PSYCHOPHARMACOLOGY by: Jay Balicha

ANTIDOTE – Flumazenil (Romazicon)

ANTI PSYCHOTICS – Decrease POSITIVE and NEGATIVE SIDE EFFECTS – DIZZINESS (Common), H,N,V, Clumsy, Hang
SYMPTOMS over effect
DANGER :
TYPICAL – Old, High EPS, Treat POSITIVE SYMPTOMS 1. Dependence/Addiction
“ZINE” 2. CNS Depression
Chlorpromazine (Thorazine)
Chlorperazine (Compazine) ANTI-DEPRESSANTS – effective after 2-3 weeks
Thioridazine (Mellaril)
Fluphenazine (Prolixin) MAOI’S (MONOAMINE OXIDASE INHIBITORS) – PANAMA
Perphenazine (Trilafon)
Haloperidol (HALDOL)  Isocarboxazid (Marplan)
 Phenelzine (Nardil)
ATYPICAL – New, Low EPS, Treat POSITIVE & NEGATIVE  Tranylcypromine (Parnate)
SYMPTOMS o Selegiline (Emsam)- Patch*
“DONE” “PINE”
Resperidone (Resperdal) Clozapine (Clozaril) *Avoid TYRAMINE RICH FOODS (cause HYPERTENSIVE
Molindone (Moban) Olanzapine CRISIS)
(Zyprexia) Preservatives (canned, sealed)
Ziprasidone (Geodon) Quetiapine (Seroquel) Soy, Soya, Yoghurt
Salami
SIDE EFECTS Avocado, Banana, Papaya
1. Dry Mouth, Constipation Cheese (Swiss, Cheddar, Aged, Mozzerella)
2. Photosensetivity ****KNOW**** SAFE CHEESE (Processed, Cottage, Cream)
3. Hypotenstion – Orthostatic hypotension TCA’s (TRICYCLIC ANTIDEPRESSANT’S) ends with “PRAMINE”
4. EPS “ TRIPTYLINE”
EXTRAPYRAMIDAL SYMPTOMS Imipramine (Tofranil) Amitriptyline (Elavil)
1. TARDIVE DYSKENISIA –Lip smucking, Tongue twitching Desipramine (Norpramin) Protrityline (Aventyl)
2. PSEUDO PARKINSONISM – Tremors(reversible), Trimipramine (Surmontil) Nortriptyline (Vivactyl,
Rigidity, Mask face Pamelor*)
3. DYSTONIA – Neck Rigidity (Dysphagia), Pupillary Clomipramine (Anafranil) –OCD*
paralysis Trazodone (Desyrel)
4. AKATHESIA – Feeling of ants under their pants, restless, **ANTICHOLINERGIC SIDE EFFECTS
irritable, jittery, agitated Dry Mouth, Constipation, Decrease BP, Blurred Vision,
ADJUNCT DRUGS/ANTICHOLINERGICS – muscle relaxants Hallucination, Increase Appetite
1. Cogentin
2. Benadryl SSRI’S (SELECTIVE SEROTONIN REUPTAKE INHIBITORS) –
3. Akineton Ends with INE but not PINE and PRAM
4. Artane
 Fluoxetine (Prozac) Citalopram (Celexa*)
TOXIC SIDE EFFECTS
1. NEUROLEPTIC MALIGNANT SYNDROME  Paroxetine (Paxil, Pexeva) Escitalopram (Lexapro)
High fever (1st sign), Musle rigidity, spasm,  Sertraline (Zoloft)
Decrease LOC.  Fluvoxamine (Luvox) –OCD*
2. AGRANULOCYTOSIS – Sorethroat  Vilazodone (Viibryd)
3. Leukopenia – check CBC
4. Hepatotoxic ***SIDE EFFECTS – Sexual Dysfunction, GI Symptoms
(H,N,V,Abd’l pain)
***KNOW***DECANOATE- IM/IV Antipsychotics
St. John's wort (Hypericum perforatum) – US Herbal
ANXIOLYTIC/BENZODIAZEPINES – Decrease Anxiety, Muscle
relaxant
‘ZEPAM” “ZOLAM” Antidepressant
Diazepam (Valium) Alprazolam (Xanax)
Lorazepam (Ativan) Estazolam (Prosom) ANTI-MANIC AGENTS/MOOD STABILIZERS
Oxazepam (Serax) Midazolam (Versed) LITHIUM CARBONATE (Eskalith)
Flurazepam (Dalmane) *Chlorazepate Dipotassium (Tranxene) VALPROIC ACID (Depakote)
Clonazepam ( Rivotril) *Buspirone (Buspar) CARBAMAZEPINE (Tegretol)
Temazepam (Restoril) *Chlordiazepoxide (Librium) ANTIPSYCHOTIC

