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NCLEX MARK K > psych meds > Flashcards

psych meds Flashcards

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1
Q

ALL psychiatric drugs cause

A

low BP and weight changes—usually weight gain

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2
Q

Phenothiazines

A

First generation or typical antipsychotics (MAJOR tranquilizers)
• They don’t cure … They just reduce symptoms
• We use ZINEs for the ZANY (Cuckoos) … Antipsychotics

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3
Q

First generation or typical antipsychotics end in

A

ZINE (Thorazine, Compazine)

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4
Q

Phenothiazines in small doses, they are… in large doses…

A

small- they are antiemetics (to treat vomiting)

large- Antipsychotics

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5
Q

Antipsychotics S/Es

A

= “ABCDEFG”
o Anticholinergic (dry mouth, urinary retention)
o Blurred vision
o Constipation
o Drowsiness
o EPS (tremors, Parkinson)
o Foto sensitivity
o aGranulocytosis (low WBC count, immunosuppressed)
Teach patient how to recognize and report sore throat and symptoms of infection

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6
Q

• What is the nursing action when someone presents with a S/E?

A

Educate

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7
Q

• What is the nursing action when someone presents with a Toxic effect?

A

o HOLD the drug ! Notify HCP

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8
Q

Decanoate or “Caprate” form of a medication

A
  • The long-acting form of a drug
  • Sometimes denoted with the letter “D”
  • IM form given for non-compliance
  • Often Court-ordered
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9
Q

Tricyclic Antidepressants

A
  • Grandfathered into the NSSRI (Non-selective serotonin reuptake inhibitor) group
  • Mood elevators (Happy pills)
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10
Q

Examples of Tricyclic Antidepressants

A

• Elavil (elevates), Trofranil, Aventyl, Desyrel

- amitryptiline, nortyptiline, imiparamine

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11
Q

Side effects of Tricyclic Antidepressants

A

Anticholinergic (especially, dry mouth) Blurred Vision
Constipation
Drowsiness
Euphoria (happy)

Q-T prolongation

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12
Q

How long do you have to wait to see effects of TCA

A

Must take meds for 2 to 4 weeks for beneficial effects

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13
Q

Benzodiazepines

A

Anti-anxiety, minor tranquilizers

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14
Q

Benzodiazepines names

A 
• Always have ZEP in the name
• Remember ZZzzs for falling/going to
sleep
• Many benzodiazepines end in “Pam” or
“Lam”
• Prototype: Valium, induction of anesthetic, muscle relaxant, alcohol
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15
Q

Benzos can be used as…

A 
o Seizures medications
o Preop induction of anesthesia
o Muscle relaxants
o EtOH withdrawal medications
o Ventilation—medication to relax and calm down pts on a ventilator
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16
Q

How long until benzos start working

A

• Benzos work quickly … But do not take them for more than 2 to 4 weeks

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17
Q

Administer major and minor tranquilizers at the same time. Why?

A

• The major antipsychotics take a long time to start working
• The minor antipsychotics start working right away
• Both are administered at the same time
• Example: pt is usually put on Valium and Elavil at the same time
o Valium is discontinued in 2 to 4 weeks once Elavil kicks in

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18
Q

S/Es of Benzodiazepines

A 
“ABCD” 
• Anticholinergic
• Blurred Vision
• Constipation
• Drowsiness
19
Q

Monamine Oxidase (MAO) Inhibitors

A
  • Antidepressant

* Depression is thought to be caused by norepinephrine, dopamine, and serotonin in brain

20
Q

Name of MAOIs starts with

A

• MARplan, NARdil, PARnate the beginnings—all rhyme

21
Q

S/E of MAOIs

A
  • Anticholinergic
  • Blurred Vision
  • Constipation
  • Drowsiness
22
Q

Teaching points MAOIs

A

Avoid tyramine-containing food … May cause Hypertensive Crisis

23
Q

Food with tyramine

A

o Fruits/Veggies—Avoid salad “BAR”: Bananas, Avocados (guacamole), Raisins (dried fruit)
o Grains—Ok to have, except Yeast
o Meats—No organs liver, kidney, tripe, heart, no preserved meats (smoked, dried, cured,
pickled, hot dogs)
o Dairy—No cheese except for mozzarella, cottage cheese (no aged cheese)
o No EtOH, elixirs, tinctures (iodine/betadine) caffeine, chocolate, licorice, soy sauce

