Psych pharm test

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lleiber
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Psych pharm test
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2010-09-28 20:43:50
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Psychiatric drug questions
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  1. All extrapyramidal side effects are reversible.

    True or False
    False
  2. Specific antipsychotics are often ordered because of their specific side effects.

    True or False
    True
  3. A problem with antipsychotics is that tolerance develops.

    True or False
    False
  4. Tardive dyskinesia, weight gain, and impotence are among the most troubling side effects in outpatient management with the traditional antispychotics.

    True or False
    True
  5. Fatal side effects from the antispychotics, such as neuroleptic malignant syndrome are rare.

    True or False
    True
  6. Only positive symptoms are targeted by Typical and Atypical antispychotics.

    True or False
    True - Typical - delusion, hallucination, formal thought disorder, bizarre behavior

    False - Atypical - effective flattening, apathy, asociality, attention impairment
  7. Medication appropriate for a person in acute and extreme psychomotor agitation is:
    • Typical - Haldol, Thorazine
    • Atypical - Geodon, Ativan
  8. The patient has been taking lithium for months. Her most recent blood level was 2.2 mEq/L. What reactions might the nurse expect to see?
    This is above maintenance level.

    From 2 - 3.5 - increased tremors, muscular irritability, psychomotor retardation, mental confusion, giddiness, excessive output of dilute urine

    From 3.5 - above - potentially life threatening, arrhythmia, MI, cardiovascular collapse, impaired consciousness, nystagmus, seizures, oliguria, aneuria
  9. The patient has been taking Prozac, a SSRI, for 3 weeks. In your teaching for the patient would include telling him about common side effects involved with this drug. What are the common side effects?
    Headache, insomnnia, sexual dysfunction, GI upset, weight changes, anxiety
  10. When you are teaching the patient about his SSRI, Zoloft, he askes you, "What makes this such a good drug?" What are some of the positive attributes of the SSRIs? What is one of the most serious, although rare, side effects of the SSRI?
    Positive: lower incidence of anticholinergic SE, less cardio-toxicity, faster onset of action than TCAs, effective antidepression with anxious features, clients with psychomotor agitation, less dangerous when OD.

    • Rare: Serotonin Syndrome - overreaction of Central Serotonin receptor
    • abdominal pain, diarrhea, sweating, fever, tachycardia, increased BP, delirium, myodonis, increased motor activity, hyperpyrexia, irritability, hostility, moood changes, shock, death.
  11. What are the signs and symptoms of Central Serotonin Syndrome?
    overreaction of Central Serotonin receptorabdominal pain, diarrhea, sweating, fever, tachycardia, increased BP, delirium, myodonis, increased motor activity, hyperpyrexia, irritability, hostility, moood changes, shock, death.
  12. Benzodiazepines
    Xanax, Ativan, Librium, Serax, Klonopin, Tranxene, Valium
  13. Selective Serotonin Reuptake Inhibitors
    Prozac, Zoloft, Celexa, Luvox, Paxil, Lexapro
  14. Antianxiety drugs
    Klonopin, Xanax, Librium, Tranxene, Valium, Ativan, Serax, Atarax
  15. Anti-parkinsonian
    Cogentin, Artane, Akineton, Parsidol, Kemadrin, Benadryl, Symmetrel, Parlode
  16. Tricyclics
    Elavil, Tofranil, Anafranil, Norpramin, Sinequan, Pamelor, Aventyl
  17. Serotonin Syndrome
    SSRIs with MAOIs
  18. Atypical antipsychotics
    Clozaril, Risperdal, Zyprexa, Seroquel, Geodon, Abilify, Invega, Consta-Risperdal LA.
  19. Hypertensive Crisis
    MAOIs with decongestant/cold remedies
  20. Typical neuroleptic antipsychotics
    Prolixin, Haldol, Stelazine, Navane, Thorazine, Mellaril, Loxitane
  21. Mood stabilizers
    Lithium, Depakote, Tegretol, Klonopin, Depakene, Lamictal, Neurontin, Trileptal, Topamax, Symax, Calan
  22. Serotonin Syndrome is the enhancement of action of combinations of antidepressant drugs for better efficacy in patients with depression.

    True or False
    False
  23. Neuroleptic malignant syndrome, a common side effect of antipsychotic drugs, responds well to increased doses of any psychotropic drugs used to treat mental illness.

    True or False
    False - DC all drugs
  24. Hypertensive crisis, a result of MAOIs and tyramine-rich foods, is treated by holding the next dose of drug, elevating the patient's head and attaining medication for lowerin the blood pressure.

    True or False
    True
  25. Lithium toxicity occurs when blood levels of lithium are raised beyond the therapeutic window by fluid and electrolyte loss, decreased renal functioning or overdose.

    True or False
    True
  26. Tricyclic antidepressants should be avoided if possible, or dispensed in amounts for 1 week at a time, in patients who are at risk for suicide.

