Term
|
Definition
Benzos:Librium
Valium
Ativan
Adjunct Meds: carbamazepine(tegretol)
clonidine(catapres)
propanolol(inderal) |
|
|
Term
|
Definition
Maintenance of VS WNL, decrease Sz risk, decrease Sx intensity
NOTE: monitor VS & neuro status around the clock |
|
|
Term
| ETOH - carbamazepine (Tegretol) |
|
Definition
| Decrease the incidence of Sz |
|
|
Term
| ETOH - clonidine (Catapres) |
|
Definition
| depression of the autonomic response (decrease BP & HR) |
|
|
Term
| ETOH - Propanolol (Inderal) |
|
Definition
Depression of the autonomic response (decrease BP & HR)
Decreases cravings |
|
|
Term
ETOH Abstinence Maintenance
MEDS |
|
Definition
Dsulfiram (Antabuse)
Naltrexone
Acamprosate (Campral) |
|
|
Term
| ETOH - Disulfiram (Antabuse) |
|
Definition
Behavioral (aversion) Therapy
If drinking ETOH:
-acetaldehyde syndrome will occur (N/V, sweating, palpitations, hypotension). Can progress to resp. & CV depression, Sz and death
Avoid ALL ETOH (cough syrup, aftershave)
Sx persist 2wks after DC |
|
|
Term
|
Definition
Opioid antagonist that suppresses craving & pleasurable effects of ETOH (also opioid withdrawal)
-Assess Hx of opioid dependency - could initiate withdrawal syndrome
-Take w/meals to avoid GI upset
-Monthly IM if compliance poor |
|
|
Term
| ETOH - Acamprosate (Campral) |
|
Definition
Decreases the unpleasant effects of withdrawal (anxiety, restlessness)
-diarrhea may result, maintain adequate fluid intake, avoid if preggo |
|
|
Term
|
Definition
Amitriptyline (Elavil)
Imipramine (Tofranil)
Doxepin (Sinequan)
Nortriptyline (Aventyl)
Amoxapine (Asendin)
Trimipramine (Surmontil) |
|
|
Term
|
Definition
Orhtostatic hypotension
-If significant drop, stop med & call HCP
Anticholinergic Effects
Sedation (take HS)
Toxicity resulting in cholinergic blockade & <3 toxicity
-dysrhythmias, mental confusion & agitation
Decrease Sz threshold
Diaphoresis |
|
|
Term
| TSAs - Contraindications/Precautions |
|
Definition
Do not use in Sz disorders
Use Cautiously in pts w/ CAD, DM, liver, kidney * resp disorders, urinary retentions & obstruction, angle closure glaucoma, benign prostate hypertrophy, hyperthyroidism |
|
|
Term
| TCAs Med/Food Interactions |
|
Definition
| -w/ MAOIs ->HTN ->Severe antihistamines and other anticholinergics -concurrent use of smpathomimetics may result in ^effects of meds -ETOH, benzos, opioids, &antihistamines ->CNS DEPRESSION |
|
|
Term
|
Definition
fluoxetine (Prozac)
citalopram (celexa)
escitalopram (Lexapro)
paroxetine (Paxil)
sertraline (Zoloft) |
|
|
Term
|
Definition
-Sexual dysfunction (wellbutrin, nefazodone has less SE)
-CNS stim (inability to sleep, agitation, anxiety)-notify HCP, Take AC
-Weight decrease early on, then ^
-SEROTONIN SYNDROME: 2-72hrs after Tx -mental confusion, difficulty concentrating, agitation, fever, anxiety, hallucinations, hyperreflexia, incoordination, diaphoresis
-Withdrawal Sx: HA, nausea, visual disturbances, anxiety, dizziness, tremors -TAPER!
-Rash
-GI Bleed (caution in pts w/ Hx or if taking anticoag.)
-Bruxism (mouth guard) |
|
|
Term
|
Definition
-Fluoxetine & paroxetine -^ birth defect risk, use other SSRIs
-Don't take w/ MAOI's or TCAs
-Caution in renal &/or liver dysfunction, <3 disease, Sz disorders, DM, ulcers, Hx of GI bleed |
|
|
Term
| SSRI - Med/Food Interactions |
|
Definition
-MAOIs, TCAs, St John's Wort -^ Serotonin Syndrome.
*DC MAOIs 14 days before SSRI use. Fluoxetine should be DC'd 5wks before MAOIs
-Warfarin (Coumadin): Monitor PTT&INR
-^ levels of TCAs & Lithium
-NSAIDs & anticoags can further suppress plt aggregation |
|
|
Term
| MAOIs - Med/Food Interaction |
|
Definition
-Avoid OTC decongestants & Cold remedies
-Use w/ TCAs ->HTN crisis
-vasopressors -> HTN
-w/ SSRIs -> Serotonin Syndrome
-antiHTN meds ->hypotension
-meperidine (Demerol)-> hyperpyrexia
-tyramine ->HTN crisis (HA, nausea, ^HR, ^BP) -aged cheese, pepperoni, salami, avocados, figs, bananas, smoked fish, protein |
|
|
Term
| MEDS for Bipolar Disorder |
|
Definition
Lithium
valproic acid (Depakote)
carbamazepine (Tegretol)
lamotrigine (Lamictal) |
|
|
Term
|
Definition
-GI Distress (take w/food or milk)
-Fine hand tremors (admin beta blocker -propanolol). If ^tremors, watch for toxicity
-Polyuria, mild thirst (use k sparing diuretics)
-weight gain
-renal toxicity (monitor I&O, adjust dosage, assess BUN & Cr)
-Bradydysrhythmias, hypotension, electolyte imbalances (encourage fluid intake)
-Goiter & hypothyroidism w/ long term Tx |
|
|
Term
|
Definition
-early (<1.5)-diarrhea, n/v, thirst, polyuria, muscle weakness & slurred speech.
