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Psychiatric Nursing > Final Medications > Flashcards

Final Medications Flashcards

1
Q

SSRI medications

A

Paxil (paroxetine)

Prozac (fluoxetine)

Lexapro (esclatlopram)

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2
Q

SSRI side effects

A 
Initially= insomnia and anxiety 
Nausea
Diarrhea 
Sleepiness 
Emotional flattening 
Decreased libido, difficulty reaching orgasm
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3
Q

SSRI indications

A

Anti- anxiety

Eating disorder

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4
Q

SSRI mechanism of action

A

Increases serotonin, indirectly acts on GABA
Used 1st in chronic anxiety disorders
3-4 weeks for sx control
Best with psychotherapy

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5
Q

Benzodiapene medications

A

Chloridiazepoxide (librium)

Lorazepam (ativan)

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6
Q

Benzodiapenes side effects

A 
Drowsiness 
Confusion 
Lethargy 
Tolerance 
Psychological/ physical dependence 
Potentiates effects of CNS depressants (ie, alcohol)
May aggravate sx of depression 
Orthostatic hypotension
Paradoxical excitement
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7
Q

Benzodiapenes indications

A

Anti- anxiety

Tx of alcohol withdrawal (substitution therapy using Ativan)

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8
Q

Precautions when using benzodiapenes

A

Taper gradually- withdrawal from benzos can be life threatening
Contraindications in patients that have hx of substance abuse
Use cautiously in elderly (orthostatic hypotension)

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9
Q

Medication to treat opioid overdose

A

Naloxone (Narcan)

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10
Q

Medication to treat opioid withdrawal

A

Methadone (dolophine) substitution - methadone is an opioid like drug
Buprenorphine

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11
Q

Indications of bupropion (zyban )

A

Nicotine treatment

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12
Q

bipolar disorder is characterized by ___ ___ from euphoria to ___ with intervening periods of ____. ___ or a ___ pattern may be present

A 
mood swings 
depression
normalcy
delusions 
seasonal
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13
Q

bipolar disorders

A 
bipolar 1 
bipolar 2
cycothymic disorder 
substance/ medication induced 
bipolar d/t another medical condition
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14
Q

dopamine and __ levels are excessive in ___

A

norepinephrine

mania

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15
Q

in bipolar __ dopamine and ___ levels are ___

A

depression
norepinphrine
deficient

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16
Q

medications that induce bipolar

A

steriods
amphetamines
antidepressents
narcotics

17
Q

a ___ episode happens for at least __ week consisting of elevated, __ or ___ mood. there is marked impairment usually requiring hospitalization that is __ attributal to substances or medical condition

A 
manic 
1 
expansive
irritable 
not
18
Q

sx of mania

A 
inflated self- esteem/ grandiousity
decreased need for sleep
pressured speech
flight of ideas
distractability 
increased goal directed activity 
excess participation in activites with potentially painful results 
aggitation
irritability 
aggression
19
Q

hypomanic episode

A 
4 day period of elevated expansive or irritable mood 
there is a change in behavior 
observable changes in mood
no marked impairment 
not attributable to substance/ condition
20
Q

cycothymic disorder involves ___ fluctuating mood disturbance of at least 2 years. ___ periods of elevated mood and __ mood that does not meed the criteria for ___ episode or ___. the patient is never without sx for more than __ months

A 
chronic 
numerous 
depression 
hypomanic 
MDD 
2
21
Q

substance/ medication induced bipolar

A

direct result of substance ingestion or withdrawl causing signifcant distress and impairment

22
Q

bipolar d/t another medical conditoin

A

direct result from another medical conditon

23
Q

bipolar in children looks like ___

A

ADHD

24
Q

restraint guidelines

A

less restrictive proven ineffective
behavior is a serious immediate danger to patient/ staff/ others
face to face evaluation at least every hour
15 minute checks for 1:1
debriefing
nurse can initiate but must be backed by dr within 1 hour

25
Q

pharm for bipolar

A

mood stabalizers
- lithium

anticonvolsant

  • tegretol
  • depakene
  • lamictil

antipsychotics

  • zyprexa
  • seroquel
  • risperdal
26
Q

ranges for bipolar

A
  1. 0- 1.5 for acute mania

maintance: 0.6- 1.2

27
Q

side effects of lithium

A 
drowsiness, dizziness, headache 
dry mouth, thirst
n/v 
hand tremors 
polyuria, dehydration
wt gain
acne 
lithium toxicity
28
Q

lithium toxicity

A 
renal impairment 
diabetes insipidous 
hypotension
arrhythmias
irregular pulse
29
Q

NURSING ACTIONS LITHIUM TOXICITY

A

get lithium level immediately if signs of ANY toxicity

30
Q

labs for before lithium tx

A

kidney/ thyroid function
ecg after 50
wt, bmi

31
Q

lab tests for maintence

A

1-2 weeks until stable
monthly first 6 months
check kidney function 1-2 times/ yr

32
Q

depakote side effects and lab

A 
sedation 
wt gain
hepatoxicity
hepatitis 
prolonged bleeding time

platlet count, liver function, wt every 6 months

33
Q

lamictil side effects and lab

A

steven johnson’s syndrome

34
Q

tegretol side effects and lab

A

steven johnsons
aplastic anemia
hyponaterima

initiation= cbcb, kidney thyroid function
tx= cbc every 2 weeks for 2 months; kidney liver and thyroid function every 6-12 months
35
Q

teaching for litium

A 
na intake
exercise 
adequate fluid intake
wt 
contreceptative use 
carry id 
sx of toxicity
36
Q

teaching for anitconvolsants

A

dont stop abruptly

37
Q

antipsychotic teachin

A

sunblock
othostatic hypotension
good oral care
no alcohol

Psychiatric Nursing (2 decks)

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