Psychiatry

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Author:
AngelGoosie
ID:
311921
Filename:
Psychiatry
Updated:
2015-11-24 17:21:48
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psychiatry
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Nursing Psych Cards
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  1. What are the commonly used brand names for the following?

    Alprazolam (al PRAY zoe lam)
    Clonazepam (kloe NAZE e pam)
    Diazepam (dye-AZE-uh-pam)
    Lorazepam
    Oxazepam (ox-AZE-uh-pam)

    What is the drug category?
    • Alprazolam (Xanax)
    • Clonazepam (Klonipin)
    • Diazepam (Valium)
    • Lorazepam (Ativan)
    • Oxazepam (Serax)

    Benzodiazpines
  2. Name 5 things benzodiazepines treat / are used for
    • Anxiety & anxiety symptoms
    • Acute alcohol withdrawal
    • Skeletal muscle spasms
    • Convulsions, status epilepticus
    • Sedation during pre-op
  3. What is the general action of benzodiazepines?
    Depress subcortical levels CNS (limbic system & reticular formation)

    Increases effects of GABA (calming effect)
  4. What is buspirone? How is it different from CNS depressants?
    Brand Name: BuSpar

    An anti-anxiety medication that does not depress the CNS (compared to benzos)

    Produces effects by interacting with serotonin, dopamine, & other neurotransmitters

    Physical & psychological tolerance is not an issue (compared to benzos)

    Onset is delayed (takes 10-14 days between onset of therapy & symptom relief
  5. Contraindications for anti-anxiety agents
    • Pregnancy, lactating
    • Narrow angle glaucoma
    • Shock
    • Coma
    • Taking another CNS depressant
  6. Why should caution be taken when giving anti-anxiety medications to anyone with…

    A history of drug abuse or addiction?
    A history of depression or suicide?
    Benzos are habit forming, cause dependence

    CNS depressants exacerbate symptoms of depression

    Depression is a symptom during withdrawal
  7. Side effects of benzos are...
    • Drowsiness, lethargy
    • Confusion, impaired memory
    • Poor coordination
    • Exaggeration of depression symptoms
    • Orthostatic hypotension
    • Dry mouth
  8. Symptoms of benzodiazepine withdrawal are…
    • Increased anxiety
    • Depression
    • Insomnia
    • Abdominal & muscle cramps
    • Vomiting
    • Sweating
    • Seizures

    Remember that abrupt withdrawal can be life threatening!
  9. What are the generic names of the following?

    What category are these medications?

    Abilify
    Clozaril
    Seroquel
    Invega
    Zyprexa
    Risperdal
    Latuda
    Geodan
    • Abilify (aripiprazole)
    • Clozaril (clozapine)
    • Seroquel (quetiapine)
    • Invega (paliperidone)
    • Zyprexa (olanzapine)
    • Risperdal (risperidone)
    • Latuda (lurasidone)
    • Geodan (ziprasidone)

    These are Atyptical Anti-psychotics
  10. What are the generic names of the following?

    What category are these medications?

    Thorazine
    Prolixin
    Mellaril
    Stelazine
    • Thorazine (chlorpromazine)
    • Prolixin (fluphenazine)
    • Mellaril (thioridazine)
    • Stelazine (trifluoperazine)

    A class of typical anti-psychotics called Phenothiazines
  11. What is the generic name for Haldol?
    What category is it in?
    How long does it take this medication to take effect?
    • Generic name is haloperidol
    • Typical Anti-psychotic, in the Butyrophenone family
    • 4 weeks
  12. Which medications treat positive symptoms and which negative of schizophrenia?
    Typical Anti-Psychotics treat Positive

    Atypical Anti-Psychotics treat Both 
  13. Which anti-psychotic has a high risk of agranulocytosis?
    What % of those who take it get it?
    What precautions are put in place?
    • Clozapine (Clozaril)
    • 2%
    • Patient must be put on the national registry
    • Patient must have CBCs weekly for the 1st six months
    • Afterwards, CBCs are done every other week
    • Medication is filled to last until next blood test
  14. Side effects for anti-psychotics are…
    • Orthostatic Hypotension
    • Patient may feel dizzy when changing
    • positions

    • Anti-Cholinergic side effects
    • Dry mouth, constipation
    • Urinary retention
    • Blurred vision

    • Extra pyramidal side effects (EPS)
    • Pseudo Parkinsonian Side Effects
    • Dystonic Side Effects

    • Tardive Dyskinesia
    • Neuroleptic Malignant Syndrome (NMS)
  15. Pseudo Parkinsonian Side Effects are…
    A type of EPS (Extra pyramidal Side Effect)

    • Difficulty speaking, swallowing
    • Loss of balance
    • Mask-like face
    • Shuffling gait
    • Tremors (more common in elderly)
    • Cogwheel rigidity (ratchet-like movement of joints)
    • Drooling
    • Coarse pill-rolling movements of fingers at rest
  16. Dystonic Side Effects are…
    A type of EPS (Extra pyramidal Side Effect)

    • Sustained muscle contractions / spasms
    • Twisting & repetitive movements, abnormal postures
    • Inability to move eyes
    • Weakness of arms & legs (more common in younger patients)
  17. what is Tardive Dyskinesia (TD)?
    An adverse effect of anti-psychotic drugs

    • Uncontrolled rhythmic movements of mouth, face, & extremities
    • Lip smacking or puckering
    • Puffing of cheeks
    • Uncontrolled chewing
    • Rapid movement of the tongue

    If noted, call provider ASAP as irreversible damage may occur

    If EPS (extra pyramidal side effects) is managed, patients will not get TD
  18. What is Neuroleptic Malignant Syndrome?

    List the symptoms & management of it.
    A rare but life threatening adverse effect of anti-psychotic drugs

    • Symptoms
    • Fever
    • Respiratory distress
    • Cardiac problems
    • Patient’s BP is all over the place (hypo or hyper)
    • Tachycardia
    • Diaphoresis
    • Rigidity
    • Convulsions & delirium
    • Elevated CPK levels

    It can happen any time while on medication (patient could be on it for a long time and then just get it)

    Get patient to ICU STAT & manage symptoms until the medication is out of the system as there is no antidote

    After recovery, patient will need to go on a different medication that is chemically different

    CPK is an enzyme found mainly in the heart, brain, and skeletal muscle
  19. What does decanoate mean?
    What anti-psychotics are available in decanoate form?
    How often should the medication be given?
    • Decanoate Form
    • Sustained release given IM

    • Given every 2-4 weeks
    • HALDO Decanoate (haloperidol)
    • HALDO Decanoate 100 (haloperidol)
    • Fluphenazine decanoate (formerly Prolixin)

    • Given every 2-3 weeks
    • Risperidone Injct (Risperdal Consta)
  20. To treat acute symptoms of EPS, such as acute dystonic reactions, administer ______ as a one-time deal.

    Name the drug & route.
    Why is it a one-time deal?

    Then, administer a(n) ______
    (name the drug category & example)
    Diphenhydramine (Benadryl) 25-50 mg IM or IV

    This is a one-time deal because this medication makes the patient sleepy

    Administer an anticholinergic such as Benztropine (Cogentin) 1-2 mg IM or IV

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