Antidepressants
A patient on an antidepressant says, “It’s been 5 days and I’m not less depressed.” Your nursing response is this
Educate that antidepressants take weeks to work and to continue taking as prescribed
A rash on this medication must be reported immediately due to risk of Stevens-Johnson Syndrome
Lamotrigine (Lamictal)
This class is used for alcohol withdrawal because it works on similar receptors as alcohol
Benzodiazepines
First-generation antipsychotics are more likely to cause this type of side effect
extrapyramidal symptoms (EPS)
Stimulants are not recommended in patients with this movement disorder
Tourette’s syndrome
This black box warning applies to all antidepressants
Increased risk of suicide
Coarse tremors, ataxia, tinnitus, and vomiting suggest this emergency
Lithium toxicity
This life-threatening complication can occur with benzodiazepines
Respiratory depression
Rigidity, lead-pipe stiffness, and high fever indicate this emergency
Neuroleptic Malignant Syndrome (NMS)
Name 2 non-stimulant medications for ADHD
Guanfacine, Clonidine, Strattera (Atomoxetine), Wellbutrin (Bupropion)
This dangerous condition includes hyperreflexia and clonus
Serotonin syndrome
Your patient is taking lithium, you teach them that _______ tremors are a normal side effect while _______ tremors are a sign of lithium toxicity.
Fine tremors (normal side effect)
Coarse tremors (lithium toxicity)
Unlike benzodiazepines, this anxiolytic takes weeks to work and has no abuse risk
Buspirone (BuSpar)
Second-generation antipsychotics are more associated with this syndrome
Metabolic syndrome
This anticonvulsant is highly teratogenic and associated with neural tube defects
Valproic acid (Depakote)
Name 3 things a patient on an MAOI should avoid
Cold medicine, aged cheeses, cured meats, how dogs, fermented products (sauerkraut, soy sauce), tap/craft beers, red wine, and overripe fruit
This anticonvulsant can cause agranulocytosis and requires infection monitoring
Carbamazepine (Tegretol)
Why is BuSpar safer for for long term use than benzodiazepines?
No abuse or dependence risk
This medication treats EPS
Benztropine (Cogentin) OR benadryl
TCAs are dangerous in overdose because they cause this cardiac complication
TDP/cardiac arrythmias
This medication treats serotonin syndrome
cyproheptadine
Name 3 patient education points for a patient taking lithium
-Consistent sodium intake!
-Drink 2-3L of water per day
-Requires routine blood draws
-Avoid NSAIDs, ACE inhibitors, diuretics
-Signs of lithium toxicity
-Teratogenic (notify provider if planning to get pregnant)
These receptors are enhanced by benzodiazepines to produce calming effects
GABA-A
Antipsychotics carry a black box warning for increased death in this population
Elderly patients with dementia-related psychosis
Name 2 patient teaching points for stimulants
-Take in the mornign (not too late in the day)
-Regularly monitor HR and BP
-Insomnia is a common side effect
-In children: monitor weight gain and growth
-Controlled substances (store securely, don't share)