NR 326 MEDICATIONS FOR ALCOHOLISM AND
MENTAL HEALTH DISORDERS EXAM 2 REVIEW
Medications
• Thiamine ( Alcoholism treatment; B vitamin )
• Lorazepam (Ativan, Benzo)
• Chlordiazepoxide
• Folic Acid ( alcoholism, Vitamin)
• Fluphenazine ( 1st Gen antipsychotic, EPS, can be used for
schizophrenia ,akathisia acute dystonia,
parkinsonism(tremors, bradykinesia, tardive dyskinesia, risk
of QT prolongation)
• Buspirone
• Fluoxetine
• Escitalopram
1. Thiamine (Vitamin B1)
Use:
• Alcoholism treatment, Wernicke-Korsakoff syndrome,
thiamine deficiency, beriberi, peripheral neuropathy.
• Prevents neurological complications associated with chronic
alcohol use.
Mechanism of Action (MOA):
• Thiamine is essential for glucose metabolism and energy
production. It acts as a coenzyme in carbohydrate metabolism
and helps prevent neurological damage in alcohol-related
conditions. Contraindications:
• Hypersensitivity to thiamine.
• Use cautiously in patients with a history of allergic reactions.
Nursing Implications:
• Administer before glucose infusion in alcohol withdrawal to
prevent Wernicke’s encephalopathy.
• Monitor for signs of anaphylaxis when given IV.
• Educate on dietary sources (whole grains, meats, legumes) and
, alcohol cessation.
2. Lorazepam (Ativan) –
Benzodiazepine Use:
• Anxiety disorders, alcohol withdrawal, status
epilepticus, sedation, muscle spasms.
• Used in alcohol withdrawal to prevent seizures and agitation.
MOA:
,• Enhances the effect of gamma-aminobutyric acid (GABA), an
inhibitory neurotransmitter, leading to sedation, muscle
relaxation, and anxiolytic effects.
Contraindications:
• Severe respiratory depression, sleep apnea, acute narrow-
angle glaucoma.
• Use cautiously in elderly patients (increased fall risk).
• Pregnancy Category D – risk of fetal harm.
Nursing Implications:
• Monitor for respiratory depression, drowsiness, dizziness,
and dependency.
• Avoid alcohol and CNS depressants.
• Taper gradually to prevent withdrawal symptoms.
• Use flumazenil as an antidote for overdose.
3. Chlordiazepoxide (Librium) –
Benzodiazepine Use:
• Alcohol withdrawal syndrome, anxiety, preoperative sedation.
MOA:
• Enhances GABA activity, producing anxiolytic, sedative, and
muscle relaxant effects.
Contraindications:
• Respiratory depression, severe hepatic impairment, hypersensitivity.
• Pregnancy Category D – risk of fetal abnormalities.
Nursing Implications:
• Monitor for excessive sedation, confusion, and
respiratory depression.
• High risk for dependency and withdrawal – do not stop abruptly.
• Advise patients to avoid alcohol and driving while taking
this medication.
4. Folic Acid (Vitamin
B9) Use:
• Alcoholism-related folate deficiency, pregnancy
supplementation, megaloblastic anemia, prevention of
neural tube defects.
MOA:
, • Essential for DNA synthesis and red blood cell production.
Alcoholism depletes folate levels, leading to anemia and
neurological complications.
MENTAL HEALTH DISORDERS EXAM 2 REVIEW
Medications
• Thiamine ( Alcoholism treatment; B vitamin )
• Lorazepam (Ativan, Benzo)
• Chlordiazepoxide
• Folic Acid ( alcoholism, Vitamin)
• Fluphenazine ( 1st Gen antipsychotic, EPS, can be used for
schizophrenia ,akathisia acute dystonia,
parkinsonism(tremors, bradykinesia, tardive dyskinesia, risk
of QT prolongation)
• Buspirone
• Fluoxetine
• Escitalopram
1. Thiamine (Vitamin B1)
Use:
• Alcoholism treatment, Wernicke-Korsakoff syndrome,
thiamine deficiency, beriberi, peripheral neuropathy.
• Prevents neurological complications associated with chronic
alcohol use.
Mechanism of Action (MOA):
• Thiamine is essential for glucose metabolism and energy
production. It acts as a coenzyme in carbohydrate metabolism
and helps prevent neurological damage in alcohol-related
conditions. Contraindications:
• Hypersensitivity to thiamine.
• Use cautiously in patients with a history of allergic reactions.
Nursing Implications:
• Administer before glucose infusion in alcohol withdrawal to
prevent Wernicke’s encephalopathy.
• Monitor for signs of anaphylaxis when given IV.
• Educate on dietary sources (whole grains, meats, legumes) and
, alcohol cessation.
2. Lorazepam (Ativan) –
Benzodiazepine Use:
• Anxiety disorders, alcohol withdrawal, status
epilepticus, sedation, muscle spasms.
• Used in alcohol withdrawal to prevent seizures and agitation.
MOA:
,• Enhances the effect of gamma-aminobutyric acid (GABA), an
inhibitory neurotransmitter, leading to sedation, muscle
relaxation, and anxiolytic effects.
Contraindications:
• Severe respiratory depression, sleep apnea, acute narrow-
angle glaucoma.
• Use cautiously in elderly patients (increased fall risk).
• Pregnancy Category D – risk of fetal harm.
Nursing Implications:
• Monitor for respiratory depression, drowsiness, dizziness,
and dependency.
• Avoid alcohol and CNS depressants.
• Taper gradually to prevent withdrawal symptoms.
• Use flumazenil as an antidote for overdose.
3. Chlordiazepoxide (Librium) –
Benzodiazepine Use:
• Alcohol withdrawal syndrome, anxiety, preoperative sedation.
MOA:
• Enhances GABA activity, producing anxiolytic, sedative, and
muscle relaxant effects.
Contraindications:
• Respiratory depression, severe hepatic impairment, hypersensitivity.
• Pregnancy Category D – risk of fetal abnormalities.
Nursing Implications:
• Monitor for excessive sedation, confusion, and
respiratory depression.
• High risk for dependency and withdrawal – do not stop abruptly.
• Advise patients to avoid alcohol and driving while taking
this medication.
4. Folic Acid (Vitamin
B9) Use:
• Alcoholism-related folate deficiency, pregnancy
supplementation, megaloblastic anemia, prevention of
neural tube defects.
MOA:
, • Essential for DNA synthesis and red blood cell production.
Alcoholism depletes folate levels, leading to anemia and
neurological complications.
