Term
Mood Disorders: Antidepressant Agents
Category: Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)
Duloxetine (Cymbalta) |
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Definition
Axn: Potentiate serotonergic, noradrenergic activity in the CNS.
Use: Major depressive disorder
Dosage: PO 40-60 mg/day as a single dose or 2 divdd doses
SE: insomnia, dizziness, decreased appetite and weight, diaphoresis, hallucinations, seizures, malignant neuroleptic-like syndrome reaction
NC: BP lying, standing, q4hr. If systolic BP drops 20 mmHg, hold and notify prescriber. Assess mental status for any suicidal, depression, or panic tendencies. Assess for malignant neuroleptic-life syndrome reaction. |
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Term
Mood Disorders: Antidepressant Agents
Category: SNRIs
Trazodone (Desyrel) |
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Definition
Axn: selectively inhibits serotonin, norepinephrine uptake by brain, potentiates behavorial changes
Use: depression
Dose: Adult - PO 150 mg/day in divided doses
Child (6-18 yo) - PO 1.5-2 mg/kg/day in divided dose
Geriatric - PO 25-50 mg at bedtime
SE: dizziness, drowsiness, suicide in children/adolescent, orthostatic hypotension, ECG changes, tachycardia, HTN, blurred vision, diarrhea, dry mouth, urinary retention
NC: Assess mental status (suicidal, depression, panic, psychiatric symptoms.) ECG for flattening of T wave, bundle branch block, AV block, dysrhythmias, BP (lying/standing) - if systolic BP drops 20 mmHg hold and notify prescriber. |
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Term
Psychosis: Antipsychotic Drugs
Category: Typical Antipsychotics 1st gen.
Chlorpromazine (Thorazine) |
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Definition
Axn: Depresses crebral cortex, hypothalamus, limbic system, which control activity aggression.
Use: psychotic disorders, mania, schizophrenia, anxiety
dosage: Adult- PO 10-50 mg q1-4hr initially then increase up to 2 g/day if needed. IM 10-50 mg q1-4hr.
SE: rash, pseudoparkinsonism, akathisia, dystonia, tardive dyskinesia, seizures, headache, orthostatic hypotension, anorexia, neuroleptic malignant syndrome
NC: assess mental status before initial administration and monthly, check swallowing of PO meds (hoarding or giving to others), BP sitting, stnading, lying take HR and RR q4h during intial treatment, for neuroleptic malignant syndrome: hyperpyrexia, muscle rigidity, altered mental status. |
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Term
Psychosis: Antipsychotic Drugs
Category: Typical Antipsychotics 1st gen.
Thioridazine (Mellaril) |
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Definition
Axn: Depresses crebral cortex, hypothalamus, limbic system, which control activity aggression
Use: psychotic disorders, schizophrenia
Dose: Adult- PO 25-100 mg tid, max 800 mg/day
SE: headache, orthostatic hypotension, anorexia, constipation, neuroleptic malignant syndrome
NC: assess mental status before first dose, check for swallowing PO, BP standing and lying and HR and RR, check for neuroleptic malignant syndrome (altered mental status, muscle rigidity, hyperthermia, dyspnea, fatigue). |
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Term
Psychosis: Antipsychotic Drugs
Category: Typical Antipsychotics 1st gen.
Fluphenazine (Prolixin) |
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Definition
Axn: Depresses crebral cortex, hypothalamus, limbic system, which control activity aggression
Use: psychotic disorders, schizophrenia
dose: adult - PO 2.5-10 mg in divided doses q6-8 hr, max 40 mg/day
IM initially 1.25 mg then 2.5-10 mg in divided doses q6-8hr
SE: headahce, EPS (pseudoparkinsonism, akathisia, dystonia, tardive dyskinesia) drowsiness, seizures, neuroleptic malignant syndrome, orthostatic hypotension, rash
NC: BP standing and lying; take pulse and RR q4hr during intial treatment, establish baseline before starting tx; report drops of 30 mmHg. EPS including akathisia (inability to sit still, no pattern to movements), tardive dyskinesia (bizarre movements of jaw, mouth, tongue, extremities), pseudoparkinsonism (rigidity, tremors, pill rolling, shuffling gait). |
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Term
Psychosis: Antipsychotic Drugs
Category: Typical Antipsychotics 1st gen.
Haloperidol (Haldol) |
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Definition
Axn: Depresses crebral cortex, hypothalamus, limbic system, which control activity aggression
Use: psychotic disorders
Dose: adult - PO 0.5-5 mg bid or tid initially depending on severity of condition, max 100 mg/day.
SE: EPS: pseudoparkinsonism, akathisia, dystonia, tardive dyskinesia, drowsiness, headache, seizures, neuroleptic malignant syndrome, orthostatic hypotension, anorexia, rash, constipation
NC: BP standin and lying, report drops of 30 mmHg, EPS, neuroleptic malignant syndrome |
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Term
Psychosis: Antipsychotic Drugs
Category: Typical Antipsychotics 1st gen.
Thiothixene (Navane) |
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Definition
Axn: Alters the effect of dopamine in the CNS
Use: schizophrenia and other psychotic disorders
Dose: PO initial dose 5-10 mg/day. Optimal dose 15 -30mg/day, no exceeding 60 mg/day
SE: neuroleptic malignant syndrome, sedation, blurry vision, dry eyes,constipation, dry mouth, photosensitivity
NC: assess for neuroleptic malignant syndrome, mental status |
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