Psychotherapeutic Drugs Flashcards
Anxiolytic drugs
Benzodiazepines ends in -lam/pam
-alprazolam
-diazepam
-lorazepam
Miscellaneous drug is Buspirone
Adverse effects of benzodiazepines
over-expression of therapeutic effects
-drowsy, dizzy
-hypotension (have pt sit before stand)
-headaches
-N/V constipation
-dry mouth
Antidote for benzodiazepines
Flumazenil (Romazican)
(Fluh-maz-uh-nil)
Interactions w/ benzodiazepines
do not mix w/ alcohol, will have additive CNS depression and death
-occurs more in pt w/ hepatic/renal compromise
Buspirone
misc anti-anxiety med
-lacks sedative/dependency properties unlike benzos
Alprazolam adverse effects and what to avoid it with
-slow, sleepy, drowsy side effects
-avoid w/ alcohol/contraceptives
-AE: confusion, headaches
Diazepam indications, and adverse effects (valium)
given to someone with anxiety/panic attack
-slow, sleepy, drowsy
-avoid in pt w/ hepatic problems
-AE: confusion
Lorazepam (ativan) indications
To treat or prevent alcohol withdrawel
Mood stabilizing drugs indications
for bipolar disorder
-lithium carbonate
-lithium citrate
Drug of choice to treat mania
lithium carbonate/citrate
Therapeutic range for lithium
Maintenance range: 0.6-1.2
Acute mania: 1-1.5
What should be monitored while taking lithium?
sodium levels (NAtremia) (135-145)
below 135=holds onto lithium=toxicity
Most serious adverse effect on lithium
cardiac dysrhymias (monitor the heart)
What does long term use of lithium cause
hypothyroidism
(test patients thyroid before administering this medication)
Antidepressant drug classifications
tricyclic antidepressants
MAOIs
Second gen
SSRIs
SNRIs
-high risk of suicide at beginning of therapy
-tell pt it can take at least 6 weeks for therapeutic effects to occur
Amitriptyline
tricyclic antidepressant
-been replaced by SSRIs as first line antidepressant
Amitriptyline indications
treats insomnia/neuropathic pain
tricyclic antidepressant indications
(Amitriptyline)
-depression
-childhood eneursis
-adjunctive analgesic for chronic pain
Overdose w/ tricyclic
very lethal
CNS/cardiovascular system is mainly effected
-death results from cardiac dysrhythmias/seizures
MAOIs indications
-used for PD, rarely for depression
-isoscarboxazid
-phenelzine
-tranylcypromine
-selegiline
What can taking tyramine w/ MAOIs result in
hypertensive crisis
foods that contain tyramine
-aged mature cheese (cheddar, bleu, swiss)
-smoked pickled aged meats
-red wines
-fava beans (italian beans)
-pepperoni/salami
-yeast extracts
-fish poultry sausage corned beef
Second generation antidepressants
Bupropion
SSRIs
-fluoxetine
-sertraline (ends in -ine)
Miscellaneous: Mirtazapine
What is bupropion for
helps w/ smoking cessation, brand name is (Zyban)
second generation AE:
Insomnia
SSRIs
-fluoxine
-sertraline
-Bupropion
Serotonin syndrome in second gen S/S
to much serotonin (feel good chemical)
-hyperthermia
-seizures
-cardiac dysthymias
Rhabdomylosis (muscle breakdown)
When do we administer Fluoxetine
SSRI
-give in the morning, causes insomnia
AE: dizzy, drowsy, insomnia, anxiety
Duloxetine indications
SNRI
-used for pain resulting from diabetic peripheral neuropathy, or fibromyalgia
Mirtazapine indication and when to give this med
An appetite stimulant for older patients that causes sedation, give the dose at bedtime, fall risk
Antpsychotics
used for drug induced psychosis, and schizophrenia
-known as tranquilizer
typical:
haloperidol (more ADE)
atypical:
quetiapine (less ADE)
Clozapine
Adverse effects w/ antipsychotics
-agranulocytosis (decreased WBC)
-hemolytic anemia (rbc are destroyed)
-tardive dyskinesia (involuntary
contraction of oral/facial muscles)
MONITOR CBC
Extrapyramidal symptoms of antipsychotics
-akathisia (restless muscles)
-acute dystonia (painful muscle spams)
What can we give a patient to treat acute dystonia
trihexyphenidyl and benztropine
Haloperidol indication
long term treatment of psychosis
Clozapine adverse effects
second gen atypical antipsychotic
AE: blood dyscrasias (changes in composition of blood)
MONITOR WBC FREQUENTLY, ESPECIALLY IN THE BEGINNING
Risperidone
for schizophrenia
therapeutic dose is 1-6
Risperidol consta: last 2 weeks
lnrega sustenna: last 1 month
psychotherapeutic nursing interventions
wear sunscreen b/c of light sensitivity
-obtain liver/renal function test
Positive symptoms of schizophrenia
-symptoms that a normal person does not have
-hallucinations
-delusions
-conceptual disorganization
Negative symptoms of schizophrenia
Not bad, they lack in what a normal person has
-apathy (lack of interest)
-social withdrawel
-catatonia (inable to move properly)
