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Mental Health Nursing > Psych Meds > Flashcards

Psych Meds Flashcards

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1
Q

MAO-Inhibitors (Monoamine Oxidase Inhibitors) SE and Precautions

A 
• Tachycardia
• Urinary hesitancy, constipation
• Impotence
• Dizziness
• Insomnia
• Muscle twitching
• Drowsiness
• Dry mouth
• Fluid retention
*** (Hypertensive crisis: severe
hypertension, severe headache, chest pain, fever, sweating, nausea and vomiting)
• Confusion
***No tricyclics or SSRI (wait 2 weeks; 5 weeks for Prozac)!!!
***No OTC Meds!!!!!!!
***Major concern is need for dietary restrictions—certain drug and food interactions can cause hypertensive crisis.
• Instruct client not to eat foods with high tyramine content: aged cheese, red wine, beer, beef and chicken, liver, yeast, yogurt, soy sauce, chocolate, bananas!!!!
• Teach client to use caution around
machinery
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2
Q

Isocarboxazid: Trade Name, Class, TX?

A
  • Marplan
  • TCA
  • Depression, Phobias, Anxiety
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3
Q

Phenelzine sulfate: Trade Name, Class, TX?

A
  • Nardil
  • TCA
  • Depression, Phobias, Anxiety
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4
Q

Tranylcypromine sulfate: Trade Name, Class, TX?

A
  • Parnate
  • TCA
  • Depression, Phobias, Anxiety
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5
Q

SSRIs (Selective Serotonin Reuptake Inhibitors) SE and Precautions

A 
SE:
• Drowsiness
• Dizziness, light-headedness • Headache
• Insomnia
• Depressed appetite
• Serotonin syndrome
• Sexual dysfunction
• Allergic reaction or rash; withhold
drug if occurs
• Weight gain
Precautions:
• Effective 2-4 weeks after treatment is initiated
• No MAOI wait 2 weeks
Monitor for serotonin syndrome
(defined by at least 3 symptoms):
→ Rapid onset of altered mental
states
→ Agitation
→ Myoclonus
→ Hyperreflexia
→ Fever
→ Shivering
→ Diaphoresis
→ Ataxia
→ Diarrhea
• No St. John’s Wort!!!!
• Must be tapered slowly if discontinuing or changing from one SSRI to another!!!!
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6
Q

Fluoxetine HCl: Trade Name, Class, TX?

A

-Prozac
-SSRI
-TX:
• Depression
• Anxiety
• Panic disorder
• Aggression
• Anorexia nervosa
• OCD

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7
Q

Paroxetine: Trade Name, Class, TX?

A

-Paxil
-SSRI
-TX:
• Depression
• Anxiety
• Panic disorder
• Aggression
• Anorexia nervosa
• OCD

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8
Q

Sertraline: Trade Name, Class, TX?

A

-Zoloft
-SSRI
-TX:
• Depression
• Anxiety
• Panic disorder
• Aggression
• Anorexia nervosa
• OCD

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9
Q

Fluvoxamine: Trade Name, Class, TX?

A

-Luvox
-SSRI
-TX:
• Depression
• Anxiety
• Panic disorder
• Aggression
• Anorexia nervosa
• OCD

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10
Q

Citalopram: Trade Name, Class, TX?

A

-Celexa
-SSRI
-TX:
• Depression
• Anxiety
• Panic disorder
• Aggression
• Anorexia nervosa
• OCD

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11
Q

Tricyclics (TCAs) SE and Precautions

A

-Anticholinergic effects: dry mouth,
blurred vision, constipation, and
urinary retention
• sedation, psychomotor slowing, and poor concentration
• Cardiac: tachycardia,orthostatic, hypotension, quinidinelike
effect on the heart (assess history of myocardial infarction), prolongation of QTc interval
• GI: nausea and vomiting
• Narrow therapeutic index (can be
lethal in overdose)
Precautions:
• Administer at bedtime to minimize
sedative effect.**
• Takes 2-6 weeks to achieve
therapeutic effects
• 1-3 weeks should elapse between
discontinuing tricyclics and initiating MAO inhibitors.
• Teach client to avoid alcohol, antihypertensive drugs.
• Carefully evaluate suicide risk.

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12
Q

Amitriptyline HCl, Trade Name, Class, TX?

A
  • Elavil
  • TCA
  • Depression
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13
Q

Desipramine HCl, Trade Name, Class, TX?

A
  • Norpramin
  • TCA
  • Depression
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14
Q

Imipramine HCl, Trade Name, Class, TX?

A
  • Tofranil
  • TCA
  • Depression
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15
Q

Nortriptyline HCl, Trade Name, Class, TX?

