MH Meds

what drug class is used as anti-anxiety meds

benzodiazepines

name examples of anti anxiety benzodiazeopines

lorazepam (ativan)

alprazolam (xanax)

diazepam (valium)

lorazepam drug routes

PO

IM

SL

IV

what is the drug of choice for anxiety

the benzodiazepine LORAZEPAM

who should lorazepam be used in caution with

pts with hepatic dysfunction

what is the drug route for alprazolam

PO

what is a major nursing consideration for patients on alprazolam

paradoxical - opposite response

the drug elicits the opposite response in pts with personality disorders and older adults

what r the drug routes for diazepam

PO

IM

IV

what is a major nursing consideration for diazepam

rapid onset of calming and sedating

what kind of half life does diazepam have

long half life

*use cautiously in the older adult

name the first generation antipsychotics

haloperidol (haldol)

perphenazine

chlorpromazine (thorazine)

loxapine (adasuve)

what drug routes are used for haloperidol

PO

IM

IV

when using the IV route for haloperidol what is required

cardiac monitoring

what kind of side effect profile does haloperidol have

favorable

what is a major risk for pts taking haloperidol

neuroleptic malignant syndrome so monitor and test for muscle rigidity

what is the drug route for perphenazine

PO

what is a pt taking perphenazine at risk for

malignant syndrome so keep hydrated and freqeuntly check and monitor for muscle rigidity

what is the drug route of chlorpromazine

PO

PR

IM

what should we watch for in pts taking chlorpromazine

hypotension chloro.

what do injections of chlorpromazine cause

pain

what is a major nursing consideration of chlorpromazine

its SEDATING

what is the drug route of loxapine

inhalation

what is the rate of the systemic delivery for loxapine

rapid

when is loxapine contraindicated

when individuals have a breathing disorder

where is loxapine avaliable

thru restricted programs

what are the second generation antipsychotics

risperidone (risperdal)

olanzapine (zyprexa, zyprexa zydis)

ziprasidone (geodon)

what is the drug route for risperidone

PO

orally disintegrating tablet

what does risperidone do

calms while txing underlying condition

what should we monitor in pts taking risperidone

hypotension

reflex tachycardia

what r the drug routes for olanzapine

PO

IM

orally disintegrating tablet

when is olanzapine useful

in pts who r unresponsive to haloperidol

what does olanzapine do

calms while treating underlying condition

what should we monitor for in pts taking olanzapine

hypotension

what should never be combined with olanzapine

LORAZEPAM

what are the drug routes for ziprasidone

PO

IM

is ziprasidone more or less sedating

less

who should use ziprasidone cautiosuly

QT prolongation -heart rhythm disorder that causes fast heart beat

name examples of anti anxiety and second gen antipsychotics that can be combined

haloperidol, lorazepam, and diphenhydramine or benzotropine

haloperidol, lorazepam, and diphenhydramine or benzotropine. how is this combo given

PO

IM

haloperidol, lorazepam, and diphenhydramine or benzotropine. where is this combo given

acute settings

haloperidol, lorazepam, and diphenhydramine or benzotropine. what are men who take this combo at risk for

dystonia

haloperidol, lorazepam, and diphenhydramine or benzotropine. increased agitation in relation to this combo is due to what

akathisia caused by the meds

how is the combo lorazepam and benadryl given

PO*

IM

when should the lorazepam/Benadryl combo be considered

if pt has difficulty taking haloperidol

what are the drug routes for lorazepam and ziprasidone

PO

IM

when is the combo lorazepam and ziprasidone preferred

if pt has difficulty taking haloperidol or if provider is trying to minimize the sedative effect

what disorders is lithium used to treat

intellectual disability

conduct disorder

antisocial personality

bipolar disorder

prison inmates

what is measure bf tx with lithium

TSH levels

due to the anti aggressive properties of lithium, what may the blood levels be

lower than those necessary to treat bipolar mania

what disorders do anticonvulsants tx

schizophrenia

prison inmantes

antisocial/bordeline personality

conduct disorders

bipolar disorders

what do anticonvulsants do in terms of impulsive aggression

reduce it

what is important to know with anticonvulsants

similar doses with bipolar disorder

multiple drug interactions

what should be monitored when taking anticonvulsants

CBC and LFTs

periodic blood levels

what does gabapentin treat

pts with coexisiting anxiety disorder and personality disorders

does gabepentin interact with other anticonvulsants

no

what criteria is needed for individuals taking benzodiazepines

underlying component of anxiety

what r individuals taking benzodiazepines at risk for

abuse

dependence

withdrawal

benzodiazepines may cause what?

paradoxical aggression

what do second gen anti psychotics tx

schizophrenia

psychosis

mania

what drug is superioir to other second generation drugs

clozapine

what should be monitored for pts taking clozapine

ANC monthly

what is a major benefit of second gen antipsychotics

fewer side effects and greater adherence than first gen antipsychotics

what do betablockers treat

organic brain disease

brain injury

dementia

intellectual disability

who is propranolol contraindicated for

asthma

copd

IDDM

what effects of beta blockers explain the anti aggresive effects we see

sedation

what do psychostimulants treat

ADD/ADHD in children and adults

what is a potential risk of psychostimulants

addiction and abuse