Psychotherapeutic Drugs Flashcards
Define Affective.
- mood disorders
- characterized by change in mood
- ex. bipolar disorder
Define Psychotic disorders.
- severe mental illness that often impairs mental function to the point of causing significant disability
- loss of contact w/ reality
- ex. schizophrenia
What is an example of a Mood-Stabilizer?
Lithium
What is Lithium used for?
bipolar disorders (alleviate symptoms of acute mania)
What is the therapeutic range of lithium?
Narrow therapeutic range: 0.6-1.2 mEq/L
Lithium nursing considerations?
- Ensure client’s serum sodium level is WNL
- Assess for cues of lithium toxicity.
- CNS: slurred speech, muscle weakness, tremor
- GI: vomiting, diarrhea
What is a common adverse effect among Antidepressants?
- Drowsiness
~ Caution client to avoid driving or activities that require mental alertness
List some First Generation Antidepressants.
- Tricyclic Antidepressants (TCAs)
- Tetracyclics
- MAOIs
What is an example of a Tricyclic Antidepressant (TCAs)?
amitriptyline
What is Amitriptyline used for?
depression, chronic pain syndromes
Amitriptyline adverse effects?
- cardiac dysrhythmias
- suicidal thoughts
Amitriptyline nursing considerations?
No antidote for toxicity; administer activated charcoal if the ingestion occurred 2 hours before treatment
What is an example of a Tetracyclic?
mirtazapine
Mirtazapine adverse effects?
Suicidal thoughts
What is an example of a MAOI?
phenelzine
Phenelzine adverse effects?
- hypertensive crisis/emergency
- orthostatic hypotension
What should you avoid when taking Phenelzine?
food and drinks with high tyramine content
- aged cheese
- aged meat
- caffeine
- alcohol
List some Second Generation Antidepressants.
- Selective serotonin reuptake inhibitors (SSRIs)
- Selective Serotonin and norepinephrine reuptake inhibitors (SSNRIs)
What are some examples of Selective serotonin reuptake inhibitors (SSRIs)?
- citalopram
- fluoxetine
- sertraline
Selective serotonin reuptake inhibitors (SSRIs) adverse effects?
QT prolongation
Selective serotonin reuptake inhibitors (SSRIs) drug interactions?
MAOIs: fatal reaction
Nursing considerations for Citalopram, Fluoxetine, and Sertraline?
- Assess mood for suicidal tendencies, especially during early therapy
- Assess for serotonin syndrome
What is an example of a Selective Serotonin and norepinephrine reuptake inhibitors (SSNRIs)?
duloxetine
Duloxetine adverse effects?
orthostatic hypotension, increased BP
Duloxetine drug interactions?
MAOIs: fatal reactions
Duloxetine nursing considerations?
- Assess for cues of suicidal thoughts and/or increased depression
- Assess for serotonin syndrome
What is an example of a Herbal?
St. John’s Wort
What is St. John’s Wort used for?
depression, anxiety, sleep disturbances, & nervousness
What are some nursing considerations for ALL Psychotic Disorder drugs?
- all of these medications can cause increased suicidal tendencies in children, adolescents, and young adults and increased risk of death in elderly clients
- all of these medications may cause weight gain
- fall safety for ALL of these medications need to be employed
- all of these medications may cause extrapyramidal symptoms
- tx of PO overdose will be activated charcoal
- if giving PO, ensure medication is taken and not cheeked/hoarded
List a First Generations drug used to treat Psychotic Disorders.
haloperidol
Haloperidol adverse effects?
extrapyramidal symptoms
List some Second Generations drugs used to treat Psychotic Disorders.
- clozapine
- risperidone
- aripiprazole
Clozapine nursing considerations?
Monitor WBC (weekly monitoring for 1st 6 months)
Risperidone mechanism of action?
May act by antagonizing dopamine and serotonin in the CNS
Aripiprazole adverse effects?
- increased risk of suicide in children & young adult
- increased risk of death in elderly
