psychotropic medications

treat symptoms of psychosis (delusions, hallucinations, schizoaffective disorder, manic phase of bipolar disorder)

antipsychotics

primary/adverse side effects of antipsychotics

EPS, neuroleptic malignant syndrome, tardive dyskinesia, anticholinergic side effects

Risperidone (respiradal)

• drug class?

atypical antipsychotic

Haloperidol (Haldol)

• drug class?

conventional antipsychotic

Chlorpromazine (thorazine)

• drug class?

conventional antipsychotic

Clozapine (clozaril)

• drug class?

atypical antipsychotic

Adverse side effect of Clozapine (clozaril)

agranulocytosis

Agranulocytosis symptoms and nursing action

fever, malaise, leukopenia, ulcerative sore throat, weekly WBC count

antidepressants treat:

-major depressive disorder

…

anxiety, depressed bipolar phase, psychotic depression

phenelzine (nardil)

drug class?

antidepressant monoamine oxidase inhibitor

A pt. is prescribed Nardil, the nurse must educate the pt. to avoid which types of food to prevent a hypertensive crisis

(i.e, soy sauce, marmite, yogurt, sour cream, peanuts, MSG, saurkraut)

mature/aged cheeses, aged meats, fava beans, tofu, banana peel, overripe fruit, avocado, beer

hypertensive crisis symptoms

severe hypertension, hyperpyrexia, tachycardia, diaphoresis, tremulousness, cardiac dysrhythmias

phenelzine (Nardil) common side effects

daytime sedation, insomnia, weight gain, dry mouth, orthostatic hypotension, sexual dysfunction

Sertraline (Zoloft), Fluoxetine (prozac), Paroxetine (Paxil) ((SSRIs)) can treat _______, besides the normal antidepressant purposes

ocd

MAOIs have fatal drug interactions with:

• MAOIs

• ______________

• SSRIs

• _____________(ex: meperidine)

• ___________

• CNS Depressants

• dextromethorphan

• antihypertensives

• general anesthetics

MAOIs potentially lethal in overdose

tricyclic antidepressants, opiate derivatives, buspirone

SSRIs common side effects:

• anxiety

• _______

• ________

• nausea

• insomnia

• sexual dysfunction (diminished sex drive or difficulty achieving orgasm)

• weight gain

agitation, akathisia

Benzodiazepines treat:

• ___________

• insomnia

• OCD

• depression

• ptsd

• ______________

anxiety, alcohol withdrawal

Benzodiazepines side effects:

• prone to __________

• CNS depression-associated effects- _______, ________ , poor coordination, _______________

physical dependence, drowsiness, sedation, impaired memory

An older adult client is placed on Chlordiazepoxide (a benzodiazepine), what will the nurse look out for and assess?

fall risk, pronounced memory deficit, night UI

If using a Benzodiazepine for sleep, advise the client that they might feel ________, __________ the next day.

sedation, hangover effect

Carbamazepine (Tegretol)

drug class?

anticonvulsant used as mood stabilizer

Valproic acid (Depakote) drug class?

anticonvulsant used as mood stabilizer

Mood stabilizer treats:

• ______ disorder by stabilizing mood, preventing or minimizing the highs & lows

• acute episodes of ______

bipolar, mania

Anticonvulsant/mood stabilizer common side effects:

drowsiness, sedation, dry mouth, blurred vision

Carbamazepine (tegretol) specific side effects:

common- drowsiness, sedation, dry mouth, blurred vision

rashes, orthostatic hypotension

Carbamazepine (Tegretol) adverse effects:

• _______________

• __________________

aplastic anemia, agranulocytosis

Valproic acid (Depakote) adverse side effects

hepatic failure, teratogenic effects, pancreatitis

Valproic acid (Depakote) specific side effects

weight gain, alopecia, hand tremor

lithium carbonate (Lithium) drug class?

antimanic mood stabilizer

Lithium carbonate (Lithium) side effects:

• mild nausea or diarrhea

• anorexia

• _________

• ______

• _______

• metallic taste in mouth

polydipsia, polyuria, fine hand tremor

causes adverse reaction when mixed with alcohol in body

ONLY USE; deterrent to drinking alcohol (sensitizing agent alcohol antagonist)

for those who ABSTAIN, not impulsive drinkers

Disulfiram (Antabuse)

buspirone (Buspar) drug class?

nonbenzodiazepine

buspirone side effects

dizziness, sedation, nausea, headache

why might buspirone be given instead of a benzodiazepine?

does not cause physical dependence

Disulfiram (Antabuse) side effects:

• ________

• throbbing headache

• __________

• sweating

• nausea

• dizziness

• weakness

flushing, dry mouth, vomiting

Antipsychotic nursing implications:

• report problems; DO NOT discont.

• maintaining medication regimen

• dry mouth: _____, ______

• constipation: _______, increase water/bulk-forming foods; stool softeners

• Monitor sleepiness or drowsiness they feel

• avoid driving

• if dose 4hrs. overdue, ______

• ______(photosensitivity)

SF fluids/hard candy, exercise, omit, sunscreen

Phenelzine [MAOI] adverse effects

Hypertensive crisis, fatal drug interactions, lethal in overdose

Benzodiazepines (I,e, chlordiazepoxide, alprazolam, lorazepam, diazepam) nursing considerations:

• AVOID ________

• Make pt. Aware of decreased response time, slower reflexes, possible sedatives effects when doing mentally alert activities

• _______ _________

Alcohol, never discontinue abruptly

SSRIs (sertraline, fluoxetine, paroxetine) considerations:

• Take at morning time

• __________

• Caution when driving

Take with food

Mood-stabilizer (carbamazepine, valproic acid) considerations:

• Monitor _____________ 12hrs. after last dose

• Nausea: take with FOOD

• Don’t drive until dizziness, lethargy, or fatigue, blurred vision subside

Drug serum levels

Lithium considerations

• Monitor __________

• Take with food for nausea

• Tremor: ________

Drug serum levels, propanolol