Ch. 16 Drug Cards - Emotional, Mood, and Behavioral Disorders Flashcards
sertraline (Zoloft) Therapeutic Class:
Antidepressant
sertraline (Zoloft) Pharmacologic Class
Selective serotonin reuptake inhibitor (SSRI)
sertraline (Zoloft) is used for what?
treatment of depression, anxiety, obsessive-compulsive disorder, and panic.
sertraline (Zoloft) MOA
inhibit the reuptake of serotonin in the brain.
How would you administer sertraline as an oral liquid?
mix with water, ginger ale, lemon/lime soda, lemonade, or orange juice.
When administering sertraline (Zoloft), when should the nurse take extreme precautions?
in patients with:
cardiac disease
hepatic impairment
seizure disorders
suicidal ideation
mania
hypomania.
sertraline (Zoloft) interactions with MAOIs
may cause neuroleptic malignant syndrome, extreme hypertension, and serotonin syndrome
confusion, anxiety, restlessness, hypertension, tremors, sweating, hyperpyrexia, or ataxia.
S&S of serotonin syndrome
Patient education for sertraline (Zoloft) & MAOIs
Do not take concurrently w/ a MAOI or within 5 weeks of discontinuing MAOI meds
imipramine (Tofranil) Therapeutic Class:
Antidepressant; treatment of nocturnal enuresis in children
imipramine (Tofranil) Pharmacologic class
Tricyclic Antidepressant (TCA)
Side effect of TCAs
paradoxical diaphoresis
When a patient is prescribed imipramine (Tofranil), diaphoresis may not be a reliable indicator of what?
other disease states such as hypoglycemia.
imipramine (Tofranil) causes what?
anticholinergic effects
imipramine (Tofranil) MOA
blocks the reuptake of serotonin and norepinephrine
Unlabeled uses of imipramine (Tofranil)
intractable pain
anxiety disorders
withdrawal syndromes from alcohol and cocaine
Patient education for imipramine (Tofranil)
Therapeutic effectiveness may not occur for 2 or more weeks.
Photosensitivity
Side effect of imipramine (Tofranil)
imipramine (Tofranil) contraindications
Should not be used in cases of:
acute recovery after MI
defects in bundle-branch conduction
narrow-angle glaucoma
severe renal or hepatic impairment.
Patients should not use this drug within 14 days of discontinuing MAOIs.
imipramine (Tofranil) drug interactions
many
CNS depressants - sedation
cimetidine (Tagamet) - increased serum levels and possible toxicity
clonidine - reverse antihypertensive effects and potentiate CNS depression
Oral contraceptives - increase or decrease imipramine levels
Disulfiram - delirium and tachycardia
altered blood glucose tests.
Elevation of serum bilirubin and alkaline phosphatase is likely.
imipramine (Tofranil) lab tests
phenelzine (Nardil) Therapeutic classification
antidepressants
phenelzine (Nardil) Pharmacologic classification
MAOI
Washout periods of 2 to 3 weeks are required before introducing other drugs.
phenelzine (Nardil) Administration alerts
Abrupt discontinuation of phenelzine (Nardil) may cause what?
rebound hypertension.
Patient education for the patient taking phenelzine (Nardil)
Drug effects may persist for 2 to 3 weeks after therapy is discontinued.
Severe hypertension may occur when ingesting foods containing tyramine.
phenelzine (Nardil) adverse effects
phenelzine (Nardil) contraindications
Patients with:
cardiovascular or cerebrovascular disease
hepatic or renal impairment
phenelzine (Nardil) drug interactions
interacts with MANY drugs
methylphenidate (Ritalin, Concerta) Therapeutic Classification:
Attention deficit–hyperactivity disorder (ADHD) drug
methylphenidate (Ritalin, Concerta) Pharmacologic Classification
CNS stimulant
methylphenidate (Ritalin, Concerta) Controlled Substance Schedule
Schedule II drug
methylphenidate (Ritalin, Concerta) actions
heightened alertness with focus and attention
Activation is partially achieved by the release of neurotransmitters such as norepinephrine and dopamine. Impulsiveness, hyperactivity, and disruptive behavior are usually reduced within a few weeks.
methylphenidate (Ritalin, Concerta) MOA
methylphenidate (Ritalin, Concerta) adverse effects in a non-ADHD patient
nervousness and insomnia
methylphenidate (Ritalin, Concerta) Black Box Warning
Scheule II drug with high abuse potential
methylphenidate (Ritalin, Concerta) drug interactions
Interacts with many drugs