-advanced (1.5-2)-mental confusion, poor coordination, coarse tremors, & ongoing GI distress
-Severe (>2.0-2.5)-extreme polyuria, tinnitus, blurred vision, ataxia, sz, severe hypotension ->coma& poss. death
>2.5-rapid progression of sx->coma or death. Hemodialysis |
|
|
Term
| Lithium CONTRAINDICATIONS |
|
Definition
-Teratogenic, esp during 1st tri.
-caution in pts w/ renal dysfxn, <3disease, hyponatremia & dehydration |
|
|
Term
| Lithium MED/FOOD interactions |
|
Definition
-Diuretics -decreased Na->decreased Lithium excretion->Toxicity.
-Anticholinergics (antihistamines, TCAs)-ab. discomfort from urinary retention&polyuria. AVOID
*encourage ^Na in diet &2-3L/day of fluid
-NSAIDs (ibuprofen, celebrex)-will ^ renal absorption of lithium->toxicity (use aspirin of mild analgesic) |
|
|
Term
| carbamazepine (Tegretol) SE |
|
Definition
| -min cognitive effect -CNS: nystagmus, double vision, vertigo, staggering gait, H/A (lower dosage then steadily ^) -Blood dyscrasias (obtain baseline CBC & plt.) -Teratogenesis -Hypo-osmolarity-promotes ADH excretion->inhibits H2O excretion by kidneys &places HF @risk for fluid overload -Skin Disorders- dermatitis, rash (antiinflamm. or antihistamine, wear sunscreen) |
|
|
Term
| valproic acid (Depakote) SE |
|
Definition
-GI (NV, indigestion): take w/food
-Hepatotoxicity aeb anorexia, N/V, fatigue, ab. pain, jaundice (Baseline LFTs & admin lowest poss. dose)
-pancreatitis aeb n/v, ab.pain (monitor amylase levels, DC med)
-Thrombocytopenia (Monitor plt)
-Teratogenesis |
|
|
Term
| lamotrigine (Lamictal) SE |
|
Definition
double/blurred vision, dizziness, HA, N/V
-Serious skin rash - Stevens-Johnson |
|
|
Term
| MOOD STABILIZING AEDs -Contraindications |
|
Definition
-preg risk
-carbamazepine contraindicated w/bone marrow suppression or w/bleeding disorders
-valproic acid (Depakote) - in pts w/ liver dysfxn |
|
|
Term
| MOOD STABILIZING AEDs - MED/FOOD INTERAXNS |
|
Definition
-carbamazepine (Tegretol)
*birth control, coumadin: decrease in effects of these meds.
*Grapefruit juice-inhibits metabolism->^blood levels
*Phenytoin, phenobarbital: Decrease effects of Tegretol
-Valproic Acid-*Phenytoin, phenobarbital decrease effects of depakote
-Lamotrigine:*carbamazepine,phenytoin, pheobarbital: ^1/2life of lamotrigine |
|
|
Term
| Neuroleptic Malignant Syndrome (NMS)s/s |
|
Definition
-sudden^ fever
-BP fluctuations
-dysrhythmias
-muscle rigidity
-LOC change -> coma
*stop med!, monitor VS, apply cooling blankets, admin antipyretics, ^fluids, dantrolene or bromocriptine -muscle relaxation. wait 2wks before resuming |
|
|
Term
| Mgmt of EPS Sx of antipsychotics |
|
Definition
Acute Dystonia-anticholenergics (benzotropine or benedryl)
Parkinsonism-Tx w/ benztropine, diphenhydramine or amantadine (symmetrel)
Akathisia-Beta blockers, benzos, or anticholinergics
TD-decrease dose, switch to atypical |
|
|
Term
|
Definition
| dealing w/ anxiety by reaching out to others |
|
|
Term
|
Definition
dealing w/unacceptable feelings or impulses by unconsciously substituting acceptable forms of expression
ex: angry at boss->work out like crazy) |
|
|
Term
|
Definition
| voluntarily denying unpleasant thoughts and feelings |
|
|
Term
|
Definition
| putting unacceptable ideas, thoughts and emotions out of conscious awareness |
|
|
Term
|
Definition
shifting feelings r/t an object, person, or situation to another less threatening object, person or situation
ex: person angry about losing job->destroys child's favorite toy |
|
|
Term
|
Definition
| Overcompensating or demonstrating the opposite behavior of what is felt |
|
|
Term
|
Definition
| indirectly behaving aggressively but appearing to be compliant |
|
|
Term
|
Definition
| developing a physical symptom in place of anxiety |
|
|
Term
|
Definition
| performing an act to make up for prior behavior |
|
|
Term
|
Definition
| managing emotional conflicts through actions, rather than self-reflection |
|
|
Term
|
Definition
| temporarily blocking memories and perceptions from consciousness |
|
|
Term
|
Definition
| expressing negative thoughts of self and/or others |
|
|
Term
|
Definition
| expressing extremely positive thoughts of self/others |
|
|
Term
|
Definition
| demonstrating an inability to reconcile neg and pos attributes of self or others |
|
|
Term
|
Definition
| blaming others for unacceptable thoughts or feelings |
|
|
Term
|
Definition
| Pretending the truth is not reality to manage the anxiety of acknowledging what is real |
|
|