    True or False
    True - deladly if taken in OD
  27. Tardive dyskinesia
    late onset movement disorder - facial grimaces, abnormal tongue movements, finger movements
  28. Signs and symptoms of Lithium toxicity
    Severe tremor, N/V, ataxia, severe diarrhea, confusion, tinnitus
  29. Akathesia
    An EPS that causes motor restlessness
  30. Hypertensive crisis
    Occipital headache, stiff neck, flushing, palpitations
  31. Neuroleptic Malignant Syndrome
    High fever, lead pipe rigidity, diaphoresis, elevated CPK
  32. SSRI
    Zoloft, Paxil, Luvox
  33. Mood stabilizers
    Tegretol, Neurontin, Depakote
  34. Anticholinergic side effects
    Dry mouth, urinary retention, constipation, blurred vision
  35. Extrapyramidal side effects
    Common SE of traditional antipsychotic medications - outside the voluntary tract
  36. These drugs require restricted use of aged cheese, cured meats, red wine, OTC cold and sinus medications.
    Parnate, Nardil, Marplan, EMSAM (MAOIs)
  37. Treatment of alcohol withdrawal
    Libriu, Serax
  38. ADHD treatment with CNS stimulants
    Ritalin, Cylert, Adderall, Concerta, Vyvanse
  39. Antiparkinsonian medications
    Cogentin, Akineton, Parsidol, Kemadrin, Artane, Benadryl, Symmetrel, Parlode
  40. Paradoxical excitement, dependency,, tolerance
    Valiu, Ativan, Klonopin, Xanax
  41. Atypical antipsychotic medications
    Clozaril, Risperdal, Zyprexa, Seroquel
  42. Clozaril
    Antipsychotic, Atypical Antipsychotic
  43. Prozac
    Antidepressant, SSRI
  44. Elavil
    Antidepressant, Tricyclic
  45. Cogentin
    Antiparkinsonian, Anticholinergic
  46. Ritalin
    CNS stimulant
  47. Tegretol
    Anticonvulsant, Mood stabilizer, Antimanic
  48. Klonopin
    benzodiazepine, anticonvulsant, antianxiety
  49. Seroquel
    atypical antipsychotic
  50. Wellbutrin
    antidepressant
  51. BuSpar
    antianxiety
  52. Celexa
    antidepressant, SSRI
  53. Depakote
    anticonvulsant, mood stabilizer, antimanic
  54. Haldol
    antipsychotic, typical antipsychotic
  55. Prolixin
    typical antipsychotic
  56. Marplan
    MAOI, antidepressant
  57. Zyprexa
    atypical antipsychotic
  58. Serax
    Benzodiazepine, antianxiety
  59. Parnate
    MAOI, antidepressant
  60. Lithium
    antimanic
  61. Artane
    anticholinergic, antiparkinsonian
  62. Librium
    Benzodiazepine, antianxiety
  63. Paxil
    SSRI, antidepressant
  64. Invega
    Atypical antispychotic
  65. Abilify
    Atypical antispychotic
  66. Aricept
    antidemntia
  67. Tofranil
    Tricyclic antidepressant
  68. Geodon
    Atypical antipsychotic
  69. Seroquel
    Atypical antipsychotic
  70. Ativan
    Benzodiazepine, antianxiety
  71. Zoloft
    SSRI antidepressant
  72. EMSAM
    MAOI, antidepressant
  73. Kemadrin
    antiparkinsonian, antipsychotic
  74. Risperdal
    atypical antipsychotic
  75. Namenda
    antidemntia
  76. Desyrel
    antidepressant
  77. What is the mechanism of action of antidepressants?
    block reuptake of neurotransmitters - serotonin, norepinephrine, dopamine - which increases levels
  78. For what must the nurse be on the alert with the client who is receiving antidepressant medication?
    • Serotonin syndrome, anticholinergic crisis
    • sudden lift in mood - suicide intention
  79. As the nurse, when would you expect the client to begin showing signs of symptomatic relief after the initiaition of antidepressant therapy?
    1-4 weeks
  80. The names of tricyclic antidepressants
    Elavil, Tofranil, anafranil, Norpramin, Sinequan, Pamelor, Aventyl
  81. The names of MAOI antidpressants
    Nardil, Parnate, Marplan, EMSAM
  82. The names of SSRI antidepressants
    Prozac, Luvox, Paxil, Zoloft, Celexa, Lexapro
  83. Names of SSNRI antidepressants
    Cymbalta, Effexor, Pristiq
  84. Names of NDRI antidepressants.
    Wellbutrin, Remeron, Desyrel
  85. Describe some common side effects and nursing implications for tricyclic antidepressants.
    • Constipation - high fiber diet, increase exercise, monitor fluid and food intake
    • Orthostatic hypotension - rise slowly, avoid hot showers and tub baths
    • tachycardia, arrhythmias - monitor BP, P, R
    • Photosensitivity - sunscreen
    • Dry mouth - ice chips, water, hard candy
    • Lowered seizure threshold
  86. What is the most potentially life-threatening adverse effect of MAOIs?
    Hypertensive Crisis
  87. What are the signs and symptoms of hypertensive crisis?
    Severe occipital headache, palpitations, N/V, fever, increased BP, chest pain and coma.

    Stop drug immediately, monitor VS, give short acting antihypertensive, use cooling measures. Teach patient to avoid foods high in typramine.
  88. Lithium carbonate is the drug of choice for________?
    Mania
  89. Many times when individuals are started on lithium, the physician also orders antipsychotic medication. Why might he or she do so?
    Lithium takes 1-3 weeks to work. It is given as maintenance or prophylaxis, antipsychotics will start to work on current behaviors immediately.
  90. What is the therapeutic range for lithium?
    • Acute - 1.0 - 1.5 mEq/L
    • Maintenance - 0.6-1.2 mEq/L
  91. What are the initial signs and symptoms of lithium toxicity
    blurred vision, ataxia, tinnitus, persistent N/V, severe diarrhea, severe tremor
  92. Describe some implications for the client on lithium therapy
    • Dry mouth - ice chips, water, hard candy
    • Headache - analgesics
    • GI problems - give with food
    • Monitor VS 2-3times/day
    • Monitor I&O
    • Need water intake of 2500-3000 ml/d
    • Reduced calorie diety
    • Advice to avoid activities requiring alertness
    • check lithium level
    • inadequate sodium can cause toxicity
  93. What is the mechanism of action for antianxiety medications?
    Depress subcortical levels of CNS - particularly limbic system and reticular formation - CNS depression
  94. What is the most commonly used group of antianxiety meds?
    Benzodiazepines
  95. Name the antianxiety medications.
    Klonopin, Librium, Xanax, Tranxene, Valium, Ativan, Serax, Atarax
  96. What are the most common side effects of antianxiety medications
    drowsiness, confusion, lethargy
  97. What instruction must be given to the client on long term antianxiety therapy in order to prevent a potentially life-threatening situation?
    Do not abruptly DC - can cause psychosis.
  98. What is thought to be the mechanism of action that produces the desired effect with antipsychotic medications?
    Block post-synaptic receptors in the basal ganglia, hypothalamus, limbic system, brainstem and medulla
  99. The Atypical antipsychotics are a commonly used group of antipsychotic medications. What are some examples
    Clozaril, Risperdal, Zyprexa, Seroquel, Geodon, Abilify, Invega
  100. Phenothiazines are a group of Typical antipsychotic medications. Name some examples
    Prolixin, Haldol, Stelazine, Navane, Thorazine, Mellaril, Loxitane
  101. Describe potential adverse hormonal effects associated with antipsychotic therapy.
    • decreased libido
    • retrograde ejaculation
    • gynecomastia
    • amenorrhea
    • weight gain
  102. Agranulocytosis is a potentially very serious side effect of antipsychotic therapy. The nurse and client should be on the alert for symptoms of:
    sore throat, fever, malaise
  103. Neuroleptic malignant syndrome is a rare but potentially fatal side effect of antipsychotic drugs. List symptoms for which the nurse must be on the alert when assessing for NMS.
    Severe parkinsonian muscle rigidity, lead pipe rigidity, hyperpyrexia, tachycardia, increase in CPK, tachpnea, BP fluctuations, diaphoresis, rpaid deterioration of mental status to stupor and coma.
  104. Describe the symptoms of extrapyramidal side effects associated with antipsychotic therapy.
    • Pseudoparkinsonism - shuffling gate, drooling, tremor, masklike face, blunted affect, stooped and stiff posture, akinesia, bradykinesia.
    • Akathisia - continued restlessness
    • Dystonia - involuntary muscular movements of face, arms, legs
    • Oculogyric crisis - uncontrolled rolling back of eyes
    • Tardive dyskinesia - bizarre facial and tongue movements
  105. What is the classification of medication that is commonly prescribed for drug-induced extrapyramidal reactions? Give two examples
    Antiparkinsonian - anticholinergic - Cogentin, Artane
  106. Describe a life-threatening situation that could occur in the client who abruptly withdraws from long-term use of CNS stimulants. give two examples of CNS stimulants
    • suicidal idealation, increased dreaming, psychotic behavior.
    • Ritalin, Concerta, Adderall, Cylert, Vyvanse
  107. Name two medications that are used in the treatment of dementia.
    Namenda, Reminyl, Exelon, Aricept
  108. What are some common side effects with TCAs?
    • Anticholinergic effects
    • Blurred vision - should subside in a few weeks
    • Constipation - high fiber diet, monitor fluid and food intake; increase exercise
    • Urinary retention - report hesitancy or inability to urinate, monitor I&O
    • Orthostatic hypotension, dizziness - rise slowly, monitor BP, avoid hot showers
    • Tachycardia, arrhythmias - monitor BP, P, R&R,
    • Decreased seizure threshold - institute precautions if needed
    • Esophageal reflux
    • Photosensitivity - wear sunscreen
    • Weight gain - encourage activity, reduced calorie diet
  109. What are some common side effects with SSRI and the nursing implications?
    • anticholinergic effects
    • insomnia, agitation - take early in day, avoid caffeine
    • headache - analgesics
    • weight loss - give caloric intake, weigh daily
    • sexual dysfunction - switch to another antidepressant if necessary
    • dizziness - do not participate in activities that require alertness
    • GI upset - give with food
  110. What are some side effects of MAOIs and the nursing implications?
    • anticholinergic effects
    • Hypotension - monitor BP, have pt. rise slowly
    • CNS hyperstimulation - reassure pt; assess for psychosis, hypomania or seizures
    • Hepatic and hematologic dysfunction - CBC and liver function tests
  111. Side effect that can occur with Desyrel (NDRI)
    priapism
  112. What are the symptoms that can occur with hypertensive crisis? With what category of antidepressants do they occur? What are the nursing implications?
    • MAOIs
    • S&S: severe occipital headache, palpitations, N/V, fever, increased BP, chest pain, coma

