Psych Drugs Flashcards
what are 7 stages of the nurse-pt relationship
- pre-interaction
- intro
- orientation
- working
- termination
what are 7 principles for psych
1) do not give or accept gifts
2) do not give advice, rather “what do u think u should do?”
3) do not give gaurantees “if you _____, ____ will happen”
4) if pt says something, best answer = one that keeps them talking
5) do not use slang (may take literally)
6) use empathy!
ALL psych drugs have which symptoms
- hypotension
- weight changes (often weight gain)
1st generation antipsychotics end in
_____zine
ex. phenothiazine
(think: zines for the zane (insane))
what is the action of 1st gen antipsychotics
- decrease psych symptoms
- does not cure
- large dose = anti psychotic
- major tranquilizers = big guns
what are side effects of 1st gen antipsychotics
Anticholinergics
Blurred Vision
Constipation
Drowsiness
EPS
Fotosensitivity (photosensitivity)
aGranulocytosis (low WBC)
what are anticholinergic side effectrs
- dry mouth
- blurry vision
- constipation
- decreased urination
what is decanoate?
- drugs that contain a decanoate ester, which is a chemical group that prolongs the action of the drug in the body
ex. haldol decanoate
what are tricyclic antidepressants
- old type of anti-depressant
- NSSRIs
what do tricyclic antidepressants do
- increase mood
what are examples of tricyclic antidepressntas?
ex. amitriptyline, clomipramine, notriptyline
what are side effects of tricylic antidepressants
Anticholinergic
Blurred vision
Constipation
Drowsiness
Euphoria
how long does it take before tricyclic antidepressants work
2-4 weeks
what are benzos used for
- anti anxiety
- minor tranquilizer
what are examples of benzos
- have “zep” in them
ex. diazepam, clonazepam, lorazepam
(think “zeps” and “zines” are tranquilizers, zzz’s make you sleep)
what are indications for benzos
- pre-op for anesthesia
- alcohol withdrawal
- seizures
- muscle relaxant
- help when fighting ventilator
how long can people take benzos
- no longer than 2-4 weeks
how long until benzos work?
- work quickly
what are side effects of benzos
Anticholinergic
Blurred vision
Constipation
Drowsiness
what risk is associated with benzos
- risk of safety and injury
what are MAO inhibitors
- type of antidepressant
what are examples of MAO inhibitors
- phenelzine
- selegiline
- tranylcypromine
what are side effects of MAO inhibitors
Anticholinergic
Blurred vision
Constipation
Drowsiness
what pt teaching should be provided r/t MAO inhibitors
to prevent a severe, acute, sometimes fatal, HTN crisis:
- avoid all foods with tyramine
- no OTC meds
what are examples of foods with tyramine
- Banana, Avacado, Raisons/dried fruit (think salad BAR)
- no organ meats
- no preserved meats
- no hotdogs
- no cheese except cottage and mozza
- no yogurt
- no alcohol
- no chocolate, caffeine,
- no soya sauce
- no liquorice
what is lithium used for
- treats bipolar disorder
- decreases mania
lithium is the only psych drug that doesnt…
- alter neurotransmitting –> is an electrolyte
what are side effects of lithium
Peeing
Pooping
Paresthesia (1st side effect of all electrolyte imbalances)
what are signs of lithium toxicity
- tremor
- diarrhea (severe)
- metallic taste
what interventions should be implemented if on lithium
- increase fluids (r/o dehydration due to increased peeing & pooping, watch Na)
- if sweaty +++, no free water, give gatorade or an electrolyte solution
lithium is closely related to… how so?
Na
- low Na = lithium more toxic
- high Na = lithium ineffective
- normal Na required for lithium to be effective
what is fluoxetine
an SRRI anti-depressant
what are side effects of fluoxetine/SSRIs
Anticholinergic
Blurred vision
Constipation
Drowsiness
Euphoria
Insomnia (give before noon & not at hs)
what the dose of fluoxetine is changed in a adolescent or young adult, what should you monitor for?
- increased risk of suicidal ideation
what is haldol/haloperidol?
- a long acting IM antipsychotic
- typical 1st gen anti-psychotic
what are side effects of haloperidol
Anticholinergic
Blurred vision
Constipation
Drowsiness
EPS
Fotosensitivity
aGranulocytosis
what might elderly pts on haloperidol develop if overdosing?
Neuroleptic
Malignant
Syndrome
(EMS)
what is EMS
- potentially fatal hyperpyrexia (fever) with temps of 106-108
- medical emergency
a haloperidol dose for older adults should be what compared to adults>
1/2
what are other signs of NMS
- tremors
- anxiety
- altered mental status
- muscle rigidity
what is the first action if a questions tells you they are taking a major transquilizer and have symptoms of anxiety, tremors, and confusion?
- take their temp.
what is clozapine? what is it used for
- prototype atypical anti-psychotic
- used for severe schizo
what is an advantage to using clozapine? disadvantage?
- advantage: no ABCDEF side effects
- disadvantage: agranulocytosis –> monitor
typical antipsychotics (major tranquilizers) end in…
- ____zine
2nd generation atypical anti-psychotics (major tranq) end in…
- ____ zapine
minor tranquilizers end in…
_____zep
what is geodon/ziprasidone?
- used to treat schizophrenia and bipolar disorder
what is a signif side effect of ziprasidone
- prolongs QT interval = risk of sudden cardiac arrest
- DO NOT use in people with heart problem
what is setraline
- SSRI
what is a side effect of setraline
insomnia
what are interactions that occur with setraline
- increases toxicities of other drugs = decrease dose of other drugs
- st john’s wart –> serotine syndrome
- warfarin –> increases risk of hemorrhage, decrease warfarin dose
what are signs of serotine syndrome
Sweating
Apprehension
Dizziness
Headache
( think “SAD Head”)
