72 terms

Exam #3 Pyschiatric Nursing Drugs

Phyenytoin (Dilantin) is a - (therapeutic class)
these drugs may be used with litium to treat mania or bipolar disorder
anticonvusants. Include: Dilanton, Tegretol
involuntary back and forth movements of the eyes
Interventions for Phyenytoin (Dilantin)
monitor for suicidal thought/ behavior, assess oral hygiene, observe for the development of rash & discontinue if skin reactions occur, Administer after meals, Pt should avoid alcohol
Chlopromazine (Thorazine) is used to
treat schizophrenia, mania,and bipolar disorder, control nausea & vomiting and to control hiccups
When d/c Chlopromazine (Thorazine)
it should be tapered to decrease withdrawal symptoms
Side effects of Chlopromazine (Thorazine)
Shuffling walk, blank facial expression, agitation, increased appetite, wt gain, dysuria, widening or narrowing of the pupils
Adverse reactions of Chlopromazine (Thorazine)
uncontrollable, rhythmic face, mouth, or jaw movements, yellowing of the skin or eyes, difficulty breathing or swallowing, fast or irregular heartbeat, and vision loss at night
Carbamazine (Tegretol) is a______ that's used to treat_______
Anticonvulsant, used to treat bipolar disorder, esp for rapid cyclers, and paranoid thinking. May be used along with Lithium
Lithium (Lithbid) is a
mood stabilizer, used to treat manic depression, or bipolar disorder
The action of Lithium (lithbid)
alters cation transport in nerve and muscle and influences reuptake of neurotransmitters
Interventions for Lithium (lithbid)
Assess mental status, Monitor I&O, fluid intake of at least 2000-3000 ml/day and eat a diet consistent in sodium intake, Administer with food or milk,
Amitriptyline (Elavil) is a _______ used to treat___
tricyclic antidepressant, used to treat depression and has a more sedative effect for agitation or restlessness
Amitriptyline (Elavil) should not be given with
MAOIs and antidepressants (fluoxetine or Prozac)
The action of Amitriptyline (Elavil)
potentiates the effect of serotonin and norepinephrine in the CNS
interventions for Amitriptyline (Elavil)
obtain wt, BMI, FBG, monitor b/p and pulse, administer with food, advise pt to change positions slowly and to avoid alcohol
Flouxetine (Prozac) classification
SSRI, antidepressant
Flouxetine (Prozac) is used to treat
Major depressive disorder, OCD, Panic disorder, Bipolar 1 disorder, treatment resistant depression
Flouxetine (Prozac) should not be taken with what other drugs?
Flouxetine (Prozac) should be taken
in the morning with food
Serotonin Syndrome
mental changes, agitation, tachycardia, hyperthermia, hyper-reflexia, incoordination, nausea, vomitting, diarrhea
Tranycypromine (Parnate) is a (classification?)
MOAI, antidepressant
Tranycypromine (Parnate) used to treat
major depressive episode for pts who do not respond to other modes of therapy
MOAIs inhibit the enxyme monoamine oxidase resulting in
accumulation of neurotransmitters (dopamine, serotonin, epinephrine, norepinephrine)
When using MOAIs pt must be instructed to
limit food containing tryramine b/c too much may result in hypertensive crisis
Signs of hypertensive crisis
chest pain, tachycardia or bradycardia, severe headache, nausea, vomitting, neck stiffness, sweating, enlarged pupils
Tranycypromine (Parnate) should be given
in the morning, b/c could cause sleep disturbances if given at night.
Sertraline (Zoloft) classification is
SSRI, antidepressant
Sertraline (Zoloft) is used to treat
Major depressive disorder, panic disorder, OCD, social phobia, GAD
side effects of Sertraline (Zoloft) include
dizziness, fatigue, headache, diarrhea, dry mouth, sexual dysfunction, altered taste, increased sweating, hyponatremia, and tremor ect.
Duloxetine (Cymbalta) classification is
SSRI, antidepressant
Duloxetine (Cymbalta) is used to treat
Major depressive disorder, GAD
side effects of Duloxetine (Cymbalta) include
fatigue, insomnia, blurred vision, increased B/P, decreased appetite, dry mouth, nausea, diarrhea, vomitting, dysuria, increased sweating, rash, tremor, ect.
