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Xanax, Librium, Valium, Ativan, Serax
Buspar, Atarax, Vistaril
Anti anxiety/anxiolytics
Prozac, Paxix, Zoloft, Celexa, Luvox
Elavil, Anafranil, norpramin, sinequan, trofranil, pamelor, vivactil
TCA's - tricyclics
Marplan, Nardil, Parnate
Wellbutrin, Desyrel, Effexor, Serzone, Ludiomil, Remeron
lithium, tegretol, depakene, klonopin, neurontin
clozaril, risperdal,zyprexia, seroquel geodon, abilify
atypical antipsycotics
artane, cogentin, kemardrin, benadryl
antiparkinson agents
alcohol deterrent
ritalin, dexedrine, cylert
thorazine, mellaril, prolixin, haldol
anti psycotics, typical
narcotic antagonist
Cognex, Aricept
Alzheimers tx
sudden, severe, pounding, occipital HA, neck stiffness, N/V sweating, up BP tachy
Hypertensive crisis
sore throat fever malaise, flue like symptoms, skin rashes,
extrapyramidal sx,
tremors shuffling gait, drooling, oculogyric crisis, tardive dyskinesia
involuntary muscular movements of the face, armss, legs back
restlessness, an urgent need for movement, EPS with antipsychotics
eyes roll back into head and look upward
Occulogyric crisis
What do you give for occulogyric crisis?
What is tardive dyskinesia?
involuntary repetitious movements or spasms of the uscles of the face, limbs and trunks
what does tardive dyskinesia usually affect?
mouth and tongue
What causes TD?
antipsycotic drugs
Tx of TD?
cholinergic drugs to reduce spasms
neuroleptic malignant syndrome
What is NMS?
complication of neuroleptic meds, rare, potentially fatal
S/S of NMS?
severe parkinsonian sx, tachy, hyperpyrexia,
tx of NMS
parlodel or dantrolene
anticholinergic effects
anti SLUD, hypotension, dry mouth, constipation, blured vision,
What are parkinsonian sx?
tremors, shuffling gait, drooling, rigidity
tx for drug induced parkonsonian sx
anticholinergics like cogenix or benadryl
teaching for orthostatic hypotension
rise slowly from lying position, dangle feet then stand slowly,
teaching for photosensitiy
limit exposure to sun, always use sunscreen and sunglasses
CNS depressents teaching
7-10 days to become effective, report restlessness or spastic movements no alcohol
which of the psychotropic drug categories are considered addictivew
role of acetylcholine
sleep arousal, pain perception, modulation, coordination of movement, memory
regulation of mood, cognition, perception, locomotion, cardiovascular fx, sleep and arousal
regulation of movements and coordingation, emotions, voluntary decision making, inhibits release of prolactin
sleep and arousal, libido, appetite, mood, aggression
mediates allergic and inflammatory reactions may play a role in depressive illness
prevents postsynaptic excitation - feel good stuff
higher doses of a drug are needed over time to elicit the same response
prolonged painful penile erection, may occur as an adverse effect of some antidepressane meds, trazodone
Retrograde ejactulation
ejaculation of the seminal fluid backwards into the bladder, may occur as a side effect of antipsychotic med
cessation of the menses, may be a side effect of some antipsychotic meds
muscular weakness, loss of partial loss of muscle movement, EPS associated with antipsycotic meds
Lap time
time between ingestion of med and onset of med
blood dyscrasias
abnormal condition of the blood
chemical that is tored in the axon terminal of the presynaptic neuron. electrical impulse through the neuron stimulates the release of the neurotransmitter into the
reabsorption of neurotransmitter
seizure threshold
amount of stimulus needed to produce a convulsive seizure
nerve cell
parts of neuron
cell body axon dendtrites
junction between 2 neurons
synaptic cleft
small space between axon terminal of 1 neuron and the cell body
what conditions are antipsychotics given?
tx of acute and chronic psychosis, intractable hiccoughs, controlling tics and vocal utterances
other names for antipsychotics
psychotropics, neuroleptics, major tranquilizers
are typical antipsychotics more helpful withthe positive or negative characteristics of schizophreniz
What are the side effects of antipsychotics
EPS, N/V urinary retention
what antipsyccholtics are often given to non complicatn cts why
halidol and proloxin deconate are injectable and last a month
describe the action of antipsychotics as they relate to amines
may decrease of block action of dopamine in the brain
why are cts often non compliatent with antipsychoitcs
side effects
What is clozoril
antipsychotic agent
when is clozoril given
tx of schizophrenia pts who are unresponsive to or intolerant of standard therapy with other antipsychotisc
Half life of clozoril
8-12 hours
does clozoril cross blood brain barriesr or placenta
yes both
when is clozoril contraindicated?
