Antidepressants
The reason that we use the nickname "Amy trips a lot" for the TCA amitriptyline.
What is because TCA's cause sedation?
Commonly end in "pam" or "lam" and can be used daily or PRN for anxiety.
What are benzodiazepines?
Have more risk of causing Extrapyramidal symptoms such as dystonia, pseudoparkinsonism, akathisia, and tardive dyskinesia
What are typical or first generation antipsychotics such as haloperidol, chlorpromazine?
0.6--1.2 mEq/L
What is the therapeutic range of lithium?
Give with a meal or right before a meal (preferably breakfast), do not give after 4 pm, monitor for depression/suicidal ideation, monitor for diaphoresis, tachycardia, weight loss
What is patient/parent education with ADHD meds such as methylphenidate, amphetamines?
Initial weight loss followed by weight gain, sexual dysfunction, GI discomfort, headache, increase in suicidal thoughts
What are possible side effects of SSRI's or SNRI's?
Taken daily to decrease anxiety, sometimes prescribed with a benzo at first because it takes it 4-6 weeks to start having an effect.
What is buspirone?
Cause less anti-cholinergic effects, less hypotension, and less likely to cause neuroleptic malignant syndrome
What are atypical or second generation antipsychotics such as clozapine, risperidone, and quetiapine
Do not participate in activities that will cause excessive sweating, drink adequate amounts of non-caffeinated/non-alcoholic fluids daily, consume adequate/normal amounts of sodium daily, report any diarrhea/vomiting to provider, report coarse tremors or anorexia
Modafinil or armodafinil
What are meds that are prescribed for narcolepsy or "sleep attacks"?
Alcohol, aged or smoked cheeses or meats, soy sauce, avocados, pickles
What are foods/drinks high in tyramine that should be avoided by anyone who takes MAOI's?
These meds if discontinued abruptly can cause anxiety/panic attacks and withdrawal symptoms.
What are benzodiazepines?
Neutropenia and hyperlipidemia
What are adverse effects of clozapine?
Weight gain, hypothyroidism or goiter, fine tremors, renal toxicity, thirst/polyuria, GI upset
What are adverse effects of lithium?
This is the benzodiazepine ordered many times for alcohol withdrawal to prevent seizures
What is chlordiazepoxide?
This is the biggest concern with TCA's especially if someone overdoses on them
What are cardiac dysrhythmias?
It does not cause the sedation, dependency issues, or the same dangers that benzodiazepines can
What is the reason that buspirone is better than benzodiazepines for anti-anxiety?
Diaphoresis, fever, led-pipe muscle rigidity, unstable vital signs, confusion, tachycardia
What are signs/symptoms of neuroleptic malignant syndrome?
Very severe drowsiness, extreme confusion, seizures, coma, death
What can happen if lithium toxicity is not recognized or reported? Levels over 1.5 mEq/L
Can be used as an antidepressant in the Wellbutrin formulation but can also be used for nicotine withdrawal
What is bupropion? Zyban formulation
Nausea/vomiting, diarrhea, hyperreflexia, agitation/confusion, tremors, delusions/hallucinations, tachycardia, headache
What are signs/symptoms of serotonin syndrome that can happen when combining antidepressants with other antidepressants or St. John's Wort?
Fatal respiratory depression and hypotension can occur if combined with opioids, alcohol or other CNS depressants
What does the black box warning state on benzodiazepines?
Cooling blankets, IV fluids, vital sign monitoring, kidney function monitoring, possibly administer dantrolene
What are Nursing interventions with neuroleptic malignant syndrome?
What is lithium?
Can be used to deter alcohol consumption
What is disulfiram?