholinergic (can't see, can't sleep,
|! |! |! |! |! |! |! |! |! |! |!
can't shit, can't spit), CYP2D6 inhibitor, increases TCA, phenothiazines, Type
|! |! |! |! |! |! |! |! |! |!
1C antiarrhythmics, weight gain, GI, sex dysfunction, insomnia, serotonin
|! |! |! |! |! |! |! |! |!
syndrome
,Lithium |!
Major Side Effects - Correct answer ✔increased thirst & urination, impaired
|! |! |! |! |! |! |! |! |! |! |!
concentration/memory, fatigue, tremor, weight gain. |! |! |! |! |!
Toxicity: cramps, v/d, kidney dysfunction, coarse tremor, confusion,
|! |! |! |! |! |! |! |!
irritability. Severe toxicity: seizures, coma, death.
|! |! |! |! |!
Fluvoxamine (Luvox) |! |!
Major Side Effects - Correct answer ✔nausea, vomiting, weight gain, sex
|! |! |! |! |! |! |! |! |! |! |!
dysfunction; BIG BBW for SI on this drug|! |! |! |! |! |! |!
Major side effects for sertraline, fluoxetine, paroxetine, and fluvoxamine
|! |! |! |! |! |! |! |! |!
(generals for all) |! |!
•Most side effects are immediate and go away with time - Correct answer
|! |! |! |! |! |! |! |! |! |! |! |! |!
✔sexual dysfunction (dose dependent- men: delayed ejaculation, ED; men
|! |! |! |! |! |! |! |! |!
and women: decreased sexual desire, anorgasmia)
|! |! |! |! |!
GI: decreased appetite, nausea, diarrhea, constipation, dry mouth
|! |! |! |! |! |! |!
Mostly CNS: insomnia, sedation, agitation, tremors, headache, dizziness
|! |! |! |! |! |! |!
,Autonomic: sweating |!
Bruising and rare bleeding |! |! |!
Rare hyponatremia (mostly in elderly)
|! |! |! |!
Rare hypotension
|!
SIADH
Weight gain |!
Rare: seizures, induction of mania, activation of suicidal ideation and
|! |! |! |! |! |! |! |! |! |!
behavior
Major side effects for sertraline, fluoxetine, paroxetine, and fluvoxamine
|! |! |! |! |! |! |! |! |!
(generals for all) r/t to increased serotonin - Correct answer ✔concentrations
|! |! |! |! |! |! |! |! |! |! |!
at serotonin receptors in parts of brain and body other than those that cause
|! |! |! |! |! |! |! |! |! |! |! |! |! |!
therapeutic actions (e.g. unwanted actions of serotonin in sleep centers
|! |! |! |! |! |! |! |! |! |!
causing insomnia or in gut causing diarrhea)
|! |! |! |! |! |!
can cause diminished dopamine release and might contribute to emotional
|! |! |! |! |! |! |! |! |! |!
flattening, cognitive slowing, and apathy in some patients
|! |! |! |! |! |! |!
, Major side effects for sertraline, fluoxetine, paroxetine, and fluvoxamine
|! |! |! |! |! |! |! |! |!
(generals for all) |! |!
Patients with diagnosed or undiagnosed bipolar or psychotic disorders -
|! |! |! |! |! |! |! |! |! |!
Correct answer ✔may be more vulnerable to CNS-activating actions of SSRIs
|! |! |! |! |! |! |! |! |! |!
Know major side effects for lithium (typically dose related) - Correct answer
|! |! |! |! |! |! |! |! |! |! |! |!
✔Ataxia, dysarthria, delirium, tremor, memory problems
|! |! |! |! |!
Polyuria, polydipsia (nephrogenic diabetes insipidus)
|! |! |! |!
Diarrhea, nausea |!
Weight gain |!
Euthyroid goiter or hypothyroid goiter, possibly with increased TSH and
|! |! |! |! |! |! |! |! |! |!
reduced thyroxine levels
|! |!
Acne, rash, alopecia
|! |!
Leukocytosis
Life Threatening: TOXICITY: TREMOR, ATAXIA, N/V/D, SEDATION, DI,
|! |! |! |! |! |! |! |!
INTESTINAL NEPHRITIS, T WAVE FLATTENING, SEIZURES |! |! |! |! |!
