Tyramine & Bipolar Disorder – Pharmacology for Nurses

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Chapter 16: Psychotherapeutic Drugs Test: Tyramine & Bipolar Disorder

The key terms in this Pharmacology course include Psychotherapeutic Drugs, Selective Serotonin Reuptake Inhibitor (SSRI), Bipolar Disorder, Tyramine, Extrapyramidal Symptoms, Therapeutic Effects, Haloperidol, Neutropenia, Anxiety Disorder, Pharmacology for Nurses: Practical Applications


Before beginning a patient’s therapy with selective serotonin reuptake inhibitor (SSRI) antidepressants, the nurse will assess for concurrent use of which medications or medication class?

Aspirin

Nonsteroidal anti-inflammatory drugs

Anticoagulants

Diuretics

Use of selective serotonin reuptake inhibitor (SSRI) antidepressants with warfarin results in an increased anticoagulant effect. SSRI antidepressants do not interact with the other drugs or drug classes listed. See Table 16-6 for important drug interactions with SSRIs.


The nurse reads in the patient’s medication history that the patient is taking buspirone (BuSpar). The nurse interprets that the patient may have which disorder?

Depression

Bipolar disorder

Schizophrenia

Anxiety disorder

Buspirone is indicated for the treatment of anxiety disorders, not depression, schizophrenia, or bipolar disorder.


Clozapine (Clozaril), an atypical antipsychotic, is prescribed for a patient. The nurse will monitor for which adverse effect during this drug therapy?

Photosensitivity

Severe neutropenia

Hypotension

Edema

Atypical antipsychotics may cause severe neutropenia. The other effects are adverse effects of conventional antipsychotics.


The nurse is reviewing the food choices of a patient who is taking a monoamine oxidase inhibitor (MAOI). Which food choice would indicate the need for additional teaching?

Grapefruit juice

Pancakes and maple syrup

Pepperoni pizza

Fried eggs over-easy

Cured meats such as pepperoni contain tyramine. Patients who are taking MAOIs need to avoid tyramine-containing foods because of a severe hypertensive reaction that may occur. The other foods listed do not contain tyramine.


Which statements are true regarding the selective serotonin reuptake inhibitors (SSRIs)? (Select all that apply.)

Cogentin is often also prescribed to reduce the adverse effects that may occur.

Monitor the patient for extrapyramidal symptoms.

If the patient has been on an MAOI, a 2- to 5-week or longer time span is required before beginning an SSRI medication.

Avoid foods and beverages that contain tyramine.

These drugs have anticholinergic effects, including constipation, urinary retention, dry mouth, and blurred vision.

Therapeutic effects may not be seen for about 4 to 6 weeks after the medication is started.

During SSRI therapy, therapeutic effects may not be seen for 4 to 6 weeks. To prevent the potentially fatal pharmacodynamic interactions that can occur between the SSRIs and the MAOIs, a 2- to 5-week washout period is recommended between uses of these two classes of medications. The other options apply to other classes of psychotherapeutic drugs, not SSRIs.


A patient has been taking haloperidol (Haldol) for 3 months for a psychotic disorder, and the nurse is concerned about the development of extrapyramidal symptoms. The nurse will monitor the patient closely for which effects?

Dry mouth and constipation

Drowsiness and dizziness

Increased paranoia

Abnormal muscle movements

Extrapyramidal symptoms are manifested by abnormal muscle movements, and the incidence of such symptoms is high during haloperidol therapy. The other options are incorrect.