Psychotherapeutic Drugs Flashcards
Risperidone IM injection duration
Approx. 2 weeks
MAOI’s tyramine foods
aged mature cheeses, smoked, pickled meats, yeast extracts, red wines, italian broad beans
Ingestion of tyramine foods with psychotherapeutics leads to:
hypertensive crisis, which may lead to cerebral hemorrhage, stroke, coma or death
Involuntary muscle symptoms similar to those of PD
extrapyramidal symptoms
Distressing muscle restlessness
Akathisia
Painful muscle spasms
acute dystonia
What medication is used to treat extrapyramidal symptoms?
benztropine (Cogenetin) and trihexyphenidyl (Artane)
Drug of choice for mania
Lithium
When levels of litihium exceed 1.5-2.0 mmol/
L begin to produce toxicity including GI discomfort, tremor, confusion, somnolence, seizures, and possibly death
Lithium toxicity
What helps maintain therapeutic lithium levels
Normal sodium range
What is the therapeutic level for lithium?
0.6-1.2 mmol/L
Clozapine (Clozaril) AE:
blood dyscrasia- any disorder affecting the blood, lymphoid tissue, bone marrow, or blood coagulation process
St. John’s wart interactions
tyramine foods, MAOIs and SSRIs
What is somnolense?
sleepiness during the day
Antidepressant onset
May take up to 8 weeks to see therapeutic effects
SSRI patient teaching:
Fiber supplement must be taken atleast 2 hrs before or after to avoid interaction with drug absorption.
Which drugs require a tapering dose of 2 months to discontinue
SSRIs
Discontinuation syndrome
happens with or without tapering. Dizziness, diarrhea, movement disorders, insomnia, irritability, visual disturbances, lethargy, anorexia, and lowered mood
A rare collection of symptoms resulting from elevated levels of neurotransmitter serotonin; may occur with use of any psychotropic drug that enhances brain serotonin activity such as antidepressants, buspirone, tramadol
serotonin syndrome
A potentially hazardous adverse effect of any drug or combination drug with serotonergic activity
serotonin syndrome
A patient is on clozapine (Clozaril) therapy for 2 months. What beverage(s) should the nurse instruct the patient to avoid?
a) grapefruit juice
b) apple juice
c) cola
d) caffeinated tea
e) fruit mix beverage of apple, mango, and grapefruit
a, e
The nurse is administering clozapine (Clozaril.) What long term monitoring that is associated with this medication should the nurse prioritize? select all.
a) mood swings
b) agranulocytosis
c) weight gain
d) postural hypotension
b, c
A patient is on selective serotonin reuptake inhibitor medication. What possible adverse effect should the nurse instruct the family to monitor as a priority?
a) visual disturbances
b) tardive dyskinesia
c) suicidal thoughts
d) bleeding tendencies
c) suicidal thoughts
The caregiver of a patient who has started on antidepressant therapy asks the nurse “ how long will it take for him to feel better?” What is the best response by the nurse?
a) well, depression rarely responds to medication therapy
b) he should be feeling better in a few days
c) it make take 4-6 weeks before you see an improvement
d) you may not see any effects for several months
c) it may take 4-6 weeks before you see an improvement
A patient was started on an antipsychotic drug that results in extrapyramidal effects. What clinical manifestations should the nurse monitor? select all
a) tremors
b) elation and a sense of well being
c) painful muscle spasms
d) motor restlessness
e) bradycardia
a, c, d
A patient has been taking antipsychotic medication for years, and his wife has noticed that he has had some new physical symptoms. She describes him as having odd facial movements, sticking out his tongue, and having movements of his arms that he cannot seem to control. The nurse suspects that the patient is exhibiting signs of which condition?
a) hypomania
b) serotonin syndrome
c) tardive dyskinesia
d) neuroleptic malignant syndrome
c) tardive dyskinesia
The unpleasant state of mind in which real or imagined dangers are anticipated or exaggerated or both
anxiety
A state characterized by an expansive emotional state (including symptoms of extreme excitement and elation) and hyperactivity.
