Pharmacology Week 12: Psychotropic, Anxiety, Sedation and Insomnia Medications Flashcards
Psychotropic Medications
- Anti-Psychotics (Haloperidol)
- Anti-Depressant (Duloxetine)
- Mood Stabilizers (Lithium)
Anti-Psychotic Drugs
treat signs + symptoms of psychoses
- positive symptoms: agitation, delusions, hallucinations, illogical thinking etc.
- negative symptoms: social withdrawal, decreased affect, lack of motivation etc.
- Goal: to maintain optimum levels of functioning for the individual
Anti-Psychotic Action
block the dopamine receptors in the brain resulting in extrapyramidal adverse effects
- these effects occur outside the central nervous system and include akathisia (inability to stay still), Parkinsonism, and dystonia
- patients often stop taking these drugs because of the side effects
Anti-psychotic: Haloperidol
indicated for patients with acute or chronic psychotic disorders including schizophrenia, manic states, and drug induced psychoses
-assess mental status including orientation, mood, and behavior
Anti-psychotic: Haloperidol Side Effects
- dry mouth
- blurred vision
- photo-sensitivity
- sexual dysfunction
- sleepiness
- monitor for neurological changes
- monitor for development of neuroleptic malignant syndrome– life threatening
Anti-psychotic Drug Assessment
-assess disorder before therapy and regularly thereafter
-Assessment Includes:
>vital signs, decreased BP
>lab values for elevated renal + liver enzymes
>intake + output for dehydration, urinary retention, and constipation
-it may take several weeks to see desired effects
-take medication as directed and should not increase, decrease or abruptly stop the medication without consulting with healthcare provider
Antidepressants
used to treat effective disorders including but not limited to depression, obsessive-compulsive disorder, panic disorders, post-traumatic stress disorder, and anxiety
-several classifications–> selective serotonin re-uptake inhibitors (SSRIs), monoamine oxidase (MAO) inhibitors, and tricyclic antidepressants (TCAs)
Adverse Reactions of Antidepressants
- anxiety
- insomnia
- somnolence
- palpitations
- sexual dysfunction
- decreased blood glucose level
- orthostatic hypotension
- SSRIs and MAOIs should never be used in combination
- concurrent ingestion of MAO inhibitors and tyramine-containing foods may lead to hypertensive crisis. Symptoms include chest pain, severe headache, nuchal rigidity, nausea, vomiting, photosensitivity, and enlarged pupils
Antidepressant: Duloxetine
indicated for patients with major depressive disorder, generalized anxiety disorders, diabetic peripheral neuropathic pain and fibromyalgia
-Therapeutic Effect: decreased depressive symptoms, decreased neuropathic pain and decreased symptoms of anxiety and pain
Therapeutic Effects of Duloxetine (antidepressant)
- decreased depressive symptoms
- decreased neuropathic pain
- decreased symptoms of anxiety + pain
Common Side Effects of Duloxetine (antidepressant)
- seizures, suicidal thoughts, fatigue, drowsiness, insomnia, decreased appetite, nausea, constipation, hepatotoxicity
- instruct patient to notify healthcare provider with signs of serotonin syndrome (vital sign changes, lack of coordination, nausea, vomiting, diarrhea) or
- mental status changes (suicidal thoughts, or behavior, or depression)
Mood Stabilizers: Lithium
used to prevent or relieve wide fluctuations in mood as occurs in mania or bipolar disease
- exact mechanism of action is not known but it is thought to influence re-uptake of neurotransmitters
- has a narrow therapeutic index
What to Assess and Look for With Patients Taking Lithium? (Mood Stabilizer)
- assess mental status frequently and initiate suicide precautions if indicated
- has a narrow therapeutic index so monitoring drug levels frequently is important
- assess for signs + symptoms of Lithium toxicity including vomiting, diarrhea, slurred speech, drowsiness, and decreased coordination
- low sodium levels can predispose patient to toxicity
Anxiety, Sedation, and Insomnia Drugs
- Anti-anxiety (Diazepam)
- Sedative/ Hypnotics (Zolpidem)
Anti-anxiety Medications
used to treat anxiety disorders and are very commonly prescribed in the U.S.
- 3 main types: benzodiazepines, atypical anxiolytics, and SSRIs
- relieve anxiety temporarily but must be used in conjunction with psychotherapy to identify and hopefully resolve underlying problems
- teach relaxation techniques
- avoid hazardous activities until effect of drug is known
- have the potential for abuse