A
  • Aventyl
  • TCA
  • Depression
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16
Q

Protriptyline HCl, Trade Name, Class, TX?

A
  • Vivactil
  • TCA
  • Depression
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17
Q

Maprotiline, Trade Name, Class, TX?

A
  • Ludiomil
  • TCA
  • Depression
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18
Q

Escitalopram, Trade Name, Class, TX?

A

-Lexapro
-SSRI
-• Depression
• Anxiety
• Panic disorder
• Aggression
• Anorexia
nervosa
• OCD

19
Q

Vilazodone, Trade Name, Class, TX?

A

-Viibryd
-SSRI
-• Depression
• Anxiety
• Panic disorder
• Aggression
• Anorexia
nervosa
• OCD

20
Q

Trazodone, Trade Name, Class, TX?

A

-Desyrel
-Mixed SSRI (Atypical Antidepressant)
-• Depression
• With trazodone:
insomnia,
dementia with
agitation
(• Safer than tricyclics and MAO
inhibitors in terms of side effects)
**Priapism (rare but med. emergency)

21
Q

S/NRIs (Serotonin/Norepinephrine Reuptake Inhibitors) SE and Precautions

A

Same As SSRI SE EXCEPT (Sweating and No dizziness)
**Same As SSRI teaching EXCEPT
• Take baseline blood pressure and
monitor periodically (can cause slight drop in BP).
• Monitor for worsening of pretreatment symptoms and
inform client of possibility.

22
Q

Duloxetine, Trade Name, Class, TX?

A

-Cymbalta
-SNRI
-• Depression
• Anxiety
• Panic disorder
• Aggression
• Anorexia
nervosa
• OCD
• Management of
diabetic neuropathic
pain

23
Q

Venlafaxine, Trade Name, Class, TX?

A

-Effexor
-SNRI
-• Depression
• Anxiety
• Panic disorder
• Aggression
• Anorexia
nervosa
• OCD
• Management of
diabetic neuropathic
pain

24
Q

Desvenlafaxine, Trade Name, Class, TX?

A

-Pristiq
-SNRI
-• Depression
• Anxiety
• Panic disorder
• Aggression
• Anorexia
nervosa
• OCD
• Management of
diabetic neuropathic
pain

25
Q

Bupropion, Trade Name, Class, TX? + SE Precautions?

A

-Wellbutrin/Zyban
-Norepinephrine Dopamine Reuptake Inhibitors (NDRIs)
-depression, ADHD, and smoking cessation
-Anxiety and sleep disturbances
**SE/Precautions
*Insomnia, tremor, anorexia and
weight loss, dry mouth
• Sleep disturbances, poor appetite,
pain, sexual dysfunction, sedation
*Lowers seizure threshold
*No Alcohol
*No Herbs Ephedra (HTN )

26
Q

Benzodiazepines SE and Precautions

A 
* Sedation
• Drowsiness
• Ataxia
• Dizziness
• Irritability
• Blood dyscrasias
• Habituation and
increased tolerance
*Take at bed time, no operating machinery, no alcohol, or other sedatives, must be tapered down, short term use only!!!
27
Q

Which (non Benzo) drug is Approved for long-term

treatment of insomnia?

A

Ramelteon (Rozerem)

28
Q

Clorazepate dipotassium Trade Name, Class, TX? + SE Precautions?

A

-Tranxene
-Benzodiazepine
• Reduce anxiety
• Induce sedation, relax muscles,
inhibit convulsions
• Treat alcohol and drug
withdrawal
symptoms
• Safer than sedative-hypnotics

29
Q

List 3 Nonbenzodiazepine Sleep Aids

A

Buspirone (BuSpar) (Anxiety)
Zolpidem (Ambien) (Short term insomnia)
Ramelteon (Rozerem) (Long term Insomnia)

30
Q

Lithium carbonate (Carbolith) SE

A

• Nausea, fatigue, thirst, polyuria,
and fine hand tremors
• Weight gain
• Hypothyroidism

31
Q

Lithium carbonate (Carbolith) Toxicity Signs?

A

Early signs of toxicity: diarrhea,
vomiting, drowsiness, muscle
weakness, lack of coordination
HESI HINT:
Monitor serum lithium levels carefully.
The therapeutic and toxic levels are very close to each
other on the readings. Signs of toxicity are evident when
lithium levels are more than 1.5 mEq/L. Blood levels
should be drawn 12 hours after last dose.

32
Q

Lithium carbonate (Carbolith) Precautions and Med Education?

A

• Lithium is excreted by the kidney. Maintain
adequate serum levels. 0.6-1.2 mEq
• Assess electrolytes, especially sodium.
• Baseline studies of renal, cardiac and thyroid
status must be obtained before lithium
therapy is begun.
• Teach client early symptoms of lithium toxicity.
If drug is continued, coma, convulsions,
and death may occur.
• Instruct client to keep salt usage consistent.
• Use with diuretics is contraindicated.
Diuretic-induced sodium depletion can
increase lithium levels, causing toxicity.

