Mental Health Drugs

Diazepam Therapeutic Class

Antianxiety agent, sedative-hypnotic, antiseizure

Diazepam Pharm Class

Benzodiazepine, GABA receptor agonist

Diazepam MOA

Potentiates GAB and acts as a CNS depressant

Diazepam Indications

Alcohol withdrawal

Diazepam ADRs

Respiratory depression, seizures if abruptly stopped, and CNS depression

Diazepam Nursing Considerations

Adminster with caution in patients with alcohol use, assess for sedation, dizziness, and respiratory depression, abrupt discontinuation may cause withdrawal symptoms, educate to avoid alcohol

Control IV substance

Zolpidem Therapeutic Class

Sedative-hypnotic

Zolpidem Pharm Class

Nonbenzodiazepine, anxiolytic, drug for insomnia

Zolpidem MOA

Enhances the action of GABA

Zolpidem Indications

Short-term insomina

Zolpidem Nursing Considerations

Take immediately before sleep, avoid alcohol and CNS depressants, educate about risk of sleepwalking and other unusual behaviors

Modafinil Therapeutic Class

Drug for narcolepsy

Modafinil Pharm Class

CNS stimulant

Modafinil MOA

Binds to dopamine transporters and inhibits dopamine reuptake promoting wakefulness

Modafinil Indications

Approved to treat narcolepsy

Modafinil ADRS

SJS

Modafinil Nursing Considerations

Monitor for signs of severe allergic reactions, caution in heart disease, and educate on potential side effect like insomnia and anxiety

Fluoxetine Therapeutic Class

Antidepressant, antianxiety

Fluoxetine Pharm Class

SSRI

Fluoxetine MOA

Inhibits serotonin reuptake and increases serotonin levels

Fluoxetine ADRs

Serotonin syndrome and QT prolongation

Fluoxetine Contraindications

History of seizures

Fluoxetine Nursing Considerations

Monitor for serotonin syndrome, monitor for suicidal thoughts when starting antidepressants (especially in young adults)

Venlaxfaxine Therapeutic Class

Antidepressant

Venlaxfaxine Pharm Class

SNRI

Venlaxfaxine MOA

Inhibits the reuptake of serotonin and norepinephrine

Venlaxfaxine Indications

GAD and SAD

Venlafaxine ADRs

Sexual dysfunction, insomnia, serotonin syndrome and tachycardia

Venlaxfaxine Contraindications

BPD and seizures

Venlaxfaxine Nursing Considerations

Monitor BP due to possible increase, and monitor for suicidal thoughts

Imipramine Therapeutic Class

Antidepressant

Imipramine Pharm Class

TCA

Imipramine MOA

Inhibits norepinephrine and serotonin. Also blocks other receptors (histamine, ACh, and alpha-adrenergic, and Na channels)

Imipramine Indications

MDD and neuropathic pain

Imipramine ADRs

Dry mouth, constipation, sedation, tachycardia, and dysrhythmias

imipramine Nursing Considerations

Monitor for sucidial thoughts, and educate patient about side effects

Phenelzine Therapeutic Class

Antidepressant

Phenelzine Pharm Class

MAOI

Phenelzine MOA

Inhibits MAO enzyme preventing NT breakdown (increases availability)

Phenelzine Indications

Hypertensive crisis

Phenelzine Nursing Considerations

Avoid foods rich in tyramine (charcuterie board foods)

Lithium Carbonate Therapeutic Class

Antimania, BPD

Lithium Carbonate Pharm Class

Alkali metal ion salt

Lithium carbonate MOA

Alters NT balance to stabilize mood

Lithium Carbonate ADRs

Narrow TI (0.6 - 1.0 to 0.6 - 1.2), renal impairment, dysrhythmias and lithium toxicity

Lithium Carbonate Nursing Considerations

Monitor serum lithium levels due to narrow TI, monitor renal function and Na levels, hydrate patient in order to maintain normal sodium levels, monitor renal function and ECG in long-term sue

Valproic Acid Therapeutic Class

Antiepileptic drug (AED)

Valproic Acid Pharm Class

Mood stabilizer

Valproic Acid MOA

Increases GABA availability. Also inhibits glutamate and binding sof NMDA receptors

Valproic Acid Indications

BPD (for managing manic episodes)

Valproic Acid ADRs

Hepatotoxicity and thrombocytopenia

Valproic Acid Nursing Considerations

Monitor liver function and platelet count, and educate about teratogenic effects

Haloperidol Therapeutic Class

Antipsychotic

Haloperidol Pharm Class

First-gen Antipsychotic (FGA), non-phenothiazine, D2 receptor antagonist

Haloperidol MOA

Blocks dopamine receptors in the brain

Haloperidol Indications

Acute psychosis and mania (severe agitation and mania), and severe behavioral problems

Severe behavioral problems

Haloperidol ADRs

Extrapyramidal symptoms (EPS), tardive dyskinesia (TD), and neurleptic malignant syndrome (NMS)

Chlorpromazine Therapeutic Class

Antipsychotic

Chlorpromazine Pharm Class

Phenothiazine, dopamine receptor antagonist

Chlorpromazine MOA

Blocks dopamine receptors. Also has some antihistaminic and anticholinergic properties contributing to sedative effects

Chlorpromazine Indications

Schizoprenia and acute psychosis

Chlorpromazine Nursing Considerations

Monitor for EPS, NMS, and orthostatic hypotension, get regular bloodwork to monitor agranulocytosis

Risperidone Therapeutic Class

Antipsychotic, antimanic agent

Risperidone Pharm Class

Second-generation antipsychotic (SGA)

Risperidone MOA

Blocks 5HT (serotonin), and D2 (dopamine) receptors in the brain improving positive and negative symptoms. Helps with mood stabilization and managing symptoms

Risperidone Indications

Schizophrenia, BPD, and behavioral issues in autism or dementia (Off-label)

Risperidone Nursing Considerations

Monitor weight and lipid profile

Aripiprazole Therapeutic Class

Antipsychotic

Aripiprazole Pharm Class

Second-generation antipsychotic (SGA)

Aripiprazole MOA

Blocks D2 and 5HT2A (serotonin)

Aripiprazole Indications

Schizophrenia, BPD and adjunct for depression, autisim, irritability associated with schizophrenia (off-label)