Week 10: Psychotherapeutic Drugs Flashcards
Mood Stabilizers
lithium
Used for?
Adverse effects? CV
Neuro?
Used for Bipolar disorders
Adverse effects:
cardiac dysrhythmias
hypotension
NEURO:
tremor
confusion
drowsiness, somnolence
impaired memory
seizure
Lithium
Narrow therapeutic range?
Monitor what?
Educate clients to avoid what?
Also avoid what?
lithium toxicity signs?
**Narrow therapeutic range:
0.6-1.2 mEq/L!!!!!!
Monitor lithium and serum sodium levels
Educate client to avoid excessive amounts of coffee, tea, and cola b/c of it’s diuretic action
Avoid activities that cause excess sodium loss (heavy exertion, exercise in hot weather, sauna)
fine tremors and thirst
Tricyclic Antidepressants
Amitriptyline
(Ami tripped at CHS high school)
Used for?
Adverse effects?**
what can this med cause?
depression, chronic pain syndromes
**cardiac dysrhythmias
**hypotension
**Suicidal thoughts
Weight gain
Amitriptyline
Antidote?
Can also try?
Assess for
No antidote for toxicity; administer activated charcoal if the ingestion occurred 2 hours before treatment
Can also try sodium bicarbonate
**Assess for suicidal tendencies, especially during EARLY therapy!!!!
Amitriptyline
Full therapeutic effects take?
May cause?
Implement?
Can cause?
Full therapeutic effects may be seen 2-6 weeks after initiating therapy
May cause drowsiness and blurred vision
Implement fall precautions, esp. in geriatric clients
Can cause weight gain
Tetracyclic Antidepressants
Mirtazapine
Used for?
Can cause?***
major depressive disorders
Suicidal thoughts!!!!!
Monoamine Oxidase Inhibitor (MAOI)
Phenelzine
(phenelzine HO)
Used for?
Can cause?***
asses for what?
Drug interactions?
major depressive disorders
**hypertensive crisis/emergency
**orthostatic hypotension
Suicidal thoughts!!!!!
assess during early therapy
Almost everything!!!
Foods & Drinks to AVOID when on MAOI?? 6
foods high in tyramine?
Assess for what?
-Aged mature cheese
-Smoked or pickled meats
-Aged or fermented meats
-Yeast extracts
-Red wines
-Italian broad beans
Assess mood for suicidal tendencies, especially during early therapy
2nd Generation
SSRIs
Used for?
Adverse effect?
Drug interactions? 4
depression
**QT prolongation!!!!
Suicidal thoughts
Apathy
Insomnia
Drug interactions:
Warfarin, Phenytoin
MAOIs: fatal reactions
Linezolid, methylene blue, and St. John’s wort
QT prolongation drugs
SSRI
Drug profile and Nursing considerations
Citalopram
Asses for? 2
Monitor?
Assess mood for suicidal tendencies, especially during early therapy
Assess for serotonin syndrome
Monitor serum potassium and magnesium levels for clients at risk for electrolyte imbalances prior to and periodically during therapy
SSRI
Fluoxetine
Can also treat?
Asses for?
Administer when?
SSRIs may cause?
Can also treat bulimia, OCD, panic disorder and PMDD
Assess mood for suicidal tendencies, especially during early therapy
Assess for serotonin syndrome
Administer in the morning
decreased libido and sexual dysfunction
2nd Generation
SSNRI
Adverse effects?
**orthostatic hypotension
**increased BP
Drug interaction:
MAOIs: fatal reactions**
TCAs, SSRIs, Linezolid,
methylene blue, and St. John’s wort
SSNRIs
Duloxetine
Used for?
Monitor what?
May cause? 2
depression and general anxiety disorder
chronic pain and diabetic peripheral neuropathic pain
-Monitor BP
-May cause drowsiness
-may cause decreased libido and sexual dysfunction
Herbal- St. John’s wort
Used for?
Contraindications?
Potential drug interactions?
Used for depression, anxiety, sleep disturbances, & nervousness
clients w/ bipolar, schizophrenia, Alzheimer’s, & dementia
ALOT
Drug to Treat Psychotic
Disorders
First generation?
Second generation?
First generation
* haloperidol
Second generation
* clozapine
* risperidone
* aripiprazole
All of the 1st and 2nd generation drugs to treat psychotic disorders can
cause increased?
may cause?
need to implement?
may also cause?
tx of PO overdose?
If giving PO?
***suicidal tendencies in children, adolescents, and young adults and increased risk of death in elderly clients
*** weight gain
***fall safety for ALL of these medications
***extrapyramidal symptoms
*** activated charcoal
*** ensure medication is taken and not cheeked/hoarded
1st Generation Antipsychotic:
Haloperidol
Does what in the brain?
Used for?
Adverse effects?
Ensure that?
Monitor client for what?
What safety?
Alters the effects of dopamine in the CNS
Long-term treatment of psychosis
***QT prolongation, hypotension
extrapyramidal symptoms
ensure that medication is actually taken and not hoarded
Monitor client for cues of akathisia (restlessness, desire to keep
moving)
Fall safety
2nd Generation Antipsychotic:
Clozapine
Used for?
monitor??
Schizophrenia unresponsive to or intolerant of standard therapy w/ other antipsychotics
***Monitor WBC (weekly monitoring for 1st 6 months)
2nd Generation Antipsychotic:
Risperidone
used to treat?
drug interactions?
may decrease?
what decreases the metabolism?
Schizophrenia
Increased CNS depression w/ other CNS depressants, kava, valerian, and chamomile
May decrease the antiparkinsonian effects of levodopa or other dopamine agonists
Clozapine decreases the metabolism and may increase effects of risperidone
2nd Generation Antipsychotic
Aripiprazole
Used for?
Increased risk of what?**
-Schizophrenia,
-Bipolar disorder
-Major depressive disorder
-Agitation associated with autistic disorders
*** increased risk of suicide in children & young adult;
increased risk of death in elderly!!!
