Antipsychotics
What type of symptoms do first-generation antipsychotic drugs target? What types of symptoms do second-generation antipsychotic drugs target?
Positive
Positive & Negative
What medication class is the first line tx for depression? Give examples
SSRIs
Fluoxetine, Sertraline, Paroxetine, Citalopram
What is the gold standard medication for bipolar disorders?
Lithium
What are anticonvulsants used for?
Bipolar
Manic Episodes
How is dystonia treated?
How is Akathisia treated?
How is tardive dyskinesia treated?
1. Diphenhydramine
2. Beta Blockers
3. Deutetrabenazine
What are common side effects for first and second generation antipsychotics?
Weight gain, sedation, orthostatic hypotension, QT prolongation, anticholinergic effects
What is serotonin syndrome?
Life threatening condition, happens when taking 2 SSRIs or an SSRI with a MAOI or St Johns Wort
If a patient is on _______ this can increase lithium concentrations
diuretics
Which anticonvulsant has a black box warning for liver damage, birth defects, and pancreatitis?
Valproate
Neuroleptic Malignant Syndrome occurs with what class of drugs? What are some symptoms and what is the tx?
Antipsychotics
Severe muscle rigidity, elevated temperature, changes in levels of consciousness
Stop administration of medication, monitor vital signs, and give a dopamine agonist and muscle relaxants
Clozapine is associated with a risk for _________ and a patient must have a _______ count of ________ and a _______ count of ________ to be on this medication
agranulocytosis
WBC >3500
ANC >2000
What foods can not be consumed in large amounts while taking a MAOI?
Foods that contain tyramine
Ex. Aged cheese, wine, beer, smoked meats, raisins, coffee, tea, sour cream, yogurt
What is the therapeutic level for lithium?
0.6-1.5
What anticonvulsant can cause steven-johnsons syndrome?
Lamotrigine
What happens if a patient eats a large amount of tyramine rich foods?
Hypertensive Crisis
What is an example of a first-generation antipsychotic medication? What are some examples of a second-generation antipsychotic medications?
First-generation antipsychotic - Haldol
Second-generation antipsychotic - Olanzapine, Risperidone, Quetiapine, Ziprasidone, Aripiprazole, Clozapine
Common side effects of antidepressant medications include?
Sedation
Weight Gain
Fatigue
Headache
Dizziness
What about sodium should we tell our patients when taking lithium?
Do not significantly change sodium intake
When giving valproate what should we monitor?
CBC
Coagulation Tests
Kidney and liver functions
Thyroid
What are some extrapyramidal side effects that can occur in patients taking antipsychotics? Acute & Chronic.
Chronic: Tardive Dyskinesia
If a patient is experiencing neuroleptic malignant syndrome what should be done?
If a patient is experiencing anticholinergic crisis what should be done?
- Stop administration of medication and give dopamine antagonist
- Stop the medication and give physostigmine
When giving TCAs what should we monitor for? What patient population should not consume these?
Cardiotoxicity
Do not give to patients with seizure disorders or suicide patients
Use caution in patients with CAD, DM, liver & kidney disease/issues
Lithium toxicity symptoms include?
Persistent N/V
Mental Confusion
Ataxia
Diarrhea
What are some adverse effects/safety concerns for anticonvulsants
CNS Depression
Nystagmus (eye beats)
Neuromuscular disturbances
We should not administer MAOIs with what drugs?
Amphetamines
Dopamine
Epinephrine
Vasoconstrictors