    Stop drug immediately, give short-acting antihypertensive, use cooling measures. Teach patient to avoid foods high in tyramine.
  113. What are the signs and symptoms of Anticholinergic Crisis and what are the nursing implications?
    S&S: purposeless overactivity, agitation, confusion, disorientation, dysarthria, dry, flushed skin, tachycardia, sluggish and dilated pupils, change in LOC.

    DC drug and notify doctor. Related to effects of anticholinergic drugs. Cumulative effects of too much anticholiergic effects.
  114. What are the signs and symptoms of Serotonin Syndrome?
    • Potentially fatal, results from combining serotonin-enhancing psychotropic drugs and MAOI.
    • S&S: hyperreflexia, hyperthermia, myoclonus and other symptoms suggestive of NMS.
  115. What is the action of antimanic drugs?
    Antimanic may enhance reuptake of serotonin and norepinephrine, thus decreasing levels in body. Anticonvulsants and channel blockers - unclear how they work.
  116. What are the signs and symptoms and nursing implications of Lithium?
    • Drowsiness, dizziness, headache - do not participate in activities that require alertness, give analgesics
    • Dry mouth, thirst - sugarless candy, ice, water, good oral hygiene
    • Fine hand tremors - report to dr - may give small doses of propranolol
    • Hypotension, arrhythmias, pulse irregularities - monitor Vs 203times/day; may decrease dose
    • Polyuria, dehydration - monitor daily I&O, may subside, monitor skin turgor
    • Weight gain - instruct pt on reduced calorie diet; instruct about adequate Na intake, 2500cc fluid/day
  117. What are the side effects and nursing implications of anticonvulsants?
    • N/V - give with food
    • Blood dyscrasias - regular blood tests, CBS
    • Prolonged bleeding time with valproid acid - platelet count and bleeding time
  118. What are the Antimanic medications?
    • Antimanic - Lithium
    • Anticonvulsants - Klonopin, tegretol, Depakene, Depakote, Lamictal, Neurontin, Trileptal, Topamax
    • Combination drug - Symbax
    • Calcium Channel Blockers
    • Calan, Isoptin
  119. What are the categories of drugs that are used for antimania?
    Antimanic, anticonvulsants, Calcium Channel Blockers
  120. What are the side effects and nursing implications of calcium channel blockers?
    • Drowsiness, dizziness - do not operate dangerous equipment until alert
    • Hypotension, bradycardia - take VS before initiation of therapy and daily before administration
    • Nausea, constipation - give with food, increase fluid and fiber in diet
  121. What are the signs and symptoms of lithium toxicity?
    blurred vision, ataxia, tinnitus, persistent N/V, sevre diarrhea, severe tremor
  122. What are the names of the CNS stimulants?
    Amphetamines: Ritalin, Cylert, concerta, Adderall, Vyvanse

