25 Med for Children + Adolescents who have Mental Health Issues

Question 1

CNS stimulants

drug names

Answer 1

• methylphenidate
• amphetamine
• dextroamphetamine
• dexmethylphenidate
• lisdexamfetamine

*METH to AMP up

Question 2

CNS stimulants

action

Answer 2

raise level of norepinephrine + dopamine into CNS

Question 3

CNS stimulants

indication

Answer 3

ADHD - paradoxical

Question 4

CNSS stimulants

A/E

Answer 4

• CNS stim (insomnia, restless)
• wt loss + growth suppression r/t reduced appetite
• cardiovasc effects
• psychotic manifestations
• withdrawal rxn
• skinr ash (meth patch)
• toxicity

Question 5

to prevent over stimulation (insomnia, restless), CNS stimulants should be admin no later than…

Answer 5

4pm

• also keep the dosage as low as possible
• avoid caffeine

Question 6

cardiovascular effects of CNS stimulants + nursing actions

Answer 6

• dysrhythmias, chest pain, high BP
• can incr risk of sudden death w pt w heart abnormalities
• monitor VS + ECG

Question 7

toxicity findings + nursing actions for CNS stim

Answer 7

dizzy, palpitatn, HTN, hallucination, seizure

• treat hllcntn w CHLORPROMAZINE
• treat seizure w DIAZEPAM
• admin fluids

Question 8

CNS stimulants

CI

Answer 8

• hx of substance abuse
• cardiovasc disease
• severe anxiety
• psychosis

Question 9

CNS stimulant

interactions

Answer 9

• MAOI- hypertensive crisis

- caffeine + OTC cold/decongestant- incr CNS stim

Question 10

CNS stim

teaching

Answer 10

• 30-45min before meals
• no later than 4pm
• full effect 6 wks
• admin on reg schedule

Question 11

SNRI

drug names

Answer 11

• atomoxetin (not a stimulant)

- buproprion

Question 12

SNRI

indication

Answer 12

ADHD

Question 13

SNRI

A/E

Answer 13

• appetite/growth supprsn, wt loss
• GI effects (N/V, ab pain)
• suicidal ideation
• hepatotoxicity
• CNS effect (headache, insomnia, irritable)

Question 14

SNRI to avoid GI effects…

Answer 14

take w food

Question 15

signs of liver damage

Answer 15

• flu-like manifestation
• jaundice
• ab pain

Question 16

SNRI

CI

Answer 16

• suicidal ideation
• angle-closure glaucoma
• pheochromocytoma

Question 17

SNRI

interactions

Answer 17

MAOI- hypertensive crisis

SSRI -incr level of atomoxetine

Question 18

TCA

drug names

Answer 18

despramine
imipramine
clomipramine

Question 19

TCA

action

Answer 19

block reuptake of norepinephrine + serotonin which intensifies them

Question 20

TCA

indication

Answer 20

• dprssn
• autism
• ADHD
• panic disorder
• separation anxiety
• social phobia
• OCD

Question 21

TCA

A/E

Answer 21

• orthostatic hypotension
• antichol effects
• wt gain r/t incr appetite
• sedation
• decr seizure threshold
• diaphoresis
• toxicity

Question 22

orthostatic hypotension teaching

Answer 22

monitor BP w first dose

change position slowly

Question 23

TCA toxicity

characteristics

Answer 23

cholinergic blockage + cardiac toxicity

-dysrhythmias, mental confusn, agitation> seizures, coma, death

Question 24

TCA toxicity

teaching

Answer 24

• 1wk supply of med at a time
• obtain baseline ECG
• monitor VS frequently

Question 25

TCA | CI

Answer 25

- recent MI, or hx of HF - hx prolonged QT - can incr suicidal tendencies - careful w seizures, CAD, diabetes, liver, kidney

Question 26

TCA | interactions

Answer 26

antihistamine- incr antichol MAOI, epinephrine, dopamine -hypertensive crisis -ETOH, benzo, opioid, antihistamin - CNS depress

Question 27

TCA | teaching

Answer 27

- take before bedtime bc sedation | - high suicide potential so only give 1 wk supply for acutely ill, then 1 month supply

Question 28

A2-Adrenergic Agonist | drug name

Answer 28

- guanfacine | - clonidine

Question 29

A2-Adrenergic Agonist | indication

Answer 29

- ADHD - tic disorder - conduct + oppositional defiant disorders

Question 30

A2-Adrenergic Agonist | A/E

Answer 30

- CNS dprssn (sedatn, drowsy, tired) - cardiovasc dprssn - wt gain - GI effects

Question 31

A2-Adrenergic Agonist | cardiovascular depression + TEACHING

Answer 31

- hypotention - bradycardia - monitor BP + pulse during initial tx - abrupt discontinuation> rebound HTN

Question 32

A2-Adrenergic Agonist | GI effects

Answer 32

- N/V - constipatn - dry mouth

Question 33

A2-Adrenergic Agonist | teaching

Answer 33

- monitor BP + pulse in early - avoid high fat> incr absorp of guanfacine - careful w anyhypertensive - careful w ETOH + cns dprssnt

Question 34

Atypical AntiPsychotics | drug names

Answer 34

- risperidone - olanzapine - aripiprazole - quetiapine

Question 35

Atypical AntiPsychotics [risperidone, olanzapine, aripiprazole, quetiapine] action

Answer 35

blocks serotonin, dopamin receptors

Question 36

Atypical AntiPsychotics [risperidone, olanzapine, aripiprazole, quetiapine] indication

Answer 36

- autism - conduct disorder - OCD - relief of psychotic manifestations

Question 37

Atypical AntiPsychotics [risperidone, olanzapine, aripiprazole, quetiapine] A/E

Answer 37

- DM - wt gain - hypercholesterolemia - orthostatic hypotensn - antichol effects - agitatn, dizzy, sedatn, sleep disruptn - mild EPS

Question 38

Atypical AntiPsychotics [risperidone, olanzapine, aripiprazole, quetiapine] teaching

Answer 38

- avoid ETOH + CNS dprssnt | - levodopa counteracts the effects

Question 39

SSRI | drug names

Answer 39

- fluoxetine - sertraline - fluvoxamine

Question 40

SSRI | indication

Answer 40

- intermittent explosive disorder - autism - OCD - depression - bulimia - anxiety

Question 41

SSRI | complications

Answer 41

- agitation, anxiety, sleep disturbance - tremors - headaches - weight changes - GI effects

Question 42

SSRI interactions

Answer 42

MAOI, SNRI, buspirone, + St. Johns Wort | -incr risk for serotonin syndrome