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NSG-322 Final Exam Drug List

List of highly tested medications
Course

Behavioral Health Nursing (NSG-322)

77 Documents
Students shared 77 documents in this course
Academic year: 2022/2023
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Anxiety Medications - Benzodiazepines - Beta Blockers: Propranolol — Helps with physiologic aspect of anxiety and social anxiety - Buspirone: first line for GAD (long-term therapy) — REQUIRES 2-4 WEEKS FOR EFFECTIVENESS - Antihistamines: Diphenhydramine and hydroxyzine — helpful for immediate relief, potentially used short- or long-term - SSRIs: Used as the first-line for anxiety, OCD, and BDD. - citalopram (Celexa) - escitalopram (Lexapro) (Not effective for social anxiety disorder or panic disorder) - fluoxetine (Prozac) - fluvoxamine (Luvox) - paroxetine HCl (Paxil) - sertraline (Zoloft) - SNRI: Used for panic disorder, GAD, and social affective disorder (SAD) - TCAs and MAOIs 2nd and 3rd line if treatment resistant - Gabapentin, pregabalin, carbamazepine (Tegretol) – shown to be effective for clients diagnosed with GAD especially if somatic symptoms are also present.

Somatic Disorder Medications: Illness anxiety disorder: SSRIs, CBT, and therapeutic physician relationship - Overall, treat comorbid depression and anxiety for all somatics disorders

Stress Disorder Medications: RAD: bibliotherapy, family therapy, and depressions and anxiety medications

PTSD: - SSRIs: Medications can help with reducing anxiety and controlling obsessive thinking - Prazosin: Found to lessen the severity & frequency of PSTD-related nightmares - Psychotherapy and CBT - Exposure therapy. This therapy helps people face and control their fear. It exposes them to the trauma they experienced in a safe way. It uses mental imagery, writing, or visits to the place where the event happened. The therapist uses these tools to help people with PTSD cope with their feelings. - Cognitive restructuring. This therapy helps people make sense of the bad memories. Sometimes people remember the event differently than how it happened. They may feel guilt or shame about what is not their fault. The therapist helps people with PTSD look at what happened in a realistic way. - Stress inoculation training. This therapy tries to reduce PTSD symptoms by teaching a person how to reduce anxiety. Like cognitive restructuring, this treatment helps people look at their memories in a healthy way. - EMDR – Eye movement Desensitization and Reprocessing: Rapid eye movement therapy conducted while processing raw emotions from trauma. EMDR works by utilizing lateral eye movement which helps to transfer information from the non-hippocampus

dependent area (Situationally Accessible Memory storage) in the amygdala to the Verbally Accessible Memory area in the hippocampus to complete the processing of the trauma.

Depressive Disorder Medications: *All antidepressants carry a black box warning of risk for suicide in adolescents *Assess for serotonin syndrome: Hyperactivity, high BP, fever, tachy, seizures - Administer serotonin receptor blockade (cyproheptadine, methysergide, propranolol) - Cooling blankets, chlorpromazine (for hyperthermia) - Dantrolene, diazepam (for muscle rigidity or rigors) - Anticonvulsants - Artificial ventilation - Induced paralysis First-Line treatment: - SSRIs (onset effectiveness 1-2 weeks, full effectiveness 2-4 weeks) - SNRIs: No HTN, no glaucoma! - Atypical antidepressants - Mirtazapine: Can be combined with SSRI: weight gain, sedation, good for older people + severe depression (insomnia drug too) - Bupropion: Depression and smoking cessation (energizing can induce mania and anxiety): takes several weeks to work - Ketamine & esketamine: monitor post (treatment-resistant depression): must stay 2 hrs in doctor’s office for observation - TCAs: Take at bedtime, urinary retention + severe constipation! - amitriptyline, doxepin, imipramine, and nortriptyline Second line treatment: - MAOIs (monoamine oxidase inhibitors): - Phenelzine - Tranylcypromine - EMSAM: Selegiline (Exelon) is administered in transdermal patch form – some of the tyramine-related interactions are less severe because the med bypasses the GI system. - Hypertensive crisis can occur if consuming tyramines (table 15) - Must remain tyramine free for 2 week after stopping an MAOI - If changing from fluoxetine to an MAOI, the client must wait 5 weeks to begin the MAOI to avoid serotonin syndrome - If changing from a different SSRI to an MAOI, the wait between meds must be 2 weeks; also 2 weeks if switching from an MAOI to an SSRI (including fluoxetine) - Drugs for a hypertensive crisis: IV phentolamine (alpha-1 blocker), oral chlorpromazine (typical antipsychotic), Sublingual nifedipine (calcium channel blocker) - CAM (St. John’s wort)

