Module 7: Introduction to Psychopharmacology Read Townsend

Bonus Chapter 1 (online book resource).

Instructions: Please fill in the blanks and answer the questions in
the space provided:
1. What is the mechanism of action by which antidepressant medications
achieve the desired effect (regardless of the different physiological processes
by which this action is accomplished)?
Increase the concentration of norepinephrine, serotonin, and/or
dopamine in the body
2. For what must the nurse be on the alert with the client who is receiving
antidepressant medication?
As the drug takes effect the mood may shift and energy increases,
patient may now have the energy to implement suicide plan.
3. As the nurse, when would you expect the client to begin showing signs of
symptomatic relief after the initiation of antidepressant therapy?
It typically takes 1-4wks but it depends on the medication.
4. Name an example of a tricyclic antidepressant: Elavil. Name an example of
an MAOI Nardil. Name an example of an SSRI Prozac.
5. Describe some common side effects and nursing implications for tricyclic
antidepressants.
Common side effects include: dry mouth: sugarless candy, ice frequent
water sips lots of fluids, foods high in fiber Request order for HS dose
orthostatic hypotension Rise slowly for sitting lying positions Monitor for
signs & symptoms
Hypertensive crisis is the most potentially life-threatening adverse effect
of MAOIs. Symptoms for which the nurse and client must be on the alert
include: Liver dysfunction, severe occipital headaches, palpitations,
shortness of breath, nausea & vomiting, muscle rigidity, fever, sweating,
blood pressure increase, chest pain, coma, death if it progressed w/o
intervention

What must be done to prevent these symptoms from occurring? (Your answer
must include some examples.)
Avoid foods high in tyramine like aged cheese like swiss, avoid pickles,
herring,
preserved meats, beer, wine, chocolate, yogurt, OTC cold meds
and diet pills
6. Lithium carbonate is commonly prescribed for bipolar mania. Many times
when these individuals are started on lithium therapy, the physician also
orders an antipsychotic medication. Why might he or she do so?
Antipsychotics are prescribed to decrease the hyperactivity on an
immediate basis until the lithium can take effect
7. There is a narrow margin between the therapeutic and toxic serum levels of
lithium carbonate. What is the therapeutic range, and list the initial signs and
symptoms of lithium toxicity.
0.6-1.5 mEq/L; blurred vision, ataxia, tinnitus, persistent nausea and
vomiting, severe diarrhea
8. Describe some nursing implications for the client on lithium therapy.
Give with food, ensure client gets adequate sodium in their diet, 25003000 mL fluids
per day, and check lithium levels before giving, monitor
I&Os diet to prevent weight gain
9. What is the mechanism of action for anxiolytics (with the exception of
buspirone)?
CNS depression
10.
What is the most commonly used group of anxiolytics? Give two
examples.
Librium, xanax
11.

What are the most common side effects of anxiolytics?

Drowsiness, sedation, confusion, orthostatic hypotension, CNS

depression
12.
What must the client on long-term anxiolytic therapy be instructed in
order to prevent a potentially life-threatening situation?
Do not stop taking abruptly; they must taper off med gradually.

13.
What is thought to be the mechanism of action that produces the
desired effect with antipsychotic medications?
CNS depression
14.
Phenothiazines are an example of a typical antipsychotic group. Give
two examples of phenothiazines and two examples of the newer atypical
antipsychotics.
Thorazine & prolixin; risperdal & zyprexa
15.
Describe potential adverse hormonal effects associated with
antipsychotic therapy.
Decreased libido, retrograde ejaculation, gynecomastia, amenorrhea,
weight gain
16.
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, and malaise.
17.
Neuroleptic malignant syndrome (NMS) 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 muscle rigidity, fever (107), tachycardia, tachypnea, fluctuating
blood pressure, diaphoresis, rapid deterioration of mental status, coma,
death
18.
Describe the symptoms of extrapyramidal side effects associated with
antipsychotic therapy.
Pseudoparkinsonism tremor/shuffle gait, drool, restlessness, stiff neck,
difficulty
swallowing
19.
What is the classification of medication that is commonly prescribed for
drug-induced extrapyramidal reactions? Give two examples of these
medications.
Antiparkinsonian agents: benzotropine: cogentin trihexyphenidyl
(artane) Benadryl
Describe a potentially life-threatening situation that could occur in the client
who abruptly withdraws from long-term use of CNS stimulants.

Depression & suicidal ideation