psych meds Flashcards by Madeline Peters

ALL psychiatric drugs cause

low BP and weight changes—usually weight gain

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Phenothiazines

First generation or typical antipsychotics (MAJOR tranquilizers)
• They don’t cure … They just reduce symptoms
• We use ZINEs for the ZANY (Cuckoos) … Antipsychotics

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First generation or typical antipsychotics end in

ZINE (Thorazine, Compazine)

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Phenothiazines in small doses, they are… in large doses…

small- they are antiemetics (to treat vomiting)

large- Antipsychotics

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Antipsychotics S/Es

= “ABCDEFG”
o Anticholinergic (dry mouth, urinary retention)
o Blurred vision
o Constipation
o Drowsiness
o EPS (tremors, Parkinson)
o Foto sensitivity
o aGranulocytosis (low WBC count, immunosuppressed)
Teach patient how to recognize and report sore throat and symptoms of infection

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• What is the nursing action when someone presents with a S/E?

Educate

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• What is the nursing action when someone presents with a Toxic effect?

o HOLD the drug ! Notify HCP

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Decanoate or “Caprate” form of a medication

The long-acting form of a drug
Sometimes denoted with the letter “D”
IM form given for non-compliance
Often Court-ordered

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Tricyclic Antidepressants

Grandfathered into the NSSRI (Non-selective serotonin reuptake inhibitor) group
Mood elevators (Happy pills)

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Examples of Tricyclic Antidepressants

• Elavil (elevates), Trofranil, Aventyl, Desyrel

- amitryptiline, nortyptiline, imiparamine

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Side effects of Tricyclic Antidepressants

Anticholinergic (especially, dry mouth) Blurred Vision
Constipation
Drowsiness
Euphoria (happy)

Q-T prolongation

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How long do you have to wait to see effects of TCA

Must take meds for 2 to 4 weeks for beneficial effects

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Benzodiazepines

Anti-anxiety, minor tranquilizers

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Benzodiazepines names

• Always have ZEP in the name
• Remember ZZzzs for falling/going to
sleep
• Many benzodiazepines end in “Pam” or
“Lam”
• Prototype: Valium, induction of anesthetic, muscle relaxant, alcohol

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Benzos can be used as…

o Seizures medications
o Preop induction of anesthesia
o Muscle relaxants
o EtOH withdrawal medications
o Ventilation—medication to relax and calm down pts on a ventilator

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How long until benzos start working

• Benzos work quickly … But do not take them for more than 2 to 4 weeks

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Administer major and minor tranquilizers at the same time. Why?

• The major antipsychotics take a long time to start working
• The minor antipsychotics start working right away
• Both are administered at the same time
• Example: pt is usually put on Valium and Elavil at the same time
o Valium is discontinued in 2 to 4 weeks once Elavil kicks in

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S/Es of Benzodiazepines

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“ABCD” 
• Anticholinergic
• Blurred Vision
• Constipation
• Drowsiness

Monamine Oxidase (MAO) Inhibitors

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Antidepressant

* Depression is thought to be caused by norepinephrine, dopamine, and serotonin in brain

Name of MAOIs starts with

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• MARplan, NARdil, PARnate the beginnings—all rhyme

S/E of MAOIs

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Anticholinergic
Blurred Vision
Constipation
Drowsiness

Teaching points MAOIs

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Avoid tyramine-containing food … May cause Hypertensive Crisis

Food with tyramine

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o Fruits/Veggies—Avoid salad “BAR”: Bananas, Avocados (guacamole), Raisins (dried fruit)
o Grains—Ok to have, except Yeast
o Meats—No organs liver, kidney, tripe, heart, no preserved meats (smoked, dried, cured,
pickled, hot dogs)
o Dairy—No cheese except for mozzarella, cottage cheese (no aged cheese)
o No EtOH, elixirs, tinctures (iodine/betadine) caffeine, chocolate, licorice, soy sauce

Lithium

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Used for treating Bipolar disorder—it decreases the mania LI = BI

S/E of lithium

Very Unique—acts more like an electrolyte—think: Potassium/Lithium • The 3Ps as S/Es o Peeing (Polyuria) o Pooping (diarrhea) o Paresthesia (earliest sign of electrolyte imbalance)

Toxic effects of lithium

* Tremors * Metallic taste * Severe diarrhea

What is the #1 nursing intervention in a pt on lithium presenting with peeing/pooping all the time?

``` • #1 intervention o Give pt fluids • The above S/Sx are S/Es—expected • Monitor sodium • Low sodium makes lithium toxic • High makes lithium ineffective • Sodium needs to be normal ```

Prozac (fluoxetine)

• SSRI, mood elevator

• Side effects of Prozac (fluoxetine) are

``` o Anticholinergic o Blurred Vision o Constipation o Drowsiness o Euphoria (happy) • Causes insomnia so give before noon. If bid, give at 6 a.m. and noon ```

Prozac (fluoxetine) risks in adolescents

• When changing doses, watch for suicidal risk in adolescents

HALDOL (haloperidol)

* Tranquilizers (basically same as Thorazine) | * First generation antipsychotics

• S/E of Haldol

o Anticholinergic (dry mouth, urinary retention) o Blurred vision o Constipation o Drowsiness o EPS (tremors, Parkinson) o Foto sensitivity o aGranulocytosis (low WBC count, immunosuppressed)

Haldol may cause..

• Pts may develop NMS (neuroleptic malignant syndrome) from overdose o Seen in elderly and young white schizophrenic pts o High fever over 105 o Their doses should be about 1⁄2 usual adult dose

How to differentiate NMS (neuroleptic malignant syndrome) from EPS (extrapyramidal syndrome)?

• Measure the pts’ temperature o If temperature is WNL, this is EPS o If temperature is 102 and rising, call the emergency response team and notify HCP... NMS is life threatening • NMS presents with anxiety and tremors, and so does EPS

Clozaril (clozapine)

• Atypical antipsychotic

• S/Es of clozapine (clozaril)

o aGranulocytosis! It is worse than cancer drugs and can trash the pt’s bone marrow

• Geodon (ziprasidone) has a black box warning

* Prolong the QT interval, which can cause sudden cardiac arrest * Do not use in pts with cardiac condition

Second generation antipsychotics

end in “Zapine”

What is the #1 nursing intervention in a pt taking Clozaril (clozapine)

• Monitor the WBC

Zoloft (Sertraline)

• Antidepressant

Zoloft (Sertraline) cant interact with..

• Interact with the followings because they are not metabolized in the liver o St. John’s Wort and cause serotonin syndrome o Warfarin and cause bleeding

• S/E of serotonin syndrome is

``` “SAD Head” o Sweating o Apprehensive (impending sense of doom) o Dizzyness o Headache ```

The nurse should anticipate lowering the dose of sertraline (Zolof) of a pt on..

St. John’s Wort and Warfarin

MAOI meds

phenelizine isocarboxazid selegiline

psych meds Flashcards

(44 cards)