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Antipsychotic Drugs
Antipsychotic Drugs
Antipsychotic Drugs
ANTI-MANIC DRUGS
Mood stabilizers.
Takes effect in 1-3 weeks or more
Indicated for manic episode in bipolar
disorders
Normalizes
serotonin,
norepinephrine,
acethycholine and dopamine to prevent
depression and mania
Side effects: mild nausea and vomiting, fine
hand tremors, loss of appetite, polydipsia,
polyuria, metallic taste in the mouth, edema,
acne
Examples:
Lithium
(Eskalith,
Lithium
Carbonate), Carbamazepine, Valproic Acid
Normal serum level: 0.6-1.2 mEq/L
Toxic level: more than 1.5 mEq/L
Nursing Management:1. Monitor serum lithium
level regularly. 2. 3 grams of daily salt. 3. 2-3
liters of fluids per day. 4. Mannitol and dialysis
for lithium toxicity. 5. Do not give morning
dose until serum sample is taken.
ANTI-PARKINSONS
Usually appear after initial dose of antipsychotics. Treats EPS
Attempts to correct imbalance between
dopamine and acetylcholine
Side effects: sedation, atropine psychosis,
photosensitivity, anti-cholinergic side-effects,,
agranulocytosis,
orthostatic
hypotension,
hormonal changes.
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Examples:
Cogentin,
Artane,
Parlodel,
Larodopa, Benadryl
Nursing Management: 1. Give meds with food.
2. Observe for therapeutic side effects and
improvement in gait and posture. 3. Teach
about orthostatic hypotension. 4. Limit
strenuous activities. 5. Avoid taking antidepressants. 6. Weekly CBC monitoring. 7.
Weigh client regularly. 8. Calorie-controlled
diet and light exercise.
ANTI-DEPRESSANTS
Mood elevators; second line agent
Indications: major depressive disorders,
anxiety disorders, bipolar disorders, eating
disorders
Balances serotonin and norepinephrine
Tricyclic Anti-depressants (1-3 weeks):
Sinequan, Pamelor, Elavil, Norpramine,
Tofranil.
Antidote: Physostagmine (Antilirium) only with
life threatening symptoms
MAOI (2-4 weeks): Parnate, Nardil, Marplan;
third line agent
Used for clients who does not respond to TCA
or cannot tolerate SSRI
Contraindications: pregnancy, lactation, CHF,
HPN, liver and kidney problems, alcoholism,
schizophrenia, over 60 and under 16 years of
age, DM
Avoid
tyramine-rich
food---causes
hypertensive crisis
Antidote: Phentolamine ( Regitine) for
increased BP
SSRI (2-3 weeks): first line agent; Zoloft, Paxil,
Prozac
Broad spectrum action, most popular
Indications: depression, anxiety, bulimia,
alcoholism, schizophrenia, OCD
Nursing Management: 1. Should be taken in
morning for 4 weeks for full effects. 2. Avoid
TCA or MAOI= FATAL!!! 3. Monitor BP before
dosage change to detect hypo pr hypertension.
4. Avoid altering dosage. 5. Do not operate
machineries and driving. Report unusual
symptoms like tremors, nausea and vomiting,
anorexia, nervousness and sexual dysfunctions.
6. Notify doctor of depression worsens.
ELECTROCONVULSIVE THERAPY
Introduction of 70-150 volts for 0.2-8.0
seconds producing 30-60 seconds seizures,
confusion and memory loss.
Contraindications:
recent
MI,
asthma,
pulmonary disorders, increase ICP, fractures
and dislocations
Nursing Management: 1. Informed consent.
2. NPO by midnight baseline VS and memory
abilities and premeds like Atropine sulfate
(decreases secretions); Brevital ( short-acting
barbiturate);
succinylcholine
(muscle
relaxant).
Post- treatment: side lying, oxygenate, orient,
quiet environment.
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