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8/30/24, 4:10 AM NURS 663 Exam 1 Flashcards | QuizletScience Medicine Psychiatry
NURS 663 Exam 1
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Terms in this set (139)
Manic episode: 1+ week of a colon elevated, expansive or irritable mood and increase
energy. 3+ symptoms from B: distractibility, indiscretion, irresponsible, grandiosity, flight
Bipolar one disorder DSM five criteria
of ideas, activity(Increase goal-orient), decreased need for sleep, talkativeness or
pressured speech.
Hypo mania and major depressive disorder: hypo mania same as mania with decreased
Bipolar two DSM five criteria severity and duration and no functional impairment for episode of four or more days
and no psychosis
Manic and depressive symptoms time by side usually with comorbid substance abuse
Mixed episodes (bipolar)
increased risk of suicide and psychosis
rapid cycling Four or more cycles per year no greater than a week well period
Two or more years of mood cycling with dysthymia and hypo mania decreased intensity
Cyclothymia DSM-V Criteria than bipolar disorder meets criteria for hypo mania but does not meet criteria for major
depressive disorder
HE'S 2 SAD depressive symptoms lasting two or more years that is subsydromal
Dysthymia DSM five criteria characterized by hopelessness decreased energy, decrease self-esteem for two years,
abnormal sleep, abnormal appetite impaired decision-making.
Catalyzes the deamination of monoamines intracellularly and MAO transport Reuptake
MAOÍ Mechanism of action generally
extracellular monoamines
MAO-A Mechanism of action MAO-A Oxidizes serotonin norepinephrine and epinephrine
MAO-B Mechanism of action Oxidizes phenylalanine
MAO-A and MAO-B mechanism of action Oxidizes dopamine non-preferentially
Date with Tyra banks with wine and cheese in Maui— can cause hypertensive crisis
related to tyramine from aged food.
MAOs Neumonic -2
MAWIs= my arms weight increased= effective for atypical depression
Hypertensive crisis, diet restriction, avoid meds, five week after Prozac, two week after
MAOs adverse effects-6
other antidepressants, no other medications for two weeks after discontinuing
MAOs diet restriction-4 compounds Tyrosine, high tyramine, tryptophan, phenylalanine
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Aged cheese, aged wine, fava or broad bean pods, sauerkraut, soy sauce, tap or draft
Tyrosine foods-10
beer, overripe fruit, cured meat, spoiled food
Antidepressants, Dextromethorphan, stimulants, sympathomimetics, meperidine,
MAOs drugs to avoid- 6
disulfiram
Increased weight, drowsy, dizzy, orthostatic hypotension, tremor, headache, dry mouth,
MAOs side effects 11
constipation, change in sexual drive, peripheral Edema, sweating
Inhibit 5HT2, norepinephrine, dopamine and reuptake slows. Amino group interferes
Tricyclic mechanism of action
with ASP - 98 in HSERT. Causing down regulation of receptors.
Anticholinergic effects (dry mouth, blurred vision, constipation, urine retention,
impotence). Histamine effects (sedation, increased weight). Adrenergic alpha receptor
Tricyclic side effects
(postural hypotension). Direct membrane effects (decrease seizure threshold and
arrhythmias). 5HT2 receptor (increase weight and decrease anxiety).
Start at 25 to 50 mg per day, titrate 25 to 50 mg per day per week, Max dose is 300 mg
Amitriptyline dosing/Class
per day/TCA
Amitriptyline, nortriptyline, clomipramine, imipramine, protriptyline, doxepin,
Names of tricyclics 10
amoxapine, desipramine, mapratiline, tripramine
Tricyclics are useful-2 Pain, migraine
Tricyclics adverse effects-2 Overdoses are cardiotoxic, high potency increases the risk of mania
Nortriptyline mnemonic No-triptyline equals less sedation and hypotension
Think car goes over tricycle to remember that an overdose is cardiotoxic. Do you
Tricyclics mnemonic-2 remember mechanism think trans =serotonin and norepinephrine Chans= Na+ and Ca+
Ans= ACH and histamine
Clomipramine mnemonic/class TCA- think comipramine for obsessive compulsive disorder
Imipramine- pneumonic and class I'm peeingamine- nocturnal enuresis
Unilateral electrode in ECT indications Typically first line because it has less cognitive side effects but has less efficacy
The use of electrical shock current delivered to the brain to induce a seizure that treats
What is ECT?
depression. Goal is to reverse atrophy.
Bipolar disorder, schizophrenia, schizoaffective disorder, catatonia, neuroleptic
ECT is FDA approved for what
malignant syndrome, treatment resistant refractory major depressive disorder
What is ECT schedule Typically Monday Wednesday Friday for 6 to 12 sessions
Bilateral electrode placement in ECT Classic placement increases cognitive side effects but has better efficacy. Reserved for
indications urgency such as life-threatening depression profound distress and catatonia
Cognitive side effects such as memory loss, head, neck, jaw pain, nausea, myalgia's
ECT side effects and Risks 8
procedure is low risk
It's an implant in the chest that stimulates the left Vegas nerve by Paul stations and it's
What is vagus nerve stimulation
controlled by an on off switch that is activated by a magnet
Stimulates the brain stem nuclei which changes serotonin in the limbic and cortical
How does vagus nerve stimulation work
systems
Vagal nerve stimulation side effects-4 Voice altered, breathlessness, neck pain, no cognitive side effects
Vagus nerve stimulation is FDA approved for FDA approved for epilepsy and under investigation for major depressive disorder and
what in under investigation for what bipolar disorder
Placement of rapid alternating magnets on scalp cause impulse to structures and is
What is trans cranial magnetic stimulation
focused
Goal of trans cranial magnetic stimulation Firing of neurons will alter pathology
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