Psychiatric Drugs Flashcards
What are the S/Es of Phenothiozines
o Anticholinergic (dry mouth, urinary retention)
o Blurred vision
o Constipation
o Drowsiness
o EPS extrapyramidal symptoms (tremors, Parkinson)
o Foto sensitivity
o aGranulocytosis (low WBC count, immunosuppressed) Teach patient how to recognize and report sore throat and symptoms of infection
First generation or typical antipsychotics
All end in “Zine”
o Example: Thorazine, Compazine
• They don’t cure … They just reduce symptoms
• We use ZINEs for the ZANY (Cuckoos) … Antipsychotics
• In small doses, they are antiemetics (to treat vomiting)
Example: Thorazine, Compazine
• They don’t cure … They just reduce symptoms
• We use ZINEs for the ZANY (Cuckoos) … Antipsychotics
• In small doses, they are antiemetics (to treat vomiting)
• The long-acting form of a drug
• Sometimes denoted with the letter “D”
• IM form given for non-compliance
• Often Court-ordered
Decanoate or “Caprate” form of a medication
- Grandfathered into the NSSRI (Non-selective serotonin reuptake inhibitor) group, They are Mood elevators (Happy pills), Must take meds for 2 to 4 weeks for beneficial effects.
So, after the first week of antidepressant therapy, pt will complain the drug is not working - Name 4
- What are its S/E?
- Tricyclic Antidepressants
- Elavil (elevates), Trofranil, Aventyl, Desyrel
- Side effects of TCA are
- Anticholinergic (especially, dry mouth)
- Blurred Vision
- Constipation
- Drowsiness
- Euphoria (happy)
_______ for Zany (major antipsychotics)
Zines
Anti-antiety, minor tranquilizers
Benzos
(1) Anti-anxiety, minor tranquilizers
Always have ZEP in the name
Remember ZZzzs for falling/going to sleep
Many end in “Pam” or “Lam”
Prototype: Valium, induction of anesthetic, muscle relexant, alcohol
Can be used as:
(5) Seizures medications, (2) Preop induction of anesthesia,
(3) Muscle relaxants,
(4) EtOH withdrawal medications, (6) Ventilation—medication to relax and calm dwn pts on a ventilator
They work quickly.. But do not Take for more than
Benzodiazepines
What are other indication of Benzos?
Seizures medications
Preop induction of anesthesia
Muscle relaxants
EtOH withdrawal medications
Ventilation—medication to relax and calm down pts on a ventilator
Learn the Generic name / Trade
The only questions that has generic name are ones that are reasonable to expect new graduate to know.
Examples:
Acetaminophen =
Warfarin =
Meperidine =
Acetylsalicylic acid =
Acetaminophen = Tylenol
Warfarin = Coumadin
Meperidine = Demeral
Acetylsalicylic acid = Aspirin
Administer major and minor tranquilizers at the same time. Why?
• 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
A similar example for giving major and minor tranquilizers together is the concurrent use of Heparin and Coumadin (warfarin)
How so
• Heparin works right away but a pt should not be on it for a long time • Coumadin takes a few days to start working but a pt can be on it for the rest of his life
S/Es of Benzodiazepines
S/Es of Benzodiazepines are “ABCD”
• Anticholinergic • Blurred Vision • Constipation • Drowsiness
• Antidepressant • Depression is thought to be caused by norepinephrine, dopamine, and serotonin in brain • Name of MAOIs starts with • MARplan, NARdil, PARnate the beginnings—all rhyme
Monamine Oxidase (MAO) Inhibitors
What are S/E of MAOIs
“ABCD”
Anticholinergic
Blurred VIsion
Constipation
Drowsiness
What do we teach pts taking MAOIs?
Why?
Teaching Points
• Avoid tyramine-containing food … May cause Hypertensive Crisis
• Food with tyramine
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 chees except for mozzarella, cottage cheese (no aged cheese)
o No EtOH, elixirs, tinctures (iodine/betadine) caffeine, chocolate, licorice, soy sauce
What psych medication can cause HYPERTENSIVE CRISIS?
Therefore, what do we teach pts taking this med
Monamine Oxidase (MAO) Inhibitors
*We teach pts to avoid tyramine-containing food… because they may cause hypertensive crisis
- avoid the salad “BAR”: banana, avocados, raisins
- avoid yeasr
- no liver, kidneym, tripe, heart, no preserved meats (smoked, dried, cured, pickled, hot dogs)
- np dairy (expect mozzarella, cottage cheese (ni aged cheese))
- avoid EtOH, elixirs, tinctures (iodine/betadine) caffeine, chocolatye, licorice, soy sauce
• Used for treating Bipolar disorder—it decreases the mania LI = BI
Lithium
It’s S/e is Very Unique—acts more like an electrolyte—think: Potassium/Lithium
Lithium
What are the S/Es of Lithium
• S/E: Very Unique—acts more like an electrolyte—think: Potassium/Lithium
• The 3 Ps as S/Es
o Peeing (Polyuria)
o Pooping (diarrhea)
o Paresthesia (earliest sign of electrolyte imbalance)
The earliest sign of electrolyte imbalance is Paresthesias = Numbness and Tingling
What is the #1 nursing intervention in a pt on lithium
What is the #1 nursing intervention in a pt on lithium presenting with peeing/pooping all the time?
• #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
What are signs that there is toxic effects of lithium?
• Tremors
• Metallic taste
• Severe diarrhea
High ________ will make lithium ineffective
Sodium
________ makes lithium toxic
LOW sodium
An SSRI, mood elevator
Can cause insomnia. Therefore, give before noon
When changing doses of this medication, we watch for??????
What are its side effects?
Prozac (fluoxetine)
When changing doses, watch for suicidal risk in adolescents
o Must recently change the dose and be an adolescent of young adult
• Side effects of Prozac are
o Anticholinergic o Blurred Vision o Constipation o Drowsiness o Euphoria (happy)
