25 Med for Children + Adolescents who have Mental Health Issues Flashcards
CNS stimulants
drug names
- methylphenidate
- amphetamine
- dextroamphetamine
- dexmethylphenidate
- lisdexamfetamine
*METH to AMP up
CNS stimulants
action
raise level of norepinephrine + dopamine into CNS
CNS stimulants
indication
ADHD - paradoxical
CNSS stimulants
A/E
- CNS stim (insomnia, restless)
- wt loss + growth suppression r/t reduced appetite
- cardiovasc effects
- psychotic manifestations
- withdrawal rxn
- skinr ash (meth patch)
- toxicity
to prevent over stimulation (insomnia, restless), CNS stimulants should be admin no later than…
4pm
- also keep the dosage as low as possible
- avoid caffeine
cardiovascular effects of CNS stimulants + nursing actions
- dysrhythmias, chest pain, high BP
- can incr risk of sudden death w pt w heart abnormalities
- monitor VS + ECG
toxicity findings + nursing actions for CNS stim
dizzy, palpitatn, HTN, hallucination, seizure
- treat hllcntn w CHLORPROMAZINE
- treat seizure w DIAZEPAM
- admin fluids
CNS stimulants
CI
- hx of substance abuse
- cardiovasc disease
- severe anxiety
- psychosis
CNS stimulant
interactions
- MAOI- hypertensive crisis
- caffeine + OTC cold/decongestant- incr CNS stim
CNS stim
teaching
- 30-45min before meals
- no later than 4pm
- full effect 6 wks
- admin on reg schedule
SNRI
drug names
- atomoxetin (not a stimulant)
- buproprion
SNRI
indication
ADHD
SNRI
A/E
- appetite/growth supprsn, wt loss
- GI effects (N/V, ab pain)
- suicidal ideation
- hepatotoxicity
- CNS effect (headache, insomnia, irritable)
SNRI to avoid GI effects…
take w food
signs of liver damage
- flu-like manifestation
- jaundice
- ab pain
SNRI
CI
- suicidal ideation
- angle-closure glaucoma
- pheochromocytoma
SNRI
interactions
MAOI- hypertensive crisis
SSRI -incr level of atomoxetine
TCA
drug names
despramine
imipramine
clomipramine
TCA
action
block reuptake of norepinephrine + serotonin which intensifies them
TCA
indication
- dprssn
- autism
- ADHD
- panic disorder
- separation anxiety
- social phobia
- OCD
TCA
A/E
- orthostatic hypotension
- antichol effects
- wt gain r/t incr appetite
- sedation
- decr seizure threshold
- diaphoresis
- toxicity
orthostatic hypotension teaching
monitor BP w first dose
change position slowly
TCA toxicity
characteristics
cholinergic blockage + cardiac toxicity
-dysrhythmias, mental confusn, agitation> seizures, coma, death
TCA toxicity
teaching
- 1wk supply of med at a time
- obtain baseline ECG
- monitor VS frequently
TCA
CI
- recent MI, or hx of HF
- hx prolonged QT
- can incr suicidal tendencies
- careful w seizures, CAD, diabetes, liver, kidney
TCA
interactions
antihistamine- incr antichol
MAOI, epinephrine, dopamine -hypertensive crisis
-ETOH, benzo, opioid, antihistamin - CNS depress
TCA
teaching
- take before bedtime bc sedation
- high suicide potential so only give 1 wk supply for acutely ill, then 1 month supply
A2-Adrenergic Agonist
drug name
- guanfacine
- clonidine
A2-Adrenergic Agonist
indication
- ADHD
- tic disorder
- conduct + oppositional defiant disorders
A2-Adrenergic Agonist
A/E
- CNS dprssn (sedatn, drowsy, tired)
- cardiovasc dprssn
- wt gain
- GI effects
A2-Adrenergic Agonist
cardiovascular depression + TEACHING
- hypotention
- bradycardia
- monitor BP + pulse during initial tx
- abrupt discontinuation> rebound HTN
A2-Adrenergic Agonist
GI effects
- N/V
- constipatn
- dry mouth
A2-Adrenergic Agonist
teaching
- monitor BP + pulse in early
- avoid high fat> incr absorp of guanfacine
- careful w anyhypertensive
- careful w ETOH + cns dprssnt
Atypical AntiPsychotics
drug names
- risperidone
- olanzapine
- aripiprazole
- quetiapine
Atypical AntiPsychotics [risperidone, olanzapine, aripiprazole, quetiapine]
action
blocks serotonin, dopamin receptors
Atypical AntiPsychotics [risperidone, olanzapine, aripiprazole, quetiapine]
indication
- autism
- conduct disorder
- OCD
- relief of psychotic manifestations
Atypical AntiPsychotics [risperidone, olanzapine, aripiprazole, quetiapine]
A/E
- DM
- wt gain
- hypercholesterolemia
- orthostatic hypotensn
- antichol effects
- agitatn, dizzy, sedatn, sleep disruptn
- mild EPS
Atypical AntiPsychotics [risperidone, olanzapine, aripiprazole, quetiapine]
teaching
- avoid ETOH + CNS dprssnt
- levodopa counteracts the effects
SSRI
drug names
- fluoxetine
- sertraline
- fluvoxamine
SSRI
indication
- intermittent explosive disorder
- autism
- OCD
- depression
- bulimia
- anxiety
SSRI
complications
- agitation, anxiety, sleep disturbance
- tremors
- headaches
- weight changes
- GI effects
SSRI interactions
MAOI, SNRI, buspirone, + St. Johns Wort
-incr risk for serotonin syndrome
