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Cognition Meds
| Question | Answer |
|---|---|
| Benzodiazepines | -Alprazolam -Diazepam -Lorazepam -Clonazepam -Oxazepam |
| Benzodiazepine Side Effects | -CNS depression -Lightheadedness -Unsteady gait -Amnesia -Respiratory depression -Depression |
| Benzodiazepine Antidote | Flumazenil |
| Benzodiazepine Purpose | -Anxiety disorders |
| Benzodiazepine Contraindications | -Sleep apnea -Insomnia -Alcohol use |
| Benzodiazepine Nursing Considerations | -Must be tapered, can cause withdrawal symptoms -Monitor respiratory rate and O2 sats -Increased risk for dependency |
| Non-Benzodiazepines | -Eszopicione -Zolpidem |
| Non-Benzodiazepines Side Effects | -Daytime sleepiness -Dizziness -Hallucinations -Impaired alertness and motor coordination can occur |
| Non-Benzodiazepines Nursing Considerations | -Use lowest effective dose -Give right before bedtime -Risk for dependence -Pt should allow for a minimum of 8 hours of sleep |
| Selective Serotonin Reuptake Inhibitors (SSRI) | -Paroxetine -Sertraline -Citalopram -Escitalopram -Fluoxetine -Fluvoxamine |
| SSRI Purpose | -First line of treatment for depression |
| SSRI Side Effects | -Sexual dysfunction (decreased libido, ED) -CNS stimulation (anxiety, agitation, insomnia) -Weight loss early use, weight gain with long term use -Serotonin syndrome -GI bleeding (dark tarry stools) -Bruxism (grinding of teeth) |
| SSRI Nursing Considerations | -Take in the morning; no caffeine -If has seizures give benzo -If diaphoretic give acetaminophen -Must be tapered can cause withdrawal -Monitor sodium levels -SSRIs do NOT play nicely with MAOIs or TCAs -Takes 1-3 weeks for therapeutic level |
| Serotonin Norepinephrine Reuptake Inhibitors (SNRI) | -Venlafaxine -Desvenlafaxine -Duloxetine -Levomilnacipran |
| SNRI Side Effects | -Nausea -Decreased appetite -Weight loss -Hypertension -Tachycardia -Blurred vision -Mydriasis (dilated pupils) |
| SNRI Nursing Considerations | -Does NOT play nicely with MAOIs (increased risk for serotonin syndrome) -Must taper can cause withdrawal symptoms -If switching from SNRI to SSRI must taper and wait 2 weeks between medications) |
| Atypical | -Bupropion -Vilazodone -Mirtazapine -Trazodone |
| Atypical Side Effects | -Headache -Constipation -Tachycardia -Hypertension -Weight loss -Sedation |
| Atypical Contraindications | -History of seizures -Eating disorders |
| Atypical Nursing Considerations | -Does NOT play nice with MAOIs -Vilazodone and Trazodone can't be taken with grapefruit juice |
| Tricyclic Antidepressants (TCA) | -Amitriptyline -Imipramine -Nortriptyline -Trimipramine -Desipramine -Clomipramine |
| TCA Side Effects | -Orthostatic hypotension -Photophobia -Dry mouth -Urinary retention -Sedation -Constipation -Cardiac toxicity (dysrhythmias) -Seizures -Excessive sweating -Serotonin syndrome |
| TCA Nursing Considerations | -Take at night -Monitor heart and/or EKG -Can decrease seizure threshold (likely not good for those with history of seizures) |
| Monoamine Oxidase Inhibitors (MAOI) | -Phenelzine -Isocarboxazid -Tranylcypromine -Selegiline |
| MAOI Side Effects | -Anxiety -Agitation -Orthostatic hypotension -Hypertensive crisis (d/t eating foods with tyramine) |
| MAOI Contraindications | -Pheochromocytosis (tumor of the adrenal gland) |
| MAOI Nursing Considerations | -Does NOT play nice with SSRIs and SNRIs -Take at night -Encourage voiding before taking |
| Foods Containing Tyramine | -Aged cheese -Salami -Bologna -Avocado -Smoked fish -Soy sauce -Figs -Bananas -Raisins -Liver -Red wine |
| Central Nervous Stimulants | -Methylphenidate -Dexmethylphenidate -Amphetamine Mixture |
| Central Nervous Stimulants Side Effects | -Insomnia -Weight loss -Suppress growth and appetite -Dysrhythmias -Chest pain -Shortness of breath -Hallucinations/paranoia -Dizziness |
| Central Nervous Stimulants Contraindications | -History of substance abuse -Hypertension -Glaucoma -Hyperthyroidism |
| Central Nervous Stimulants Nursing Considerations | -Don't give past 1600 -Don't give with caffeine -Never stop abruptly, taper slowly to avoid withdrawal |
Created by:
NikkiLeigh83
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