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PSYCHMEDS
2ND GENERATION
| Question | Answer |
|---|---|
| 2ND GENERATION/ATYPICAL ANTIPSYCHOTICS | CLOZAPINE(CLAZARIL)USED AS A LAST RESORT FOR PEOPLE WITH RETRACTABLE PSYCHOSIS.S/E DROWSINESS, SEDATION, DIZZINESS, TACHYCARDIAPOSS FATAL S/EAGRANULOCYTOSIS, CONVULSIONS, NEUTROPHILS < 2000/ABSOL NEUTROPHILS <1000 D/C PERM |
| MOOD STABILIZERS | LITHIUM, TEGRETOL(carbamazepine), DEPAKOTE (divalproex), LAMICTAL (lamotrigine), NEURONTIN (gabapentin), TOPAMAX (topiramate), KLONOPIN (CLONAZEPAM)**USED FOR BIPOLAR, MOOD CHANGES WITH MANIA AND PSYCOSIS |
| LITHIUM | MOST ESTABLISHED STABILIZER, NORMALIZES REUPTAKE OF NT, REDUCES RELEASE OF NOREPI, ACTION OCCURS INTRACELLULARLY INSTEAD OF AT SYNAPSE, REQUIRES SERUM MONITORING |
| LITHIUM | THEURAPEUTIC RANGE 0.6-1.2S/E: N/D ANOREXIA, FINE HND TREMOR, POLYURIA, POLYDIPSIA, METAL TASTE, FATIGUE, >WBC..LATER S/E: WGT GAIN, ACNE, ALOPECIA, COARSE TREMORS, CONFUSSION, SLURRED SPCH, SEDATION..EVENT LEADING TO: ARRITHYMIAS, SEIZURES, COMA, DEATH |
| LITHIUM TEACHING | COMPLIANCE, SERUM LEVELS, TAKE WITH FOOD, HYDRATION, Na INTAKE SHOULD STAY AT LEVEL AS WHEN MED WAS THERAPEUTIC.HAND TREMORS...HOLD LITHIUM |
| SEROTONIN | INHIBITS CATECHOLAMINE AND MEDIATES COGNITIVE EFFECTS, EMOTIONS DURING PANIC, MEMORY AND ANXIETY, VIOLENCE/AGGRESSION, SEXUAL FUNCTION, SLEEP/WAKE CYCLE |
| ANTIDEPRESSANTS TYPICAL/STANDARD | ELAVIL (amitriptyline), TOFRANIL (imipramine)req bld level, PAMELOR (nortriptyline) req bld levelANTICHOLINERGIC S/E, CARDIAC S/E1980'SOD=DEATHNEEDS TO BE TAPERED OFF |
| ANTIDEPRESSANTS SSRI'S | PROZAC (fluexetine)stim effect, ZOLOFT (sertraline), PAXIL (paroxetine), CELEXA (citalopram), LEXAPRO (escitaopram)1990'sOD=SEROTONIN SYNDROME |
| ANTIDEPRESSANTS MAOI'S | MARPLAN(isocarvexazid), NARDIL(pheneizine), PARNATE(tranylcypromine)menoamine oxidase inhibitors MENOAMINES(NOREPI,EPI, DOPAMINE,TYRMINE)TRYPTOPHAN WILL INCREASE TYRAMINE WHICH >BP.DIETARY RESTRICTIONS: AGED,SMKD,FERM FOORS,ETOH,COFF,CHOC, MANY OTC MEDS |
| MAOI'S | MUST BE D/C GRADUALLYORIGINALLY USED FOR TBPATIENT MUST BE COGNITIVELY AWARE ENOUGH TO FOLLOW DIET AND RESTRICTIONS |