Psych Drugs

Question 1

what are 7 stages of the nurse-pt relationship

Answer 1

• pre-interaction
• intro
• orientation
• working
• termination

Question 2

what are 7 principles for psych

Answer 2

1) do not give or accept gifts
2) do not give advice, rather “what do u think u should do?”
3) do not give gaurantees “if you _____, ____ will happen”
4) if pt says something, best answer = one that keeps them talking
5) do not use slang (may take literally)
6) use empathy!

Question 3

ALL psych drugs have which symptoms

Answer 3

• hypotension
• weight changes (often weight gain)

Question 4

1st generation antipsychotics end in

Answer 4

_____zine

ex. phenothiazine

(think: zines for the zane (insane))

Question 5

what is the action of 1st gen antipsychotics

Answer 5

• decrease psych symptoms
• does not cure
• large dose = anti psychotic
• major tranquilizers = big guns

Question 6

what are side effects of 1st gen antipsychotics

Answer 6

Anticholinergics
Blurred Vision
Constipation
Drowsiness
EPS
Fotosensitivity (photosensitivity)
aGranulocytosis (low WBC)

Question 7

what are anticholinergic side effectrs

Answer 7

• dry mouth
• blurry vision
• constipation
• decreased urination

Question 8

what is decanoate?

Answer 8

• drugs that contain a decanoate ester, which is a chemical group that prolongs the action of the drug in the body

ex. haldol decanoate

Question 9

what are tricyclic antidepressants

Answer 9

• old type of anti-depressant
• NSSRIs

Question 10

what do tricyclic antidepressants do

Answer 10

• increase mood

Question 11

what are examples of tricyclic antidepressntas?

Answer 11

ex. amitriptyline, clomipramine, notriptyline

Question 12

what are side effects of tricylic antidepressants

Answer 12

Anticholinergic
Blurred vision
Constipation
Drowsiness
Euphoria

Question 13

how long does it take before tricyclic antidepressants work

Answer 13

2-4 weeks

Question 14

what are benzos used for

Answer 14

• anti anxiety
• minor tranquilizer

Question 15

what are examples of benzos

Answer 15

• have “zep” in them

ex. diazepam, clonazepam, lorazepam

(think “zeps” and “zines” are tranquilizers, zzz’s make you sleep)

Question 16

what are indications for benzos

Answer 16

• pre-op for anesthesia
• alcohol withdrawal
• seizures
• muscle relaxant
• help when fighting ventilator

Question 17

how long can people take benzos

Answer 17

• no longer than 2-4 weeks

Question 18

how long until benzos work?

Answer 18

• work quickly

Question 19

what are side effects of benzos

Answer 19

Anticholinergic
Blurred vision
Constipation
Drowsiness

Question 20

what risk is associated with benzos

Answer 20

• risk of safety and injury

Question 21

what are MAO inhibitors

Answer 21

• type of antidepressant

Question 22

what are examples of MAO inhibitors

Answer 22

• phenelzine
• selegiline
• tranylcypromine

Question 23

what are side effects of MAO inhibitors

Answer 23

Anticholinergic
Blurred vision
Constipation
Drowsiness

Question 24

what pt teaching should be provided r/t MAO inhibitors

Answer 24

to prevent a severe, acute, sometimes fatal, HTN crisis:
- avoid all foods with tyramine
- no OTC meds

Question 25

what are examples of foods with tyramine

Answer 25

- Banana, Avacado, Raisons/dried fruit (think salad BAR) - no organ meats - no preserved meats - no hotdogs - no cheese except cottage and mozza - no yogurt - no alcohol - no chocolate, caffeine, - no soya sauce - no liquorice

Question 26

what is lithium used for

Answer 26

- treats bipolar disorder - decreases mania

Question 27

lithium is the only psych drug that doesnt...

Answer 27

- alter neurotransmitting --> is an electrolyte

Question 28

what are side effects of lithium

Answer 28

Peeing Pooping Paresthesia (1st side effect of all electrolyte imbalances)

Question 29

what are signs of lithium toxicity

Answer 29

- tremor - diarrhea (severe) - metallic taste

Question 30

what interventions should be implemented if on lithium

Answer 30

- increase fluids (r/o dehydration due to increased peeing & pooping, watch Na) - if sweaty +++, no free water, give gatorade or an electrolyte solution

Question 31

lithium is closely related to... how so?

Answer 31

Na - low Na = lithium more toxic - high Na = lithium ineffective - normal Na required for lithium to be effective

Question 32

what is fluoxetine

Answer 32

an SRRI anti-depressant

Question 33

what are side effects of fluoxetine/SSRIs

Answer 33

Anticholinergic Blurred vision Constipation Drowsiness Euphoria Insomnia (give before noon & not at hs)

Question 34

what the dose of fluoxetine is changed in a adolescent or young adult, what should you monitor for?

Answer 34

- increased risk of suicidal ideation

Question 35

what is haldol/haloperidol?

Answer 35

- a long acting IM antipsychotic - typical 1st gen anti-psychotic

Question 36

what are side effects of haloperidol

Answer 36

Anticholinergic Blurred vision Constipation Drowsiness EPS Fotosensitivity aGranulocytosis

Question 37

what might elderly pts on haloperidol develop if overdosing?

Answer 37

Neuroleptic Malignant Syndrome (EMS)

Question 38

what is EMS

Answer 38

- potentially fatal hyperpyrexia (fever) with temps of 106-108 - medical emergency

Question 39

a haloperidol dose for older adults should be what compared to adults>

Answer 39

1/2

Question 40

what are other signs of NMS

Answer 40

- tremors - anxiety - altered mental status - muscle rigidity

Question 41

what is the first action if a questions tells you they are taking a major transquilizer and have symptoms of anxiety, tremors, and confusion?

Answer 41

- take their temp.

Question 42

what is clozapine? what is it used for

Answer 42

- prototype atypical anti-psychotic - used for severe schizo

Question 43

what is an advantage to using clozapine? disadvantage?

Answer 43

- advantage: no ABCDEF side effects - disadvantage: agranulocytosis --> monitor

Question 44

typical antipsychotics (major tranquilizers) end in...

Answer 44

- ____zine

Question 45

2nd generation atypical anti-psychotics (major tranq) end in...

Answer 45

- ____ zapine

Question 46

minor tranquilizers end in...

Answer 46

_____zep

Question 47

what is geodon/ziprasidone?

Answer 47

- used to treat schizophrenia and bipolar disorder

Question 48

what is a signif side effect of ziprasidone

Answer 48

- prolongs QT interval = risk of sudden cardiac arrest - DO NOT use in people with heart problem

Question 49

what is setraline

Answer 49

- SSRI

Question 50

what is a side effect of setraline

Answer 50

insomnia

Question 51

what are interactions that occur with setraline

Answer 51

- increases toxicities of other drugs = decrease dose of other drugs - st john's wart --> serotine syndrome - warfarin --> increases risk of hemorrhage, decrease warfarin dose

Question 52

what are signs of serotine syndrome

Answer 52

Sweating Apprehension Dizziness Headache ( think "SAD Head")