Psychiatric Pharmacology Flashcards
Benzodiazepines
Diazepam [Valium], Alprazolam [Xanax], Chlordiazepoxide [Librium], Lorazepam [Ativan], Clonazepam [Klonopin], Oxazepam [Serax]
Anxiolytic
Side effects: dizziness, clumsiness, sedation, headache, fatigue, sexual dysfunction, blurred vision
Nursing implications: avoid other CNS depressants (antihistamines and alcohol); avoid caffeine; caution with operating machinery; change positions slowly; use sugar-free beverages or hard candy; drink adequate fluids’ take only as prescribed; do not stop abruptly
Non-benzodiazepines
Buspirone [BuSpar], Meprobamate (Mil-town, Equanil)
Anxiolytic
Side effects: dizziness, restlessness, agitation, drowsiness, headache, weakness, nausea, vomiting, paradoxical excitement or euphoria
Nursing implications: changes positions slowly; caution with operating machinery; take with food; report persistent restlessness, agitation, excitement, or euphoria
First-generation antipsychotics
Chlorpromazine [Thorazine], Perphenazine [Trilafon, Etrafon], Fluphenazine [Prolixin], Thioridazine [Mellaril], Mesoridazine [Serentil], Thiothixene [Navane], Haloperidol [Haldol], Loxapine [Loxitane], Molindone [Moban], Trifluoperazine [Stelazine]
Dopamine antagonists
Used to treat positive signs of schizophrenia (ex: delusions, hallucinations, disturbed thinking)
Second-generation antipsychotics
Clozapine [Clozaril], Risperidone [Risperdal], Olanzapine [Zyprexa], Quetiapine [Seroquel], Ziprasidone [Geodon], Paliperidone [Invega], Iloperidone [Fanapt], Asenapine [Saphris], Lurasidone [Latuda]
Dopamine and serotonin antagonists
Used to treat the positive and negative signs of schizophrenia (ex: lack of volition and motivation, social withdrawal, and anhedonia)
Antipsychotic dept injections
Fluphenazine [Prolixin], Haloperidol [Haldol], Risperidone [Risperdal Consta], Paliperidone [Invega Sustenna], Olanzapine [Zyprexa Relprevv], Apriprazole [Abilify Maintena]
Maintenance therapy
Side effects: extra pyramidal symptoms, tardive dyskinesia, seizures, and neuroleptic malignant syndrome; weight gain, sedation, photosensitivity, anticholinergic effects
SSRI Antidepressants
Fluoxetine [Prozac], Sertraline [Zoloft], Paroxetine [Paxil], Citalopram [Celexa], Escitalopram [Lexapro], Vortioxetine [Trintellix]
Side effects: headache, dizziness, sedation, diarrhea, nausea, vomiting, sweating, constipation, dry mouth, weight gain, sexual dysfunction, insomnia, tremor, constipation
Nursing interventions: monitor for hypo-natremia, encourage adequate fluids, administer with food, report sexual difficulties, encourage hard candy or sugar-free beverages, promote balanced nutrition and exercise
Tricyclic antidepressants
Amitriptyline [Elavil], Amoxapine [Asendin], Doxepin [Sinequan], Imipramine [Tofranil], Desipramine [Norpramin], Nortriptyline [Pamelor]
Side effects: dizziness, orthostatic hypotension, tachycardia, sedation, headache, tremor, blurred vision, constipation, dry mouth, weight gain, rashes, sweating, cardiac dysrhythmias
Nursing implications: report rashes or sexual dysfunction, assist client in changing positions, administer at bedtime, encourage exercise, monitor cardiac function, maintain balanced nutrition and exercise, sugar-free beverages and hard candy
Atypical antidepressants
Venlafaxine [Effexor], Desvenlafaxine [Pristiq], Duloxetine [Cymbalta], Bupropion [Wellbutrin], Nefazodone [Serzone], Mirtazapine [Remeron], Vilazodone [Viibryd]
Side effects: increased blood pressure and pulse, headache, sedation, nausea, vomiting, insomnia, constipation, dry mouth, sweating, blurred vision; two can alter AST, ALT, alkaline phosphates, creatinine, glucose, cholesterol, LDH, electrolytes, and hematocrit
Nursing implications: administer with food, encourage adequate fluids, sugar-free beverages or hard candy, monitor liver and kidney function, report sexual difficulties, change positions slowly
MAOI antidepressants
Isocarboxazid [Marplan], Phenelzine [Nardil], Tranylcypromine [Parnate]
Side effects: drowsiness, dry mouth, overactivity, insomnia, nausea, anorexia, constipation, urinary retention, and orthostatic hypotension
Nursing implications: assist client in changing positions, administer in the morning, administer with food, ensure adequate fluids, low-tyramine diet
Anticonvulsants as mood stabilizers
Carbamazepine [Tegretol], Divalproex [Depakote], Gabapentin [Neurontin], Lamotrigine [Lamictal], Topiramate [Topamax], Oxcarbazepine [Trileptal]
Side effects: dizziness, ataxia, hypotension, sedation, blurred vision, leukopenia, nausea, vomiting, rashes, tremor, confusion, confusion
Nursing implications: assist client in changing positions, monitor gait and assist, report rashes, provide rest periods, administer with food, orient client
Target symptom: affective aggression (normal)
Drugs: lithium, anticonvulsants, low-dose antipsychotics
Target symptom: predatory (hostility/cruelty)
Drugs: antipsychotics, lithium
Target symptom: organic-like aggression
Drugs: cholinergic agonists [Donepezil], imipramine [Tofranil]
Target symptom: ictal aggression (abnormal)
Drugs: carbamazepine [Tegretol], diphenylhydantoin [Dilantin], benzodiazepines
Target symptom: emotional lability
Drugs: lithium, carbamazepine [Tegretol], antipsychotics
