Side/ Adverse Effects
What are the side effects for bupropion?
N- Nausea, vomiting, weight loss
I- Increases risk of suicide
P- Psychosis, hallucinations, delusions
E- Effects on the CNS ( insomnia, agitation, tremor, headache)
S- Seizures
What are the nursing interventions for risperidone?
-Monitor for drowsiness, insomnia, dizziness, and other CNS effects
-Prepare to treat acute dystonia with anticholinergic drugs as prescribed
-Prepare to treat Parkinson's symptoms with anti-Parkinson's drugs
-Some of these effects may require a change to another antipsychotic drug
-Monitor weight, blood glucose, cholesterol/triglyceride levels periodically
What are the therapeutic uses for venlafaxine?
-Major Depression
- Social anxiety disorder
- Generalized anxiety disorder (GAD)
What are the signs of Serotonin Syndrome?
-Sweating
-Tremor
-Agitation
-Hyperreflexia
-Fever
-Confusion
-Anxiety
What are the client education for chlorpromazine?
-Notify provider for feelings of inner restlessness, inability to sit still, muscle rigidity, tremors, sluggish movements, drooling, shuffling gait, severe spasms of the neck and body, involuntary movement of tongue, face, limbs, and trunk begin to occur.
-Chew gum or suck on hard candy to treat dry mouth
-Increase fluids/fiber to prevent constipation, urinate just before taking medication
-Encourage client to report palpitations, fainting spells, other cardiac symptoms
-Wear gloves when handling these medications to prevent contact dermatitis
-Instruct clients to wear sunscreen, protective clothing, sunglasses, and avoid sun exposure
-Advise clients to report sudden fever immediately
What are the side effects of Lithium?
M- Muscle Weakness
U- Urinary frequency increase
T- Tremors (may be side effect of toxicity)
G- Goiter/ Hypothyroidism
U- Upset GI (in early treatment, subsiding with time)
T- Toxicity
What are the nursing interventions for benzodiazepines?
-Monitor clients for falls and other injury after administration
-Assess clients memory following administration
-Monitor for paradoxical effects (especially in elderly)
-Monitor VS, especially with IV administration
-Monitor clients for signs of tolerance and dependence
-Taper over 1 to 2 weeks to prevent/ minimize withdrawal
-Monitor for signs of withdrawal, reverse sedation with IV flumazenil
-Provide airway and blood pressure support as needed for parenteral overdose
What is the therapeutic level for Lithium?
-Initial treatment of manic episode 1.0 to 1.5 mEq/L
-Maintenance levels 0.6 to 1.2 mEq/L
-Plasma levels at or greater than 1.5 mEq/L can result in toxicity
What are the signs/symptoms of TCA toxicity?
Cholinergic blockage
Cardiac toxicity
Mental confusion
Coma
Seizures
Agitation
Dysrhythmias
Death
What are the client instructions for amitriptyline?
-Take at bedtime to prevent daytime sleepiness
-Do not drive or perform hazardous activities if drowsy
-Sit/Stand slowly
-Urinate before taking medication
-Increase fiber/fluid to prevent constipation
-Chew gum, suck on hard candy, or sip water to prevent dry mouth
-Report any feeling or self harm or worsening depression
-Do not stop taking the medication abruptly
-Take drug as prescribed
What are the side/adverse effects of temazepam?
-Headache
-Drowsiness
-Paradoxical Effects
-cognitive impairment
-Lethargy
-Respiratory depression with OD
-Fall hazard with elderly
-Hangover effects from interfering with REM
What are the nursing interventions for chlorpromazine?
-Treat with Beta Blockers/Benzodiazepine
-Possibly switch to low-potency antipsychotics, atypical antipsychotic
-Treat on short term basis with anti-Parkinson's drugs
-Administer IM or IV anticholinergic (Benadryl) in case of acute dystonia
-Monitor for dry mouth, constipation, urinary retention, counsel client about sexual dysfunction
-Monitor VS, periodic ECG, serum potassium levels
-Wear gloves to prevent personal dermatitis
-Prepare to administer IV dantrolene
-Use cooling measures and antipyretics
- Keep client hydrated
-Give Benzodiazepines for anxiety
What are the contraindications/precautions for bupropion?
A- Allergy
S- Seizure
S- Suicidal Ideation increase
A- Antidepressants (MAOI's)
L- Liver/renal dysfunction
T- Tumor in CNS/ Head trauma
E- Eating Disorder
D- Disorders (schizophrenia, bipolar, diabetes, alcohol)
What are the signs/symptoms of Lithium toxicity?
Nausea
Muscle Weakness
Fine tremor that progresses to coarse tremors
Ataxia
Confusion
Seizures
Coma
Death
What are the client instructions regarding venlafaxine?
- Take drug with food
-Report headache
-Take over the counter pain medications PRN
-Have BP checked regularly
-Take medication in morning to avoid interference with sleep
-Do not stop taking medication abruptly
-Report any worsening of depression or thoughts of suicide
What are the side/adverse effects of venlafaxine?
H- Headache
I- Insomnia
H- Hypertension
A- Anorexia
N- Nausea
D- Discontinuing abruptly causes withdrawal
S- Suicidal Ideations may increase
What are the nursing interventions for Lithium?
H- Hypothyroidism/ thyroid function tests yearly
O- Output
T- Tremors
K- Kidney Function (BUN & CREATINE)
I- Intake
B- Beta blockers to reduce tremors
E- Electrolyte imbalance
L- Lithium levels below 1.0 mEq/L
L- Levels of sodium (low levels can cause toxicity)
What is the therapeutic use of betaxolol?
Topical therapy that helps lower IOP in chronic open-angle glaucoma and acute closed-angle glaucoma
What herbal supplements interact with velafaxine?
St. Johns Wort and sour date nut
What does Lithium interact with?
-NASID's (except aspirin), tetracyclines, diuretics, methyldopa, and probenecid increase risk for toxicity
-Phenothiazine antipsychotics, such as haloperidol, increases risk for dyskinesias and urinary retention
-Ace inhibitors. may increase lithium levels, causing toxicity
What are the side/adverse effects of amitriptyline?
D- Drowsiness
O- Overdose (life-threatening dysrhythmias, confusion, seizures) TCA toxicity
W- Withdrawal symptoms
A- Anticholinergic Effects
S- Suicide risk increases
H- Hypotension
What are the withdrawal symptoms for venlafaxine?
- Anxiety
- Agitation
- Headache
- Tachycardia