Term
| Nonpharmacologic Methods to treat sleep problems |
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Definition
Decrease naps
avoid caffeine
tapes, relaxation
warm milk
backrub |
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Term
Sedative-Hypnotics
Side Effects
Dependence
Tolerance |
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Definition
Most frequently prescribed drugs
Side Effects include: respiratory depression, Hangover, REM rebound (vivid dreams), nightmares, hypersensitivity (rash, urticaria (hives)) and depression |
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Term
Barbituates
Benzodiazepines
piperidinediones |
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Definition
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Term
| Short term Barbiturates used for achieving sleep |
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Definition
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Term
| Intermediate barbiturates used for sustaining sleep |
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Definition
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Term
| Ultra short barbiturates used for general anesthesia |
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Definition
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Term
| Barbiturates interact with |
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Definition
| narcotics, alcohol, oral anticoagulants and other sedatives. |
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Term
Should be restricted to short term use only.
Not recommended for elderly |
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Definition
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Term
|
Definition
| nausea/vomiting,diarrhea, hangover, respiratory distress and laryngospasm, hepatotoxicity (especially if used with tylenol) |
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Term
Benzodiazepines
used for anxiety or for sleep |
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Definition
anxiety ativan and xanax
sleep dalmane, halcion, serax, restoril and doral |
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Term
| Benzodiazepines suppress stage |
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Definition
| 4 NREM sleep and will result in vivid dreams or nightmares and will delay REM stage, decrease feelings of being well rested. Not used for longer than 3-4 weeks. |
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Term
|
Definition
half-life of 45-100 hours and highly protein bound.
not recommended for elderly, discontinued in many hospitals as hypnotic choice. |
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Term
Short acting benzodiazepines
(used for the elderly) |
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Definition
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Term
| Drug interaction with short acting benzodiazepines Serax and Halcion |
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Definition
| increase hypnotic action with alcohol, cns depressants and tagamet |
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Term
|
Definition
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Term
|
Definition
similar to barbituates, are addictive and can cause severe adverse reactions.
vasomotor collapse, blood dyscrasias
used with caution in patients with renal disease and depression. |
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Term
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Definition
| does suppress REM, and has less hangover effects, patients complain of GI distress. avoided in patients with liver or renal failure. Interacts with lasix, coumadin and other cns depressants. |
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Term
|
Definition
Depress the cns system
one area of the body |
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Term
| Balanced general anesthesia |
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Definition
combination of drugs used for anesthesia
first is a hypnotic, evening before, second a narcotic or benzo for relaxation and an anticholinergic (atropine to dry secretions) one hour before , third a short acting barbituate (pentothal) and fourth an inhaled gas and finally a muscle relaxant and needed. Positive effects including reduced cardiac and gi side effects and decreases in the amount of anesthesia given. |
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Term
|
Definition
analgesia
excitement
surgical
medullary paralysis |
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Term
|
Definition
Inhalation: (nitrous oxide, cycloproprane, seroflurane)
Intravenous: induction or short procedures, pentothal (shivering and tremors can occur) Innovar, ketelar, amidate.
Topical: decrease sensitivity, limited to mucosa membranes, xylocanine, novacaine. Used for nerve blocks, dental procedures, suturing (ester or amides)
Spinal: local injection into l 3/4 Nursing measures(increasing fluids and keeping head of bed flat) |
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Term
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Definition
| mental disorder, more than oney symptom such as difficulty in processing information, delusions, hallucinations, incoherence, catatonia or aggressive violent behavior. Imbalance of dopamine. |
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Term
|
Definition
| block dopamine antagonists, block or inhibit dopamine in an attempt to regain balance. (antiemetic effect) Medications inhibit dopamine. |
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Term
|
Definition
| too much antipsychotic will cause symptoms similar to Parkinson's disease. Rigidity, tremors and shuffling gait. |
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Term
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Definition
| one of the major psychotic diseases, chronic disorder with both positive and negative symptoms. New anti psychotics are much better ate treating both pos and negative symptoms of schizophrenia. |
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Term
Schizophrenia
Positive symptoms |
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Definition
| agitation, incoherent speech, delusions, paranoia |
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Term
Schizophrenia
Negative Symptoms |
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Definition
| decrease or loss of function and motivation |
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Term
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Definition
| phenothiazines work by blocking dopamine and norepinephrine, therefore produce sedation and hypotension |
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Term
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Definition
| Block dopamine but have a weaker affinity for D2( 5 types of dopamine receptors) and a stronger affinity for D4 therefore they also block serotonin and have fewer extrapyramidal or sedative side effects. |
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Term
| Extrapyramidal side3 effects |
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Definition
| stooped posture, mask like faces, rigidity, tremors, shuffling gait, pill rolling and bradykinesia. Treatment include: Cogentin, Ativan, Benzo's |
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Term
|
Definition
Many not disappear if drug stopped
Protruson and rolling of tongue, sucking and smaking movements of lips, chewing motion, facial dyskinesia, involuntary movements of the body and extremities. |
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Term
|
Definition
| facial grimacing, involuntary upward eye movement, muscle spasms of tongue, face, neck and back, laryngeal spasms |
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Term
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Definition
| Restless, trouble standing still, paces the floor, feet in constant motion rocking back and forth. |
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Term
Antipsychotic
Side Effects |
|
Definition
Pseudoparkinsonism
Acute dystonia
Akanthisia
Tardive dyskinesia |
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Term
Neuroleptic malignant syndrome
associated with antipsychotics |
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Definition
rare, potentially fatal adverse effect
muscle rigidity, sudden high fever, altered mental status, vital sign changes, respiratory/renal failure |
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Term
Phenothiazines
3 categories |
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Definition
aliphatic Thorazine, useed rarely.
