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Pharm Phorm week 4 - weekly assignments
Mental-Health Nursing (NR-326)
Chamberlain University
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Pharm Phorm
Prototype drug: Nardil/Phenelzine
Class: antidepressant/ MAOI Clinical Indications: (top three) 1. Depression Mechanism of Action: increases the amount of certain natural substances that are needed to maintain mental balance (serotonin) Side/Adverse Effects: (adverse in bold) Weakness, drowsiness, dizziness, dry mouth, constipation, weight gain Decreased sexual ability, uncontrollable shaking of any part of the body, muscle twitching or jerking Route and Dosage: Adults only PO: 15 mg Nursing Implications: (top 3) 1. Take as prescribed, avoid double dosing even if missed dose 2. Avoid driving or other activities required alertness until patient knows the effect the medication has Patient Teaching The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Other Considerations: (controlled substance; narrow therapeutic window; short half-life; peak and trough; antidote, etc.) Phenelzine is contraindicated in patients who exhibit hypersensitivity to the drug or who have pheochromocytoma, congestive heart failure, severe renal impairment, or renal pathology, abnormal LFTs, or a history of liver disease.
Prototype drug: Buspar/Buspirone
Class: antianxiety agent Clinical Indications: (top three) 1. Anxiety relief Mechanism of Action: binds to serotonin and dopamine receptors in the brain
Side/Adverse Effects: (adverse in bold) Blurred vision, nasal congestion, sore throat, tinnitus, chest pain (angina), palpitations, tachycardia Nausea, rashes, myalgia, incoordination, numbness, dizziness, drowsiness, headache Route and Dosage: Adults only PO: 7 mg twice daily Nursing Implications: (top 3) 1. Assess degree and manifestations of anxiety before and periodically during therapyHistory of substance abuse should be assessed
Patient Teaching Take as directed, do not double doseAvoid driving or other activities requiring alertness Avoid alcohol or other CNS depressants Other Considerations: (controlled substance; narrow therapeutic window; short half-life; peak and trough; antidote, etc.) Notify healthcare provider of any involuntary movements of facial or cervical muscles
Prototype drug: Antabuse/Disulfiram
Class: antabuse Clinical Indications: (top three) 1. used to treat chronic alcoholism 2. sometimes prescribed for other uses; Mechanism of Action: inhibits the enzyme aldehyde dehydrogenase Side/Adverse Effects: (adverse in bold) flushing of the face, headache, nausea, vomiting, chest pain, weakness, blurred vision, mental confusion, sweating, choking, breathing difficulty, and anxiety. Excessive tiredness, weakness, lack of energy, loss of appetite, upset stomach, vomiting, yellowness of the skin or eyes, dark urine. Route and Dosage: Adults only PO: 500 mg daily Nursing Implications: (top 3) 1. Used in recovery programs that include medical supervision and counseling 2. Alcohol rehab – inpatient/outpatient rehab 3. Detox Patient Teaching Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to disulfiram. Disulfiram is not a cure for alcoholism, but discourages drinking. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take disulfiram exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Other Considerations: (controlled substance; narrow therapeutic window; short half-life; peak and trough; antidote, etc.) Never give disulfiram to a patient in a state of alcohol intoxication or without the patient's full knowledge. The patient should not take disulfiram for at least 12 hours after drinking. A reaction may occur for up to 2 weeks after disulfiram has been stopped. If cannot swallow the tablets, crush them and mix the medication with water, coffee, tea, milk, soft drink, or fruit juice.
Prototype drug: Abilify/Aripiprazole
Class: SDAM serotonin-dopamine activity modulators Clinical Indications: (top three)
1. 2. AntipsychoticMood stabilizer
Mechanism of Action:receptors and antagonist activity at the 5HT receptor Psychotropic activity may be due to agonist activity at dopamine D2 and Serotonin 5HT
Side/Adverse Effects: (adverse in bold) ConstipationTremor DrowsinessExtrapyramidal reactions
Route and Dosage: Adults only PO: 10-15 mg once daily Nursing Implications: (top 3) 1. Assess weight and BMI initially and throughout therapyMonitor BP 3. Monitor for onset akathisia Patient Teaching Change positions slowly to minimize orthostatic hypotensionAvoid driving and other activities that require alertness
Other Considerations: (controlled substance; narrow therapeutic window; short half-life; peak and trough; antidote, etc.) Advise patient that extreme temperatures should be avoided because this drug impairs body temperature
Pharm Phorm week 4 - weekly assignments
Course: Mental-Health Nursing (NR-326)
University: Chamberlain University
