ANTIPSYCHOTICS
Life threatening side effect of a 2ND generation antipsychotic.
Name the medication.
WHAT is:
Agranulocytosis
Clozapine (Clozaril)
First line treatment for Depression
General side effects
WHAT IS
SSRIs - Selective Serotonin Reuptake Inhibitors
Headache, GI disturbance, nervousness, anxiety, sexual dysfunction, insomnia/sedation
medications used for panic disorder that are considered the safest because of low incidence of side effects and lack of physiological dependence
WHAT IS
SSRIs
4 mood stabilizers
WHAT IS
Lamotrigine (Lamictal)
Depakote (Valproic Acid)
Lithium, Lithobid, Eskalith (Lithium Carbonate)
Tegretol (Carbamazepine)
Stimulant Side effects & Patient teaching
WHAT IS
Decreased appetite, Weight loss/Growth suppression, Nervousness, Insomnia
High calorie breakfast, after school & bedtime snack, Monitor height & weight
Restlessness, cannot sit still, and has muscle stiffness.
Medication used to treat this
WHAT is
Akathisia
Benztropine (cogentin) 2mg
"I'm taking medication and the NP tells me I can't eat sauerkraut"
Name the Class and 3 medications
WHAT IS
MAOIs
PANAMA
Tranylcypromine (PArnate), Phenelzine (NArdil), (MArplan)
Side effects of benzodiazepines
WHAT IS
CNS depression, such as drowsiness, sedation, poor coordination, and impaired memory or clouded sensorium.
Signs of Lithium Toxicity
WHAT IS
GI disturbance: nausea, vomiting, diarrhea
Neurological disturbance: lack of coordination, drowsiness, muscular weakness, slurred speech, ataxia, blurred vision, giddiness, tinnitus, muscle twitching, coarse tremors, polyuria
Withhold dose and call physician, Drug should not be stopped abruptly
Deterrent Medication for Alcoholism
Patient Teaching
WHAT IS
Disulfiram (Antabuse)
Teach patient to read labels and avoid products with alcohol
Neck twists to one side, and his eyes appear to roll back in the sockets.
Medication used to treat this
WHAT IS
Dystonic reaction
Diphenhydramine (benadryl) 25 mg IM
Change in mental state: confusion and agitation Neuromuscular excitement: muscle rigidity, weakness, sluggish pupils, shivering, tremors, myoclonic jerks, collapse, and muscle paralysis Autonomic abnormalities: hyperthermia, tachycardia, tachypnea, hypersalivation, and diaphoresis
WHAT IS
Serotonin Syndrome
3 non benzodiazepines medications used to treat anxiety
WHAT IS
Buspirone (BuSpar)
Clonidine (Catapres)
Propranolol (Inderal)
Lithium Therapeutic level
WHAT IS
Lab test: 2X/week lithium levels (draw blood sample prior to next dose or 8–12 h after last dose)
Remember that the stated therapeutic level in Videbeck is 0.5 to 1.5 mEq/L, HOWEVER many institutions have narrowed this range due to the life threatening risks related to Lithium toxicity to 0.5 to 1.2 mEq/L
Atypical Antidepressants
WHAT IS
Bupropion (Wellbutrin)
Mirtazapine (Remeron)
Muscle rigidity, high fever, increased muscle enzymes (particularly creatine phosphokinase), and leukocytosis (increased leukocytes)
Treatment
WHAT IS
NMS - Neuroleptic Malignant Syndrome - serious and frequently fatal condition
Stop medication, may cause cardiovascular collapse need transfer for emergency treatment --
Dizziness, orthostatic hypotension, tachycardia, sedation, headache, tremor, blurred vision, constipation, dry mouth and throat, weight gain, urinary hesitancy, and sweating
WHAT IS side effects of Tricyclic antidepressants
Tricyclic antidepressants are contraindicated in severe impairment of liver function and in myocardial infarction (acute recovery phase). They cannot be given concurrently with MAOIs. Because of their anticholinergic side effects, tricyclic antidepressants must be used cautiously in clients who have glaucoma, benign prostatic hypertrophy, urinary retention or obstruction, diabetes mellitus, hyperthyroidism, cardiovascular disease, renal impairment, or respiratory disorders
Issues related to regular use of benzodiazepines
WHAT IS
Tolerance, dependence, addiction
Side effect Lamotrigine (Lamictal)
WHAT IS
Serious skin reactions. They can happen weeks to months after starting the medication.
Pt education-Contact your care team right away if you notice fevers or flu-like symptoms with a rash
Dementia Medications
General side effects
WHAT IS
Donepezil (Aricept)
Rivastigmine (Exelon)
Memantine (Namenda)
GI symptoms - nausea, vomiting, diarrhea, Dizziness
Abnormal, involuntary movements such as lip smacking, tongue protrusion, chewing, blinking, grimacing, and choreiform movements of the limbs and feet.
Treatment
WHAT IS
Tardive Dyskinesia
Tardive dyskinesia is irreversible once it appears, but decreasing or discontinuing the medication can arrest the progression. In addition, newly approved medications to treat tardive dyskinesia, valbenazine (Ingrezza) and deutetrabenazine (Austedo, Teva),
Behavior that would indicate an increased suicidal risk
WHAT IS
An abrupt improvement in mood, calling family members to make amends, crying when discussing sadness, feeling overwhelmed by simple daily tasks, statements such as “I’m such a burden for everyone” , statements such as “Everything will be better soon”
Issues with using Buspirone (BuSpar) for treatment of anxiety
Very slow speed of onset
Common side effects of buspirone include dizziness, sedation, nausea, and headache
Rationale for adequate salt and water in diet when taking lithium
Patient teaching
WHAT IS
Lithium is a salt that has a greater affinity for receptor sites than sodium chloride.
Metabolic Syndrome & Nursing interventions
WHAT IS
A serious side effect related to the use of 2nd generation antipsychotics. Results in Obesity, high BMI, HTN, High blood sugar level, high cholesterol, high triglycerides
Monitor waist circumference, healthy eating, exercise, anti obesity meds