PMHNP I - Exam 1 -
Psychopharmacology
Psychotropic Medications - ✔✔Antidepressants, antipsychotics, mood stabilizers, anxiolytics,
hypnotics, stimulants
Organized by structure
MOA
Distinguished by subtle differences in molecular structure.
Most psychotropics are lipophilic and highly protein bound; thus, older adults have more body fat and
less protein, more likely to develop toxicity.
Pharmacology - ✔✔Study of what drugs do and how they do it.
Pharmacokinetics - ✔✔What the BODY does to the DRUG (ADME)
Pharmacodynamics - ✔✔What the DRUG does to the BODY
Time course and intensity of a drug's effect
Drug MOA
Therapeutic Index - ✔✔Measure of a toxicity or safety of a drug
The ratio of the median toxic dose to the median effective dose
The median toxic dose is the dose at which 50% of patients experience a toxic effect
If the therapeutic index is high, it is reflected by a wide range dosage of which the drug is prescribed
(Haloperidol, Depakote)
If the therapeutic index is low, careful monitoring of serum drug levels will be needed (Lithium)
, Suicidal Ideation and Antidepressant Tx - ✔✔Higher risk up to age 24 in short term tx (4-16 wks)
BBW
Clozapine ADR - ✔✔Agranulocytosis
Lamictal ADR - ✔✔SJS
Nefazodone (Serzonel) ADR - ✔✔Hepatic failure
Phenelizine (Nardil) ADR - ✔✔Stroke
Thioridzaine (Mellaril) ADR - ✔✔Heart Block
Longterm Complication of DRA Haldol - ✔✔Tardive dyskinesia; increased risk of breast CA (larger
cumulative doses)
Somnolence - ✔✔Often an intended effect of many psychotropic drugs
Treat insomnia, anxiety, or agitation
Clinician should alert patient to use caution when driving or operating heavy machinery
Management of somnolence can include:
- Adjusting the time or dosing of medication
- Switch to an alternative medication
GI Disturbances - ✔✔Consequence of muscarinic activity (Ach) - constipation, dry mouth
Most of the body's serotonin is in the GI tract
Psychopharmacology
Psychotropic Medications - ✔✔Antidepressants, antipsychotics, mood stabilizers, anxiolytics,
hypnotics, stimulants
Organized by structure
MOA
Distinguished by subtle differences in molecular structure.
Most psychotropics are lipophilic and highly protein bound; thus, older adults have more body fat and
less protein, more likely to develop toxicity.
Pharmacology - ✔✔Study of what drugs do and how they do it.
Pharmacokinetics - ✔✔What the BODY does to the DRUG (ADME)
Pharmacodynamics - ✔✔What the DRUG does to the BODY
Time course and intensity of a drug's effect
Drug MOA
Therapeutic Index - ✔✔Measure of a toxicity or safety of a drug
The ratio of the median toxic dose to the median effective dose
The median toxic dose is the dose at which 50% of patients experience a toxic effect
If the therapeutic index is high, it is reflected by a wide range dosage of which the drug is prescribed
(Haloperidol, Depakote)
If the therapeutic index is low, careful monitoring of serum drug levels will be needed (Lithium)
, Suicidal Ideation and Antidepressant Tx - ✔✔Higher risk up to age 24 in short term tx (4-16 wks)
BBW
Clozapine ADR - ✔✔Agranulocytosis
Lamictal ADR - ✔✔SJS
Nefazodone (Serzonel) ADR - ✔✔Hepatic failure
Phenelizine (Nardil) ADR - ✔✔Stroke
Thioridzaine (Mellaril) ADR - ✔✔Heart Block
Longterm Complication of DRA Haldol - ✔✔Tardive dyskinesia; increased risk of breast CA (larger
cumulative doses)
Somnolence - ✔✔Often an intended effect of many psychotropic drugs
Treat insomnia, anxiety, or agitation
Clinician should alert patient to use caution when driving or operating heavy machinery
Management of somnolence can include:
- Adjusting the time or dosing of medication
- Switch to an alternative medication
GI Disturbances - ✔✔Consequence of muscarinic activity (Ach) - constipation, dry mouth
Most of the body's serotonin is in the GI tract
