PPT #3 Flashcards
3 medication options for Mood stabilizers
Lithium, antiepileptic meds, atypical antipsychotics
3 antiepileptic meds
Valproic acid, lamotrigine, and carbamazepine
Benefits of Lithium
highly effective, treats from above and below, and lowers suicide risk
The problem with lithium?
narrow therauptic window. below the window it doesnt work. above is toxic
What should lithium levels be?
<1.5 mEq/L
Side effects of Lithium
Mild nausea, diarrhea, fine hand tremors, polyuria and polydipsia, weight gain
Early Signs of Lithium Toxicity (ACNE)
ataxia, coarse tremors, n/v/d, ears ringing
Client teaching for Lithium
take food, maintain fluid and salt intake, avoid strenous exercise, signs of toxicity
Anxiolytics
Benzos, buspirone, antidepressants, beta blockers, certain antihistamines
Common use of Benzos
anxiety disorders, alcohol withdrawal, muscle spasms, seizure disorders, sleep disorders
Benzo Drugs?
Alprazolam, diazepam, lorazepam, chlorodiazepoxide, clonazepam
Difference in benzos?
The onset and duration
How do Benzos work?
They help GABA work better and work immediately after absorption and work on the same receptor as alchohol.
Problem with Benzos?
Sedation, ataxia, impaired memory. Addictive and you must slowly wean long term users off
Benzo Precautions?
History of drug abuse, liver disease, and elderly
Key points of benzos
For short term use, dont drink with alcohol, dont quit abruptly and Flumazenil is the antdote for overdose of benzos
How does Buspirone work?
It binds to serotonin receptors and loosely to dopamine receptors
How does buspirone compare to other benzos?
no abuse potential, not a cns depressant, no major withdrawal issues
Disadvantage of buspirone
takes longer to work. clients must avoid drinking grapefruit juice
Common uses of FGAs
Schizophrenia, agitation, n/v intractable hiccups
What are the FGAS?
Haloperidol, chlorpromazine
Positive symptoms of schizophrenia
auditory hallucinations, delusions, disorganized speech, bizarre behavior
Negative symptoms of schizophrenia
affective flattering, alogia, avolition, anhedonia, and social isolation
How do FGAs work?
They block dopamine receptors in the brain
Side effects of FGAs
anticholinergic effects, orthostatic hypotension, sedation, neuroendocrine effects, photosensitivity
Extra pyramidal symptoms of FGAs
acute dystonia, akathisia, parkinsonism, tardive dyskinesia
Neuroleptic Malignant syndrome
FEVER
fever, elevated WBC’s and CPK, vital signs unstable, encephalopathy, rigidity
HYC of FGAS
wear sunscreen, dont treat EPS with antipsychotics
Common use of SGAs
schizophrenia, bipolar, dementia with psychotic features
What drugs are SGAs?
clozapine, risperidone, olanzapine, aripiprazole
How do SGAs work?
Block dopamine and serotonin
Problem with SGAs ?
Lower risk of EPS, high metabolic syndrome, expensive, equally effective
Metablic syndrome
centraal obesity, hypertension, high blood sugar, dyslipidema
Highly effective, can cause agranulocytosis,requires weekly monitoring (WBCs) report signs of infection
clozapine
