NUR 255
EXAM 3 STUDY GUIDE
(Covers Units 6, 7, & 8)
Concepts of Aging, Chronic Illness & Mental Health
Nursing - Galen College of Nursing
,Exam 3 Study Guide Mental Health
What is pharmacodynamics?
- Effect of drugs on the body, drug action and biological response
- Understand that side effects will be based on the person and will be different for all ages.
What is pharmacokinetics?
- Action of person on drug, absorption, gastric acid, motility, metabolism, in liver, excretion in
kidney or bowel.
- Blood level of drug guides dosage, determines type and amount of drug alternation for
individuals with altered metabolic or exertion functions
o An example of a drug that you’ll get levels on is lithium.
Anxiolytic Medications:
- Benzodiazepines:
These cause withdraw when coming off and if you don’t ween off it can cause death.
Additive medications such as benzo you don’t want to give to addicts unless you have to.
You can’t stop taking them without talking to DR first, don’t stop cold turkey
If they put them on Morphine it won’t cut it for helping come off of it, needs to be a Benzo.
o Lorazepam *Ativan*
This one seems to be the go to for medications now.
Can be given in all forms
o Alprazolam *Xanax*
This can only be given PO
o Diazepam *Valium*
o Clonazepam *Klonopin*
- Atypical Antidepressants:
o Busprinone *BuSpar*
Not addictive, this medication is good for addicts, used for depression and
anxiety
- SNRI’s
o Venlafaxine *Effexor*
o Duloxetine *Cymbalta*
Hypnotic Drugs:
- Benzodiazepines:
These are considered sleep inducers
o Flurazepam *Dalmane*
o Temazepam *Restoril*
, o Triazolam *Halcion*
o Estazolam *Prosom*
o Quazepam *Doral*
- Z-Hypnotics:
These are straight sleeping pills
o Zolpidem *Ambien*
o Zaleplone *Sonata*
o Eszopiclone *Lunesta*
- Melatonin Receptor Agonists:
o Ramelteon *Rozerem*
- Doxepin
o Doxepin *Silenor*
Antidepressant Medications:
***All antidepressants they aren’t going to see improvements for several weeks *2-3 weeks* up to 6
weeks like TCAs.***
- Selective Serotonin Reuptake Inhibitors aka SSRI’s:
These only have serotonin, they have the least amount of side effects. Sexual dysfunction is
the biggest side effect with these medications. Penis dysfunction and also just not being able
to have an orgasm.
This plus every other antidepressant medication have a bigger risk for suicide. As they feel
better they have the energy to kill themselves.
o Fluoxetine *Prozac*
o Sertraline *Zoloft*
o Paroxetine *Paxil*
o Citalopram *Celexa*
o Escitalopram *Lexapro*
o Fluvoxamine *Luvox*
- Serotonin-Norepinephrine Reuptake Inhibitors aka SNRI’s:
They are more effective for some because they effect 2 neurotransmitters, don’t have huge
side effects just know that suicide is the biggest thing.
o Venlafaxine *Effexor*
o Desvenlafaxine *Pristiq*
o Duloxetine *Cymbalta*
- Serotonin-Norepinephrine aka SNDI’s:
o Mirtazapine *Remeron*
Cross over for chronic pain and Cymbalta and Effexor, have to be careful to give
antidepressant medication to bipolar people. They can send them straight into
mania.
- Monoamine Oxidase Inhibitors aka MAOIs:
, These interact with basically everything such as tyramine. Dietary restrictions are big with
this medication. Can’t have anything pickles, aged, processed, rich. So no cheese, no
dressing on salads for example.
Eating something with Tyramine can cause hypertensive crisis *the liver doesn’t process it.
o Isocarboxazid *Marplan*
o Phenelzine *Nardill*
o Tranylcypromine *Parnate*
- Atypical Antidepressants
o Bupropion *Wellbutrin*
Also used for smoking sensation as well as antidepressant
Can cause hallucinations
o Vilazodone *Viibryd*
o Trazodone *Oleptro
- Tricyclic antidepressants aka TCAs:
Anticholinergic can affects when taking this medication
This class of medication can cross over and be used for chronic pain.
o Can take 7 days to get relief for chronic pain but for depression can take up to 6
weeks.
o Nortriptyline *Pamelor*
o Amitriptyline *Elavil*
o Imipramine *Tofranil*
Mood Stabilizer and Anticonvulsant Drugs
- Mood stabilizers:
Anticonvulsants and lithium are added together to help with mania episodes.
o Lithium *Eskalith*
Bipolar people need to take lithium, it works great for them except has a thin
therapeutic index. It can go toxic quickly 0.5-1.5 scale. If they drink to much
water it will go below the index. If they have to much salt the lithium level can
get messed up as well. These are good diet questions for them to ask questions
on. Don’t have to push water or salt or limit it but just need to stay the same
they were drinking prior to taking the medication.
Make sure you check lithium levels in the beginning.
Long term use of lithium can effect the thyroid
o Anticonvulsants
Valproate *Depakote and Depakene*
Carbamazepine *Tegretol*
Lamotrigine *Lamictal*
Gabapentin *Neurontin*
Topiramate *Topamax*
Oxcarbazepine *Trileptal*
Pregabalin *Lyrica*
o With Anticonvulsants you must monitor liver enzymes. Also know that seizure meds
effect people differently.
