chapter 19 Flashcards
(23 cards)
Benzodiazepines
Most widely prescribed for anxiety
Exerts action on limbic system
May cause physical and psychological dependence
alprazolam -benzo
Xanax
PO 0.25-2mg tid
clonazepam - benzo
Klonopin
PO 0.5mg tid
May increase by 0.5 to 1mg every 3rd day
Do not exceed 20mg
diazepam - benzo
Valium
PO 2-10mg 2 to 4 times daily
lorazepam - benzo
Ativan
PO 2-6mg daily in 2 to 3 doses
Benzo’s
NO alcohol
CNS - drowsiness, dizziness, fatigue, dry mouth, N/V
Acute withdrawl symptoms
pre -op anxiety
Antidepressant agent
most common illness in US today
25% women
15% men
SSRI’s
Block reabsorption of serotonin
used for SAD, OCD, PD
Prozac, Zoloft, Luvox
DON’T use with MAOI’s -potentially fatal reactions
weight gain/weight loss, dizziness, drowsiness, HA
Prozac SSRI
PO 20mg daily in am Max dose 80mg
Zoloft SSRI
PO 50mg daily am or pm initially - do not exceed 200mg per day
Paxil SSRI
PO 20mg am - do not exceed 50mg daily
Luvox SSRI
PO 50mg daily bedtime - do not exceed 300mg
SNRI’s
Inhibit the uptake of serotonin and norepinephrine
used for depression, GAD, SAD
Effexor - loss of appetite, constipation, dry mouth
TCA’s
Three ring tricyclic
raise levels of serotonin and norepinephrine
likely to relieve endogenous depression
Tofranil (imipramine HCL)
Pamelor (nortriptyline HCL)
Excessive sweating
flushing
blurred vision-intraocular pressure-need reg vision checks
MAOI’s -Monitor BP
block breakdown of norepinephrine agoraphobia, hysteroid dysphoria many contraindications follow strict diet effects last 2 weeks after stopping Nardil and Parnate
Food to avoid on MAOI’s
cheese,raisins,bananas,avocados,chocolate,soy sauce,yeast extracts, wine,beer,pickles,yogurt,protein aged foods
Antimanic agents
bipolar - manic and depressive and mixed
Lithium - antimanic - muscle cramps
Does not produce sedation
alters sodium transport
prophylaxis and treatment
CONTRAINDICATIONS - renal, cardio, severe dehydration, pregnancy, sever debiliation
Lithium - Nausea, aches, pains, tremors, TAKE WITH FOOD
DONT switch brands NO alcohol or caffeine Lab draws to check levels takes 3 to 5 days to work metallic taste lithium intox - looks like stroke symptoms
Antipsychotic agents-neuroleptics
Modifies psychotic behavior
Schizophrenia
Manic phase of bipolar
Severe depression
Risperdal and Zyprexa and Abilify
Many serious side effects
fatal in neuroleptic malignant syndrome
Antipsychotic
Antipsychotic SE
drowsiness, dry mouth, constipation, urinary retention, blurred vision, dizziness, EPS - looks like parinsons