Psych drugs Flashcards
What do all psychotic drugs have in common?
ALL cause low BP and weight changes (usually gain)
What are phenothiazines? Ending? How do they work? Use?
Frist gen/typical anti psychs, major tranquilizers
end in -ZINE (Thorazine, compazine)
Only reduce symptoms, don’t cure
Large doses: ZINEs for the ZANY (Cuckoos)
Small doses: antiemetics
What are the S/E of Phenothiazines?
Anticholinergic (Dry mouth, urinary retention)
Blurred vision
Constipation
Drowsiness
EPS (tremors, parkinsons)
Foto sensitivity
aGranulocyosis (low WBC and immunosuppressed - recognize and report sore throat and s/s of infection)
If someone is experiencing a SE do you hold the drug?
NO only hold if patient is experiencing a toxic effect
What is a decanoate?
Long acting form of a drug
Given IM for non compliance
What are Tricyclic antidepressants? What do they do? Drugs?
Non-selective serotonin reuptake inhibitor
Mood elevators
Elavil, Trofranil, Aventyl, Desyrel
What are the SE of TCA?
Anticholinergic
Blurred Vision
Constipation
Drowsiness
Euphoria
How long do you need to take TCA in order to have a beneficial effect?
2-4 weeks
What are benzodiazepines? Ending? How long do you need to take before they work? How long can you take them for?
Antianxiety/ minor tranquilizer
Always have ZEP but typically end in LAM or PAM
Work immediately, DO NOT take longer than 2-4 weeks
What are the uses of a bento?
Seizures medications
Preop induction of anesthesia
Muscle relaxants
EtOH withdrawal medications
Ventilation—medication to relax and calm down pts on a ventilator
What is a major and minor tranquilizer administered at the same time?
Major anti psychs take 2-4 weeks to begin working
Minor anti psychs start working right away
Valium (diazepam) is discontinued at 2-4 weeks once major kicks in
What are the SE of benzos?
Anticholinergic
Blurred vision
Constipation
Drowsiness
What is a Monoamine Oxidase (MAO) inhibitor? Drugs?
Antidepressant
MARplan, NARdil, PARnate
What are the SE of a MAO inhibitor?
Anticholinergic
Blurred vision
Constipation
Drowsiness
What foods should be avoided with MAO inhibitors?
Foods that contain tyramine
BAR (bananas, avocados, raisins/dried fruit)
No organs like liver, kidney, heart, tripe, or preserved meats (smoked, dried, cured, pickled, hot dogs)
NO cheese unless cottage cheese and mozzarella
NO alcohol (elixirs, tinctures)
NO caffeine (chocolate, licorice, soy sauce)
What is lithium used for? What does it do?
Decreases mania in bipolar
Acts like an electrolyte
What are the SE of lithium?
Peeing
Pooping
Parethesias
Paretheisa is the EARLIEST sign of an electrolyte imbalance
What are the toxic effects of lithium?
Tremors
Metallic taste
Servere diarrhea
What is the most important nursing intervention in a patient on lithium that is presenting with peeing/pooping a lot?
What about if patient is presenting with metallic taste and severe diarrhea?
FLUIDS
FLUIDS and notify HCP since this is toxic
What should be monitored with a patient on Lithium?
Monitor sodium b/c needs to be normal
Low sodium –> lithium toxicity
High sodium –> lithium is ineffective
What is an SSRI? Drugs?
Mood elevate
Fluoxetine (prozac)
What are the SE of fluoxetine (SSRI)?
Anticholinergic
Blurred vision
Constipation
Drowsiness
Euphoria
When should you give fluoxetine?
What should you watch for in adolescents when changing the dose?
Causes insomnia so give it early in day not at bedtime
Watch for suicidal risk in adolescents when changing the dose
What is haldol (haloperidol)?
Frist gen/typical, tranquilizer (basically the same as thorazine)
What are the SE of haldol?
Anticholinergic
Blurred vision
Constipation
Drowsiness
EPS
Foto sensitivity
aGranulocytosis
What is a symptom that could develop form overdose on haldol? How do you tell the difference between this and EPS?
NMS (neuroleptic malignant syndorme) - life threatening
Elderly should have 1/2 normal adult dose
High fever over 105, tremors, anxiety
EPS will also present with anxiety and tremors BUT only NMS will have a fever so if they have a fever call emergency response and notify HCP
What is clozapine? What is the advantage? SE?
Atypical antipsychotics/second gen (-ZAPINE)
Advantage is that it does not cause A-F SE
Does cause aGranulocytosis b/c trashes pts bone marrow (monitor WBC)
What is difference about ziprasidone (second gen)?
BBW of prolong QT interval –> sudden cardiac arrest
Avoid in patients with cardiac conditions
What is sertraline? What are the SE?
Anitdepressant
SAD Head
Sweating
Apprehension
Dizzyness
Headache
Can cause insomnia
What should not be taken with Sertraline
St Johns wort –> serotonin syndrome
Warfarin –> cause bleeding
If taking either of these then the dose needs to be decrease b/c sertraline inhibits them from being broken down –> toxicity
