Mod 5 Study Set Flashcards
Sedation, Anticholinergic effects (dry mouth, dry eyes, urinary retention, constipation)
Tricyclic Antidepressants (TCAs)
Amitriptyline (Elavil)
Clomipramine
Tricyclic Antidepressants (TCAs)
Monitor for cardiac symptoms.
Ask about St Johns Wort
Taper when discontinuing the drug.
Overdose can be lethal; there is no antidote—only supportive care.
Tricyclic Antidepressants (TCAs)
hypotension, vertigo, dizziness, nausea, constipation, dry mouth, diarrhea, headache, restlessness, blurred vision, hypertensive crisis
Monoamine Oxidase Inhibitors (MAOIs)
A hypertensive crisis occurs if large amounts of fermented foods, alcohol, or aged cheese are ingested.
foods high in tyramine can lead to hypertensive crisis
Monitor for increased risk of serotonin syndrome if taken with SSRI/SNRI.
Monoamine Oxidase Inhibitors (MAOIs)
Isocarboxazid (Marplan)
Phenelzine (Nardil)
Monoamine Oxidase Inhibitors (MAOIs)
Citalopram (Celexa)
Escitalopram (Lexapro)
Fluoxetine (Prozac)
Paroxetine (Paxil)
Sertraline (Zoloft)
Selective Serotonin Reuptake Inhibitors (SSRIs)
Nausea, dry mouth, sweating, insomnia, anorexia, sexual dysfunction
Selective Serotonin Reuptake Inhibitors (SSRIs)
Screen for suicidal ideation.
Monitor for serotonin syndrome.
Taper dose when discontinuing drug.
Taking the herbal St. John’s wort can increase risk of serotonin syndrome.
Sexual dysfunction may be reduced by dividing the dose or delaying dosing until after sexual activity.
Selective Serotonin Reuptake Inhibitors (SSRIs)
Duloxetine (Cymbalta)
Venlafaxine (Effexor XR)
Serotonin–Norepinephrine Reuptake Inhibitors (SNRIs)
Agitation, dizziness, dry mouth, insomnia, sedation, headache, nausea, vomiting, tremor, constipation, weight loss, anorexia, excess sweating, sexual dysfunction
Serotonin–Norepinephrine Reuptake Inhibitors (SNRIs)
Monitor for serotonin syndrome.
Dose must be titrated down when stopping drug.
Taking the herbal St. John’s wort can increase the risk of serotonin syndrome.
Instruct male clients about treating priapism (erection longer than 4 hours).
Serotonin–Norepinephrine Reuptake Inhibitors (SNRIs)
Bupropion (Wellbutrin)
Norepinephrine–Dopamine Reuptake Inhibitors (NDRIs)
Dry mouth, nausea, headache, dizziness, blurred vision, tachycardia, anxiety, restlessness, agitation, aggression, racing thoughts, loss of interest in sex, suicidal ideation
Norepinephrine–Dopamine Reuptake Inhibitors (NDRIs)
Do not administer Wellbutrin with Zyban.
Avoid if there is a history of seizures, hypertension, glaucoma, bipolar disorder, liver disease, or kidney disease.
Consult primary provider if contemplating pregnancy; avoid if breastfeeding.
Norepinephrine–Dopamine Reuptake Inhibitors (NDRIs)
Diazepam (Valium)
Oxazepam
Nitrazepam
Temazepam (Restoril)
Alprazolam (Xanax, Xanax XR)
Benzodiazepines
Eszopiclone (Lunesta)
Ramelteon (Rozerem)
Zolpidem (Ambien)
Nonbenzodiazepine
Sedative - Hypnotics
Bupropion (Wellbutrin SR, Wellbutrin XL)
Mirtazapine (Remeron)
Atypical Antidepressants
Lithium Carbonate (Lithobid)
Aripiprazole (Ambilify)
Olanzapine (Fluoxetine)
Risperidone
Mood-stabilizing agents
first-generation typical antipsychotic
haloperidol
exerts its antipsychotic effects by blocking dopamine D2 receptors in the brain
haloperidol
Anticholinergic effects include increased body temperature, dry mouth, drowsiness or sedation, constipation, and urinary retention.