    Non Stimulant drug - Straterra
  123. What is the action of CNS stimulants?
    increase levels of neurotransmitters in the CNS. The produce CNS and respiratory stimulation, dilated pupils, increased motor activity and mental alertness, diminshed sense of fatigue and brighter spirits
  124. What are the side effects and nursing implications of CNS stimulants?
    • Overstimulation, restlessness, insomnia - assess mental status for changes in mood, level of activity, degree of stimulation and aggressiveness. Ensure pt is protected from injury, keep stimuli low and environment as quiet as possible to discourage overstimulation; to prevent insomnia, administer last dose 6-8 hours before bedtime.
    • Palpitations, tachycardia - monitor and record VS at regular intervals throughout therapy. Report significant changes to dr.
    • Anorexia, weight loss - to reduce anorexia, the medication can be administered immediately after meals. Weigh pt regularly because of anorexia and temporary interruption of growth and development
    • Tolerance - develops rapidly. Take drug holidays under dr. direction.
    • Drug should not be DCd abruptly. To do so could initiate: N/V, abdominal cramping, HA, fatigue, weakness, mental depression, suicidal ideation and increase in dreaming and psychotic behavior.
  125. Stopping a CNS stimulant abruptly could cause:
    N/V, abdominal cramping, HA, fatigue, weakness, mental depression, suicidal ideation and increase in dreaming and psychotic behavior.
  126. What are the side effects of Antipsychotic medications?
    Anticholinergic effects, nausea, GI upset, skin rash, ortostatic hypotension, photosensitivity, hormonal effects, weight gain, reduction of seizure threshold, salivation, EPS
  127. Anticholinergic effects are a side effect of antipsychotic and antidressant medications. What are they and what are the nursing implications?
    • Dry mouth - give sugarless hard candy, ice, water, good oral hygiene
    • Blurred vision - should subside, do not drive until vision clears
    • Constipation - high fiber diet, increase fluid intake and physical activity
    • Urinary retention - report any difficulty urinating, Monitor I&O
  128. One of the extrapyramidal symptoms of antipsychotic medications is pseudoparkinsonism. What are the signs and symptoms?
    shuffling gait, drooling, tremor, maslklike face, blunted affect, stooped and stiff posture, akinesia, bradykinesia.

    Akinesia - muscular weakness
  129. One of the extrapyramidal symptoms of antipsychotic medications is Akathisia. What are the signs and symptoms?
    Akathisia - continuous restlessness. Motor inner driven restlessness, agitation; shifting of weight from foot to foot, inability to sit still.
  130. One of the extrapyramidal symptoms of antipsychotic medications is Dystonia. What are the signs and symptoms?
    Dystonia - involuntary muscular movements of face, arms, legs. Spasms of major muscle groups of the neck, back, eyes. Oculogyric crisis - uncontrolled rolling back of eyes - may be mistaken for seizure activity; should be treated as emergency situation - contact dr and IV benzos (Cogentin) given. Stay with pt and reassure
  131. One of the extrapyramidal symptoms of antipsychotic medications is Tardive dyskinesia. What are the signs and symptoms?
    This is a late onset symptom. Bizarre facial and tongue movements, stiff neck, lip smacking, tongue protrusion and thrusting, blinking, grimacing and other excessive unnecessary facial movements. All patients receiving long-term antipsychotic therapy are at risk; symptoms are potentially irreversible; assess pt frequently by doing rating scale for EPS such as AIMS.
  132. There are two life threatening effects of antipsychotic medications. What are they and what are their symptoms and nursing indications?
    Agranulocytosis - rare - usually occurs within three months; S&S: sore throat, fever, malaise. A CBC should be done. With Clozaril patients should have weekly blood counts for 6 mths.

    Neuroleptic Malignant Syndrome - rare, but potentially fatal. S&S: severe parkinsonian muscle rigidity, lead pipe rigidity, hyperpyrexia, tachycardia, increase in CPK, tachpnea, fluctuations in BP, diaphoresis, rapid deterioration of mental status to stupor and coma. Routine assessments of temp and observe for parkinsonian symptoms. Stop drug immediately, monitor VS, degree of muscle rigidity, I&O, LOC
  133. Antiparkinsonian agents include three subcategories. What are they?
    • Anticholinergics:
    • Cogentin, Akineton, Parsidol, Kemadrin, Artane

    • Antihistamines:
    • Benadryl

    • Dopaminergic agonists:
    • Symmetrel, Parlode
  134. What is the action of antiparkinsonian agents?
    To restore the natural balance of two major neurotransmitters in CNS - acetylcholine and dopamine
  135. What are the side effects and nursing interventions of Antiparkinsonian agents?
    • Anticholinergic effects
    • Paralytic ileus - rare - monitor for abdominal distention, absent bowel sounds, N/V, epigastric pain, report to dr.
    • urinary retention - tell pt to report difficulty, monitor I&O
    • tachycardia, decreased sweating, increased temperature - assess VS each shift; report any changes
    • Nausea, GI upset - give with food
    • Sedation, drowsiness, dizziness - give at bedtime, tell pt. not to drive
    • Exacerbation of psychoses - assess for signs of loss of contact with reality; intervene during hallucinations; talk about real events; orient to reality; stay with patient during agitation and delirium; remain calm
    • orthostatic hypotension
  136. What are the categories and names of antianxiety medications?
    Antihistamines - hydroxyzine

    • Benzodiazepines:
    • Klonopin
    • Xanax
    • Librium
    • Tranxene
    • Valium
    • Ativan
    • Serax
  137. What is the action of BuSpar?
    It does not depress CNS. It is beleied to produce desired effects through interactions with serotonin, dopamine and other neurotransmitter receptors.
  138. What are the side effects and nursing indications for antianxiety medications?
    • drowsiness, confusion, lethargy (most common)
    • Tolerance - instruct patient not to dc abruptly.
    • Ability to potentiate effects of other CNS depressants - instruct not to drink alcohol or take other medications that depress CNS
    • Possibility of aggravating other depressive symptoms - assess patients mood daily; take necessary precations
    • orthostatic hypotension
    • paradoxical excitement - symptoms opposite of desired effect - stop taking drug, notify dr.
    • dry mouth
    • N/V
  139. What are the different side effects of BuSpar that do not apply to other antianxiety meds?
    • lag time of 10 days to 2 weeks between onset of therapy and subsiding of anxiety.
    • No evidence that BuSpar creates tolerance or dependence
  140. What are the life threatening effects of antianxiety meds?
    • Blood dyscrasias - sore throat, fever, malaise, easy bruising, unusual bleeding
    • Abrupt withdrawal can be life threatening because of withdrawal symptoms.
  141. What are the signs and symptoms of abrupt withdrawal from psychiatric medications?
    nausea, vomiting, malaise, weakness, tachycardia, sweating, anxiety, orthostatic hypotension, tremor, insomnia, seizures
  142. What are the names of antidemntia medications?
    Namenda, Reminyl, Exelon, Aricept, Cognex
  143. What is the action and side effects of namenda - antidementia med?
    • normalizes levels of glutamate which in excess quantities contributes to neurodegeneration
    • Treatment of moderate to severe Alzheimers meds. No evidence that it modifies underlying disease, slows down functional decline.

