Medication Identification
List 1 Monoamine Oxidase Inhibitors (MAOI)
•Isocarboxazid (Marplan)
•Phenelzine (Nardil)
•Selegiline (Emsam)
•Tranylcypromine (Parnate)
Dextroamphetamine, methamphetamine, lisdexamfetamine, methylphenidate, dexmethylphenidate, dextroamphetamine/amphetamine mixture
CNS stimulants
List 1 class of medications used to treat Tourette's syndrome.
•Antipsychotics
•Alpha agonists
The conventional antipsychotics, haloperidol (Haldol) and pimozide (Orap), have been approved by the U.S. Food and Drug Administration (FDA) for control of tics and vocal utterances associated with Tourette disorder.
Clonidine (Catapres) and guanfacine (Tenex; Intuniv) are alpha-adrenergic agonists that are approved for use as antihypertensive agents
List 1 teaching consideration for clients taking antidepressants.
Most antidepressants are generally safe. But the FDA requires that all antidepressants carry boxed warnings, the strictest warnings for prescriptions. In some cases, children, teenagers and young adults under 25 may have an increase in suicidal thoughts or behavior when taking antidepressants. This may be more likely in the first few weeks after starting or when the dose is changed. Can take 4 weeks or longer for full therapeutic effect.
Anyone taking an antidepressant should be watched closely for worsening depression or unusual behavior. If you or someone you know has suicidal thoughts when taking an antidepressant, call your healthcare professional right away or get emergency help.
SSRIs aren't habit-forming. However, stopping antidepressant treatment suddenly or missing several doses can cause withdrawal-like symptoms. This is sometimes called discontinuation syndrome. Work with your healthcare professional to slowly and safely lower your dose.
A serious condition characterized by a severe reduction in granulocytes, a type of white blood cell that fights infection
Agranulocytosis (seen with clozapine)
List 2 serotonin and norepinephrine reuptake inhibitors (SNRIs)
•Desvenlafaxine (Khedezla, Pristiq)
• Duloxetine (Cymbalta, Drizalma)
•Levomilnacipran (Fetzima)
•Milnacipran (Savella)
•Venlafaxine (Effexor)
Naloxone (Narcan), Naltrexone (ReVia), Nalmefene (Revex)
Narcotic or opioid antagonist.
•Risperidone
•Aripiprazole
Common side effects of risperidone
Drowsiness
Increased appetite
Nasal congestion
Fatigue
Constipation
Drooling
Dizziness
Weight gain
When administering risperidone, caution must be maintained concerning less common but more serious possible side effects, including neuroleptic malignant syndrome, tardive dyskinesia, hyperglycemia, and diabetes.
Common side effects of aripiprazole
Sedation
Fatigue
Weight gain
Vomiting
Somnolence
Tremor
List 1 teaching consideration for clients taking antianxiety medications.
Medication adherence, avoiding alcohol/sedatives, managing side effects (drowsiness, falls, no driving until you know how the medication impacts you), slow position changes, reporting new symptoms, safe storage, tapering off only with MD. These medications can cause tolerance (needing higher doses for the same effect) and withdrawal (physical/psychological symptoms when stopping), sometimes after just days or weeks.
Symptoms
•Agitation or restlessness, insomnia, confusion, rapid heart rate and high blood pressure, dilated pupils, loss of muscle coordination or twitching muscles, high blood pressure, muscle rigidity, heavy sweating, diarrhea, headache, shivering, goose bumps, high fever, tremor, seizures, irregular heartbeat, unconsciousness
Serotonin syndrome
List 3 selective serotonin reuptake inhibitors (SSRIs)
•Citalopram Celexa
•Escitalopram Lexapro
•Fluoxetine Prozac
•Paroxetine Paxil
•Sertraline Zoloft
•Fluvoxamine Luvox
•Vilazodone-Vibbryd
Chlorpromazine: (Thorazine), Fluphenazine: (Prolixin), Haloperidol: (Haldol), Loxapine: (Loxitane), Perphenazine: (Trilafon), Pimozide: (Orap), Thiothixene: (Navane), Thioridazine: (Mellaril), Trifluoperazine: (Stelazine)
First generation antipsychotic medications.
List 2 pharmacological treatment options for alcoholism or alcohol withdrawal.
•Disulfiram (Antabuse)
____
Alcohol withdrawal
•Benzodiazepines
•Anticonvulsants
•Multivitamin therapy
•Thiamine
List 1 side effect of CNS stimulants.
weight loss, tachycardia, decrease in rate of growth and development
Depersonalization (a feeling that you are an observer of yourself), dizziness, facial tics, headaches, inability to sleep, increased blood pressure, increased rate of breathing, irritability, feelings of depression, increased anxiety, manic behavior, mood swings
•Nausea and vomiting, diarrhea, abdominal pain, and bloated stomach.