EXAM 3 STUDY GUIDE
(Covers Units 6, 7, & 8)
Concepts of Aging, Chronic Illness & Mental Health
Nursing - Galen College of Nursing
,Exam 3 Study Guide Mental Health
What is pharmacodynamics?
- Effect of drugs on the body, drug action and biological response
- Understand that side effects will be based on the person and will be different for all ages.
What is pharmacokinetics?
- Action of person on drug, absorption, gastric acid, motility, metabolism, in liver, excretion in
kidney or bowel.
- Blood level of drug guides dosage, determines type and amount of drug alternation for
individuals with altered metabolic or exertion functions
o An example of a drug that you’ll get levels on is lithium.
Anxiolytic Medications:
- Benzodiazepines:
These cause withdraw when coming off and if you don’t ween off it can cause death.
Additive medications such as benzo you don’t want to give to addicts unless you have to.
You can’t stop taking them without talking to DR first, don’t stop cold turkey
If they put them on Morphine it won’t cut it for helping come off of it, needs to be a Benzo.
o Lorazepam *Ativan*
This one seems to be the go to for medications now.
Can be given in all forms
o Alprazolam *Xanax*
This can only be given PO
o Diazepam *Valium*
o Clonazepam *Klonopin*
- Atypical Antidepressants:
o Busprinone *BuSpar*
Not addictive, this medication is good for addicts, used for depression and
anxiety
- SNRI’s
o Venlafaxine *Effexor*
o Duloxetine *Cymbalta*
Hypnotic Drugs:
- Benzodiazepines:
These are considered sleep inducers
o Flurazepam *Dalmane*
o Temazepam *Restoril*
, o Triazolam *Halcion*
o Estazolam *Prosom*
o Quazepam *Doral*
- Z-Hypnotics:
These are straight sleeping pills
o Zolpidem *Ambien*
o Zaleplone *Sonata*
o Eszopiclone *Lunesta*
- Melatonin Receptor Agonists:
o Ramelteon *Rozerem*
- Doxepin
o Doxepin *Silenor*
Antidepressant Medications:
***All antidepressants they aren’t going to see improvements for several weeks *2-3 weeks* up to 6
weeks like TCAs.***
- Selective Serotonin Reuptake Inhibitors aka SSRI’s:
These only have serotonin, they have the least amount of side effects. Sexual dysfunction is
the biggest side effect with these medications. Penis dysfunction and also just not being able
to have an orgasm.
This plus every other antidepressant medication have a bigger risk for suicide. As they feel
better they have the energy to kill themselves.
o Fluoxetine *Prozac*
o Sertraline *Zoloft*
o Paroxetine *Paxil*
o Citalopram *Celexa*
o Escitalopram *Lexapro*
o Fluvoxamine *Luvox*
- Serotonin-Norepinephrine Reuptake Inhibitors aka SNRI’s:
They are more effective for some because they effect 2 neurotransmitters, don’t have huge
side effects just know that suicide is the biggest thing.
o Venlafaxine *Effexor*
o Desvenlafaxine *Pristiq*
o Duloxetine *Cymbalta*
- Serotonin-Norepinephrine aka SNDI’s:
o Mirtazapine *Remeron*
Cross over for chronic pain and Cymbalta and Effexor, have to be careful to give
antidepressant medication to bipolar people. They can send them straight into
mania.
- Monoamine Oxidase Inhibitors aka MAOIs:
, These interact with basically everything such as tyramine. Dietary restrictions are big with
this medication. Can’t have anything pickles, aged, processed, rich. So no cheese, no
dressing on salads for example.
Eating something with Tyramine can cause hypertensive crisis *the liver doesn’t process it.
o Isocarboxazid *Marplan*
o Phenelzine *Nardill*
o Tranylcypromine *Parnate*
- Atypical Antidepressants
o Bupropion *Wellbutrin*
Also used for smoking sensation as well as antidepressant
Can cause hallucinations
o Vilazodone *Viibryd*
o Trazodone *Oleptro
- Tricyclic antidepressants aka TCAs:
Anticholinergic can affects when taking this medication
This class of medication can cross over and be used for chronic pain.
o Can take 7 days to get relief for chronic pain but for depression can take up to 6
weeks.
o Nortriptyline *Pamelor*
o Amitriptyline *Elavil*
o Imipramine *Tofranil*
Mood Stabilizer and Anticonvulsant Drugs
- Mood stabilizers:
Anticonvulsants and lithium are added together to help with mania episodes.
o Lithium *Eskalith*
Bipolar people need to take lithium, it works great for them except has a thin
therapeutic index. It can go toxic quickly 0.5-1.5 scale. If they drink to much
water it will go below the index. If they have to much salt the lithium level can
get messed up as well. These are good diet questions for them to ask questions
on. Don’t have to push water or salt or limit it but just need to stay the same
they were drinking prior to taking the medication.
Make sure you check lithium levels in the beginning.
Long term use of lithium can effect the thyroid
o Anticonvulsants
Valproate *Depakote and Depakene*
Carbamazepine *Tegretol*
Lamotrigine *Lamictal*
Gabapentin *Neurontin*
Topiramate *Topamax*
Oxcarbazepine *Trileptal*
Pregabalin *Lyrica*
o With Anticonvulsants you must monitor liver enzymes. Also know that seizure meds
effect people differently.
