Medications / Side effects Flashcards
What is a typical antipsychotic?
First generation
- Blocks neurorecepters dopamine
- Higher risk EPS
What are some examples of typical antipsychotics?
Haldol
Loxapine
Chlorpromazine
What is a Atypical antipsychotic?
Second generation
- Blocks neuroreceptors of dopamine AND serotonin
- lower EPS risk, higher metabolic side effects
Examples of atypical antipsychotics?
Abilify
Seroquel
Olanzapine
Risperidone
Name 6 common SSRI’s
Citalopram (Celexa) Escitalopram (Lexapro) Fluoxetine (Prozac) Paroxetine (Paxil) Vilazdone (Viibryd) (Vul-la-zuh-done)
Which medications require blood monitoring?
Lithium Clozapine Epival Carbamazepine (Kar-buh-maz-zuh-peen)
Lithium side effects?
Seizures, fatigue, headache, sedation, confusion, tremors, ECG changes, metallic taste, drowsiness, psychomotor retardation
Common SSRI / antidepressant side effects?
GI: nausea, emesis, diarrhea Agitation Nervousness Drowsiness Dry mouth Dizziness Headaches, sexual problems, insomnia
Common antidepressants?
Zoloft, prozac, lexapro
Common antidepressant side effects?
Drowsiness dizziness dry mouth fatigue headache nausea / vomiting agitation restlessness
What causes serotonin syndrome?
Antidepressants can cause high levels of serotonin
more risk when two different types are combined
Signs of serotonin syndrome?
THINK: panic, confused, hot, BP
Anxiety, agitation, fever, sweating, confusion, tremors, major BP changes, increased heart rate
What is the treatment for serotonin syndrome?
Benzo’s
Muscle relaxants
What are side effects of Epival?
DRESS Suicidal thoughts Agitation Dizziness GI symptoms Pancreatitis
What is DRESS?
Inflammation of liver, lungs and heart Thrombocytopenia (Low blood platelet count) Alopecia (hair loss) Rash Leukopenia (low WBC) Hyperammonemia (Increased ammonia) Ataxia (Abnormal movement)
What are the 9 medication rights?
Right patient (two identifiers) Right medications Right dose Right time Right route Right reason Right documentation Right to refuse Right patient education
What are the signs / symptoms of EPS?
Dystonia ( muscle spasms )
Dyskinesia ( involuntary movements)
Akathisia ( Rigidity, slow movements)
Pesudoparkinsonism (drooling, shuffling gait)
Rabbit syndrome ( Rapid movements of lips)
Oculogyric crisis ( eyes roll back, EMERGENCY)
Treatment of EPS?
Lowering dose or different antipsychotic
Cogentin
What are the signs and symptoms of neuroleptic malignant syndrome (NSM)?
High fever BP abnormalities Tachycardia, Tachypnea, Tremors Dysphagia (trouble swallowing) Incontinence Agitation, drowsiness, confusion or coma
Treatment for NSM?
Supportive care temperature reduction Hydration Mild cases treated with benzo's Severe is 911
What are the signs and symptoms of Tardive dyskinesia?
Involuntary movements of tongue, toes, neck, pelves
Tongue protrusion
Lip smacking / movements of the mouth
Rapid blinking
Disfigured facial features (drooping, grimacing)
Awkward gait
Difficulty swallowing and speaking
What is tardive dyskinesia?
Late onset extrapyramidal symptoms.
TDK is persistent EPS that usually appears after long treatment
What level of Lithium in blood indicates toxicity?
Greater than 1.5 mEq/L (Milliequivalents per litre)
Severe toxicity: Serum levels of lithium above 2.0 mEq/L
Symptoms of mild to moderate lithium toxicity?
Diarrhea, vomiting, stomach pains, fatigue, tremors, uncontrollable movements, muscle weakness, drowsiness, weakness
Severe symptoms of lithium toxicity?
Slurred speech, kidney failure, rapid heartbeat, hyperthermia, uncontrollable eye movements, low blood pressure, confusion, coma, delirium, death
General side effects of Lithium?
SEIZURES, fatigue, headache, impaired memory, sedation, confusion, dizziness, drowsiness, tremors, muscle weakness, psychomotor retardation, restlessness, stupor, aphasia, blurred vision, tinnitus, ECG changes, arrhythmias, leukocytosis bloating, diarrhea, nausea, dry mouth, metallic taste
Teaching for lithium?
Low sodium levels may lead to toxicity. The patient should drink 2000–3000 mL fluid each day and eat a diet with consistent and moderate sodium intake. Excessive amounts of coffee, tea, and cola should be avoided because of the diuretic effect.
What does overdose look like?
Face is clammy to touch and has lost color, Blue lips and fingertips, Non-responsive to his/her name or a firm sternum rub using the knuckles, Slow or erratic breathing, or no breathing at all, Deep snoring or a gurgling sound (i.e. what would be described as a “death rattle”), Heartbeat is slow or has stopped
Steps for dealing with overdose?
SAVE ME
Stimulate- shake the person
Airway- assess airway
Ventilate- 1 breath every 5 seconds
Evaluate- are they breathing on thier own?
Medication- administer naloxone (ampoule)
Evaluate- again (if nothing happens in 5 min, administer another dose)
Side effects of risperidone?
severe dizziness, fainting, seizures. respiratory depression, NMS