hypersensitivity, bone marrow depression, lactation, severe CNs depression/coma
When should you use clozoril cautiously
prostatic enlarge, glaucoma, cardio/hepatic/renal disease, diabetes, serisure, not under 16
Nsg assess on clozoril
monitor pts mental status monitor BP pulse before and during, monitor for akathsia, and PS tardive dyskinesia
what is haldol
antipsychotic agent used to diminish s/s psychoses tourettes and behavior prob
use haldol cautiously in
geriatrics, cardiac disease, diabetes, pregnacny
SE of haldol
NMS, blurred vision, antislud
Which newer antipsychotic does not produce weight gain
What are antiparkinsonian agents given to mental health pts
because of EPS,
how do antipark agents work
reduch ACH
PRN order for cogentin when do you give
with eps sx
SE of benadryl,
sedation and seizures,
when do you give benadryl
SE of cogentin
disorientation, constipation, give with lots of water do reality checks with ct
Most common drug for mania
why would an antipsychotic be given during lithium lag periods
calms the pt before lithium takes effect
what is the relationship between lithium and salt and fluid
lithium and salt compete for same receptor sites, if increase fluid flush lithium out
lag period for lithium
1-3 weeks
What factors raise lithium levels?
diarrhea, diuretics, dehydration, no salt
what factrors decrease lithium levels
preg, incre na,
SE of lithium
lock of spontaneity memory loss, confusion, lethargy tremors, weight gain diff concen
which SE lithium dis
lack of spontaneity, mem loss, diff concent
Which signs indicate toxicity
weight gain and acne get worse, pruritis
NSG intv with lithium
give with food, make sure pt is well hydrated, pt is consistent iwth salt intake, set up exercise regien monitor for tox
acute therapeutic range
0.9 - 1.2 or 1.0 -1.5
maintenc lithium thera range
0-6 - 1.4 and -6 - 1.2
how often should lithium levels be monitored
once a month
why is lithium dangerous
because of the toxic levels, narrow thera range
lithium 1.7 what nsg intervent
check for peripheral collapse do not stop abruptly
whenis lithium therapy contraindicated
cardio vas or renal, brain damage, severe dehyd, na deplet
two mood stabilizers instead of litium
depakote, tegretol
what are theories about how lithium works
replaces na affects the NE and serotonin
What are cts non compliate with lithium therap
se and having to maintain low salt diet
Selective serotonin reuptake inhibitor
How do SSRI's work
increasing NE and serotonin available in the body by blocking reuptake
What does MAOI stand for?
Monoamine oxidase inhibitor
How do MAOIs work
enzyme that activate NE and serotonin release
How long does it take for antidepressants to work
2-4 weeks
what teaching needs to be done with MAOIs
advise pt that laxatives should be used only short term, cant eat certain foods
What is a parnate cheese factor
any aged products such as cheese, yogurts, has a severe reaction
can the MAOIs be given with other depressants
no should wait 7 to 14 days after takin antidepressants before start MAOi therapy
how do ssris differ from tricyclics
SSRIs inhibit the reuptake of serotonin, SSRIS are safer, less SEs
Seizures are a problem associated with which antidep
Weight loss is assocaiate with which antidep
prozac and zoloft
SE of antidepre categories
sedation, ortho hypo, arrhy, photosens, weight gain or loss,
MAOIS have what spec SE
Hypertensive crisis
What does SNRI stand for?
selectered norepi reuptake inhibitor
What are other names for the antianxiety class of drugs
benzodiazepines and barbituates
Major conditions for anti anxiety agents
anxiety, insomnia seizures
Why are benzodiazepines not a good choice for long term symptom management
develop dependence
SE for benzodiazepines
daytime sedation, drowsiness, fatigue, potentiate eTOH on CNS
NSG inter with anti anx
monitor BP p and resp, can lead to dependence, restrict drug,
How is Buspar different from other antianxieties
does not cause sedation, no abuse potential, can be used longterm, does not enhance BNS depression
Most common chemical group used in antianxiety
contraindicatiosn to benzodiazepines
do no take with other CNs depressants do not take during preg or lactation, shock, coma, glaucoma
Which is safer, benzodiazepines or barbituates?
benzodiazepines, less addictive
why should benzodiazepine not be discont abruptly
can cause severe withdrawal sx
when is librium given during alcohol withdrawal
before sx of withdrawl occur
what is GABA?
neurotransmitter found throughout CNS it is inhibitory
What effects do the antianxiety drugs have on GABA?
benzodiazepines enhance inhibitory effects of GABA
why is antabuse considered aversion therapy?
because it is take by alcoholics to help them refrain from drinking
What are dangers of antabuse?
life threatening potential reactions marked resp depress,
Rx Class of antabuse?
alchohol abuse deterrent
drugs commonly given during ECT tx
thiopental succinylcholine
what is thiopental
injectable ultra short acting anesthetic that prevents conscious awareness of ECT
What is succinylcholine
short acting NM block, prevents shock induced convulsive movements,
NSG consider for thiopental
excessive sedation, possible dependence
what drug given in narcotic overdose?
ritalin given to children with what disorder
What type of drug is ritalin
Will kids on ritalin lose weight?
what labs should you monitor on ritalin
CBC and platelets

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