pysch drugs Flashcards
Nonmaleficence
Nonmaleficence: do no harm
We must balance the beneficence of
providing the medication
quickly with the possible maleficence of obtaining a consent when
patient does not have the capacity to make the decision for
surgery
power of attorney
can choose for someone if they can continue dialysis or not
antipsychotics - end in
Phenothiazine
Nonphenothiazine
schizo - positive symptoms
▪ Agitation, anxiety, hallucinations, poor hygiene and
dress, hyperactivity, delusions, paranoia, and
hostility
schizo - negative symptoms
Flat affect; social inadequacy; diminished speech
patterns, judgment, and insight
2 types of f neuroleptic (psychosis) agents:
Typical, or first-generation
Atypical, or second-generation
antipsychotics - what action?
Block action of dopamine
phenothiazines - 3 groups
thorazine and Serentil® strong, proloxin is weaker
proloxin - side effects (kava kava is a pro)
kava kava increases EPS, sedation, dry mouth.
haldol side effects (hal gives me a headache)
sedation, headaches, dry mouth, eps
haldol interactions (hal can’t have caffeine)
caffeine
advantages of atypical meds - schizo is atypical
Effective in treating both positive and negative
symptoms of schizophrenia
respiradol side effects
◼Dry mouth, weight gain
◼Tachycardia, orthostatic hypotension
Dysrhythmias, blood dyscrasias, liver damage
Extrapyramidal Syndrome - Acute dystonia (grimacing stones)
AMuscle spasms of face, tongue, neck, and back, Facial grimacing, Involuntary upward eye movements, Laryngeal spasms
EPS - Pseudoparkinsonism
occurs with drugs that block dopamine (antipsychotics) pill rolling, shuffling feet
Neuroleptic malignant syndrome (NMS) (the FARM is malignant)
FARM: Fever, autonomic instability, rigidity, mental status changes
side effects of antipsychotics (anti-psychotics, anti-cholenergics)
Anticholinergic effects: sedation, dry mouth,
constipation, dry skin, urinary retention, blurred
vision, tachycardia, and inhibited ejaculation and
confusion in older adults
side effects of antipsychotics - endocrine (psycho makes me not pee)
Endocrine changes: glucose levels, weight gain, breast enlargement, and syndrome of inappropriate antidiuretic hormone (SIADH)
side effects of antipsychotics - random (psycho about liver, eyes, and seizures)
Liver toxicity
Ocular toxicity Seizures
Allergic skin reactions
nursing interventions (psycho gets side tracked)
Give IM by Z track into deep muscle using large-
gauge needle.
A young woman is being treated for psychosis with fluphenazine (Prolixin®). Which of the following signs would indicate the need to add an anticholinergic to the patient’s medication regimen?
Facial grimacing and tongue spasms
A patient on risperidone (Risperdal®) may be at increased risk for injury due to
Increased risk for falls due to orthostatic hypotension
A patient is receiving risperidone (Risperdol). The nurse should monitor the patient for which of the following? (Select all that apply.) (just 3 things) (Char on respir)
weight gain, ortho hypo, urinary retention,
Esketamine (Spravato®)
nasal spray for depression. dispensed at treatment centers.
Amitriptyline (Elavil®) - side effects (Amy is sleepy)
Increased sedation and anticholinergic effects with phenothiazines, haloperidol
SSRI - side effects - how long do they last?
Side effects often decrease over 2 to 4 weeks
seratonin syndrome
Requires at least three of the following:
▪ Mental status changes (confusion, hypomania) ▪ Agitation
▪ Myoclonus (sudden twitching)
▪ Hyperreflexia
▪ Diaphoresis
▪ Shivering
▪ Tremor
▪ Diarrhea
▪ Incoordination
▪ Fever
MAO inhibitors - side effects (food interactions)
Hypertensive crisis from fatal tyramine interaction (from cheese, coffee, cream,
yogurt, bananas, liver, yeast, chocolate, beer, red wine, etc.)
lithium
Monitor lithium levels every 1 to 2 months (0.5 to 1.5
mEq/L); toxic range is greater than 1.5 mEq/L. (liver)
lithium toxicity (lithium hurts my heart)
dysrhythmias
Baseline Assessment Prior to Initiating Lithium Therapy - what test? (lithium hurts my heart, so I need what test?)
EKG
A patient with reactive depression is ordered to receive fluoxetine (Prozac®). The teaching for this patient includes
The medication may cause headaches and
insomnia.
Which of the following laboratory tests is most important for the nurse to monitor when a patient is receiving lithium (Lithobid®)
Serum electrolytes (lithium depletes sodium)
ESPs - Akathisia (Akeela keeps moving)
constant motion, pacing
Tardive dyskinesia
rolling of tongue
