Psychotropic Meds Flashcards
antipsychotic drugs (neuroleptics, tranquilizers) treat what
psychotic symptoms, most frequently used for schizophrenia, available in decanoate forms that can be injected every 2-4 weeks, phenothiazine derivatives are frequently mentioned
antipsychotic drugs: symptoms most likely to respond include
POSITIVE SYMPTOMS OF PSYCHOSIS
-agitation, hallucinations, sleep disturbance, tension, combative/belligerent behavior, paranoid behavior, disorganized thinking
antipsychotic drugs: symptoms least likely to respond include
NEGATIVE SYMPTOMS
-impaired judgement, lack of insight, weight gain, withdrawal, poor motivation
antipsychotic drugs: side effects (general)
-sedation
-postural hypertension
-weight gain
-photosensitivity
-sexual dysfunction
-breast swelling (gynecomastia)
-anticholinergic side effects
-tardive dyskinesia
-extra pyramidal symptoms
-acute dystonia reactions
-neuroleptic malignant syndrome
antipsychotic drugs: anticholinergic side effects
dry mouth, blurred vision, urinary hesitation, constipation
-block/inhibit the neurotransmitter acetylcholine
antipsychotic drugs: tardive dyskinesia side effects
involuntary movements of the tongue/lips/face/jaw, and twitching, snakelike movement of extremities, can persist indefinitely after stopping
-prevention-limit exposure to antipsychotics, no cure; vitamin E can help
antipsychotic drugs: extra pyramidal symptoms (EPS)
Parkinsonian syndrome, triad of signs including tremors, rigidity, slowed movement; cogwheel feel to joints, masklike faces/diminished expressiveness (akinesia), treat side effects with Artane, Cogentin, Benadryl
-akathisia (compulsion to be in motion); purposeless motor movement, treat by lowering dose of antipsychotic
antipsychotic drugs: acute dystonic reactions
involuntary muscle spasms, tightening of mouth/jaw/neck, oculogyric crisis (eyes involuntarily look in different directions)
-treat with benzodiazepines, antihistamines, Cogentin
antipsychotic drugs: neuroleptic malignant syndrome
**medical emergency, starts after starting narcoleptic, symptoms include fever, muscle rigidity, mental status change, tachycardia; treatment-stop meds and seek immediate medical attention
thorazine
antipsychotic
mellaril
antipsychotic
stelazine
antipsychotic
prolixin
antipsychotic; also available as injectable (Prolixin D)
havane
antipsychotic
haldol
antipsychotic; also available as an injectable (haldol D)
chlorpromazine
antipsychotic
thioridazine
antipsychotic
trifluoperazine
antipsychotic
fluphenazine
antipsychotic
thiotrixene
antipsychotic
haloperidol
antipsychotic
atypical antipsychotics effective for what symptoms
negative symptoms, have less extrapyramidal symptoms, lower risk for tardive dyskinesia
clozapine (clozaril)
atypical antipsychotic
-different action
-common side effects: increase saliva production/drooling, sedation, nausea, hypotension/dizziness, tachycardia, weight gain, increased risk of seizures
-no reported tardive dyskinesia
-useful with treatment resistant patients
reperidone (Risperdal)
atypical antipsychotic
-also available as injectable
-sedation most prominent side effect (increases with dose)
-infrequent side effects-headache, dry mouth, constipation, blurred vision, urinary retention, palpitations, nervousness
-no reported tardive dyskinesia
-question of relief of both positive and negative symptoms
ariprazole (abilify)
newer antipsychotic
ziprasidone (geodon)
newer antipsychotic
quetiapine (seroquel)
newer antipsychotic
olarizapine (zyprexa/zyprexa reprev-available as injectable)
newer antipsychotic
asenapine (saphis)
newer antipsychotic
paliperidone palmitate (invega sustenna-available as injectable or sublingual tablets)
newer antipsychotic
iloperidone (fanapt)
newer antipsychotic
antidepressant drugs: tricyclic antidepressants general info
-contraindicated for certain heart disease
-lethal in OD, SSRIs safer for clients with SI
-2-3 weeks to see effect
-can monitor blood levels
antidepressant drugs: tricyclic antidepressants side effects
-autonomic, anticholinergic
-cardiovascular (tachycardia, change in EKG rhythms)
-precipitation of hypomania/rapid cycling for bipolar
imipramine (Tofranil)
common tricyclic antidepressants
amitriptyline (elavil)
common tricyclic antidepressants
notriptyline
common tricyclic antidepressants
desipramire
common tricyclic antidepressants
doxepin
common tricyclic antidepressants
antidepressants: monoamine oxidase inhibitors (MAOIs)-side effects
hypertension with high doses or also taking a TCA or stimulant, consuming high tyramine food
antidepressants: monoamine oxidase inhibitors (MAOIs) adverse drug reactions
stimulants, appetite suppressants, cold remedies, cocaine derivatives (novacain), TCA’s, anything that increases blood pressure levels
antidepressants: monoamine oxidase inhibitors (MAOIs) dietary restrictions