piperazine Prolixin, side effects include dry mouth, urinary retention, agranulcytomis and more eps than other phenothiazines.
piperidine, mellaril, side effects include few eps strong sedation and not antiemetic. |
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Term
Nonphenothiazine
3 types
highly protein bound, long half life |
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Definition
Butyrophenones Haldol
Dibenzoxazepines Moban
Thixanthenes Navane |
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Term
|
Definition
| Haldol, commonly used antipsychotic used for behavior difficulties in dementia. |
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Term
|
Definition
| can cause tardive dyskinesia |
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Term
|
Definition
| highly protein bound, drug drug interaction (alcohol, hypnotic, sedatives, narcotics) are common and half life is 15 to 35 hours, administered low doses for elderly, |
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Term
|
Definition
| blood dyscrasias and decreased seizure threshold |
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Term
| Nursing Process for Antipsychotics |
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Definition
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Term
|
Definition
Zyprexia, Risperdal and Seroquel
Block serotonin and dopamine have fewer eps symptoms |
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Term
Risperdal, Seroquel
Atypical antipsychotic
side effects |
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Definition
| dizziness, HA, constipation, insomnia, anxiety and agranulocytosis |
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Term
|
Definition
| excessive and disabling anxiety treated with benzo |
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Term
|
Definition
| panic attacks, dyspnea, choking, chest pain, heart palpation, dizziness, sweating, trembling and shaking. |
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Term
|
Definition
Valium, xanax, ativan
highly protein bound, variable half life. |
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Term
|
Definition
works on limbic system and subcortical levels of the cns.
Used for anxiety, preop, muscle relaxant for alcohol, amneic and treatment of seizure in status epilepticus. |
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Term
|
Definition
ECG changes, dependence and larygospasm.
Must be slowly withdrawn, abrupt discontinuation will cause symptoms of agitation, confusion, nervousness and tremors.
Side effects include sedation, dizziness, HA, dry mouth, blurred vision, urinary incontinence, constipation (anticholinergic se) leukopenia, fever, malaise and sore throat. |
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Term
|
Definition
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Term
|
Definition
most common psychiatric problem 10-20% of populations.
Characteristics include mood changes, sleepleness, loss of interest and abnormal activities.
Causes can be social, environmental and biological. (insufficient monamine transmitters, serotonin and norepinephrine) |
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Term
|
Definition
| Reactive or sudden (precipitating event) |
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Term
|
Definition
dysphoria, low mood and loss of interest in anything and bipolar with symptoms of wide mood swings.
Treatment: antidepressants, psychotherapy, and ect. |
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Term
|
Definition
tricyclics
ssri
mao inhibitors |
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Term
| Tricyclic antidepressants |
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Definition
block uptake of serotonin and norepinephrine, take approx 2-4 weeks to see response, can cause dependency.
If not gradually withdrawn, nausea, vomiting, anxiety and akathesia can occur. |
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Term
| Tricyclic antidepressants |
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Definition
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Term
|
Definition
| orthstatic hypotension, sedation, anticholinergic se, cardiac toxicity and seizures, caution with elderly |
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Term
|
Definition
| block re uptake of serotonin, enhancing transmission at the serotonergic synapse. Have fewer side effects. |
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Term
|
Definition
| Prozac, Luvox, Paxil, Zoloft |
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Term
|
Definition
| interacton with grapefruit juice can lead to toxicity, dizziness, insomnia, dry mouth, impotence and tremors. May take several weeks 1-4 to show effect |
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Term
|
Definition
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Term
|
Definition
| exzyme that inactivates norepinephrine, dopamine and serotonin, by blocking enzyme, you increase levels of these transmitters. Great risk of serious side effects. |
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Term
MAO inhibitors
Side Effects |
|
Definition
MAO enzyme promotes metabolism of tyramine, blocked will cause hypertensive crisis if patients ingest. (cheeses, yogurt, beer, wine, liver, sausage, bananas)
SE: agitation, restlessness and insomnia |
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Term
|
Definition
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Term
|
Definition
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Term
|
Definition
| severe mood swings, mania and depression. |
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Term
|
Definition
first antidepressant to treat bipolar.
controlling mania phase, compliance issue.
Long half life 24-36 hrs
Narrow therapeutic range
Lithium levels drawn biweekly in early stages and then monthly
Range .5-1.5/ 1.5-2.0 toxic |
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Term
|
Definition
| dry mouth, thirst, increased urination, weight gain, bloating, metallic taste and edema. Highly protein bound |
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Term
Lithium
Drug-Drug interactions |
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Definition
| nsaids, haldol, antidepressants, diuretics, and theophylline |
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Term
Depakote anticonvulsants
Tegretol/Lamictal |
|
Definition
| used to treat bipolar illness with less complications |
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Term
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Definition
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