Anti-Anxiety and Mood Stabilizers

alprazolam mechanism

enhances GABA

alprazolam indications

anxiety, panic disorders, GAD

alprazolam adverse effects

Confusion, ataxia, sedation, dependence

alprazolam interactions

alcohol and opiates

lorazepam mechanism and class

Enhances GABA; Benzodiazepine

lorazepam indication

Anxiety, sedation, seizures

lorazepam adverse effects

fall risk and respiratory depression

lorazepam nursing implication

can only be given IV push or IMover a slow injection to avoid adverse effects and monitor patient for sedation and respiratory depression.

flumazenil mechanism/class

Benzodiazepine receptor antagonist

flumazenil indication

Benzodiazepine reversal

flumazenil adverse effects

Reversal may cause seizures in long-term benzo users

lithium therapeutic level

0.6 to 1.2

lithium mechanism

Alters sodium transport, modulates neurotransmitter levels

lithium indication

bipolar disorder

lithium adverse effects

Cardiac dysrhythmia, hypotension, choreoathetotic movements

lithium nursing implications

When exceeding 1.5 > GI, tremor, seizure, etc.; Low Na/FVD puts at risk.

amitriptyline mechanism/class

Blocks serotonin and norepinephrine reuptake; TCA (Tricyclic)

amitriptyline indication

depression

amitriptyline adverse effects

can’t see/poop/pee/spit

phenelzine mechanism/class

Non-selective MAOI; inhibits breakdown of dopamine

phenelzine indication

rare for depression but used for parkinson’s sometimes

phenelzine adverse effects

hypertensive crisis when taken with tyramine > then cardiac and neuro effects till death.

phenelzine nursing implications

avoid foods with tyramine

fluoxetine mechanism/class

SSRI; blocks serotonin reuptake

fluoxetine indication

depression, OCD, panic disorder

fluoxetine adverse effects

Weight gain, sedation, hypotension

fluoxetine contraindications

MAOI therapy and allergies

haloperidol mechanism/class

Blocks dopamine receptors

haloperidol indication

Psychosis, schizophrenia, autism

haloperidol adverse effects

Insomnia, headache, minimal EPS, GI upset

haloperidol contraindications

parkinson’s disease