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LITHIUM CARBONATE – oral 4. EUPHORIA
Therapeutic level : 0.5-1.5 meq/L WITHDRAWAL SIDE EFFECTS:
Below 0.5 : Manic 1. Sweating &Yawning (1st sign)
Above 1.5: Toxic 2. GI Symptoms (H,N,V,Abd’l pain)
TOXIC SIDE EFFECTS: 3. Coryza symptoms (Teary eyes, runny nose)
 Diarrhea (1st sign) 4. Tremors
 Muscle rigidity/spasm 5. Irritable
 Decrease LOC (lethargy, stupor, coma)
*****Antidote: Diuretics (Mannitol, Diamox) ALCOHOLISM – alters a person’s Health, Career, Family &
SIDE EFFECTS: Financial status
 GI SYMTOMS (H,N,V, Abd’l pain) BAL- 0.1%
 Depression –Suicide risk ALCHOL WITHDRAWAL S/Sx (BAL below 0.1%)
DIET: Confusion
 Regular Na (2-3g/day) Hallucination (Visual,tactile)
Increase v/s
 High Fluids (2-3 L/day)
Tremors
***Avoid activities that causes excessive perspiration
Sweating (1st sign)
Seizure (last sign)
SUBSTANCE ABUSE – Use of substance other than its medical
Defense Mechanism: Denial (underestimate use)
purpose.
ALCOHOL WOTHDRAWAL SYNDROME (AWS)
TOLERANCE – Need to increase dose of substance
1. DELERIUM TREMENS – alcohol in the brain
DEPENDENCE –Physical and Psychological, Withdrawal S/Sx
S/Sx CHITS
*Mgt: Diazepam, Librium, Tranxene
CNS STIMULANTS
2. KORSAKOFF’s – Deficiency in THIAMINE and NIACIN
1. Methamphetamine HCL *ANTIDOTE: SEDATIVES
S/Sx: MEMORY DISTURBANCE
2. Cocaine
-Amnesia (antero,retro)
3. Ecstacy
- Confabulation
SIDE EFFECTS
3. WERNICK’S – Deficiency in THIAMINE
1. Pupil (Dilated)
S/Sx: EYE & BALANCE PROBLEM (Opthalmoplegia,Ataxia)
2. Palpitaion – arrest
3. Weight Loss, Decrese appetite
AVERSION THERAPY
4. Hyperactive
Introduction of painful stimuli to prevent another stimuli
5. Increse V/s
DISULFIRAM (ANTABUSE)
6. EUPHORIA
Avoid alcohol 12 hours prior to intake
7. Increase Libido
EFFECT OF ALCOHOHOL: Severe GI Symptoms
8. Insomnia
SUBSTANCES WITH ALCOHOL – Read label of Mouthwash,
WITHDRAWAL S/Sx
Cold remedies,
1. Depression
Fruit extracts (wine, skin products,
2. Hypersomnia
aftershave lotion)
3. Increase Appetite
4. Schizophrenia
PSYCHO STIMULANTS/HALLUCINOGENS
1. Cannabis Sativa *ANTIDOTE –Vit. C rich juice
2. LSD (Lysergiec Acid Diethylamide)
3. PCP (Phencylidine)
SIDE EFFECTS
1. Pupil (Dilate)
2. Blotchy, Red eye
3. Increase Libido
DANGER – Acute Psychosis (Hallucinations)
NARCOTICS/OPIATES
1. Heroine -
2. Morphine *Antidote- Naloxone (Narcan)
3. Demerol Nalbuphine (Nalline)
4. Paregoric Acid
5. Codeine
SIDE EFFECTS
1. Pupil (Constricted)
2. Piloerection (Goose bumps/flesh)
3. Constipation

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NURSE PATIENT INTERACTION