Interventions for Duloxetine (Cymbalta)
monitor b/p, pulse, weight, appetite, mental status, suicidal tendencies, instruct pt to avoid alcohol
Bupropion (wellbutrin) classification is
smoking deterrant, antidepressant, aminoketones
Action of Bupropion (wellbutrin)
decreases neuronal reuptake of dopamine in the CNS, diminished reuptake of serotonin and norepinephrine
Interventions for Bupropion (wellbutrin)
monitor mood changes, mental status, administer in the morning to decrease insomnia, admin with food, good oral hygiene, avoid alcohol, wear sunscreen
Dolophine (Methadone) is a
opiod analgesic, controlled substance schedule II
Action of Dolophine (Methadone)
alters the preception of painful stimuli, while producing generalized CNS depression. Binds to opiate receptors in the CNS
Dolophine (Methadone) is used to
decrease pain, and supress withdrawal symptoms from heroin and other opioids
Side effects of Dolophine (Methadone)
confusion, sedation, hypotension, consitpation, urinary retention, flushing, physical dependence
Interventions for Dolophine (Methadone)
asses vitals, sedation, bowel function, assess signs of withdrawal (irritability, loss of appetite, shivering, large pupils, weakness, trouble sleeping), d/c gradually, admin with food/milk
Flunitrazepam (Rohyponol) is
the date rape drug, fast acting benzodiazepine
effects of Flunitrazepam (Rohyponol)
produce inhibition and muscle relaxation, anterograde amnesia. Alcohol potentiates effects
Alprazolam (Xanax) classification
benzodiazepine, antianxiety agent, controlled substance schedule IV
Alprazolam (Xanax) used to treat
GAD, Panic disorder, anxiety associated with depression, with acute mania and acute pyschosis
Action of Alprazolam (Xanax)
may produce CNS depression, effects mediated by GABA, and inhibitory neurotransmitter
Interventions for Alprazolam (Xanax)
administer with food, instruct pt to avoid grapefruit juice, taper when d/c
Diphenhydramine (Benadryl) classification
Diphenhydramine (Benadryl) is used for
relief of allergic symptoms, parkinson's disease and DYSTONIC reactions, mild night time sedation, prevention of motion sickness
Action of Diphenhydramine (Benadryl)
antagonizes the effects of histamine at the H1 receptor sites, significant CNS depressant and anticholinergic properties
side effects of Diphenhydramine (Benadryl)
drowsiness, blurred vision, hypotension, anorexia, dry mouth, dysuria, urinary retention, chest tightness, thickened bronchial secretions, wheezing
benztropine (Cogentin) classification
antiparkinsons, anticholinergics
benztropine (Cogentin) used to treat
parkinson's disease, extrapyramidal effects, acute Dystonic reactions
action of benztropine (Cogentin)
blocks cholinergic activity in the CNS, restores natural balance of neurotransmitters
Interventions for benztropine (Cogentin)
Administer with food, for IM (only for dystonic reactions) monitor b/p pulse and put on bed rest for 1 hour after administration. monitor parkinsonian and exp symptoms, assess bowel function, I&O, urinary retention
olanzapine (Zyprexa) is a
antipsychotic, mood stabilizer, thienobenzodiazepine
olanzapine (Zyprexa) is used to treat
acute mania, bipolar I disorder, severe manic episodes, depressive disorders associated with bipolar, schizophrenia
action of olanzapine (Zyprexa)
antagonizes dopamine and serotonin type 2 in the CNS
Interventions for olanzapine (Zyprexa)
monitor for onset of akathisia (restlessness), and extrapyramidal effects ( parkinsonian), monitor for tardive dyskinesia (uncontrolled movements of face,extremeties), monitor for neuroleptic malignant syndrome, Instruct pt to avoid alcohol, wear sunscreen, use saliva substitutes
ziprasidone (Geodon) is a
atypical antisychotic, mood stabilizer
ziprasidone (Geodon) is used to treat
Bipolar mania, schizophrenia
action of ziprasidone (Geodon)
antagonizes dopamine and serotonin type 2
Interventions for ziprasidone (Geodon)
assess for rash, monitor onset of akathesia and exp side effects, insititute seizure precautions, monitor BM, monitor b/p and pulse, monitor mental status, Admin w/ food
Cocaine (crack) effects on the body
anesthetic, and stimulant
action of Cocaine (crack)
blocks the ruptake of norepinephrine, serotonin, and dopamine
Withdrawal of Cocaine phase 1 symptoms
depression, anergia, acute agitated depression
Withdrawal of Cocaine phase 2 symptoms
prolonged sense of dysphoria, anhendonia, lack of motivation, and intense cravings that can last for 10 weeks
Withdrawal of Cocaine phase 3 symptoms
intermittent cravings that can last indefinately
Cocaine (crack) intoxication signs
tachycardia, dialated pupils, grandiosity, elevated b/p, euphoria, impaired judgement ect.
Cocaine (crack) overdose effects
repiratory distress, ataxia, hyperpyrexia, convulsions, coma, stroke, MI, death
Cocaine (crack) Tx for overdose
antipsychotics, anticonvulsants, ambient cooling for hyperpyrexia