Mark Klimek Audio Lectures:Lecture 9 Psych Medications 2021 edition

- It takes 3 things to pass the NCLEX exam - Knowledge - Confidence - Exam Proficiency - You can’t apply what you don't know, but you have to be able to apply what you do know. - Go with majority: if something is 75% fatal, consider it fatal. - If you try to learn everything you will master nothing. Lecture 9 Psych Medications - All psych medications cause 2 things regardless of classification: - Lower’s blood pressure - Weight changes (usually increase weight) Phenothiazine’s - Phenothiazine’s are an old class of psych medication that have a couple different names: - First generation antipsychotic medications - Typical antipsychotics - All Phenothiazine medications end in “zine”. - Prochlorperazine - Cholorpromazine - Thioridazine - Fluphenazine - Action: - All Phenothiazine medication do not cure the psychotic disorder, they just reduce the symptoms. - In large doses they are antipsychotics - “We use zine’s for the zainy (insane)” - In small doses they are antiemetic’s - Phenothiazine’s are major tranquilizers. - “Aminoglycosides are to antibiotics” as “Phenothiazine’s are to tranquilizers” - Meaning: when no other tranquilizers are working the Phenothiazine’s are used to get the job done. - Side effects of Phenothiazine’s: - Phenothiazine’s have a long list of major side effects: - Anticholinergic effects (primarily dry mouth) - Blurred vision - Constipation - Drowsiness - EPS (Extrapyramidal syndrome): drug induced Parkinson’s - Photosensitivity - Agranulocytosis (low WBC count): immunosuppressed - Nursing Care: - The nursing care is focused on treating the side effects of Phenothiazine’s - Since patients on these medications have blurred vision, drowsiness, and EPS, the number one concern is risk for injury. - Cogentin and Artane are given to reduce EPS effects - Decanoate: - Typically abbreviated with the letter “D” - Thioridazine “D” - If the “D” comes after the name of the medication it means it is a long-acting medication. Meaning it is given once IM and its actions last for weeks or months at a time. - This is for noncompliant patients. Tricyclic Antidepressants NSSRI - Tricyclic Antidepressants are and old class of antidepressant medications that fall under the category of NSSRI (Non-Selective Serotonin Reuptake Inhibitors) medications. - These medications are mood elevators that are used to treat depression. - Elavil (amitriptyline) - Tofranil (imipramine) - Avitil - Deceril - Side effects of Tricyclic Antidepressants: - Anticholinergic (primarily dry mouth) - Blurred vision - Constipation - Drowsiness - Euphoria - The patient must take these medications for at least 2 - 4 weeks before the effects kick in. Benzodiazepines - Benzodiazepines are antianxiety medications - Benzodiazepines are considered to be minor tranquilizers - “Zine’s” major tranquilizers - “Zep’s” minor Tranquilizers - Benzodiazepines always have “zep” in their names: - Clonazepam - Chlordiazepoxide (Librium) - Diazepam (valium) - Lorazepam (Ativan) - These medications are more the just minor tranquilizers: - Used in pre-op to induce anesthesia - Used as a mu