Bipolar and Impulse Control Medications: Mood Stabilizers - Lithium

  • Risperidone
  • Aripiprazole
  • Ziprasidone
  • Quetiapine

Management of Aggressiveness Medications: - If needed, IM injection of barbiturate, antihistamine, or antipsychotic, depending on provider’s order and any underlying conditions. - Med administration without client consent is a chemical restraint, which requires the provider's order. - Atypical antipsychotics: Ziprasidone IM, or olanzapine IM/orally disintegrating - Benzo: lorazepam - Beta blocker: Propranolol for organic anger (dementia) - Clonidine: anxiety and agitation - SSRIs: Good for “anger attacks”

Psychotic Disorder Medication: 1st Gen antipsychotics: Targets positive symptoms 2nd Gen antipsychotics: Target positive and negative symptoms

Typical= 1st Generation - Chlorpromazine - Fluphenazine - Haloperidol - Perphenazine *These medications are inexpensive. But have major risks for adverse effects: - Tardive dyskinesia: Discontinue to treat - Acute dystonic reactions treat with benztropine and diphenhydramine - EPS: Lower medications, benztropine, diphenhydramine, amantadine, lorazepam — do AIMS scale - NMS (more common) — bromocriptine and dantrolene to treat NMS (cooling measure) - Agranulocytosis - Body temp alterations - Anticholinergic effects (dry mouth, urinary retention)

Atypical= 2nd generation: - Clozapine - Olanzapine - Quetiapine - Risperidone - Ziprasidone Treatment/side effects includes: - Constipation: Very common - Agranulocytosis (with clozapine): Strict weekly CBCs - Gynecomastia and hyperprolactinemia (risperidone): - ziprasidone is the potential for cardiac effects

  • Cardiomyopathy: Stop med
  • Metabolic syndrome: get blood sugar and lipid levels checked

Date Rape Drugs: - GHB: Causes anterograde amnesia — Clears from the body quickly, not detected on urinalysis - flunitrazepam (Rohypnol): retrograde and anterograde amnesia — Detectable in urine up to 72 hours - Ketamine: anterograde amnesia — Leave body quickly, undetectable - Alcohol is the most frequently used date rape drug

Neurocog/Alzheimer's Medications:

Autism: - Risperidone (for anger and aggression) - SSRI - Beta-Blocker

ADHD: Stimulants: - methylphenidate (Ritalin)- can cause insomnia, give 6-8 hours prior to bedtime - methylphenidate ER (Concerta) – give at least 12 hours prior to bedtime. - mixed amphetamine salts (primarily dextroamphetamine & amphetamine) Non-Stimulant: - atomoxetine (Strattera) - can stunt growth (monitor weight and height). - guanfacine (antihypertensive) - clonidine (antihypertensive)

Alzheimer’s Medications - Donepezil - Rivastigmine — Comes in patch form - Galantamine - Memantine — Progressed Alzheimer’s - Mirtazapine (Remeron), side effects of weight gain and sedation are often beneficial

Enuresis: - Imipramine - Desmopressin - Oxybutynin - Indomethacin Encopresis: - Stool softener - Suppository - Enema

LSD Management: - Diazepam - Chloral hydrate

Anorexia Nervosa Management: - SSRIs, atypical antipsychotics, tricyclic antidepressants are used to treat eating disordered clients’ underlying anxiety and mood issues. - Zyprexa (olanzapine) EBP findings to support treatment for anorexia - Prozac (fluoxetine) EBP findings for treatment of bulimia (decrease obsessive thoughts and vomiting) - Recent findings indicate Zyprexa (olanzapine), a second generation antipsychotic, has best effects for helping clients with anorexia gain weight and stabilize mood. It was once thought Prozac (fluoxetine) was a good agent but studies have not found significant findings to support for anorexia but is helpful for bulimia nervosa to help decrease obsessive thoughts and vomiting.

