Psych drugs

Question 1

What do all psychotic drugs have in common?

Answer 1

ALL cause low BP and weight changes (usually gain)

Question 2

What are phenothiazines? Ending? How do they work? Use?

Answer 2

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

Question 3

What are the S/E of Phenothiazines?

Answer 3

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)

Question 4

If someone is experiencing a SE do you hold the drug?

Answer 4

NO only hold if patient is experiencing a toxic effect

Question 5

What is a decanoate?

Answer 5

Long acting form of a drug

Given IM for non compliance

Question 6

What are Tricyclic antidepressants? What do they do? Drugs?

Answer 6

Non-selective serotonin reuptake inhibitor

Mood elevators

Elavil, Trofranil, Aventyl, Desyrel

Question 7

What are the SE of TCA?

Answer 7

Anticholinergic
Blurred Vision
Constipation
Drowsiness
Euphoria

Question 8

How long do you need to take TCA in order to have a beneficial effect?

Answer 8

2-4 weeks

Question 9

What are benzodiazepines? Ending? How long do you need to take before they work? How long can you take them for?

Answer 9

Antianxiety/ minor tranquilizer

Always have ZEP but typically end in LAM or PAM

Work immediately, DO NOT take longer than 2-4 weeks

Question 10

What are the uses of a bento?

Answer 10

Seizures medications
Preop induction of anesthesia
Muscle relaxants
EtOH withdrawal medications
Ventilation—medication to relax and calm down pts on a ventilator

Question 11

What is a major and minor tranquilizer administered at the same time?

Answer 11

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

Question 12

What are the SE of benzos?

Answer 12

Anticholinergic
Blurred vision
Constipation
Drowsiness

Question 13

What is a Monoamine Oxidase (MAO) inhibitor? Drugs?

Answer 13

Antidepressant

MARplan, NARdil, PARnate

Question 14

What are the SE of a MAO inhibitor?

Answer 14

Anticholinergic
Blurred vision
Constipation
Drowsiness

Question 15

What foods should be avoided with MAO inhibitors?

Answer 15

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)

Question 16

What is lithium used for? What does it do?

Answer 16

Decreases mania in bipolar

Acts like an electrolyte

Question 17

What are the SE of lithium?

Answer 17

Peeing
Pooping
Parethesias

Paretheisa is the EARLIEST sign of an electrolyte imbalance

Question 18

What are the toxic effects of lithium?

Answer 18

Tremors
Metallic taste
Servere diarrhea

Question 19

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?

Answer 19

FLUIDS

FLUIDS and notify HCP since this is toxic

Question 20

What should be monitored with a patient on Lithium?

Answer 20

Monitor sodium b/c needs to be normal

Low sodium –> lithium toxicity
High sodium –> lithium is ineffective

Question 21

What is an SSRI? Drugs?

Answer 21

Mood elevate

Fluoxetine (prozac)

Question 22

What are the SE of fluoxetine (SSRI)?

Answer 22

Anticholinergic
Blurred vision
Constipation
Drowsiness
Euphoria

Question 23

When should you give fluoxetine?

What should you watch for in adolescents when changing the dose?

Answer 23

Causes insomnia so give it early in day not at bedtime

Watch for suicidal risk in adolescents when changing the dose

Question 24

What is haldol (haloperidol)?

Answer 24

Frist gen/typical, tranquilizer (basically the same as thorazine)

Question 25

What are the SE of haldol?

Answer 25

Anticholinergic
Blurred vision
Constipation
Drowsiness
EPS
Foto sensitivity
aGranulocytosis

Question 26

What is a symptom that could develop form overdose on haldol? How do you tell the difference between this and EPS?

Answer 26

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

Question 27

What is clozapine? What is the advantage? SE?

Answer 27

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)

Question 28

What is difference about ziprasidone (second gen)?

Answer 28

BBW of prolong QT interval –> sudden cardiac arrest

Avoid in patients with cardiac conditions

Question 29

What is sertraline? What are the SE?

Answer 29

Anitdepressant

SAD Head
Sweating
Apprehension
Dizzyness
Headache
Can cause insomnia

Question 30

What should not be taken with Sertraline

Answer 30

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