CLIENT TEACHING GENERAL
which is not a part of client teaching for antidepressants? takes 7-21 days to take effect, avoid alcohol , notify if you have thoughts of suicide , or dependency can occur during or after treatment, notify the provider
dependency can occur during or after treatment, notify the provider = this is a part of teaching for antianxiety benzodiazepines
client education for nonbarbiturate anxiolytics
take medication with meals to avoid an upset stomach
can take 1 week to first notice therapeutic effects and 4 weeks for full effects
tolerance, dependence, or withdrawal is not an issue with this type of medication
what is the expected action of SSRI
inhibits serotonin reuptake allowing more serotonin to stay at the junction of neurons
what is a major side effect of MAOIS
hypertensive crisis
contraindications for antipsychotics first gen
clients who are in a coma, Parkinsons disease, liver damage, or severe hypotension
older adult clients who have dementia
use caution in clients who have prostate enlargement, heart disorders, liver or kidney disease, glaucoma, paralytic ileus, or seizures
antipsychotic education
medication could have sedative effects
case management to provide follow-up for the client and the family
group, family, and individual psychoeducation to improve problem-solving and interpersonal skills
social skills training to focus on social and ADL skills
what client education is important involving neuroleptic malignant syndrome
condition from antipsychotics : rare but life-threatening, notify the provider if you experience fever, altered mental status, muscle rigidity, or autonomic dysfunction
what is the expected action for benzodiazepines
enhance the inhibitory effects of gamma-aminobutyric acid in the central nervous system
what is tardive dyskinesia (TD)
side effect from antipsychotics, causes repetitive involuntary movements such as grimacing and eye blinking
contraindications for SSRIs
avoid alcohol, show caution in patients who have liver/renal dysfunction, seizures, and hx of GI bleeds, and show caution for patients with bipolar due to risk of mania
anti-anxiety education
monitor for manifestations of anxiety
lifestyle changes: healthy diet, exercise, avoid excessive caffeine intake, avoid substance abuse
do not adjust medication dosage without taking to the provider
evaluate coping mechanisms
client education for MAOIs
avoid foods with tyramine (beer, wine, aged cheese, organic meats, avocado) due to the potential for hypertensive crisis
avoid otc medications unless discussed with the provider
dietary restrictions of tyramine must be continued 2 weeks after meds are stopped
what is the expected action of antipsychotic first generation
block dopamine, acetylcholine, histamine, and norepinephrine receptors in the brain and periphery
inhibition of psychotic findings believed to be a result of dopamine blockade in the brain
what is serotonin syndrome
can begin 2 to 72 hours after starting treatment and can be lethal
confusion, agitation, disorientation, seizures, tachycardia, diaphoresis, N/V, coma leading to apnea
contraindications for TCA's
for pregnancy = low birth weight, preterm, respiratory issues
can cause problems if the patient has heart issues, diabetes, liver disease, or hx of seizures
mood stabilizer education
case management to provide follow up for the client and family
group, family, and individual psychotherapy for improving problem solving and interpersonal skills
client education for lithium (mood stabilizer)
- regular blood draws to check levels, levels are drawn 12 hours after the dose
- maintain current diet, drink lots of water
-some adverse effects resolve within a few weeks
expected action of lithium
produces neurochemical changes in the brain, including serotonin receptor blockade
decreases neuronal atrophy or increases neuronal growth
side effects of nonbarbiturate anxiolytics
dizziness, nausea, headache, lightheadedness, agitation
contraindications for benzodiazepines
should not be taken by breastfeeding women, can be transmitted through milk
patients who have sleep apnea, respiratory depression, or glaucoma should avoid these medications
use caution for patients with liver disease or substance abuse disorder
used short-term due to the risk of dependence
assess fall risk in older patients
antidepressant education
do not stop the medication suddenly
therapeutic effects can take weeks to achieve (7 to 21 days)
avoid driving and operating heavy equipment due to potential for sedation
avoid alcohol
notify provider if you have thoughts of suicide
client education for SSRIs
sexual dysfunction can occur, notify the provider if the effects are intolerable
follow a healthy diet and exercise
take the medication with food and can take it in the morning to avoid sleep disturbance
take daily to establish therapeutic plasma levels
observe for symptoms of serotonin syndrome
avoid concurrent use of St.John's wort
expected action TCAs
block the presynaptic transporter receptors for NE and serotonin, the blocking prevents NE from coming into contact with its degrading MAO which increases the level of NE at the synapse
what are extrapyramidal side effects
FROM ANTIPSYCHOTIC DRUGS
- dystonia (muscle stiffness)
- akathisia (restlessness)
-tardive dyskinesia
-drug-induced parkinsonism
-neuroleptic malignant syndrome (NMS)
-orthostatic hypotension
contraindications for lithium
pregnancy risk, no breastfeeding
not good for patients who have severe renal or cardiac disease, hypovolemia, or schizophrenia
use caution in older adults and patients who have thyroid disease, seizures, and diabetes