24
Q

Lithium

A

Used for treating Bipolar disorder—it decreases the mania LI = BI

25
Q

S/E of lithium

A

Very Unique—acts more like an electrolyte—think: Potassium/Lithium
• The 3Ps as S/Es
o Peeing (Polyuria)
o Pooping (diarrhea)
o Paresthesia (earliest sign of electrolyte imbalance)

26
Q

Toxic effects of lithium

A
  • Tremors
  • Metallic taste
  • Severe diarrhea
27
Q

What is the #1 nursing intervention in a pt on lithium presenting with peeing/pooping all the time?

A 
• #1 intervention 
o Give pt fluids
• The above S/Sx are S/Es—expected 
• Monitor sodium
• Low sodium makes lithium toxic
• High makes lithium ineffective
• Sodium needs to be normal
28
Q

Prozac (fluoxetine)

A

• SSRI, mood elevator

29
Q

• Side effects of Prozac (fluoxetine) are

A 
o Anticholinergic 
o Blurred Vision 
o Constipation
o Drowsiness
o Euphoria (happy)
• Causes insomnia so give before noon. If bid, give at 6 a.m. and noon
30
Q

Prozac (fluoxetine) risks in adolescents

A

• When changing doses, watch for suicidal risk in adolescents

31
Q

HALDOL (haloperidol)

A
  • Tranquilizers (basically same as Thorazine)

* First generation antipsychotics

32
Q

• S/E of Haldol

A

o Anticholinergic (dry mouth, urinary retention)
o Blurred vision
o Constipation
o Drowsiness
o EPS (tremors, Parkinson)
o Foto sensitivity
o aGranulocytosis (low WBC count, immunosuppressed)

33
Q

Haldol may cause..

A

• Pts may develop NMS (neuroleptic malignant syndrome) from overdose
o Seen in elderly and young white schizophrenic pts
o High fever over 105
o Their doses should be about 1⁄2 usual adult dose

34
Q

How to differentiate NMS (neuroleptic malignant syndrome) from EPS (extrapyramidal syndrome)?

A

• Measure the pts’ temperature
o If temperature is WNL, this is EPS
o If temperature is 102 and rising, call the emergency response team and notify HCP… NMS is life threatening
• NMS presents with anxiety and tremors, and so does EPS

35
Q

Clozaril (clozapine)

A

• Atypical antipsychotic

36
Q

• S/Es of clozapine (clozaril)

A

o aGranulocytosis! It is worse than cancer drugs and can trash the pt’s bone marrow

37
Q

• Geodon (ziprasidone) has a black box warning

A
  • Prolong the QT interval, which can cause sudden cardiac arrest
  • Do not use in pts with cardiac condition
38
Q

Second generation antipsychotics

A

end in “Zapine”

39
Q

What is the #1 nursing intervention in a pt taking Clozaril (clozapine)

A

• Monitor the WBC

40
Q

Zoloft (Sertraline)

A

• Antidepressant

41
Q

Zoloft (Sertraline) cant interact with..

A

• Interact with the followings because they are not metabolized in the liver
o St. John’s Wort and cause serotonin syndrome
o Warfarin and cause bleeding

42
Q

• S/E of serotonin syndrome is

A 
“SAD Head”
o Sweating
o Apprehensive (impending sense of doom) 
o Dizzyness
o Headache
43
Q

The nurse should anticipate lowering the dose of sertraline (Zolof) of a pt on..

A

St. John’s Wort and Warfarin

44
Q

MAOI meds

A

phenelizine
isocarboxazid
selegiline

NCLEX MARK K (18 decks)

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