Psychatric drugs (all)

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Psychatric drugs (all)
2011-11-09 07:10:56
psychatric drugs all

psychatric drugs (all)
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  1. SSRI's (selective serotonin reuptake inhibitors)
    • fluoxitine (Prozac)
    • Ciralopram (Celexa)
    • Sertraline (Zoloft)
    • Paroxetine (Paxil)
    • Escitalopram (Lexapro)

    • blocks reuptake of serotonin = more available in the gap
    • takes 1-3 weeks to be effective
    • side effects: sexual disfunction, weight gain, light headed, sleepness

    Counterindication: MAOI's (14 days between SSRI's and MAOI's)

    Teach: take same time every day, do not stop when feeling better, taper when going off, exercise, eat healthy, if sexual side effects notify Dr.
  2. TCA's (tricyclic antidepressents)
    • Oldest category
    • amitriptyling (Elavil)
    • imipramine (Trofranil)
    • Doxepin (Sinequan)
    • Nortriptline (Aventyl)

    • blocks reuptake of serotonin and norepinephrin
    • side effects: orthostatoc hypotension, anticholinergic (dry mouth, blurred vision, photophobis, acute urinary retention, constipation, tachycardia) sedation

    no antidote for overdose

    Teach: patients to chew gum or use hard candy for dry mouth, wear sunglasses, increase fiber in diet
  3. MAOI's
    • medication interactions:
    • over the counter cold meds, allergy, congestion
    • TCA's (tricyclic antidepressants)
    • narcotics
    • antihypertensive agents (reserpine)
    • amine precursors (levodopa)
    • sedatives (alcohol bensozdiapines)
    • stimulants (cocaine)

    • adverse reactions to MAOI's
    • hypotention
    • sedation, weakness, fatique
    • insomnia
    • changes in cardiac rhythm
    • muscle cramps
    • impotence
    • urinary hesitancy
    • weight gain

    • Teaching for MAOI's
    • food and medication restrictions
    • severe headache---go to ER
    • monitor BP the first 6 weeks
    • after MAOI's are stopped restrictions continue for 14 days
    • carrie a wallet card or medic alert bracelet

    • foods that contain tyramine
    • vegetables avocados, fermented soybean, sauerkraut
    • fruits figs, bananas
    • meats esp fermented, smoked, aged, smoked
    • fish dried, pickeled, smoked, fermented
    • cheeses
    • beers and wines
    • chocolate
    • caffeinated beverages
    • ginseng
    • over ripe beans fava beans
  4. Toxic effects of MAOI's
    • hypertensive crisis
    • increased BP
    • severe headache
    • stiff, sore neck
    • tachycardia
    • severe nose bleeds, dilated pupils
    • nausea and vomiting
    • chest pain, stroke, coma, death

    • treatment of hypertensive crisis
    • medication to lower blood pressure Nifedipine (procardia) Calcium channel blocker
    • IV Phentolamine a rapid acting alpha-adrenergic blocker vasodilation

    either drug monitor VS
  5. Serotonin Syndrome
    • signs and symptoms
    • hyperactivity or restlessness
    • tachycardia--CV shock
    • fever--hyperpyrexia
    • elevated blood pressure
    • altered mental stratus delirium
    • irrationality
    • seizures--status eplepticus
    • myclonus (muscle spasms)--tonic rigidity
    • abd. pain, diarrhea, bloating
    • apnea--death