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NCLEX-RN (6) Mental Health > Psych Meds > Flashcards

Flashcards in Psych Meds Deck (45)
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1

What are "Downers"?

"Downers" are medications that cause the central nervous system to be sedated. 

They are also called "Sedatives".

 

2

What types of medications and substances are "Downers"?

  • Antidepressants
  • Anxiolytics
  • Antipsychotics
  • Antiallergy drugs
  • Barbiturates
  • Benzodiazepines
  • Muscle relaxers
  • Opioids
  • Alcohol
  • Marijuana
  • St. John's wort

 

3
Side effects and nursing considerations:

Downers

  1. advise client to avoid taking too many Downers at once
    • client can become sedated, overdose, and die
  2. implement safety and fall precautions
  3. assess for suicide

​Hold med and notify HCP if client has a decreased level of consciousness.

4

What is the treatment for CNS depressant ("downer") overdose?

  • induce vomiting or gastric lavage (pump the stomach)
  • give activated charcoal
  • flumazenil IV for benzodiazepine overdose

5

What are "Uppers"?

"Uppers" are medications that cause the central nervous system to be stimulated. 

They are also called "Stimulants".

 

6
Indication:

Amphetamines

To treat ADD or ADHD

 

7
Generic names:

Amphetamines

  • dextroamphetamine, lisdexamfetamine
  • methylphenidate

8

What types of medications and substances are "Uppers"?

  • Amphetamines - methylphenidate
  • Cocaine
  • Caffeine

 

9
Side effects and nursing considerations:

Uppers

Increased heart rate, flushing, sweating

  • ​advise client to use caution with cardiovascular disorders

Hold med and notify HCP if client experiences chest pain or dysrhythmia.

 

10
Side effects and nursing considerations:

Antidepressants

  1. takes up to four weeks to work
  2. assess for risk of suicide
  3. sedation
    • ​take in the evening to prevent falls
    • avoid taking other CNS depressants at same time

11
Generic names:

SSRI Antidepressants

(Selective serotonin reuptake inhibitors)

  • citalopram, escitalopram
  • fluoxetine, paroxetine
  • vilazodone

 

12
Generic names:

SSNRI Antidepressants

(Selective serotonin norepinephrine reuptake inhibitors)

  • desvenlafaxine, venlafaxine
  • duloxetine

 

13
Generic names:

MAOI Antidepressants

(Monamine oxidase inhibitor)

  • isocarboxazid
  • phenelzine
  • tranylcypromine

 

14
Side effects and nursing considerations:

MAOI Antidepressants

(Monamine oxidase inhibitor)

  1. avoid tyramine containing foods
    • can cause a hypertensive crisis
  2. do not take within 2 weeks of other antidepressants or uppers
    • can cause serotonin syndrome

 

15
Food-med interaction:

MAOI Antidepressants

Avoid "aged foods"

  • aged cheese and meats
  • smoked and processed meats like sausage
  • soy sauce
  • beer and wine

Taking together can cause a hypertensive crisis.

 

16
Generic names:

Tricyclic Antidepressants

amitriptyline, nortriptyline

 

17
Indication:

lithium

  • to treat acute mania in bipolar disorder
  • to treat long-term control of bipolar disorder

 

18
Toxicity side effects:

lithium

  • muscle and neuro symptoms: slurred speech, decreased muscle coordination, and twitching, drowsiness
  • GI symptoms: nausea/vomiting/diarrhea

Hold med and notify HCP if experiences these side effects.

 

19
Nursing considerations:

lithium

Prevent toxicity:

  • avoid dehydration by drinking 6 - 8 glasses of water daily
  • keep salt intake and exercise consistent

Lithium is a "salt" like sodium; changes in sweating and fluid intake can cause toxicity.

 

20

therapeutic level of lithium

0.6 - 1.2

2 or greater is considered toxicity​

 

21
Indication:

Anxiolytics (Benzodiazepine)

  • to treat anxiety and insomnia
  • to treat alcohol withdrawal

22
Generic names:

Anxiolytics (Benzodiazepine)

  • alprazolam
  • clonazepam, diazepam, lorazepam
  • chlordiazepoxide​

23
Immediate complication

What is serotonin syndrome?

Serotonin syndrome is when a client's serotonin level increases to dangerous levels.

It is caused by taking too many antidepressants at once.