    S&S: monitor for hypertension - headache, vomiting, constipation, fatigue
  144. What is the action of the Cholinesterase Inhibitors (antidemntia meds)?
    prevents the breakdown of acetylcholamine and increase the availability at cholinergic synapses. Moderately improves cognition, behavior, function. Slows disease progression.
  145. What are the side effects of the cholinersterase inhibitors?
    Reminyl - monitor for N/V, loss of appetite, dizziness, syncope

    Exelon - monitor for N/V, abdominal pain, loss of appetite, upset stomach, muscle weakness

    Aricept - monitor for nausea, diarrhea, insomnia, test stools periodically for GI bleeding
  146. What are the possible side effects with all antidepressants?
    • Dry mouth
    • Sedation
    • Nausea
  147. What are the signs and symptoms of anticholinergic crisis? What are the nursing implications
    Purposeless overactivity, agistation, confusion, disorientation, dysarthuria, dry flushed skin, tachycardia, sluggish and dilated pupils, change in location.

    DC drug and notify dr.

    Retlated to the effects of anticholinergic drugs. cumulative effects of too much anticholinergic effects = anticholinergic intoxicity.
  148. What are the signs and symptoms of serotonin syndrom?
    Potentially fatal - results from combining serotonin enhancing psychotropic drugs. Causes dangerously high serotonin levels in brain.

    Hyperreflexia, hyperthermia, myoclonus and other symptoms suggestive of NMS.
  149. What is myoclonus?
    twitching or clonic spasm of muscle/groups
  150. What is dysarthuria?
    difficult and defective speech due to impairment in tongue or other muscles.
  151. What are the side effects and interventions for SSRIs?
    • insomnia/agitation - early in day
    • headache - analgesics or change drug
    • weight loss - watch caloric intake
    • sexual dysfunction - change antidepressants if intolerable
    • dizziness - do not participate in activities requiring allertness
    • GI upset - give with food
  152. What are the side effects of Prozac?
    seizures, suicidal thoughts, anxiety, headaches, drowsiness, insomnia nervousness, diarrhea, sexual dysfunction, sweating, pruritis, tremor.
  153. What are the nursing implications for Prozac?
    assess for suicidal tendencies, weigh weekly.
  154. What is the patient teaching associated with Prozac?
    Avoid alcohol, change position slowly, causes phtosensitivity.
  155. What are the side effects with Luvox?
    Suicidal thoughts, dizziness, drowsiness, headaches, insomnia, nervousness, weakness, constipation, diarrhea, dry mouth, dyspepsia, nausea, serotonin syndrome.
  156. What is the nursing implication and patient teaching with Luvox?
    taper off, assess for suicidal tendencies, serotonin syndrome, weigh weekly.

