Mental Health Meds Flashcards
Review the most common psych meds, side effects, adverse reactions, and nursing considerations.
What are “Downers”?
Medications that cause the central nervous system to be sedated.
They are also called “Sedatives”.
What types of medications and substances are “Downers”?
- Antidepressants
- Anxiolytics
- Antipsychotics
- Antiallergy drugs / Antihistamines
- Barbiturates
- Benzodiazepines
- Muscle relaxers
- Opioids
- Alcohol
- Marijuana
- St. John’s wort
What will the pupils look like if a client has overdosed on a “downer” medication such as too many anxiolytics or opioids?
Pinpoint pupils.
Adverse reactions and nursing considerations:
Downers
- advise client to avoid taking too many Downers at once - client can become sedated, overdose, and die
- implement safety and fall precautions
- assess for suicide
Hold med and notify HCP if client has a decreased level of consciousness.
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
What are “Uppers”?
Medications that cause the central nervous system to be stimulated.
They are also called “Stimulants”.
Indication:
Amphetamines
To treat ADD or ADHD.
Generic names:
Amphetamines
- dextroamphetamine, lisdexamfetamine
- methylphenidate
What types of medications and substances are “Uppers”?
- Amphetamines - methylphenidate
- Cocaine
- Caffeine
What will the pupils look like if a client has overdosed on an “upper” medication such as amphetamines?
Dilated pupils.
Side effects and nursing considerations:
Uppers
Increased heart rate, flushing, sweating, dysrhythmias - advise client to use caution with cardiovascular disorders
Hold med and notify HCP if client experiences chest pain or dysrhythmia.
Indication:
Antidepressants
To treat a variety of conditions:
- depression
- fibromyalgia
- nerve pain
- chronic pain
Adverse reactions and nursing considerations:
Antidepressants
- takes up to four weeks to work: assess for risk of suicide
- some are nephrotoxic and/or hepatotoxic: check liver and kidney labs
- some cause pancyotopenia: check WBC, RBC and H&H levels
Side effects and nursing considerations:
Antidepressants
Sedation
- take in the evening to prevent falls
- avoid taking other CNS depressants at same time
Indication:
lithium
- to treat acute mania in bipolar disorder
- to treat long-term control of bipolar disorder
Generic names:
SSRI Antidepressants
(Selective serotonin reuptake inhibitors)
- citalopram, escitalopram
- fluoxetine, paroxetine
- vilazodone
Generic names:
SSNRI Antidepressants
(Selective serotonin norepinephrine reuptake inhibitors)
- desvenlafaxine, venlafaxine
- duloxetine
Generic names:
MAOI Antidepressants
(Monamine oxidase inhibitor)
TIP:
- tranylcypromine
- isocarboxazid
- phenelzine
Side effects and nursing considerations:
MAOI Antidepressants
(Monamine oxidase inhibitor)
- avoid tyramine containing foods - can cause a hypertensive crisis
- do not take within 2 weeks of other antidepressants or uppers - can cause serotonin syndrome
Food-med interaction:
MAOI Antidepressants
Avoid “aged foods”
- aged cheese and meats
- smoked, cured and processed meats like sausage
- coffee/tea (drinks with caffeine)
- soy sauce
- beer and wine
- BAR: Bananas, Avocado, Raisins
Taking together can cause a hypertensive crisis (BP >180/120).
Generic names:
Tricyclic Antidepressants
amitriptyline, nortriptyline
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.
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.