MEDICATIONS FOR PSYCHIATRIC MENTAL HEALTH DISORDERS GUIDE 2024

ANTIMANIC AGENTS - Lithium carbonate Lithium toxicity: Serum levels >1.5 mcg/L Symptoms: Indigestion, rashes, drowsiness, nausea, vomiting, abdominal cramps, polyuria, polydipsia, ataxia, tremor, slurred speech, disorientation, and seizures. Nursing Implications: toxicity and to maintain high fluid intake and stable salt use. Periodic blood tests to assess drug level are necessary. Teach patient to avoid alcohol use. Instruct patient to take medication with food if medication causes indigestion. Avoid Diuretics Sodium level 135-145 ANTIPSYCHOTIC AGENTS - Chlorpromazine Fluphenazine HCI Haloperidol (Haldol) Anticholinergic effects: Dry mouth, blurred vision, constipation, urinary retention, postural hypotension Extrapyramid side effects (EPS): Akathisia (severe restlessness inability to stand still, foot tapping) Rare: Neuroleptic malignant syndrome: hyperthermia, muscle rigidity, labile BP, confusion, cardiovascular collapse) Nursing Implication: Suggest sugarless candy or gum for dry mouth. Instruct patient to wear sunscreen. May need to increase salt intake during hot weather. Explain need to rise slowly from sitting to standing. Decrease sweat. More EPS BLOCKS DOPAMINE ATYPICAL ANTIPSYCHOTIC AGENTS - Clozapine- Low risk of EPS and tardive dyskinesia BLACK BOX WARNING-Argonulocytosis low-WBC NURSING IMPLICATION-Suggest sugarless candy or gum for dry mouth. Explain need to rise slowly from sitting to standing olanzapine-Significant imporovement of negative behaviors; most common effects are dry mouth, dyspepsia, drowsiness, postural hypotension, no association with agranulocytosis MEDICATIONS FOR PSYCHIATRIC MENTAL HEALTH DISORDERS GUIDE 2024 risperidone-:low rate of EPS and no association with agranulocytosis LESS EPS ANTIANXIETY AGENTS-BENZO - alprazolam (Xanax) buspirone-not a benzo chlordiazepoxide HCI (LIBRIUM) clorazepate dipotassium (Tranxene) lorazepam (Ativan) oxazepam Drowsiness, ataxia, muscle weakness, occasionally disinhibition, morning hangover, transient hypotension, Potentially habit forming, aggravates depression or psychosis, dizziness Nursing Implication- Monitor for increased side effects in older adults. Teach patient not to operate machines or drive if drowsiness is occurring. Teach patient to avoid alcohol use. Instruct patient not to stop taking medications abruptly. Explain need to rise slowly from sitting to standing.