    Avoid alcohol and caffeine
  157. What are the side effects for Paxil?
    suicidal thoughts, anxiety, dizziness, drowsiness, headaches, insomnia, weakness, constipation, diarrhea, dry mouth, nausea, ejaculatory disturbance, sweating, serotonin syndrome.
  158. What are the nursing implications and patient teaching for Paxil?
    Taper off, do not crush, assess for suicidal tendencies, serotonin syndrome, OCD, PTSD, PMD, SAD, Panic Attacks
  159. What are the side effects of Zoloft?
    suicidal thoughts, dizziness, drowsiness, fatigue, headache, insomnia, diarrhea, dry mouth, nausea, sexual dysfunction, sweating, tremor, serotonin syndrome
  160. What are the nursing implications and patient teaching for Zoloft?
    • Assess for suicidal tendencies, serotonin syndrome.
    • Avoid alcohol, caffeine, use sunscreen.
  161. What are the side effects of Celexa?
    suicidal thoughts, apathy, confusion, drowsiness, insomnia, weakness, abdominal pain, anorexia, diarrhea, dry mouth, dyspepsia, flatulence, increased saliva, nausea, sweating, tremor, serotonin syndrome
  162. What are the nursing implications and patient teaching of Celexa?
    • Assess for serotonin syndrome
    • Causes photosensitivity, avoid alcohol and caffeine, change positions slowly
  163. What are the side effects of Lexapro?
    Suicidal thoughts, insomnia, diarrhea, nausea, serotonin syndrome.
  164. What are the nursing implications and patient teaching for Lexapro?
    assess for serotonin syndrome; taper off during 3rd semester; avoid alcohol and caffeine
  165. What are the drugs that are SSRIs?
    • Prozac
    • Luvox
    • Paxil
    • Zoloft
    • Celexa
    • Lexapro
  166. What are the drugs that are TCAs?
    • Elavil
    • Tofranil
    • anafranil
    • Norpramin
    • Sinequan
    • Pamelor, Aventyl
  167. What are the common side effects of TCAs?
    • Blurred vision - should subside in a few weeks; do not drive until clears
    • Constipation - increased fiber diet; monitor fluids and food intacke; increase exercise
    • Urinary retention - report hesitancy or inability; monitor I&O, see dr.
    • Orthostatic hypotension - change position slowly; monitor BP; avoid hot showers and tub baths
  168. What are the side effects of Elavil?
    suicidal thoughts, lethargy, sedation, blurred vision, dry eyes, dry mouth, arrhythmia, hypotension, constipation
  169. What are the nursing implications and patient teaching for Elavil?
    Dose titration is a slow process, taper off; give with or immediately after meal to avoid gastric upset; tablet may be crushed; patients taking high doses need ECG
  170. What are the side effects of Tofranil?
    drowsiness, fatigue, blurred vision, dry eyes, arrhythmias, hypotension, constipation, dry mouth. SE may not be noticed for 2 weeks
  171. What are the nursing implications and teaching of Tofranil?
    • dose titration is a slow process; taper off; monitor baseline and periodic ECG
    • Monitor BP and pulse; assess sexual libido
  172. What are the side effects of Anafranil?
    seizures, lethargy, sedation, weakness, blurred vision, dry eyes, dry mouth, arrhythmias, consipation, N/V, male sexual dysfunction
  173. What are some nursing implications and teaching for Anafranil?
    • give at bedtime
    • higher doses do ECGs
  174. What are the side effects of Norpramin?
    drowsiness, fatigue, blurred vision, dry eyes, dry mouth, arrhythmia, hypotension, constipation
  175. What are the nursing implications and teaching for Norpramin?
    • High doses need ECG
    • side effects may not be noticed for 2 weeks
  176. What are the side effects of Sinequan?
    fatigue, sedation, blurred vision, hypotension, constipation, dry mouth
  177. What are the nursing implications and teaching for Sinequan?
    • Increase dose at bedtime, slow titration; taper off; administer with food; do not mix oral concentrates with carbonated drinks or grape juice
    • Monitor BP, assess weight
  178. What are the side effects of Pamelor and Aventyl?
    drowsiness, fatigue, lethargy, blurred vision, dry eyes, dry mouth, arrhythmia, hypotension, constipation
  179. What are the nursing implication and teaching of Pamelor and Aventyl?
    Give with food, give at bedtime; monitor ECG
  180. What are the drugs that are MAOIs?
    Nardil, Parnate, Marplan, EMSAM
  181. What are the common side effects and nursing implications with MAOIs?
    • Anticholinergic effects - blurred vision, dry mouth, constipation, urinary retention
    • Hypotension - monitor BP, have patient rise slowly
    • CNS hyperstimulation - reassure patient, assess for psychosis, hypomania or seizures, may need to stop drug
    • Hepatic and hematologic dysfunction - blood cell counts, liver function tests, if dysfunction - DC
  182. What are the side effects of Nardil?
    seizures, dizziness, drowsiness, headaches, hyperreflexia, insomnia, tremor, twitching, weakness, hypertensive crisis, edema, orthostatic hypotension, constipation, dry mouth
  183. What are the nursing implications and teaching for Nardil?
    • may be crushed, mixed with food
    • monitor BP and pulse
    • avoid alcohol, CNS depressants, drugs, food containing tyramine, excessive caffeine
  184. What are the side effects of Parnate?
    blurred vision, dry mouth, constipation, urinary retention, hypotension, CNS hyperstimulation, hepatic and hematologic dysfunction, hypertensive crisis, seizures, agranulocytosis
  185. What are the nursing implications and teaching of Parnate?
    do not give in evening - insomnia; monitor BP, assess for psychosis, hypomania, seizures, CBC, liver function test; assess mental status, mood changes, monitor pulse rate, I&Os, avoid tyramine rich foods - hypertensive crisis; do ot DC abruptly, avoid alcohol, change position slowly, avoid caffeine
  186. What are the side effects of Marplan?
    blurred vision, dry mouth, constipation, urinary retention, hypotension, CNS hyperstimulation, hepatic and hematologic dysfunction, seizures, dizziness, headaches, hypertensive crisis, nausea
  187. What are the nursing implications and teaching of Marplan?
    do not give in pm - insomnia; assess mental status, mood changes; monitor BP and pulse rate; I&O, liver function; avoid tyramine, tryptophan, tyrosine; avoid alcohol, caffeine, CNS depressants; don't DC abruptly; change position slowly
  188. What are the side effects of EMSAM?
    blurred vision, dry mouth, constipation, urinary retention, hypotension, CNS hyperstimulation, hepatic and hematologic dysfunction, insomnia, hypertensive crisis, diarrhea, application site reaction, seizures
  189. What are the nursing implications and teaching for EMSAM?
    monitor BP, pulse rate, assess for psychosis, hypomania, CBC, liver function; apply to dry intact skin; change position slowly; avoid alcohol; avoid tyramine; CNS stimulants; avoid exposing to direct heat
  190. What are the Serotonin and Norepinephrine Reuptake Inhibitor drugs?
    • Cymbalta
    • Effexor
    • Pristiq
  191. What are the side effects of Cymbalta?
    Neuroleptic Malignant Syndrome; seizures, suicidal thoughts, fatigue, drowsiness, insomnia, hepatotoxicity, decreased appetite, constipation, dry mouth, nausea, dysuria, increased sweating, serotonin syndrome, increased risk of bleeding with aspirin, warfarin
  192. What are the nursing implications and teaching of Cymbalta?
    give without regard to meals, assess for ED, monitor BP, appetite, changes in behavior, suicidal tendencies; DC gradually, watch for anxiety, agitation, watch for serotonin syndrome; avoid alcohol
  193. What are the side effects of Effexor?
    Neuroleptic malignant syndrome, seizures, suicidal thoughts, abnormal dreams, anxiety, dizziness, headache, insomnia, nervousness, weakness, rhinitis, visual disturbances, abdominal pain, altered taste, anorexia, constipation, diarrhea, dry mouth, dyspepsia, N/V, weight loss, sexual dysfunction, ecchymosis, paresthesia, serotonin syndrome, chills
  194. What are the nursing implications and teaching for Effexor?
    Give with food; assess mental status, mood changes, suicidal tendencies; BP; avoid alcohol
  195. What are the side effects of Pristiq?
    NMS, seizures, suicidal thoughts, anxiety, dizziness, drowsiness, insomnia, decreased appetite, nausea, constipation, male sex dysfunction, sweating, serotonin syndrome
  196. What are the nursing implications and teaching of Pristiq?
    Give at the same time; assess mental status and mood change, suicidal tendencies; monitor BP, appetite; avoid alcohol.
  197. What are the Norepinephrine and Dopamine Reuptake Inhibitor drugs?
    • Wellbutrin
    • Wellbutrin Sr
    • Desyrel
    • Remeron
  198. What are the side effects of Wellbutrin and Zyban?
    Seizures, suicidal thoughts/behavior, agitation, headaches, dry mouth, N/V, tremor
  199. What are the nursing implications and teaching for Wellbutrin and Zyban?
    • CP in history of bulimia, increased risk of bleeding with warfarin, nicotine may cause hypertension
    • may be used with sedatives for first week, avoid bedtime doses, give with food, for SAD give in fall, taper in early spring, assess mood change and mental status, restrict amount available to patient, may require 4 weeks, may impair judgment, watch for suicidality, avoid alcohol, unused shell may appear in stool, use sunscreen, cease smoking during 2nd week
  200. What are the side effects of Desyrel?
    *Priapism*, suicidal thoughts, drowsiness, hypotension, dry mouth
  201. What are the nursing implications and teaching with Desyrel?
    May increase digoxin, increase CNS depression with other CNS depressants, may increase PT with warfarin; administer with meals monitor BP, P; assess mental status, suicidal tendencies; assess CBC, renal and hepatic function

    Change position slowly, avoid alcohol and CNS depressants
  202. What are the side effects of Remeron?
    no sexual disturbances, drowsiness, constipation, dry mouth, increased appetite, agranulocytosis, weight gain
  203. What are the nursing implications and teaching of Remeron?
    may give at bedtime to decrease drowsiness, assmental status and suicidal tendencies, take BP and P, weight, seizure activity, CBC, hepatic function

    Change position slowly, avoid alcohol and CNS depressants; notify dr. if dry mouth urinary retention or constipation; monitor dietary intake
  204. What are the antimanic drugs?
    Antimanic - Lithium Carbonate

    Anticonvulsants - Klonopin, Tegretol Depakene, Depakote, Lamictal, Neurontin, Trileptal, Topamax

    Combo - Symbax

    Calcium Channel Blockers - Verapamil
  205. What are the therapeutic levels of Lithium?
    • Acute - 1.0 - 1.5 mEq/L
    • Maintenance - 0.6 - 1.2 mEq/L
  206. What is the action of antimanic drugs?
    Enhance the reuptake of serotonin, norepinephrine; decrease levels in body
  207. What are the side effects of Lithium Carbonate?
    Fatigue, seizures, impaired memory, anorexia, abdominal pain, bloating, hypothyroid, drowsiness, dizziness, headache, dry mouth, thirst, GI upset, N/V, fine hand tremors, hypotension, arrhythmias, pulse irregularities, polyuria, dehydration, weight gain
  208. What are the signs of Lithium toxicity?
    blurred vision, ataxia, tinnitus, severe N/V, severe diarrhea, severe tremor - stop drug notify dr.
  209. What are the nursing implications and teaching of Lithium?
    Give with food or milk; monitor VS 2-3 times/day; monitor I&O, turgur; doctor may give propranolol for tremors; assess mental status; monitor lithium levels; draw blood samples in a.m.

