Mental Health Pharma Flashcards
Lorazepam
Therapeutic class: antianxiety agent
Indication: anxiety, sedation, seizures
Action: general CNS depression
Nursing Consideration:
- avoid alcohol
- monitor for respiratory depression
- antidote - flumazenil
Benzodiazepines
Antianxiety agents
short acting: midazolam (anti-anxiety for surgery)
intermediate acting: alprazolam, clonazepam, lorazepam
long acting: diazepam
Antidepressants
SSRIs:
- fluoextine
- sertraline
- excitalopram
TCAs
- amitriptyline
- nortriptyline
- protriptyline
MAOIs
- isocarboxazid
- phenelzine
Selective Serotonin Reuptake inhibitors (SSRIs)
(fluoxetine, sertraline, escitalopram)
Indication: depression
Action: prevent reuptake of serotonin increasing the availability of serotonin in the body
Nursing considerations:
- Monitor for serotonin syndrome
- Suicide preventions important for 2-3 weeks (when the client’s mood starts to improve, they are an increased risk for suicide)
Tricyclin Antidepressants (TCAs)
(Amitriptyline, Nortriptyline, Protriptyline)
Indication: Depression
Action: prevents the reuptake of norepinephrine and serotonin increasing these neurotransmitters in the body
Side Effects: Tachycardia, Cardiac effects, Anticholinergic effects, Sedation/Sexual dysfunction
Serotonin Syndrome
Hypertension, confusion, anxiety, tremors, ataxia (without coordinations), sweating
Monoamine Oxidase Inhibitors (MAOIs)
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 cheese, wine, pickled meats)
SEs: hypertensive crisis
Lithium (mood stabilizer)
Indication: Mania
Action: inhibits excitatory neurotransmitters such as dopamine and glutamate, and promotes GABA mediated neurotransmission
Nursing Considerations:
- DO not adminster with NSAIDS
- Monitor Drug levels (therapeutic level 0.6-1.2 mEq/L)
- Encourage adequate fluid intake
SEs: seizures, arrhythmias, fatigue, confusion, nausea, anorexia, hypothyroidism, tremors
Antipsychotics
First generation: haloperiodol
Second generation: Quetinapine, Olanzapine
Haloperidol
Therapeutic class: Antipsychotic
Indication: Schizophrenia, mania, aggressive behavior, agitation
Action: Inhibits the effect of dopamine
Nursing Considerations:
- Monitor for extrapyramidal side effects (non-reversible)
- tardive dyskinesia
- neuroleptic malignant syndrome
- can prolong the QT interval (weekly EKG)
- contraindicated in preganancy
Extrapyramidal Side Effects
repetitive lip smacking, slurred speech, dystonia, tremors, apathesia, grimacing, smacking the lips
Neuroleptic Malignant Syndrome
high fever (41-42 degrees C), muscular rigidity, altered mental status
Diphenhydramine
Therapeutic class: antihistamine
Indication: allergy, anaphylaxis, sedation
Action: antagonizes effects of histamine, CNS depression
Nursing Considerations:
- Monitor for drowsiness
- Anticholinergic effects
Nicotine - CNS stimulant
Intoxication: think “sped up”
- diarrhea
- cramping
- vomiting
- diaphoresis
- dizziness
- arrhythmias
Withdrawal
- headache
- nervousness
- hunger
- weight gain
- anger
-poor concentration
- restlessness
Cocaine - CNS Stimulant
Intoxication:
- hypertension
- tachycardia
- paranoia
- mydriasis (pupil dilation)
- increase in energy
- seizures
- death
Withdrawal
- dysphoric mood
- fatigue
- insomnia or hypersomnia
- psychomotor agitation (vivid dreams)
- chills
- depression/anxiety
