Ch 23 ATI

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Author:
hvledger1
ID:
296022
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Ch 23 ATI
Updated:
2015-02-16 18:21:57
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psych
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psych
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psych
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  1. medications for mental health problems in kids
    • tricyclic antidepressants 
    • antipsychotics 
    • nonbarbituate anxiolytics 
    • CNS stimulants
    • NE selective reuptake inhibitors
  2. Methalyphenidate
    • short acting: ritalin, methylin
    • intermediate: ritalin SR, methylin ER
    • long: ritalin LA, concerta, daytrana (transdermal)
  3. Dexmethylphenidate
    • short: focalin
    • long: focalin XR
  4. dextroamphetamine
    • short: dexadrine
    • long: dexadrine spansules
  5. Amphetamine mixture
    • short: adderall
    • long: aderall XR
  6. Lisdexamfetamine dimesylate
    long: vyvanse
  7. CNS stimulants
    • raise levels of NE, serotonin, and dopamine
    • use: ADHD, conduct disorder
  8. side effects of CNS stimulants
    • CNS stimulation-insomnia, restlessness
    • weight loss
    • dysrhythmias 
    • high BP
    • psychotic symptoms
    • withdrawal reaction
    • hypersensitivity skin reaction
  9. CNS stimulants contraindicated
    • substance abuse hx
    • cardio disorders
    • severy anxiety
    • psychosis
  10. CNS stimulants interactions
    MAOIs: concurrent use=hypertensive crisis
  11. CNS stimulants interactions
    • caffeine: may increase CNS effects 
    • avoid foods and beverages high in caffeine
  12. CNS stimulants interactions
    • phenytonin
    • warfarin
    • phenobarbital
    • inhibits metabolism=increased serum levels
    • monitor for CNS depression, signs of bleeding
  13. CNS stimulants interactions
    • OTC cold and decongestant medication
    • may lead to increased CNS stimulation
    • avoid OTC medications with CNS stimulants
  14. sustained-release tablets
    • swallow whole
    • do not crush or chew
  15. Daytrana (transdermal)
    • place patch on hip daily in the morning 
    • leave in place no longer than 9 hours 
    • alternate hips daily
  16. CNS stimulants for kids
    require handwritten prescriptions for refills
  17. CNS stimulants have a high risk for
    substance abuse
  18. NE selective reuptake inhibitor
    Atomoxetine (Strattera)
  19. Atomoxetine (Strattera)
    • block reuptake of NE
    • not a stimulant 
    • for ADHD
  20. side effects for Strattera
    • appetite depression
    • weight loss
    • growth suppression
    • GI affects
    • suicidal ideation
    • hepatotoxicity
  21. Strattera patient teaching
    • right before meals
    • with food
    • report changes in mood, increase sleep, agitation
    • liver damage (flu-like, yellow skin, abd pain)
  22. NE reuptake inhibitor
    caution in cardiovascular disorders
  23. Strattera interactions
    • MAOIs: hypertensive crisis
    • Paroxetine, floxentine, quindine gluconate: increases serum levels
  24. NE reuptake Strattera
    • one daily dose in morning
    • or two divided doses morning/afternoon
    • may take 1-3 weeks
  25. NE reuptake inhibitor
    ADHD
  26. TCAs
    • Desipramine 
    • Imipramine
    • clomirpramine
  27. TCAs
    • block reuptake of monoamine neurotransmitter NE and serotonin
    • intensifying effects
  28. TCAs in children for..
    • depression
    • autism 
    • ADHD
    • panic, school phobia, separation anxiety 
    • OCD
  29. TCAs side effects
    • orthostatic hypotension
    • anticholinergic effects
    • weight gain
    • sedation
    • toxicity-dysrhythmias, mental confusion, agitation, followed by seizure or coma
    • decreased seizure threshold
    • excessive sweating
  30. TCAs use cautiously in
    • seizures
    • diabetes
    • liver, kidney, resp. disorders
    • hyperthyroidism
  31. TCAs interactions
    • avoid 
    • MAOIs
    • antihistamines/ aniticholenergic 
    • E and dopamine direct acting sympathomimetics
    • alcohol, benzo, opioids, antihistamines
  32. TCAs
    • 1-3 weeks for effect
    • full effects: 2-3 months
  33. TCAs sudden discontinuation
    relapse
  34. TCAs: acutely ill
    • 1 week supply of medcation
    • then only 1 month supply of med at time
  35. effectiveness of TCAs in autism
    • decrease anger
    • decrease compulsive behavior
  36. Alpha 2 adrenergic agonist
    • Guanfacine 
    • Clonidine
  37. Alpha 2 adrenergic agonist
    ADHD
  38. alpha 2 side effects
    • sedation
    • drowsiness
    • fatigue
    • hypotension
    • bradycardia
    • weight gain
  39. Extended release clonidine
    contraindicated in children less than 6
  40. alpha 2 use cautiously in
    cardiovascular disorders
  41. alpha 2 interactions
    • avoid alcohol
    • antihypertensives
    • foods with high-fat will increase guanfacine absorption
  42. alpha 2 avoid discontinuation abruptly because
    can result in rebound hypertension
  43. atypical antipsychotics
    • risperidone
    • olanzapine
  44. atypical antipsychoitcs
    • block serotonin
    • dopamine
    • NE
    • histamine
    • acetylcholine
  45. atypical antipsychotics use
    • PDD, autism
    • conduct disorder
    • PTSD
    • relief of psycho symptoms
  46. atypical antipsychotics side effects
    • new onset diabetes
    • loss of glucose control in diabetics 
    • weight gain
    • hypercholesterolemia
    • orthostatic hypotension 
    • anticholergic effects
    • agitation 
    • dizzy
    • sedation
    • sleep distubed
    • mild extrapyramid movements
  47. atypical antipsychotics interactions
    • avoid alcohol
    • opioids
    • antihistamines
    • Levodopa
    • TCAs
    • barbiurates, phenytonin: decrease effect
    • Fluconazole: increase effect
  48. atypical antipsychotics
    low dose then gradually increased

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