Mark Klimek Audio Lectures: Lecture 9 Psych Medications.

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Lecture 9 Psych Medications - All psych medications cause 2 things regardless of classification: - Lower’s blood pressure - Weight changes (usually increase weight) Phenothiazine’s -... Phenothiazine’s are an old class of psych medication that have a couple different names: - First generation antipsychotic medications - Typical antipsychotics - All Phenothiazine medications end in “zine”. - Prochlorperazine - Cholorpromazine - Thioridazine - Fluphenazine - Action: - All Phenothiazine medication do not cure the psychotic disorder, they just reduce the symptoms. - In large doses they are antipsychotics - “We use zine’s for the zainy (insane)” - In small doses they are antiemetic’s - Phenothiazine’s are major tranquilizers. - “Aminoglycosides are to antibiotics” as “Phenothiazine’s are to tranquilizers” - Meaning: when no other tranquilizers are working the Phenothiazine’s are used to get the job done. - Side effects of Phenothiazine’s: - Phenothiazine’s have a long list of major side effects: - Anticholinergic effects (primarily dry mouth) - Blurred vision - Constipation - Drowsiness - EPS (Extrapyramidal syndrome): drug induced Parkinson’s - Photosensitivity - Agranulocytosis (low WBC count): immunosuppressed - Nursing Care: - The nursing care is focused on treating the side effects of Phenothiazine’s - Since patients on these medications have blurred vision, drowsiness, and EPS, the number one concern is risk for injury. - Cogentin and Artane are given to reduce EPS effects - Decanoate: - Typically abbreviated with the letter “D” - Thioridazine “D” - If the “D” comes after the name of the medication it means it is a long-acting medication. Meaning it is given once IM and its actions last for weeks or months at a time. - This is for noncompliant patients. Tricyclic Antidepressants NSSRI - Tricyclic Antidepressants are and old class of antidepressant medications that fall under the category of NSSRI (Non-Selective Serotonin Reuptake Inhibitors) medications. - These medications are mood elevators that are used to treat depression. - Elavil (amitriptyline) - Tofranil (imipramine) - Avitil - Deceril - Side effects of Tricyclic Antidepressants: - Anticholinergic (primarily dry mouth) - Blurred vision - Constipation - Drowsiness - Euphoria - The patient must take these medications for at least 2 - 4 weeks before the effects kick in. Benzodiazepines - Benzodiazepines are antianxiety medications - Benzodiazepines are considered to be minor tranquilizers - “Zine’s” major tranquilizers - “Zep’s” minor Tranquilizers - Benzodiazepines always have “zep” in their names: - Clonazepam - Chlordiazepoxide (Librium) - Diazepam (valium) - Lorazepam (Ativan) - These medications are more the just minor tranquilizers: - Used in pre-op to induce anesthesia - Used as a muscle relaxant - Used in alcohol withdrawal to prevent seizures - Help people when they are fighting the ventilator - These medications work quickly to produce the desired effect but should not be taken for more than two weeks. They can be taken PRN, but have a risk of addiction. - For patients that come to the emergency department with anxious-depression they will be given a benzodiazepine and an anti depressant. The benzodiazepine is given for 2 weeks with the antidepressant because it works quickly to reduce symptoms. After 2 weeks the antidepressant effects kick in and there is no longer a need for the benzodiazepine. - Side effects: - Anticholinergic (primarily dry mouth) - Blurred vision - Constipation - Drowsiness - Nursing care: - Nursing care is focused on treating the side effects. - Blurred vision, and drowsiness leaves the patient at risk for injury. Monoamine Oxidase Inhibitors (MAOI) - MAOI’s are antidepressants. - Not given as a first line antidepressant, rarely seen. - These medications are still around (usually in elderly patients with long history of depression) because once you are on an MAOI antidepressant you can’t get off them without having withdrawal. - MAOI antidepressant’s drugs start with “Mar”, “Nar”, and “Par”. - Marplan (Isocarboxazid) - Nardil (Phenelzine) - Parnate (Tranylcypromine) - Side effects: - Anticholinergic (primarily dry mouth) - Constipation - Drowsiness - Patient teaching: - The patient must avoid all foods containing Tyramine to prevent severe hypertensive crisis. - Bananas, avocados, and dried fruits - No organ meats (heart, liver, kidney, tongue, hotdogs) - No preserved meats (smoked, dried, cured, or pickled) - No cheeses or yogurt (except for cottage and mozzarella) - No alcohol - No chocolate or caffeine - No over the counter medications. Lithium - Lithium is an electrolyte. - Used for treating mania in bipolar disorder. ::::::::::::::::::::::::::::::::::::::::CONTENT CONTINUED IN THE ATTACHMENT::::::::::::::::::::::::::::::::::::::::::::::::::: [Show More]

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