Exam 3- Nsg 552 psychopharmacology |91 questions and answers.

personality disorders psychological disorders characterized by inflexible and enduring behavior patterns that impair social functioning substance abuse Any unnecessary or improper use of chemical substances for nonmedical purposes sexual disfunction a problem that consistently impairs sexual arousal or functioning neurodevelopmental disorders neurologically based disorders that are revealed in a clinically significant way during a child's developing years neurocognitive disorders acquired (not lifelong) disorders marked by cognitive deficits; often related to Alzheimer's disease, brain injury or disease, or substance abuse. In older adults neurocognitive disorders were formerly called dementia neurocognitive disorders psychopathologies due to various forms of damage to the nervous system not arising until adulthood Dementia Treating comorbidities such as depression-consider the whole picture Rivastigmine (Exelon) -Anticholinesterse - increases ACh -Alzheimer disease Rivastigmine (Exelon) acetylcholinesterase inhibitor- treat symptoms of alzheimers Memantine (Namenda) NMDA receptor antagonist - Alzheimer's Donepezil (Aricept) acetylcholinesterase inhibitor - inactivates enzyme that breaks down acetylcholine - which increases available acetylcholine - which slows progression of AD; SIDE EFFECTS: think parasympathetic activation - bradycardia, hypotension, urination, defecation, GI upset, salivation, sweating Galantamine (Reminyl) Acetylcholinesterase Inhibitors for Alzheimer's stops progression of alzheimers delirium an acutely disturbed state of mind that occurs in fever, intoxication, and other disorders and is characterized by restlessness, illusions, and incoherence of thought and speech. Differences in delirium and dementia delirium is often reversible dementia is not Delirium treatment - identify and address the underlying cause - optimize brain condition (O2, hydration, pain, etc. - antipsychotics (haldol) delirium an acutely disturbed state of mind that occurs in fever, intoxication, and other disorders and is characterized by restlessness, illusions, and incoherence of thought and speech. Pharmacological treatment for IDD? none behavioral therapy may be implemented and if necessary, pharmacological options for behavioral control. Must be vigilant about monitoring for SE due to potential communication problems Treatment of Autism limited. only for agitation/ behavioral decontrol. Frequently antipsychotics used. Be wary of SE, metabolic syndrome, sedation, ets. ADHD treatment Stimulants (methylphenidate, amphetamines) Treatment of ADHD Methylphenidate(Daytrana, concerta, ritalin) (blocks only Dopamine) - Nausea, decrease appetite, increase HR Adn BP stunted growth Amphetamine (blocks da and Ne)- same se Atomoxetine (straterra) NE reuptake inhibitor non stimulant - Treatment of ADHD Stimulants are 1st line (take in the AM) - Methylphenidate (concerta, daytrana, ritalin), Lisdexamfetamine (vyvanse), Amphetamine + Dextroamphetamine (adderall) Non-stimulants are 2nd line Atomoxetine (Strattera) Add on medications or used alone (Central Alpha-2A agonists): - Guanfacine (Intuniv) - Clonidine (Kapvay) Concerta half life long 3.5 hours Vyvance (Lisdexamfetamine) CNS Stimulant, used for ADHD; C-II Adderall half life 9-14 hours Adderall side effects N/V, headache, blurred vision, irritability, insomnia, loss of appetite, weight loss, hair loss, constipation, dry mouth Straterra (atomoxetine) NE reuptake inhibitor ADHD straterra (Atomoxetine)side effects Priapism, headache, insomnia, somnolence, dry mouth, nausea, abd pain, decr appetite & nausea straterra (atomoxetine) side effects nausea loss of appetite fatigue changes in mood decrease libido priapism Guanfacine Hydrochloride (intunive) Antihypertensive/Antipsychotic- used to treat ADHD guanfacine indication intuiv attention deficit hyperactivity disorder Clonidine ADHD administration frequency qhs Treatment of acute intoxication of opioids Naloxone- Respiratory depression hypotension bradycardia hypothermic Miosis Opioid Withdrawal symptoms Unpleasant physical reactions, combined with intense drug cravings, that occur when a person abstains from a drug on which he or she is physically dependent. increased lacrimation muscle aches abdominal cramps and diarrhea Opioid used in the management of withdrawal states Naloxone- MoA u-opiod antagonist Naltrexone MOA Buprenorphine- MOA-u opioid receptor partial agonist Buprenorphine/Naloxone- Suboxone Buprenorphine-Naloxone Suboxone Suboxone indication opioid dependence Acute intoxication cocaine/amphetamines treatment Benzodiazepines agitation violent muscle twitches hypertension tachycardia hyperthermic hallucinations mydriasis Alcohol acute intoxication treatment is supportive only -confusion -slurred speech -poor balance, slowed responses and reaction time -vomiting -impaired judgement Alcohol withdrawal can be life-threatening elevated LFT anxiety, tremor, increase BP/HR/RR delirium tremens / seizure meds for alcohol withdrawal -diazepam -carbamazepine -clonidine -chloridiazepoxide -phenobarbital -naltrexone meds for alcohol abstinence disulfiram, naltrexone, acamprosate Nicotine withdrawal 5 A's Ask, advise, assess, assist, and arrange Treatment of nicotine addiction nicotine patch provides transdermal doses of nicotine and has been shown to double long-term abstinence rates. Bupropion Verenicline Behavioral modification Sexual Disfunction- consider medication induced take a thorough sexual history to assess for any preexisting dysfunction erectile dysfunction inability of an adult male to achieve an erection; impotence Erectile dysfunction etiology Antidepressants, CV ds., DM, hypogonadism premature ejaculation hypoactive desire in males with ED consider medical issues as well as exogenous factors (marital discord, stressors...) personality disorders definition psychological disorders characterized by inflexible and enduring behavior patterns that impair social functioning Personality disorders treatment difficult to treat-psychotherapy only for primary traits Pharmacologic therapy for comorbidities Countertransference