    Drink 2000-3000 ml/day; consistent and moderate sodium intake, avoid excessive amount of caffeine; avoid activities cause increased sodium loss; notify doctor of diarrhea, vomiting; ECG evaluated if histor of CVD or older than 40; notify dr of irregular pulse, SOB
  210. What are the Anticonvulsants?
    • Klonopin
    • Tegretol
    • Depakene
    • Depakote
    • Lamictal
    • neurontin
    • Trileptal
    • Topamax
  211. What are the side effects of Klonopin?
    suicidal thoughts, behavioral changes, drowsiness, ataxia
  212. What are the nursing implications and teaching of Klonopin?
    Interaction with alcohol, antidepressants, antihistamines, benzodiazepines; seizure precautions; give with food; taper off; assess degree and manifestation of anxiety and mental status; assess for drowsiness, unsteadiness, clumsiness; monitor CBC and liver function.

    Avoid alcohol, CNS depressants; notify dr. of unusual tiredness, bleeding, sore throat, fever, clay color stools, yellow skin, behavior changes, suicidality, aggression, violence or other behavior changes
  213. What are the side effects of Tegretol?
    Suicidal thoughts, ataxia, drowsiness, Stevens-Johnson syndrome, toxic epidermal necrolysis, agranulocytosis, aplastic anemia, thrombocytopenia
  214. What are the nursing implications and teaching of Tegretol?
    CP in bone marrow suppression; seizure precautions, give with food, give at bedtime, do not give suspension with other liquid meds - becomes orange rubbery mass, monitor for behavior changes, monitor for changes in skin condition, monitor CBC, platelet, reticulocyte, serum, iron; perform genetic testing in patient of Asian ancestory; DC if bone marrow depression

    Notify dr if behavior changes; skin rash, fever, sore throat, mouth ulcers, bruising, abdominal pain, chills, pale stool, dark urine, jaundice, avoid alcohol and grapefruit juice; use sunscreen and nonhormonal contraception
  215. What are the side effects of Depakene?
    Suicidal thoughts; agitation, dizziness, headaches, insomnia, sedation, visual disturbances, hepatotoxicity, pancreatitis, abdominal pain, N/V, anorexia, diarrhea, indigestion, hyperammonemia; hypothermia; tremor
  216. What are the nursing implications and teaching of Depakene?
    Give with food; give at bedtime; assess for seizures; assess for suicidality, hepatic function; may interfere with accuracy of thyroid funciton test; false positive urine ketone tests;

    do not drive until dr clears; avoid alcohol and CNS depressants; watch for behavior changes, suicidality, and panic attacks; carry ID describing regimen; notify dr if anorexia, abdominal pain, severe N/V, facial edema, lethargy, bleeding, bruising; pregnant pts enroll in NAAED pregnancy registry
  217. What are the side effects of Depakote?
    suicidal thoughts, agitation, dizziness, headache, insomnia, sedation, visual disturbances, hepatotoxicity, pancreatitis, abdominal pain, anorexia, diarrhea, indigestion, N/V, hyperammonemia; hypothermia; tremor
  218. What are the nursing implications and teaching of Depakote?
    increased bleeding with warfarin; toxicity increased by aspirin and carbamazepine; give with meals; do not give with milk or carbonation; assess seizures, suicidality, mood; monitor CBC, plateletes, bleed time, hepatic function; may interfere with accuracy of thyroid function; false positive urine ketone tests;

    do not DC abruptly; no driving til cleared by dr; avoid alcohol and CNS depressants; monitor mood, behavior changes, suicidality; pregnant pts - register with NAAED pregnancy registry; carry ID, drug regimen; call dr if anorexia, abdominal pain, jaundice, severe N/V, easy bleeding, bruising
  219. What are the side effects of Lamictal?
    suicidal thoughts, ataxia, dizziness, headache, N/V, photosensitivity, rash, stevens-johnson syndrome
  220. What are the nursing implications and teaching of Lamictal?
    DC gradually, monitor for behavior chagnes, suicidal thoughts, skin rash

    Wear sunscreen, notify dr if rash, do not drive without dr ok; watch for suicidality, carry ID and medication regimen
  221. What are the side effects of Neurontin?
    suicidal thoughts, confusion, depression , drowsiness, ataxia,
  222. What are the nursing implications and teaching of Neurontin?
    antacids may decrease absorption, morphine increases levels; do not DC abruptly, monitor closely for behavior changes, assess seizures, may cause false positive urine protein test

    do not take within 2 hours of antacis, do not drive until ok'd, notify dr if behavior changes, suicidality, or before surgery. Carry ID and drug regimen
  223. What are the side effects of Trileptal?
    suicidal thoughts, dizziness, vertigo, drowsiness, fatigue, headache, abnormal vision, diplopia, nystagmus, abdominal pain, N/V, ataxia, gait disturbances, tremor
  224. What are the nursing implications and teaching of Trileptal?
    may alter effects of drugs, may decrease effectiveness of hormonal BC; implement seizure precautions; monitor ECG and electrolytes; may cause hyponatremia; may require fluid restrictions and DC of med; gradually DC, avoid alcohol and CNS depressants; no driving until okayed by dr; use alternate forms of BC; notify dr of behavior changes, suicidality; carry ID and med regimen
  225. What are the side effects of Topamax?
    increased seizures, suicidal thoughts, dizziness, drowsiness, fatigue, impaired concentration/memory, nervousness, psychomotor slowing, speech problems, sedation, abnormal vision, diplopia, nystagmus, nasea, weight loss, ataxia, paresthesia
  226. What are the teaching and nursing implications of Topamax?
    monitor for behavior changes and suicidality; monitor CBC and platelets; may cause anemia and metabolic acidosis;

