Mod 5 Study Set Flashcards by Michael Price

Sedation, Anticholinergic effects (dry mouth, dry eyes, urinary retention, constipation)

Tricyclic Antidepressants (TCAs)

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Amitriptyline (Elavil)
Clomipramine

Tricyclic Antidepressants (TCAs)

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Monitor for cardiac symptoms.

Ask about St Johns Wort

Taper when discontinuing the drug.

Overdose can be lethal; there is no antidote—only supportive care.

Tricyclic Antidepressants (TCAs)

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hypotension, vertigo, dizziness, nausea, constipation, dry mouth, diarrhea, headache, restlessness, blurred vision, hypertensive crisis

Monoamine Oxidase Inhibitors (MAOIs)

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A hypertensive crisis occurs if large amounts of fermented foods, alcohol, or aged cheese are ingested.

foods high in tyramine can lead to hypertensive crisis

Monitor for increased risk of serotonin syndrome if taken with SSRI/SNRI.

Monoamine Oxidase Inhibitors (MAOIs)

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Isocarboxazid (Marplan)
Phenelzine (Nardil)

Monoamine Oxidase Inhibitors (MAOIs)

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Citalopram (Celexa)

Escitalopram (Lexapro)

Fluoxetine (Prozac)

Paroxetine (Paxil)

Sertraline (Zoloft)

Selective Serotonin Reuptake Inhibitors (SSRIs)

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Nausea, dry mouth, sweating, insomnia, anorexia, sexual dysfunction

Selective Serotonin Reuptake Inhibitors (SSRIs)

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Screen for suicidal ideation.

Monitor for serotonin syndrome.

Taper dose when discontinuing drug.

Taking the herbal St. John’s wort can increase risk of serotonin syndrome.

Sexual dysfunction may be reduced by dividing the dose or delaying dosing until after sexual activity.

Selective Serotonin Reuptake Inhibitors (SSRIs)

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Duloxetine (Cymbalta)
Venlafaxine (Effexor XR)

Serotonin–Norepinephrine Reuptake Inhibitors (SNRIs)

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Agitation, dizziness, dry mouth, insomnia, sedation, headache, nausea, vomiting, tremor, constipation, weight loss, anorexia, excess sweating, sexual dysfunction

Serotonin–Norepinephrine Reuptake Inhibitors (SNRIs)

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Monitor for serotonin syndrome.

Dose must be titrated down when stopping drug.

Taking the herbal St. John’s wort can increase the risk of serotonin syndrome.

Instruct male clients about treating priapism (erection longer than 4 hours).

Serotonin–Norepinephrine Reuptake Inhibitors (SNRIs)

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Bupropion (Wellbutrin)

Norepinephrine–Dopamine Reuptake Inhibitors (NDRIs)

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Dry mouth, nausea, headache, dizziness, blurred vision, tachycardia, anxiety, restlessness, agitation, aggression, racing thoughts, loss of interest in sex, suicidal ideation

Norepinephrine–Dopamine Reuptake Inhibitors (NDRIs)

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Do not administer Wellbutrin with Zyban.

Avoid if there is a history of seizures, hypertension, glaucoma, bipolar disorder, liver disease, or kidney disease.

Consult primary provider if contemplating pregnancy; avoid if breastfeeding.

Norepinephrine–Dopamine Reuptake Inhibitors (NDRIs)

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Diazepam (Valium)
Oxazepam
Nitrazepam
Temazepam (Restoril)
Alprazolam (Xanax, Xanax XR)

Benzodiazepines

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Eszopiclone (Lunesta)
Ramelteon (Rozerem)
Zolpidem (Ambien)

Nonbenzodiazepine

Sedative - Hypnotics

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Bupropion (Wellbutrin SR, Wellbutrin XL)
Mirtazapine (Remeron)

Atypical Antidepressants

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Lithium Carbonate (Lithobid)
Aripiprazole (Ambilify)
Olanzapine (Fluoxetine)
Risperidone

Mood-stabilizing agents

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first-generation typical antipsychotic

haloperidol

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exerts its antipsychotic effects by blocking dopamine D2 receptors in the brain

haloperidol

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Anticholinergic effects include increased body temperature, dry mouth, drowsiness or sedation, constipation, and urinary retention.

