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Cognition Meds

QuestionAnswer
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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