Mental Health Flashcards
Antidepressants - Selective reuptake inhibitor (SSRI) Citalopram MOA
SSRIs block the reuptake of serotonin increases neurotransmitters levels in the synaptic cleft and increase stimulation of the postsynaptic receptors
Antidepressants - What are some ADRs SSRI Citalopram
Drowsiness, insomnia, nausea, vomiting, rare serotonin syndrome
Antidepressants - What are some nursing consideration of SSRI antidepressants Citalopram
Someone with suicidal ideation may not have the energy to carry out plans due to medication
Antidepressants - What are some contraindications of SSRI Citalopram
Not to be used if patient enters manic phase
Antidepressants - Serotonin/Norepinephrine reuptake inhibitor (SNRI) Venlafaxine MOA
SNRIs affect serotonin, norepinephrine and dopamine
Antidepressants - SNRI (venlafaxine) ADRs
Headache, dizziness, insomnia, dry mouth, constipation, nausea
Antidepressants - Nursing considerations SNRI venlafaxine
Serotonin syndrome, may occur following therapeutic drug use, inadvertent interaction between drugs, overdose of particular drugs or recreational use of certain drugs
Antidepressant - SNRI venlafaxine therapeutic use
depression
Antidepressant - Tricyclic TCA (Amitriptyline) MOA
TCAs block the reuptake of serotonin and norepinephrine in the brain
Antidepressant - TCA amitriptyline ADRs
Dry mouth, blurred vision, constipation, urinary retention, drowsiness, weight gain
Antidepressant - TCA amitriptyline contraindications
Recovery from MI, arrhythmia, manic phases, under 12yrs old, within 14 days of MAOI treatment
Antidepressant - MAOI (Monoamine oxidase inhibitors) Phenelzine MOA
Blocks monoamine oxidase which causes increase in epinephrine, norepinephrine, dopamine and serotonin which cause stimulation of the CNS
Antidepressant - MAOI Phenelzine ADRs
Postural hypotension, constipation, drowsiness, dry mouth, fatigue, headaches, insomina
Patient education for antidepressants
importance of medication compliance
May take 4-6 weeks to take effect
Take medication in the morning
Careful operating vehicles
Do not drink alcohol
Avoid foods high in tyramine
Mood Stabilisers/antimanic - Lithium Carbonate MOA
Mimics the effects of sodium, thereby compromising the ability of neutrons to release, activate and respond to neurotransmitters
Mood Stabilisers - Lithium Carbonate ADRs
tremor, stomach upset, polyuria, polydipsia, fatigue, drowsiness
Mood stabilisers - Lithium carbonate Nursing considerations
Toxicity
levels: mild 1.5-2mEq/L, Moderate 2-3mEq/L, severe >3mEq/l
How does it happen - dehydration, hyponatraemia, kidney failure
Mood stabilisers - Lithium Carbonate contraindications
Dehydration, low sodium, cardiac insufficiency
Mood stabilisers - Lithium Carbonate patient education
take with food, drink plenty of water, will require 3 monthly blood test, alert doctor of signs of lithium toxicity immediately
Mood stabilisers - Lithium Carbonate therapeutic use
Bipolar disorder
Antipsychotics - Typical Chlorpromazine MOA
Blocks the dopamine receptor (D2) site, inhibiting release of dopamine, helps diminish positive symptoms of schizophrenia
Antipsychotics - Typical Chlorpromazine ADRs
Higher risk of EPS, NMS, postural hypotension, photophobia, photosensitivity, weight gain, drowsiness, constipation, hyper salivation
Antipsychotics - Typical Chlorpromazine Nursing considerations
Neuroleptic malignant syndrome (NMS)
- occurs within weeks of drug change triggered by blockage of doperminergic receptors in the corpus stratum, resulting in spasticity of skeletal muscles and impair hypothalamic thermoregulation
Antipsychotics - Typical Chlorpromazine therapeutic use
Schizophrenia, mania, short term severe anxiety
Antipsychotics - Typical Chlorpromazine Contraindications
Comatose states, CNS depression, hypothyroidism
Antipsychotics - Typical Chlorpromazine Patient education
Do not drink alcohol, protect skin from sun light, tabs should not be crushed, med can make you sleepy
Antipsychotics - Atypical Clozapine MOA
Acts on both serotonin and dopamine in the brain, help diminish positive and negative symptoms of schizophrenia
Antipsychotics - Atypical Clozapine ADRs
Lower risk of TD,EPS, NMS, increase BGL, weight gain, constipation, hyper salivation
Antipsychotics - Atypical Clozapine Nursing considerations
Agranulocytosis
- Low WBC count = body unable to fight infections. Requires careful monitoring weekly blood test
Antipsychotics - Atypical Clozapine Contraindications
Comatose states, CNS depression, pheochromocytoma, hypothyroidism
Antipsychotics - Atypical Clozapine
May take a few weeks to take effect, inform of ADRs, protect skin from sunlight, tabs should not be crushed, meds make you sleepy
Antianxiety / Benzodiazepines - Diazepam MOA
Binds to GABA receptors in the CNS to enhance the effects of the GABA neurotransmitter
Slows/calms the activity of the nerves in the brain
Antianxiety / Benzodiazepines - Diazepam ADRS
Common: ataxia, dizziness, drowsiness
Rare: aggression, confusion, headache, hypotension, rashes
Antianxiety / Benzodiazepines - Diazepam Nursing considerations
Short term treatment - 4 weeks max
Benzos are addictive and tolerance develops quickly
Monitor withdrawal: vital signs, tremors, vomiting, seizures, insomnia
Antianxiety / Benzodiazepines - Diazepam Contraindications
resp. depression, marked neuromuscular respiratory weakness, acute pulmonary insufficiency, sleep apnoea syndrome
Antianxiety / Benzodiazepines - Diazepam Patient education
Not meant for long term use as increase risk for physical and psychological dependence
Use of long term therapy leads to tolerance
Never stop abruptly
Avoid alcohol
Avoid driving
