This class of medication increases serotonin levels and is first-line for anxiety and depression.
What are SSRI's?
Propranolol falls into this category and is off label used to treat anxiety.
What is a betablocker?
Depakote is the brand name for this medication.
Valproic Acid
This antihistamine is commonly used as a PRN for anxiety.
What is hydroxyzine (Atarax, Vistaril)?
This key risk side effect must be monitored when giving PRN benzodiazepines, especially in combination with opioids or other sedatives.
What is respiratory depression?
Cymbalta and Effexor fall in this class of medication.
What are SNRI's?
Haldol and Thorazine fall into this category of medication
What are first generation antipsychotics (also known as "neuoleptics" or "typical antipsychotics")?
What is the therapeutic lab level of Lithium?
0.6-1.2 mEq/L
This medication is often given PRN alongside antipsychotics to treat extrapyramidal side effects like muscle stiffness or dystonia.
What is Benztropine (Cogentin)?
This life-threatening reaction can occur when combining serotonergic drugs and is characterized by mental status changes (confusion / agitation), neuromuscular spasms, and automatic reactions (fever, tachycardia, diaphoresis).
What is serotonin syndrome?
Usually occurs within hours to 24 hours of dose increase or drug interactions
This class of medication is often used short term, related to concern for dependency, and results in acute relief of anxiety.
What are benzodiazepines?
Abilify, Zyprexa, Seroquel, Geodon, Clozaril, and Risperdal all fall under this class of medication.
What are second generation or atypical antipsychotics?
This mood stabilizer requires slow titration due to risk of a serious rash.
What is lamotrigine (Lamictal)?
This medication was originally intended to treat depression however is often used off label to assist with insomnia.
What is Trazodone (Desyrel)?
This severe drug reaction typically occurs within days to 3 weeks of starting a new medication and presents with flu-like symptoms (fatigue, fever, body aches) and a painful rash
What is Stevens-Johnson Syndrome?
Amitriptyline, imipramine, and nortriptyline are from this class of medication.
What are Tricyclic Antidepressants?
Lithium falls into this category of medications.
What is a mood stabilizer?
When taking this mood-stabilizing medication patients are advised to drink about 2–3 liters of water daily because it affects the body’s sodium and fluid balance, and dehydration can lead to toxic levels.
What is Lithium?
This medication required 1.2mL's of sterile water to reconstitute in IM form.
What is Geodon?
These foods—aged cheeses (like cheddar and blue), fermented or smoked meats and fish, soy products (such as soy sauce and miso), red wine, tap beer, and kimchi—must be avoided when taking MAOIs because they can trigger a dangerous, potentially fatal spike in blood pressure.
What is high - tyramine foods?
Bupropion (Wellbutrin) is from this class of medication
What is a Norepinephrine-dopamine reuptake inhibitors (NDRIs)?
This class of medication is also used to treat Parkinson's disease.
What are MAOI's?
This toxicity from a mood stabilizer presents with tremor, ataxia, confusion, GI distress, and can progress to seizures, often worsened by dehydration or renal impairment.
Lithium Toxicity
Related to the well documented risk for respiratory depression and excessive sedation, it is advised to give these 2 IM medications 1-4 hour apart from each other.
Ativan and Zyprexa
This delayed hypersensitivity reaction occurs 2–8 weeks after medication initiation and is marked by fever, diffuse rash, eosinophilia, lymphadenopathy, and internal organ involvement.
What is DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms) Syndrome?
Anticonvulsants / mood stabilizers (lamotrigine, carbamazepine), and antipsychotics (clozapine, olanzapine, risperdal) can trigger this