aged foods/high in tyramine, beer/wine/ale, cheese, pickled/smoked fish, beef/chicken liver, sausage, yeast supplements
phenetzine (Nardil)
antidepressants: monoamine oxidase inhibitors (MAOIs)
tranylcypromine (parnate)
antidepressants: monoamine oxidase inhibitors (MAOIs)
isocarboxazid (marplan)
antidepressants: monoamine oxidase inhibitors (MAOIs)
antidepressants: second generation antidepressants- general info
similar efficacy to MAOIs/TCAs, different side effects/adverse effects
amoxapine (Asendin)
second generation antidepressants
trazadone (desyrel)
second generation antidepressants; can also be used for sleep
maprotiline (ludiomil)
second generation antidepressants
bupropion (wellbutrin)
second generation antidepressants
venlafaxine (effexor)
second generation antidepressants
nafazodone (serzone)
second generation antidepressants
antidepressants: selective serotonin reuptake inhibitors (SSRIs)-general info
therapeutic effects similar to TCAs, less toxic and safer to heart than TCAs
antidepressants: selective serotonin reuptake inhibitors (SSRIs)- side effects
dose related; weight loss, nausea/diarrhea, nervousness/headache/tremor/anxiety (fluoxetine), somnolence (paroxetine), sexual dysfunction long term
fuoxetine (prozac)
selective serotonin reuptake inhibitors (SSRIs)
sertraline (zoloft)
selective serotonin reuptake inhibitors (SSRIs)
paroxetine (Paxil)
selective serotonin reuptake inhibitors (SSRIs)
vilazodone (vilibryd)
selective serotonin reuptake inhibitors (SSRIs)
antidepressants: serotonin-norepinephrine reuptake inhibitors (SNRIs)- general info
-similar efficacy to TCAs, less toxic, safer in OD than TCAs
antidepressants: serotonin-norepinephrine reuptake inhibitors (SNRIs)- side effects
dose related; dry mouth, loss of appetite, nausea, diarrhea, constipation, nervousness, insomnia, high blood pressure, sexual probs
duloxetine (cymbalta)
serotonin-norepinephrine reuptake inhibitors (SNRIs)
desvenlafaxine (pristiq)
serotonin-norepinephrine reuptake inhibitors (SNRIs)
lithium
mood stabilizer; narrow therapeutic index, check blood levels to monitor kidney/thyroid function
lithium side effects
enlarged/underactive thyroid, renal/kidney function-increased urination, inhibits ability to concentrate urine, need to drink more water; gastrointestinal irritation, pain, vomiting, anorexia; CNS and neuromuscular-mental dullness, fatigue, weight gain
-do not take during first trimester of pregnancy
lithium general info
-sometimes combined with antipsychotic or antidepressant, not used for unipolar depression
-2+ weeks to build therapeutic level to fully contain manic episode, need to take several times a day
-more effective for mania than depression
carbamazepine (tegretol)
anticonvulsant used to stabilize mood
-avoid during 1st trimester
-may depress bone marrow function, check blood count, monitor unusual bleeding
valproic acid (depakote)
anticonvulsant used to stabilize mood
-effective for rapid cycling and mixed bipolar
-avoid during pregnancy
gabapentin (neurontin)
anticonvulsant used to stabilize mood
lamotrigine (lamictal)
anticonvulsant used to stabilize mood
topiramae (topomax)
anticonvulsant used to stabilize mood
meds to treat panic disorder with or without agoraphobia
TCAs, MAOIs, alprazolam (Xanax), SSRI
meds to treat OCD
TCAs, MAOIs, SSRIs (fluroxamine/luvox, sertraline/zoloft)
meds to treat specific phone/social phobia
beta blockers, paxil
benzodiazepines used to treat
generalized anxiety
-safer, more effective, less abuse potential than barbiturates
benzodiazepines: side effects
impaired muscle coordination, impairment of short term memory
benzodiazepines treatment issues
chronic vs PRN, OD/abuse liability, difficult to stop, withdrawal, drug used most often in ODs
diazepam (valium)
benzodiazepines
chlordiazepoxide (librium)
benzodiazepines
lorazepam (ativan)
benzodiazepines
clorazepate (tranexene)
benzodiazepines
barbiturates (anxiolytic/minor tranquilizer)
high abuse potential, safety issues, hard to find therapeutic dose, danger when combined with alcohol
antipsychotics for anxiety
no more effective than benzos, problematic side effects, combine with anxiolytic for psychotic clients with high anxiety
buspirone (buspar)
anxiolytic/minor tranquilizer can be used to treat anxiety; 2-6 weeks for effect, need to take daily not PRN
flurazepam (dalmane)
benzo used for sleep
triazolam (halcion)
benzo used for sleep
temazepam (restoril)
benzo used for sleep
eszopicione (lunesta)
hypnotics used for sleep
zolpidem (ambien)
hypnotics used for sleep
zaleplon (sonata)
hypnotics used for sleep
ramelton (rozerem)
hypnotics used for sleep
methylphenidate (ritalin and concerta)
used for hyperactivity in kids, psychostimulant
amphetamine (adderall)
psychostimulant
pemoline (cylert)
psychostimulant
lisdexamfetamine (vyvanse)
psychostimulant
