mod 5 psychopharmacology

based off of the red stuff on the outline

antipsychotics

neuroleptics; used for schizophrenia

antidepressants

SSRI, SNRI, TCA, MAOI

benzodiazepines

sedatives, antianxiety

typical antipsychotics

haldol, mellaril, prolixin

haldol

5mg w ativan 2mg IM; used for behavioral crisis

atypical antipsychotics

clozaril, geodon, risperdal, seroquel, zyprexa, abilify

clozaril

clozapine; agranulocytosis, starts w flu like s/s, potentially fatal, CBC required weekly when first started

agranulocytosis

decreased WBC

zyprexa

olanzapine; monitor pt for sedation syndrome/postinjection delirium

antipsychotic meds side effects

metabolic syndrome, NMS, EPS, TD, anticholinergic effects

NMS

neuroleptic malignant syndrome; life threatening, temp >104, severe EPS s/s

EPS

extrapyramidal signs; dystonia, parkinsonism, akathisia, NMS; tx w diphenhydramine & benztropine

tardive dyskinesia

permenant involuntary movements; no cure

antidipressant risk

high suicide risk 2 weeks after starting meds

SSRIs

zoloft, prozac, celexa, lexapro, paxil, luvox

SNRIs

duloxetine/cymbalta, venlafaxine

TCAs

imipramine/tofranil, amitriptyline/elavil

TCA

tricyclic antidepressants; significant side effects, used off label for anxiety

MAOIs

phenelzine, tranylcypromine

MAOI

avoid tyramine, monitor for hypertensive crisis, monitor diet, use with bipolar may cause mania

stimulants

amphetamine/dextroamphetamine, methylphenidate

stimulants common effect/concern

high potential for abuse and dependence

benzodiazepine drugs

diazepam, lorazepam, alaprazolam, clonazepam

benzodiazepine risk

withdrawl symptoms can be fatal, must taper off use

lithium

mood stabilizing, first line for bipolar disorder, toxicity can occur within therapeutic range

lithium toxicity s/s

severe vomiting, diarrhea, and weakness/lack of coordination

anticonvulsants

carbamazepine, oxcarbazepine, gabapentin, divalproex, lamotrigine, phenytoin

anticonvulsants use

seizures, adjunct therapy with mood disorders

lamotrigine

lamictal; monitor for rash

anticonvulstants adverse effects

ataxia, dystonia, sinus tachycardia, hyperthermia, arrhythmias, respiratory depression

anticholinergics

benztropine

disulfiram

antabuse; deterrant for alcohol consumption, causes n/v, weakness, diaphoresis, throbbing headache, etc.

dystonia

acute muscular rigidity and cramping; includes torticollis- painful twisted head & neck, opisthotonus- full body tightness with head back & neck arched, oculogyric crisis- eyes rolled back in a locked position

parkinsonism

tremors, bradykinesia, altered gait, etc.

bradykinesia

impaired & slow movement of the limbs

akathisia

intense need to move

NMS / EPS Tx

dipenhydramine & benztropine

TD s/s

protruding & rolling tongue, blowing, smacking, spastic facial distortion, blinking, grimacing

AIMS

abnormal involuntary movement scale; screening to look for movement disorders signaling TD onset; testing every 3-6 months