what is the two prototype for antipsychotic /neuroleptic drugs
*haloperidol
* Clozapine
what is the black box warning for haloperidol and clozapine
increased risk of death in elderly pt
what are some adverse effects for haloperidol and clozapine
Sedation, Weakness, Tremors, Constipation, Urinary retention, Impotence, Blurred vision, Photophobia,Drowsiness, Dry mouth, Nasal congestion, Weight gain,Development of diabetes mellitus
oMay turn urine pink to reddish brown
The characteristics of schizophrenia are Hallucinations, paranoia, delusions, speech abnormalities, and affective problems.
true
Do psychotherapeutic agents cure mental disorders?
No
Drugs do not cure the disorder – help patients function in a more acceptable manner and carry on activities of daily living
Lithium
what are the contraindications for lithium
pregnancy and lactation
what are adverse effects for lithium
typically happen because of increased drug levels-must have lithium levels drawn as ordered
oCNS symptoms-lethargy, slurred speech, N/V and tremors
these are types extrapryamidal effects Pseudoparkinsonism, Dystonia, Akathisia, Tardive Dyskinesia,Potentially irreversible neuroleptic malignant syndrome
true
what are the nursing considerations for methylphenidate
EKG prior to beginning therapy
what is there prototype for central nervous system stimulants for attention deficit syndromes / narcolepsy
methylphenidate
Phenytoin contraindications and cautions
pregnancy and lactation
what is the pt education for lithium
oNeed for lab levels
oAdminister with food to help with GI upset
oMust maintain adequate & consistent sodium levels
oAvoid pregnancy
pt who have epilepsy do not have seizures and or loose control
false
what is the pt education for methylphenidate
Secure med in safe place
Schedule II information (no refills, ect)
Give in morning either with or after breakfast, if need second dose-give early afternoon (book says 6pm but really should be earlier)
Monitor height & weight due to potential anorexia and stunted growth
Drug holidays’ may be used but should be monitored by physician
hydantoins
phenytoin
***good if they can not tolerate sedation and drowsiness
Valproic acid (Depakene) contraindication
Pregnancy Category X
watch for **** Associated with liver toxicity
methylphenidate adverse effects
Nervousness, insomnia, dizziness, headache, blurred vision, anorexia, nausea, weight loss
gereralized is tonic clonic seizures
partial is absence seizures
true
Phenytoin pt education
don't drink Alcohol
Teach clients about needed lab levels to determine dosages
Do not abruptly stop medication-may cause status epilepticus
prototype for succinimides
Ethosuximiden (Zarontin)
Carbamazepine (prototype)-Contraindications and Cautions-
Known allergy, severe hepatic and renal dysfunction, pregnancy and lactation and decreased fertility with males
partial seizures medication
adverse for Phenytoin
Gingival hyperplasia, Steven-Johnson’s syndrome, Sedation-but not as bad as other anticonvulsants
is this general pt ed for seizure med
Baseline EEG prior to administering meds
Administer with food to help with GI upset
Discontinue med slowly to help prevent rebound seizures
Take meds as ordered (may be multiple times/day)
Wear medic alert bracelet or jewerly
true
adverse effects for partial seizures
carbamazepine
oBlack box warning regarding potential increased risk for suicidal behaviors
oShould be tapered slowly due to risk of rebound seizures