•Moderate to severe ________ can add neurological symptoms such as:
•Mental status changes that can range from mild confusion to delirium, uncontrolled shaking (tremors), coordination and balance issues (ataxia),muscle twitches (myoclonus), slurred speech (dysarthria), and overactive reflex responses (hyperreflexia).
uncontrolled eye movements (nystagmus), hyperthermia (severe cases), seizures (severe cases), coma (severe cases)
Lithium toxicity
List 4 anti-anxiety medications
•Hydroxyzine (Vistaril)
•Alprazolam (Xanax)
•Chlordiazepoxide (Librium)
•Clonazepam (Klonopin)
•Clorazepate (Tranxene)
•Diazepam (Valium)
•Lorazepam (Ativan)
Amitriptyline, Desipramine (Norpramin), Doxepin, Imipramine, Nortriptyline (Pamelor), Protriptyline
tricyclic antidepressants
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Tricyclic antidepressants block the neurotransmitters serotonin and norepinephrine from being taken back into nerve cells in the brain, a process called reuptake. Blocking reuptake raises the levels of these two neurotransmitters in the brain. Tricyclic antidepressants also affect other chemical messengers, which can lead to some of the antidepressants' side effects.
List 2 medication options for gambling disorder.
•Psychopharmacology
•Selective serotonin reuptake inhibitors
•Clomipramine
•Lithium
•Carbamazepine
•Naltrexone
List 2 side effects of antipsychotic medications.
Anticholinergic effects, nausea; gastrointestinal upset, skin rash, sedation, orthostatic hypotension, photosensitivity, hormonal effects, electrocardiogram changes, hypersalivation, weight gain, hyperglycemia/diabetes, increased risk of mortality in elderly clients with dementia, reduction in seizure threshold, agranulocytosis, extrapyramidal symptoms, tardive dyskinesia, neuroleptic malignant syndrome
Dystonia: Dystonia is long-lasting muscle contractions or starting then stopping muscle contractions. This causes abnormal, often repetitive movements or postures. It can affect many different muscles, ranging from those in your trunk and arms and legs to facial muscles.
Parkinsonism: Parkinsonism causes slowed movements (bradykinesia), tremors and stiffness or rigidity. It may also cause a stooped posture and a slow, shuffling walking pattern.
Akathisia: Akathisia makes it difficult to stay still due to inner restlessness. It typically causes repetitive movements, like leg crossing, leg swinging or shifting from one foot to another.
Tardive _____ can develop after taking an antipsychotic medication for several months or years. Symptoms include:
There’s also tardive Parkinsonism and tardive akathisia. Symptoms are similar to the acute type, but the time at which you develop symptoms happens later.
Extrapyramidal symptoms (EPS): a group of side effects that impact motor control, most often caused by antipsychotic medications
List 5 atypical antipsychotics or second-generation antipsychotic medications
•Aripiprazole (Abilify)
•Asenapine (Saphris, Secuado)
•Brexpiprazole (Rexulti)
•Cariprazine (Vraylar)
•Clozapine (Clozaril)
•Iloperidone (Fanapt),
•Lumateperone (Caplyta)
•Lurasidone (Latuda)
•Olanzapine (Zyprexa)
•Paliperidone (Invega)
•Quetiapine (Seroquel
•Risperidone (Risperdal)
•Ziprasidone (Geodon)
Ketamine and Memantine (Namenda)
NMDA receptor antagonists
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Memantine and ketamine are clinically useful NMDA receptor (NMDAR) open channel blockers that inhibit NMDARs with similar potency and kinetics, but display vastly different clinical profiles.
List 4 specific medications that can be used for bipolar disorder.
For mania
•Lithium (Eskalith, Lithobid, Lithonate)
•Anticonvulsants (carbamazepine (Tegretol), valproic acid (Depakote), and lamotrigine (Lamictal), Oxcarbazepine (Oxtellar, Trileptal)
•Verapamil (calcium channel blocker)
•Antipsychotics (Abilify, Latuda)
For depressive phase
•Use antidepressants with care (may trigger mania).
List 2 teaching considerations for clients taking lithium.
•Therapeutic range
•1.0 to 1.5 milliequivalents per liter (acute mania)
•0.6 to 1.2 milliequivalents per liter (maintenance)
•Ensure that client consumes adequate sodium and fluid in diet.
•Monitor serum levels one to two times per week until stable, then monthly.
•Blood samples should be drawn 12 hours after last dose.
A rare, life-threatening reaction to certain medications, most commonly antipsychotics, that causes symptoms like high fever, muscle stiffness, and changes in mental status. Other symptoms include an irregular heartbeat, rapid breathing, and excessive sweating.
Neuroleptic malignant syndrome (NMS)