mania
A group of psychotropic drugs prescribed to alleviate anxiety
benzodiazepines
Emotional disorders characterized by changes in mood
affective disorders
A major psychological disorder, characterized by episodes of mania or hypomania, cycling with depression
bipolar affective disorder
Patients taking MAOIs need to be taught to avoid foods containing which substance?
tyramine
An older class of antidepressant drugs
tricyclics
An abnormal emotional state characterized by exaggerated feelings of sadness, melancholy, and worthlessness out of proportion to reality.
depression
A long acting benzodiazepine
diazepam (Valium)
The most widely used tricyclic antidepressant
amitriptyline (Elavil)
An atypical antipsychotic drug used to treat anxiety
risperidone (Risperdal)
A nonbenzodiazepine drug used to treat anxiety
buspirone
Term for symptoms or adverse effects that often occur with antipsychotic medications
extrapyramidal
Medication used to treat mania
lithium
A type of serious medical illness that can take several different forms and is associated with being truly out of touch with reality
psychosis
Anxiolytic drugs
benzodiazepines and buspirone
Drugs that reduce anxiety by reducing overactivity in the CNS
anxiolytic drugs
The nurse is caring for a patient experiencing ethanol withdrawal. The nurse expects to administer which medication or medication class as treatment for this condition?
a) lithium (Carbolith)
b) benzodiazepines
c) buspirone
d) antidepressants
b) benzodiazepines
The nurse is teaching a patient receiving MAOIs. What food product should the nurse teach the patient to avoid?
a) orange juice
b) milk
c) shrimp
d) swiss cheese
d) swiss cheese (tyramine food)
The nurse calls a patient to schedule a follow up visit after the patient has been treated for depression for 4 weeks. What concern will the nurse assess for during the conversation with the patient?
a) weakness
b) hallucinations
c) suicidal ideation
d) difficulty with urination
c) suicidal ideation
The nurse is caring for a patient who has been taking clozapine (Clozaril) for 2 months. Which laboratory test(s) should be performed regularly while the patient is on this medication?
a) platelet count
b) WBC count
c) liver function studies
d) kidney function studies
b) WBC count
The nurse is giving medications to a patient. Which drug class, when administered with lithium, increases the potential for lithium toxicity?
a) thiazides
b) levofloxacin
c) calcium citrate
d) beta blockers
thiazides
A patient who has been taking lithium for 6 months has had severe vomiting and diarrhea from a GI flu. The nurse will assess for which potential problem at this time?
a) anxiety
b) chest pain
c) agitation
d) dehydration
d) dehydration
The nurse is teaching a patient about treatment with an SSRI antidepressant. Which teaching considerations are appropriate? select all.
a) the patient should be told which foods contain tyramine and instructed to avoid these foods
b) the patient should be instructed to use caution when standing up from a sitting position
c) the patient should not take any products that contain the natural health product St. John’s wort
d) This medication should not be stopped abruptly
e) drug levels may become toxic if dehydration occurs
f) the patient should be told to check with the health care provider before taking any OTC medications
b, c, d, f
A 22 yr old patient who has been taking lithium for 3 months has had severe vomiting and diarrhea from a GI flu. What is the nurse’s priority assessment at this time?
Priority assessment is to look for dehydration and changes in mental status. Fluid loss lead to dehydration, dangerous for patients taking lithium because dehydration and sodium imbalances lead to lithium toxicity.
A 68 yr old patient has been taking SSRI antidepressant for 5 weeks. His wife calls and expresses concern because he has started to give away some of his keepsakes. What is the nurses priority action.
Priority is to watch for suicidal idealation which may increase during the weeks after antidepressant therapy has started. Nurse should instruct the wife to bring her husband in asap for exam and don’t leave him alone