24

What are the early symptoms and treatment of serotonin syndrome?

  • early symptoms: agitation, muscle twitching, rapid heart rate, sweating and ataxia
  • treatment: medication is held and dose is adjusted. Symptoms may go away and no additional treatment is needed.

25
Immediate complication

What are the late symptoms and treatment of serotonin syndrome?

Serotonin syndrome

  • late symptoms: muscle rigidity, high fever, seizures, coma
  • treatment: muscle relaxers, serotonin blocking drug (benzodiazepines), oxygen, IV fluids, ventilator

 

26

What is antidepressant discontinuation syndrome?

Antidepressant discontinuation syndrome is when a client experiences symptoms from abruptly stopping an antidepressant.

Medication is usually taken for about 6 weeks before symptoms can occur.

 

27

What are the symptoms and treatment for antidepressant discontinuation syndrome?

  • symptoms: nausea/vomiting/diarrhea, strange behavior such as sensory disturbances and abnormal movements
  • treatment: no treatment; symptoms usually stop within 1-2 weeks and are not life-threatening

28
Indication:

Antipsychotics

To treat bipolar syndrome, schizophrenia, and acute aggression.

29
Generic names:

1st generation/typical Antipsychotics

haloperidol

30
Generic names:

2nd generation/Atypical Antipsychotics

  • aripiprazole
  • olanzapine, quetiapine
  • risperidone, lurasidone

31
Side effects:

Antipsychotics

  • anticholinergic side effects
  • weight gain
  • orthostatic hypotension
  • low white blood cell count

32
Nursing considerations:

Antipsychotics: anticholinergic side effects

  1. causes blurry vision
    • implement safety / fall precautions
  2. causes urinary retention
    • monitor intake and output
  3. causes dry mouth
    • give candy or ice chips
  4. causes constipation
    • encourage fluids/fiber/walking

"can't see, can't pee, can't spit, can't shit"

33
Nursing considerations:

Antipsychotics: weight gain

  • teach about healthy diet and exercise
  • assess for onset of diabetes mellitus

34
Nursing considerations:

Antipsychotics: orthostatic hypotension

  • teach to sit at side of bed for a few minutes before getting up
  • implement safety and fall precautions

35
Nursing considerations:

Antipsychotics: low white blood cell count

Assess for signs of infection

36

What are extrapyramidal symptoms (EPS)?

Extrapyramidal symptoms (EPS) are early side effects of Antipsychotics caused by a decrease in dopamine.

 

37

What are the symptoms and treatment of extrapyramidal symptoms (EPS)?

Symptoms: Parkinson-like symptoms.

  • tremor, shuffling gait, muscle rigidity

Treatment: Give an antiparkinson: benztropine.

  • This will increase dopamine for better muscle control.

 

38

What is tardive dyskinesia?

Tardive dyskinesia are side effects from long term use of antipsychotics.

39

What are the symptoms and treatment of tardive dyskinesia?

Symptoms:

  • bizarre facial and tongue movements, lip smacking, stiff neck, and difficulty swallowing

Treatment:

  • Stop or taper the current psych medications. Symptoms can become permanent.

 

40
Immediate complication

What is neuroleptic malignant syndrome?

Neuroleptic malignant syndrome is a rare and fatal reaction to antipsychotics.

41
Immediate complication

What are the symptoms and treatment of neuroleptic malignant syndrome?

Symptoms:

  • severe muscle rigidity, drooling, difficulty swallowing, very high fever, tachycardia, tachypnea, rapid decrease in LOC, coma

Treatment: 

  • antipyretics, seizure precautions
  • meds: dantrolene or bromocriptine to increase dopamine, which helps with muscle control

42
Immediate complication

What EKG finding should prompt the nurse to avoid giving antipsychotics or antidepressants?

Don't give antipsychotics or antidepressants with a prolonged QT.

It can lead to life-threatening cardiac dysrhythmias.

43
Generic names:

Antialzheimer drugs

  • memantine
  • donepezil​

 

44
Indication:

disulfiram

To prevent clients from drinking alcohol by causing severe nausea and vomiting when the client drinks alcohol.

45
Nursing considerations:

disulfiram

  • client must abstain from alcohol for at least 12 hours before the first dose is administered
  • if alcohol is consumed, effects will begin within several minutes to 30 minutes
  • avoid alcohol for at least 14 days after disulfiram is discontinued