NURS 663 Exam 1 Study Guide
Bipolar one disorder DSM five criteria
(Ans- Manic episode: 1+ week of a colon elevated, expansive or irritable
mood and increase energy. 3+ symptoms from B: distractibility,
indiscretion, irresponsible, grandiosity, flight of ideas, activity(Increase goal- orient), decreased need for sleep, talkativeness or pressured speech.
Bipolar two DSM five criteria
(Ans- Hypo mania and major depressive disorder: hypo mania same as
mania with decreased severity and duration and no functional impairment for episode of four or more days and no psychosis
Mixed episodes (bipolar) (Ans- Manic and depressive symptoms time by side usually with comorbid substance abuse increased risk of suicide and psychosis
rapid cycling (Ans- Four or more cycles per year no greater than a week well period
Cyclothymia DSM-V Criteria (Ans- Two or more years of mood cycling with dysthymia and hypo mania decreased intensity than bipolar disorder meets criteria for hypo mania but does not meet criteria for major depressive disorder
Dysthymia DSM five criteria (Ans- HE'S 2 SAD depressive symptoms lasting two or more years that is subsyndromal characterized by hopelessness decreased energy, decrease self-esteem for two years, abnormal sleep, abnormal appetite impaired decision-making.
MAOÍ Mechanism of action generally (Ans- Catalyzes the deamination of monoamines intracellularly and MAO transport Reuptake extracellular monoamines 1 / 3
MAO-A Mechanism of action (Ans- MAO-A Oxidizes serotonin norepinephrine and epinephrine
MAO-B Mechanism of action (Ans- Oxidizes phenylalanine
MAO-A and MAO-B mechanism of action (Ans- Oxidizes dopamine non-preferentially
MAOs Neumonic -2 (Ans- Date with Tyra banks with wine and cheese in Maui— can cause hypertensive crisis related to tyramine from aged food.
MAWIs= my arms weight increased= effective for atypical depression
MAOs adverse effects-6 (Ans- Hypertensive crisis, diet restriction, avoid meds, five week after Prozac, two week after other antidepressants, no other medications for two weeks after discontinuing
MAOs diet restriction-4 compounds (Ans- Tyrosine, high tyramine, tryptophan, phenylalanine
Tyrosine foods-10 (Ans- Aged cheese, aged wine, fava or broad bean pods, sauerkraut, soy sauce, tap or draft beer, overripe fruit, cured meat, spoiled food
MAOs drugs to avoid- 6 (Ans- Antidepressants, Dextromethorphan, stimulants, sympathomimetics, meperidine, disulfiram
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MAOs side effects 11 (Ans- Increased weight, drowsy, dizzy, orthostatic hypotension, tremor, headache, dry mouth, constipation, change in sexual drive, peripheral Edema, sweating
Tricyclic mechanism of action (Ans- Inhibit 5HT2, norepinephrine, dopamine and reuptake slows. Amino group interferes with ASP - 98 in HSERT. Causing down regulation of receptors.
Tricyclic side effects (Ans- Anticholinergic effects (dry mouth, blurred vision, constipation, urine retention, impotence). Histamine effects (sedation, increased weight).Adrenergic alpha receptor (postural hypotension). Direct membrane effects (decrease seizure threshold and arrhythmias). 5HT2 receptor (increase weight and decrease anxiety).
Amitriptyline dosing/Class (Ans- Start at 25 to 50 mg per day, titrate 25 to 50 mg per day per week, Max dose is 300 mg per day/TCA
Names of tricyclics 10 (Ans- Amitriptyline, nortriptyline, clomipramine, imipramine, protriptyline, doxepin, amoxapine, desipramine, mapratiline, tripramine
Tricyclics are useful-2 (Ans- Pain, migraine
Tricyclics adverse effects-2 (Ans- Overdoses are cardiotoxic, high potency increases the risk of mania
Nortriptyline mnemonic (Ans- No-triptyline equals less sedation and hypotension
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