Other common adverse effects are sedation, weight gain, erectile dysfunction in males, and oligomenorrhea or amenorrhea in females.
haloperidol
Integrates thoughts
Promotes movement in concert with ACh
Stimulates hypothalamic endocrine activity
Enhances judgment
Dopamine
(DA)
Stabilizes mood
Induces sleep
Regulates temperature
Controls appetite
Serotonin (5-hydroxytryptamine)
(5-HT)
Affects attention and concentration
Raises energy level
Heightens arousal
Norepinephrine
(NE)
Assists memory storage
Promotes movement in concert with DA
Prepares for action
Acetylcholine
(ACh)
Reduces arousal and aggression
Inhibits excitatory neurotransmitters like NE and DA
Decreases seizure potential
Gamma-aminobutyric acid
(GABA)
Promotes neuronal excitation
Acts as a neurotoxic mediator in various neurologic disorders
Glutamate
(GT)
(DA)
Dopamine
(5-hydroxytryptamine)
(5-HT)
Serotonin
Norepinephrine
(NE)
Acetylcholine
(ACh)
Gamma-aminobutyric acid
(GABA)
(GT)
Glutamate
Decreases seizure potential
(GABA)
Promotes neuronal excitation
Glutamate
Assists memory storage
Prepares for action
Acetylcholine
Affects attention and concentration
Norepinephrine
Induces sleep
Controls appetite
(5-hydroxytryptamine)
(5-HT)
Integrates thoughts
Stimulates hypothalamic endocrine activity
Enhances judgment
Dopamine
mental illness that causes unusual shifts in a person’s mood, energy, activity levels, and concentration.
Bipolar Disorder
mental illness that causes persistent and intense feelings of sadness, hopelessness, and a lack of pleasure
Depression
mental illness that causes excessive and uncontrollable worry and anxiety about various aspects of life
Generalized Anxiety Disorder
mental illness involving unhealthy eating behaviors and attitudes toward food, body weight, and body image
Eating Disorders
mental illness characterized by the harmful use of a substance that leads to significant impairment in daily life
Substance Use Disorder
a progressive neurological condition that impairs cognitive functioning, including memory, reasoning, and the ability to perform everyday tasks, often affecting behavior and mood.
Dementias
a vague, uneasy feeling, the cause of which is not readily identifiable. It is evoked when a person anticipates nonspecific danger.
Anxiety
a feeling of terror in response to someone or something specific that a person perceives as dangerous or threatening.
Fear
attention is heightened, Sensory perception is expanded, Focus is on stimuli. Reality is intact. Information processing is accurate. Person feels in control. Muscle tone increases. Heart rate, BP, and breathing slightly increase. Perspiration is noticeable.
Mild
person is more easily distracted, Concentration is slightly impaired. Person can redirect attention. Learning takes more effort. Perception narrows. Problem solving becomes difficult. Person is irritable and feels inadequate. Muscles are tense. Slight leg or hand tremors may occur. Rate, pitch, and volume of speech change. Respiratory depth and vital signs increase. Sleep is disturbed.
Moderate
attention span decreases. Person cannot concentrate or remain focused. Perception is reduced. Ability to learn is impaired. Information processing is inaccurate or incomplete. Person is aware of extreme discomfort. Effort is needed to control emotions. Person feels incompetent. Symptoms include hyperventilation, dizziness, tachycardia, heart palpitations, and hypertension. Fine motor movement is impaired. Communication is limited.
Severe
person exaggerates details. Perception is distorted. Learning is disabled. Thoughts are fragmented. Speech is incoherent. Movements are haphazard, usually in an effort to escape. Symptoms include dyspnea, fainting, tremors, and diaphoresis.
Panic
Building trust
Restoring comfort
Modifying communication
Adjusting teaching
Ensuring safety
Helping problem-solve
Six areas of nursing management of anxious clients
Generalized anxiety disorder
Panic disorder
Phobic disorders
PTSD
Obsessive-compulsive disorder
anxiety disorders
Drugs categories to treat anxiety disorders
Anxiolytics: benzodiazepines - -pam drugs
Anxiolytics: adjuvant agents – Buspar
Antidepressants – Duloxetine or Venlafaxine
Beta-adrenergic blockers – Atenolol or Metoprolol
psychotherapy used to treat anxiety disorders
Psychotherapy
Cognitive therapy
Behavioral therapy
agitation, anxiety, restlessness, disorientation, diaphoresis, hyperthermia, tachycardia, nausea, vomiting, tremor, muscle rigidity, hyperreflexia, myoclonus, dilated pupils, ocular clonus, dry mucous membranes, flushed skin
Symptoms of Serotonin Syndrome
a potentially fatal drug-induced condition caused by too much serotonin in synapses in the brain
Serotonin Syndrome
