psychotropic medications

Question 1

difference between typical and atypical antipsychotics

Answer 1

atypical are less likely to cause EPS
atypical treats both positive and negative symptoms of schizophrenia, rarely causes agranulocytosis
typical antipsychotics- blocks norepinephrine which causes hypotension and sedative effects

Question 2

drug interactions with antipsychotic drugs

Answer 2

alcohol 
hypnotics 
sedatives 
narcotics 
barbiturates

Question 3

classic major side effects of typical antipsychotics (haldol and prolixin)

Answer 3

puritis, photosensitivity, sedation, dizziness, h/a, seizures, dry mouth, nasal congestion, blurred vision, urinary retention, gi distress, EPS
prolixin- periphrial edema, tachycardia
haldol- orthostatic hypotension

Question 4

what is prolixin?

Answer 4

a typical antipsychotic, manages the symptoms of schizophrenia

Question 5

interactions and contraindications of prolixin- fluphazine

Answer 5

renal and liver damage, hypersensitivity, blood dyscrasia, cns depressents, etoh, kava kava

Question 6

interactions and contraindications of haldol

Answer 6

narrow angle glaucoma, liver kidney damage, orthostatic hypotension, dysrythmia, urinary retention, cns depression, anticholinergics (increased toxicity), decreased effects with phenobarbital, carbamazepine, caffeine

Question 7

side effects of atypical antipsychotics

Answer 7

sedation, drowsiness, wt gain, wt loss, h/a, fatigue, blurred vision, hyper/hypoglycemia, insomnia, agitation, anxiety, constipation, n/v, dizziness, sexual dysfunction

Question 8

adverse effects of atypical antipsychotics

Answer 8

orthostatic hypotension, seizures, hypertension, tachycardia, bradycardia, EPS, seizures, angina, angioedema, diabetes, suicidal ideation, NMS, agranulocytosis, neutropenia, luekopenia

Question 9

contraindications of atypical antipsychotics

Answer 9

dysrythmias, blood dyscrasia, liver damage

Question 10

Nursing interventions for antipsychotics

Answer 10

vs/ cheeking meds, give w food, IM not IV, EPS, NMS, WBC, may turn urine brown or pink, 3-6 weeks to work

Question 11

side effects of benzodiazepines

Answer 11

drowsiness, dizziness, confusions, blurred vision, weakness, restlessness, sleep disturbance, hallucinations, GI distress

Question 12

signs and symptoms of benzo withdrawal

Answer 12

tremor, agitation, nervousness, sweating, insomnia, anorexia, muscle cramping

Question 13

nursing interventions for patients taking benzos

Answer 13

encourage client to drink fluids, may take 1-2 weeks to work, no more than 2-4 wks to prevent tolerance, do not take with other cns depressants, NO kava kava, do not take w antacids or caffeine, take w food to prevent gi discomfort, warn client against abrupt stopping, take w food to prevent GI discomfort, warn client against abrupt discontinuation of drugs

Question 14

SSRIs side effects

Answer 14

H/a, nervousness, restlessness, insomnia, seizures, tremors, GI distress, sexual dysfunction, suicidal ideation, works over 2-4 weeks
can cause hyper or hypotension

Question 15

prototype- fluoxitine

Answer 15

increased effects with hypoglycemia, increased risk for respiratory depression, GI distress, sexual dysfunction,

Question 16

SNRI prototype

Answer 16

venlafaxine (Effexor)

Question 17

side effects of venlafaxine (Effexor)

Answer 17

drowsiness, dizziness, nervousness, confusion

Question 18

MAOIS uses

Answer 18

only used in patients with depression uncontrolled by TCAs

Question 19

side effects of MAOIS

Answer 19

agitation, restlessness, insomnia, anticholinergic effects, orthostatic hypotension, hypertension with tyramines

Question 20

drug interactions with MAOIS

Answer 20

VS, mood, suicidal tendencies, cold medicine, take with food, do not drive, do not stop abruptly, take before BED, 2-4 weeks for response, do not take with herbs, gisneng, or st johns wart

Question 21

types of mood stabilizers

Answer 21

lithium, anticonvulsants, tegrotal, valproic acid, lamotrigine

Question 22

therapeutic range for lithium

Answer 22

0.5-2.5mEq

Question 23

what levels can drop with lithium

Answer 23

sodium!

Question 24

side effects of lithium

Answer 24

h/a, drowsiness, dizziness, hypotension, dysrythmias, restlessness, slurred speech, dry mouth, metallic taste, GI distress, tremors, muscle weakness, edema of hands and feet, increased urination, blood dyscrasias

Question 25

signs and symptoms of lithium toxicity

Answer 25

Nausea and vommiting! severe diarrhea, blurred vision, ataxia, tinnitus, tremors, confusion, dysrythmias, seizures

Question 26

nursing intervention for lithium

Answer 26

vs, na levels, urine output, renal function, 1-2L of fluid daily, take w food, monitor lithium levels 1-2 months, toxicity occurs after 2mEq, wear med alert bracelet, dont drive until you know how med effects you, drug may take 1-2 weeks to work, encourage pt to avoid caffeine, crash diets, nsaids, diruetics, pregnancy

Question 27

carbmazepine

Answer 27

manages manic episodes

Question 28

uses for valporic acid

Answer 28

management of major depression, bipolar disorder, tonic clonic seizures, migraine prophylaxis

Question 29

action of ritalin

Answer 29

increases dopamine and norepinephrine which increases stimulation dose can be gradually increased until wanted effects occur

Question 30

side effects of ritalin

Answer 30

nervousness, sleeplessness, palpitations, SOB,, fainting, aggressiveness, hearing voices, slows growth, seizures, blurred vision, impaired circulation, do not take when agitated or nervous

Question 31

contraindications of ritalin

Answer 31

hx of glaucoma, tics, tourretes, use a MAOI or have in the last 14 days