    if more than one dose missed, gradually DC; may cause decreased sweating and increased body temp; hydrate well in heat; 2000-3000 ml/day to prevent stones; avoid driving until response known; avoid alcohol and CNS depressants; use nonhormonal BC; use sunscreen; carry ID, notify dr if behavior changes, eye problems or before surgery
  227. What is a combination antipsychotic and antidepressant for Bipolar treatment?
    Symbax - zyprexia and fluoxetine
  228. What are the side effects of Symbax?
    NMS, seizures, suicidality, agitation, dizziness, headache, restlessness, sedation, weakness, amblyopia, rhinitis, constipation, dry mouth, weight changes, tremor, agranulocytosis, insomnia, anxiety, nervousness, diarrhea, sexual dysfunction, increased sweating, pruritus
  229. What are the nursing implications and teaching of Symbax?
    Monitor CBC - may cause leukopenia

    change position slowly, extrapyramidal and dyskinsia; use sunscreen, decrease libido, notify dr if behavior changes, insomnia, headaches
  230. What are the Calcium Channel Blockers?
    Verapamil - Calan, Isoptin
  231. What are the side effects of verapamil?
    drowsiness, dizziness, cypotension, bradycardia, nausea, constipation, arrhythmias, CHF, stevens-johnson syndrome
  232. What are the nursing implications and teaching of verapamil?
    give with food or milk; patient should remain recumbent for 1 hour after IV, administer over 2 minutes; monitor BP, PR, ECG, I&O, daily weight, signs of CHF, renal and hepatic function

    Avoid large amounts of grapefruit juice and caffeine; teach to take pulse; contact dr if HR<50; change position slowly; good dental hygiene; avoid alcohol, cold meds; notify dr of irregular HB or severe headache, wear sunscreen
  233. What are the Central Nervous System stimulants - amphetamines?
    • Ritalin
    • Cylert
    • Concerta
    • Adderall
    • Vyvanse
  234. What is the action of CNS stimulants - amphetamines?
    Increase levels of neurotransmitters in CNS; produce CNS and respiratory stimulation; dilated pupils, increased motor activity and mental alertness; decreased sense of fatigue and brighter spirits
  235. What are the side effects of Ritalin?
    hyperactivity, insomnia, restlessness, tremor, sudden death, hypertension, palpitation, tachycardia, anorexia
  236. What are the teaching and nursing implications of Ritalin?
    Give with water, milk, or juice; monitor BP, P, R; assess for heart disease; monitor for behavior chang; monitor height and weight

    Avoid caffeine; shell may appear in stool; may need medication holidays
  237. What are the side effects of Cylert?
    seizures, insomnia, hepatic failure, anorexia, additive CNS stimulants with other CNS stimulants
  238. What are the teaching and nursing implications of Cylert?
    give in the morning; medication holidays; assess attention span; motor or vocal tics; impulse control; behavior changes; monitor height and weight; serum ALT every 2 weeks; may cause elevated LDH; alkaline phosphate, AST and ALT levels; taper off; may cause dizziness; avoid caffeine; may cause liver failure
  239. What are the side effects of Concerta?
    hyperactivity, insomnia, restlessness, tremor, sudden death, hypertension, palpitations, tachycardia, anorexia
  240. What are the teaching and nursing implications of Concerta?
    give on empty stomach, take with water milk or juice; monitor BP, P, R; monitor height and weight; may produce false sense of euphoria and well being; monitor CBC, differential and platelet count; take last dose 6 hours before bedtime; do not abruptly DC; avoid caffeine
  241. What are the side effects of Adderall?
    hyperactivity, insomnia, restlessness, tremor, sudden death, palpitations, tachycardia, anorexia
  242. What are the teaching and nursing implications of Adderall?
    Fruit juices can increase effect of amphetamine; medication free days; monitor BP, P, R; obtain family history; may produce false sense of euphoria; high dependence and abuse potential; assess height and weight; take last dose 6H before bed; avoid caffeine; may impair judgment; may cause dry mouth
  243. What are the side effects of Vyvanse?
    behavioral disturbances, sudden death, anorexia
  244. What are the teaching and nursing implications of Vyvanse?
    • administer in morning; assess attention span and impulse control; monitor BP, P, R; history of family sudden death; evaluate unexplained syncope; monitor height and weight; monitor for behvior change
    • notify HCP of signs and symptoms of heart problems; check weight 2-3 times/weekly
  245. What is the CNS nonstimulant drug for ADHD?
    Straterra
  246. What are the traditiona/typical antipsychotics?
    • Prolixin
    • Haldol
    • Stelazine
    • Navane
    • Thorazine
    • Mellaril
    • Loxitane
  247. What are the side effects of Prolixin?
    NMS; extrapyramidal reactions, photosensitivity, agranulocytosis; may increase risk of lithium toxicity; may cause Q & T wave changes
  248. What are the teaching and nursing implications of Prolixin?
    Do not mix with caffeine, tannins or pectinates; assess mental status, BP, P, R, ECG; watch that patient swallows pills; assess fluid take and bowel function; observe for akathisia, parkinsonia, dystonia; give benzos or benadryl for symptoms

    Change position slowly; may cause drowsiness; use sunscreen; good oral hygiene; notify HCP of bleed, rash, hepatic or renal function
  249. What are the side effects of Haldol?
    seizures, extrapyramidal reactions, blurred vision, dry eyes, constipation, dry mouth, agranulocytosis, NMS
  250. What are the teaching and nursing implications of Haldol?
    administer with food, do not dilute with coffee or tea; assess mental status, BP, P, ECG; may cause QT interval changes; monitor I&O, weight; assess fluid intake and bowel function; monitor for akathisia, parkinsonian, dystonic - give benzos; monitor for NMS, leukocytosis; increased liver function tests; increase CPK; monitor CBC and liver function tests; do not increase or DC without dr permission; may cause drowsiness; avoid alcohol; use sunscreen; good oral hygiene
  251. What are the side effects of Stelazine?
    NMS, extrapyramidal reactions, sedation, constipation, photosensitivity, agranulocytosis, lithium decreases absorption
  252. What are the teaching and nursing implications of Stelazine?
    Give with food; assess mental status, weight, BMI, BP, ECG, sedation, I&O, weight; make sure pill is swallowed; monitor for akathisia, parkinsonian, dystonic - give benzos or benadryl; monitor for NMS, CBC, liver function, ocular exams; may cause false +/- pregnancy tests.

    Do not abruptly DC, change position slowly; may cause drowsiness; avoid extremes in temps; avoid alcohol; may turn urine pink to reddish brown

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