Name the drug category
sertraline, paroxetine, fluoxetine, citalopram, escitalopram
Selective Seratonin Reuptake Inhibitors (SSRI)
How long should MAOIs and TCAs be stopped before starting another drug, such as an SSRI
Two weeks
Imipramine is a TCA used not only for depression and anxiety, but also for what disorder in children
Bedwetting (enuresis)
Name as many s/s of lithium toxicity as you can
halo around lights, tremor, GI upset, ataxia, confusion
What serious, potentially life threatening skin disorder can occur when taking mood stabilizers/antiepileptics like carbamazepine, lamotrigine, and valproic acid
Stevens-Johnson Syndrome (the combo of lamotrigine and valproic acid inc. risk)
diazepam, lorazepam, clonazepam, chloriazepoxide
Benzodiazapines
What is the potentially fatal condition that can result by mixing SSRI/SNRI with St Johns Wort, or MAOIs, or TCAs
Serotonin syndrome
This can also occur by increasing doses too rapidly
Involuntary movements caused by meds (primarily antipsychotics) that block dopamine receptors. Dystonia (muscle spasms), akathisia (restlessness), parkinsonism (tremors, rigidity), & tardive dyskinesia
Extrapyramidal symptoms (EPS)
The therapeutic lithium range is typically 0.6-1.2 mEq/L. Above what level is considered toxic?
1.5 mEq/L
Patients taking phenytoin need to be educated on good oral care due to the common side effect of:
Gingival hyperplasia
venlafaxine, duloxetine, desvenlafaxine
Serotonin-Norephinephrine reuptake Inhibitors (SNRIs)
Shivering, sweating, diarrhea, dilated pupils, agitation, headache, muscle rigidity, hyperreflexia are early to moderate s/s of:
Serotonin syndrome
Med used to treat extrapyramidal symptoms (EPS)
benztropine (Cogentin)
diphenhydramine (Benadryl) for acute
How will a low salt intake affect lithium levels?
Increase lithium levels
With these meds, nurses need to monitor platelets and educate patients to watch for bleeding/bruising. Low platelets is called:
thrombocytopenia
amitriptaline, imipramine, clomiparamine
Tricyclic Antidepressants
Name 3 signs of SEVERE serotonin syndrome
Fever, severe muscle rigidity, hyperthermia, seizures, coma
Patients taking antidepressants must be monitored for increased risk of:
suicide
What common category of OTC drugs can increase lithium levels?
NSAIDS
Elevated AST, ALT, and bilirubin may be signs of
hepatotoxicity
phenelzine, tranylcypromine, selegiline
Monoamine oxidase inhibitors (MAOI)
Eating tyramine containing foods and taking MAOIs can result in this:
Hypertensive crisis
Name another potentially life threatening condition that can result from taking antipsychotic medications. s/s fever, muscle rigidity, autonomic instability (BP, tachycardia), AMS
Malignant neuroleptic syndrome
Dehydration can increase lithium levels. How many liters/day should nurses advise clients to drink while taking lithium?
2-3 Liters
Kids taking ADHD stimulants, like Ritalin, should be monitored for what paradoxical side effects
Sedation