33
Q

Phenothiazines (Typical Antipsychotic Drugs) SE (Most Phenothiazine drugs have “AZINE” at the end!!!)

A 
• Drowsiness
• Orthostatic hypotension
• Weight gain
• Anticholinergic effects
• Extrapyramidal effects
→ Pseudo-parkinsonism
→ Akathisia
→ Dystonia
→ Tardive dyskinesia
• Photosensitivity
• Blood dyscrasias:
granulocytosis, leukopenia
• Neuroleptic malignant
syndrome
34
Q

Phenothiazines (Antipsychotic Drugs) Precautions and Teachings

A 
• Extrapyramidal effects are major
concern.
• Monitor older clients closely.
• Takes 2-3 weeks to achieve therapeutic
effect
• Keep client supine for 1 hour after
administration and advise to change
positions slowly because of effects of
orthostatic hypotension.
• Teach client to avoid:
→ Alcohol
→ Sedatives (potentiate effect of CNS
depressants)
→ Antacids (reduce absorption of drug)
35
Q

List 3 Nonphenothiazines and SE

A 
• Haloperidol (Haldol)
• Thiothixene HCl (Navane)
• Pimozide (Orap)
**Orap is used only for Tourette’s
syndrome!!!!
SE's
• Severe extrapyramidal
reactions
• Leukocytosis
• Blurred vision
• Dry mouth
• Urinary retention
36
Q

List 2 Long Acting Typical Antipsychotics (Hint: Decanoate at the end)

A
  • Fluphenazine decanoate (Prolixin Decanoate)

* Haloperidol decanoate (Haldol Decanoate)

37
Q

List Extrapyramidal effects and Characteristics

A 
• Parkinsonism 1-4 weeks
• Akathisia 1-6 weeks
• Dystonia 1-2 days
• Tardive dyskinesia: develops
late in treatment
Characteristics: 
• Rigidity, shuffling gait, pill-rolling hand
movements, tremors, dyskinesia, masklike
face
• Restlessness, agitation, and pacing;
• Limb and neck spasms; uncoordinated,
jerky movements
• Involuntary tongue and lip movements
38
Q

What is Neuroleptic malignant

syndrome and list effects

A

life-threatening neurological disorder most often caused by an adverse reaction to neuroleptic or antipsychotic drugs: high fever, tachycardia, stupor, increased respirations, severe muscle rigidity

39
Q

Neuroleptic malignant

syndrome Nursing Interventions

A

• Increased risk with phenothiazines
• Early recognition is important; transfer to medical
facility for hydration, nutritional support, and treatment
of possible respiratory failure and renal failure.

40
Q

What is Serotonin syndrome and list effects and Nursing Interventions

A 
Serotonin syndrome occurs when you take medications that cause high levels of the chemical serotonin to accumulate in your body.
• Confusion, disorientation, autonomic
dysfunction
• Notify health care provider, stat.
• Provide systems support.
41
Q

List 3 Anticholinergic Drugs

A 
Trihexyphenidyl HCl
(Artane)
• Benztropine mesylate
(Cogentin)
• Amantadine (Symmetrel)
(Acts on the extrapyramidal system to reduce disturbing
symptoms)
***Usually given in conjunction with
antipsychotic drugs
42
Q

Anticholinergic effects and Nursing Interventions for it

A 
Dry mouth, 
blurred vision, 
tachycardia,
nasal congestion, 
constipation, 
urinary
retention, 
orthostatic hypotension
Interventions:
• Encourage sips of water, chewing sugarless
gum
or hard candy.
• Increase fiber in diet.
• Change positions slowly to avoid dizziness.
• Report urinary retention to physician.
• Tolerance to these side effects will usually
occur.
43
Q

What is Disulfiram used for?

A 
AKA Antabuse 
• Treatment of alcoholism;
aversion therapy
• Interferes with breakdown
of alcohol causing an accumulation
of acetaldehyde
(a byproduct of alcohol in
the body)
Severe side effects occur if
alcohol is consumed:
• Nausea and vomiting
• Hypotension, headaches
• Rapid pulse and
respirations
• Flushed face and bloodshot
eyes
• Confusion
• Chest pain
• Weakness, dizziness
44
Q

What is Acamprosate used for?

A 
AKA Campral
• Treatment of alcohol dependence
by reducing anxiety
and unpleasant effects that
trigger resuming drinking
• Balances GABA and glutamate
neurotransmitters

Mental Health Nursing (3 decks)

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