Bulimia Nervosa Management: - Fluoxetine - Lisdexamfetamine - Dasotraline Personality disorders: - SSRIs: treat comorbid depression and panic attacks - Trazodone and venlafaxine: have low toxicity in overdose - Carbamazepine: targets impulsivity and self-harm - Lithium, anticonvulsants, SSRIs: minimize aggression - Atypical antipsychotics: help with psychotic features in BPD under stress.

Sleep Disorder Medications:

  • Antihistamines
  • Sedative-hypnotics (short term-management)
    • Zolpidem tartrate
    • Eszopiclone
    • Zaleplon
  • Melatonin
  • Melatonin agonist (ramelteon): increases the body’s melatonin production

Narcolepsy Medications:

  • Sodium Oxybate (1st line!) for Type 1 narcolepsy (narcolepsy with cataplexy)

    • dosed twice-nightly because the medication is eliminated from the body so quickly
    • Must have training program before use

  • Amphetamine-like drugs (2nd line treatments!)

    • Modafinil (less addiction potential)
    • Armodafinil (less addiction potential)
    • Methylphenidate
    • Amphetamines

  • SNRIs – especially venlafaxine – for cataplexy treatment (sometimes SSRIs are used)

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NSG-322 Final Exam Drug List

Course: Behavioral Health Nursing (NSG-322)

77 Documents
Students shared 77 documents in this course

University: Grand Canyon University

Was this document helpful?
Anxiety Medications
- Benzodiazepines
- Beta Blockers: Propranolol — Helps with physiologic aspect of anxiety and social
anxiety
- Buspirone: first line for GAD (long-term therapy) — REQUIRES 2-4 WEEKS FOR
EFFECTIVENESS
- Antihistamines: Diphenhydramine and hydroxyzine — helpful for immediate relief,
potentially used short- or long-term
- SSRIs: Used as the first-line for anxiety, OCD, and BDD.
- citalopram (Celexa)
- escitalopram (Lexapro) (Not effective for social anxiety disorder or panic
disorder)
- fluoxetine (Prozac)
- fluvoxamine (Luvox)
- paroxetine HCl (Paxil)
- sertraline (Zoloft)
- SNRI: Used for panic disorder, GAD, and social affective disorder (SAD)
- TCAs and MAOIs 2nd and 3rd line if treatment resistant
-Gabapentin, pregabalin, carbamazepine (Tegretol) – shown to be effective for clients
diagnosed with GAD especially if somatic symptoms are also present.
Somatic Disorder Medications:
Illness anxiety disorder: SSRIs, CBT, and therapeutic physician relationship
- Overall, treat comorbid depression and anxiety for all somatics disorders
Stress Disorder Medications:
RAD: bibliotherapy, family therapy, and depressions and anxiety medications
PTSD:
-SSRIs: Medications can help with reducing anxiety and controlling obsessive thinking
-Prazosin: Found to lessen the severity & frequency of PSTD-related nightmares
- Psychotherapy and CBT
-Exposure therapy. This therapy helps people face and control their fear. It exposes
them to the trauma they experienced in a safe way. It uses mental imagery, writing, or
visits to the place where the event happened. The therapist uses these tools to help
people with PTSD cope with their feelings.
-Cognitive restructuring. This therapy helps people make sense of the bad memories.
Sometimes people remember the event differently than how it happened. They may feel
guilt or shame about what is not their fault. The therapist helps people with PTSD look at
what happened in a realistic way.
-Stress inoculation training. This therapy tries to reduce PTSD symptoms by teaching a
person how to reduce anxiety. Like cognitive restructuring, this treatment helps people
look at their memories in a healthy way.
-EMDR – Eye movement Desensitization and Reprocessing: Rapid eye movement
therapy conducted while processing raw emotions from trauma. EMDR works by utilizing
lateral eye movement which helps to transfer information from the non-hippocampus

Students also viewed

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