Other common adverse effects are sedation, weight gain, erectile dysfunction in males, and oligomenorrhea or amenorrhea in females.

haloperidol

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Integrates thoughts

Promotes movement in concert with ACh

Stimulates hypothalamic endocrine activity

Enhances judgment

Dopamine
(DA)

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Stabilizes mood

Induces sleep

Regulates temperature

Controls appetite

Serotonin (5-hydroxytryptamine)
(5-HT)

Affects attention and concentration Raises energy level Heightens arousal

Norepinephrine (NE)

Assists memory storage Promotes movement in concert with DA Prepares for action

Acetylcholine (ACh)

Reduces arousal and aggression Inhibits excitatory neurotransmitters like NE and DA Decreases seizure potential

Gamma-aminobutyric acid (GABA)

Promotes neuronal excitation Acts as a neurotoxic mediator in various neurologic disorders

Glutamate (GT)

(DA)

Dopamine

(5-hydroxytryptamine) (5-HT)

Serotonin

Norepinephrine

(NE)

Acetylcholine

(ACh)

Gamma-aminobutyric acid

(GABA)

(GT)

Glutamate

Decreases seizure potential

(GABA)

Promotes neuronal excitation

Glutamate

Assists memory storage Prepares for action

Acetylcholine

Affects attention and concentration

Norepinephrine

Induces sleep Controls appetite

(5-hydroxytryptamine) (5-HT)

Integrates thoughts Stimulates hypothalamic endocrine activity Enhances judgment

Dopamine

mental illness that causes unusual shifts in a person’s mood, energy, activity levels, and concentration.

Bipolar Disorder

mental illness that causes persistent and intense feelings of sadness, hopelessness, and a lack of pleasure

Depression

mental illness that causes excessive and uncontrollable worry and anxiety about various aspects of life

Generalized Anxiety Disorder

mental illness involving unhealthy eating behaviors and attitudes toward food, body weight, and body image

Eating Disorders

mental illness characterized by the harmful use of a substance that leads to significant impairment in daily life

Substance Use Disorder

a progressive neurological condition that impairs cognitive functioning, including memory, reasoning, and the ability to perform everyday tasks, often affecting behavior and mood.

Dementias

a vague, uneasy feeling, the cause of which is not readily identifiable. It is evoked when a person anticipates nonspecific danger.

Anxiety

a feeling of terror in response to someone or something specific that a person perceives as dangerous or threatening.

Fear

attention is heightened, Sensory perception is expanded, Focus is on stimuli. Reality is intact. Information processing is accurate. Person feels in control. Muscle tone increases. Heart rate, BP, and breathing slightly increase. Perspiration is noticeable.

Mild

person is more easily distracted, Concentration is slightly impaired. Person can redirect attention. Learning takes more effort. Perception narrows. Problem solving becomes difficult. Person is irritable and feels inadequate. Muscles are tense. Slight leg or hand tremors may occur. Rate, pitch, and volume of speech change. Respiratory depth and vital signs increase. Sleep is disturbed.

Moderate

attention span decreases. Person cannot concentrate or remain focused. Perception is reduced. Ability to learn is impaired. Information processing is inaccurate or incomplete. Person is aware of extreme discomfort. Effort is needed to control emotions. Person feels incompetent. Symptoms include hyperventilation, dizziness, tachycardia, heart palpitations, and hypertension. Fine motor movement is impaired. Communication is limited.

Severe

person exaggerates details. Perception is distorted. Learning is disabled. Thoughts are fragmented. Speech is incoherent. Movements are haphazard, usually in an effort to escape. Symptoms include dyspnea, fainting, tremors, and diaphoresis.

Panic

Building trust Restoring comfort Modifying communication Adjusting teaching Ensuring safety Helping problem-solve

Six areas of nursing management of anxious clients

Generalized anxiety disorder Panic disorder Phobic disorders PTSD Obsessive-compulsive disorder

anxiety disorders

Drugs categories to treat anxiety disorders

Anxiolytics: benzodiazepines - -pam drugs Anxiolytics: adjuvant agents – Buspar Antidepressants – Duloxetine or Venlafaxine Beta-adrenergic blockers – Atenolol or Metoprolol

psychotherapy used to treat anxiety disorders

Psychotherapy Cognitive therapy Behavioral therapy

agitation, anxiety, restlessness, disorientation, diaphoresis, hyperthermia, tachycardia, nausea, vomiting, tremor, muscle rigidity, hyperreflexia, myoclonus, dilated pupils, ocular clonus, dry mucous membranes, flushed skin

Symptoms of Serotonin Syndrome

a potentially fatal drug-induced condition caused by too much serotonin in synapses in the brain

Serotonin Syndrome