Mental Health Flashcards
Lurasidone
✓ is an atypical antipsychotic
Lurasidone is approved to treat bipolar disorder and schizophrenia
✓ Other atypical antipsychotics include aripiprazole, ziprasidone, risperidone, quetiapine, olanzapine, clozapine
✓ Lurasidone should be consistently at the same time every day with food (≥350 calories)
✓ All antipsychotics carry a serious adverse effect of neuroleptic malignant syndrome (fever, tachycardia, muscle rigidity), which should be reported right away
✓ All atypical antipsychotics carry the risk of the client developing metabolic syndrome (increased blood glucose, elevated cholesterol, abdominal obesity)
Antianxiety Agents - Benzodiazepines
Short acting
● Midazolam | onset: rapid | duration 1-2 hours - quick on/ quick off
Intermediate acting
● Alprazolam | onset: intermediate | duration: 6-12 hours
● Clonazepam | onset: intermediate | duration: 18-50 hours
● Lorazepam | onset: rapid IV, intermediate PO| duration: 2-6 hours - medium on/long off
Long acting
● Diazepam| onset: rapid | duration: 20-50 hours - quick on/ long off
Lorazepam
Therapeutic class: antianxiety agent
Indication: anxiety, sedation, seizures
Action: general CNS depression
Nursing Considerations:
● Avoid alcohol
● Monitor for respiratory depression
● Antidote - flumazenil
Antidepressants
● SSRIs
○ Fluoxetine
○ Sertraline
○ Escitalopram
● TCAs
○ Amitriptyline
○ Nortriptyline
○ Protriptyline
● MAOIs
○ Isocarboxazid
○ Phenelzine
Selective Serotonin Reuptake Inhibitors - SSRIs
Examples: Fluoxetine, Sertraline, Escitalopram
Indication: Depression
Action: Prevent reuptake of serotonin, increasing the availability of serotonin in
the body
Nursing Considerations:
● Monitor for serotonin syndrome
○ Hypertension, confusion, anxiety, tremors, ataxia, sweating
● Suicide precautions important for 2-3 weeks
○ When the client’s mood starts to improve, they are at an inreased risk for suicide
○ Why? They now have the energy to follow through with a plan.
Tricyclic Antidepressants - TCA’s
Examples: Amitriptyline,
Nortriptyline, Protriptyline
Indication: Depression
Action: Prevents the reuptake of
norepinephrine and serotonin
increasing these neurotransmitters in the body
TCAs side effects
Tachycardia
Cardiac effects (prolonged QT, arrythmias)
Anticholergenic Effects
Sedation/Sexual dysfunction
Monoamine Oxidase Inhibitors - MAOIs
Examples: isocarboxazid, phenelzine
Indication: Depression
Action: blocks monoamine oxidase enzymes to increase the levels of ALL
neurotransmitters (dopamine, norepinephrine, epinephrine, serotonin)
Nursing Considerations:
● Avoid foods that are high in tyramine
○ Aged cheeses
○ Wine
○ Pickled meats
● Side effect - hypertensive crisis
Mood Stabilizers
● Lithium
Lithium
Indication: Mania
Action: Inhibits excitatory neurotransmitters such as dopamine and glutamate,
and promotes GABA-mediated neurotransmission
Nursing Considerations:
● Do not administer with NSAIDs
● Monitor drug levels:
○ Therapeutic level - 0.6-1.2 mEq/L
● Encourage adequate fluid intake
● Side effects:
○ Seizures, arrhythmias, fatigue, confusion, nausea, anorexia, hypothyroidism, tremors
Antipsychotics
● First generation
○ Haloperidol
● Second generation
○ Quetiapine
○ Olanzapine
Haloperidol
Therapeutic class: Antipsychotic
Indication: Schizophrenia, mania, aggressive behavior, agitation
Action: Inhibits the effects of dopamine
Nursing Considerations:
● Monitor for extrapyramidal side effects
● Tardive dyskinesia
● Neuroleptic malignant syndrome
● Can prolong the QT interval
○ Weekly EKG
● Contraindicated in pregnancy
Antihistamines
● Histamine-1 blocker → blocks H1 receptors in CNS - stops allergies!
○ Diphenhydramine
● Histamine-2 blocker → blocks production of stomach acid!
○ Famotidine
○ Ranitidine
Diphenhydramine
Therapeutic class: Antihistamine
Indication: Allergy, anaphylaxis, sedation
Action: Antagonizes effects of histamine, CNS depression
Nursing Considerations:
● Monitor for drowsiness
● Anticholinergic effects
