Meds Flashcards
Serotonin Syndrome
diarrhea, nausea, vomiting, tremors, headache, agitation, restlessness, diaphoresis, and in severe cases muscle rigidity, high fever, irregular heartbeat, seizures, unconsciousness, and death if left untreated.
Selective
diarrhea, nausea, vomiting, tremors, headache, agitation, restlessness, diaphoresis, and in severe cases muscle rigidity, high fever, irregular heartbeat, seizures, unconsciousness, and death if left untreated.
At risk for Serotonin Syndrome
⚠️Patient may be at risk when taking SSRIs with Buspar, TCAs (esp clomipramine), St. Johns Wort, and Eldepryl
Teachings for ADHD
use caution with operating machinery (drowsiness, dizziness, blurred vision may occur)
dont stop abruptly
monitor weight
avoid taking late in day to avoid insomnia (take after full breakfast)
dont take OTC meds without approval
for diabetic patients, monitor blood glucose 2-3x daily (be aware of need to alter insulin requirements)
avoid large intake of caffeine
notify doctor of restlessness, insomnia, anorexia, dry mouth, or rapid pounding heartbeat becoming severe and evident
Effects of anxiolytic medications
Think GABA
may potentiate effects of GABA in the brain which will produce a calming effect. most common ones used are benzos like clonazapam (Klonopin, diazepam (Valium), and alprazolam (Xanax). Increased effects happen when taken with alcohol, barbiturates, narcotics, etc. Also with herbal depressants (kava, L-tryptophan, melatonin, chamomile). ⬇️ effects can happen with smoking and caffeine
they depress subcortical levels of the CNS (the limbic system and reticular formation).
Warnings associated with MAOIs.
The FIRST antidepressant was isoniazid used for TB. Maois inhibit the release of manoamine oxidase inhibitors. Adverse effects include hypertensive crisis when interacting with SSRIs, antidepressants, Buspar. serotonin syndrome with SSRIs, TCA, St Johns Wort, morphine and narcotics can lead to hypotension, Buspar interaction can cause psychosis, agitation, and seizures. Antidiabetic interaction can cause hypoglycemia.
MAOI no’s
⚠️ AVOID TYRAMINE WITH MAOIs! (avocados, bananas, caffeine, yogurt, etc)
Tyramine with MAOIs cause hypertensive crisis
MAOIs increase the availability of norepinephrine
Neuroleptic malignant syndrome
potentially fatal complication
symp: severe muscle rigidity, high fever, tachycardia, fluctuations in blood pressure, diaphoresis, and rapid deterioration of mental status to stupor and coma.
warnings associated with sedative-hypnotic medications.
L-tryptophan is the amino acid precursor to serotonin. Effective sedative-hypnotic med to induce sleep in people with sleep-onset disorder.
barbiturates, benzos, are other sedative hypnotics.
may produce tolerance or psychological/physical dependence
caution in patients with cardiac, hepatic, renal, or respiratory insufficiency, previously suicidal, or addicted to drugs.
Hypnotics should be used SHORT TERM
behavioral changes (aggression), hallucinations, suicidal ideation have been noted
there’s a risk for injury from abrupt withdrawal from long term use + ⬇️ mental alertness caused by residual sedation
disturbed sleep pattern/insomnia r/t situational crisis, physical condition, or severe anxiety
risk for activity intolerance r/t side effects (dizziness, lethargy, drowsiness)
risk for acute confusion r/t action of the med on the CNS
adverse effects of neuroleptic (antipsychotic) medications.
EPS (Extrapyramidal symptoms), hypotension, hyperglycemia, weight gain, diabetes, orthostatic hypotension, lower seizure threshold, arrhythmias, sedation, photosensitivity, agranulocytosis, NMS
lithium
mood stabilizing (reducing roller coaster ups and downs). Was first recognized as an anti-manic. MOA unknown, hemodialysis may be warranted for lithium toxicity. Therapeutic range is 1.0-1.5 for acute mania , 0.6-1.2 for maintenance. Draw sample 12hrs after taking. SE of lithium is weight gain, dry mouth, GI upset, polyuria. ensure patient consumes adequate NA+ and fluid in diet. Hypotension and arrhythmias may occur.
valproic acid (Depakote)
mood stabilizing + anticonvulsant (reducing roller coaster ups and downs). Blood dyscrasias may occur so educate clients to report infections or other illness. Determine platelet count and bleeding time before initiating therapy. Monitor for spontaneous bleeding/bruising. barbiturates are effected with concurrent use.
clozapine
atypical antipsychotic. contraindicated in patients with uncontrolled epilepsy, myloproliferative disorders, or granulocytopenia hx. Low seizure threshold induced so assess for seizure disorder, arrythmias may occur, many report excessive salivation — sugar free gum and meds such as anticholinergics or alpha2 adrenoceptor agonists may alleviate symptoms
fluoxetine
antidepressant.
EPS
variety of symptoms that originate outside the pyramidal tracts and in the basal ganglion of the brain. Symptoms: tremors, chorea, dystonia, akinesia, akathisia, and others. May occur as a side effect of some antipsychotic medications.
