1. Ms. Judith Wikel RN BSN MEd

2.  We’ve made it to the FINAL lap in MH!  Remember the PowerPoint is an outline to facilitate study.  Read and understand objectives and watch videos that pertain to psychotherapeutic drugs.  Good Luck!

3.  Psychotherapeutic drugs - are powerful chemicals that produce profound effects on the mind, emotions, and body.  Altering chemical balances within the nervous system.

4.  Lyrica  Pregabalin (Lyrica) - is currently being used to treat several kinds of anxiety disorders as well as seizures and neuropathic pain.  Side effects are fewer than those of other antianxiety drugs, so clients are more likely to comply with treatment.

5.  The inability to sit still

6.  Extrapyramidal side effects (EPSEs) - abnormal movements produced by an imbalance of neurotransmitters in the brain.  Refer to Box 7-6 page 68.

7.  A serious and potentially fatal side effect with unstable vital signs, fever, confusion, muscle rigidity, tremor, incontinence.

8.  Antianxiety agents  Antidepressants  Antimanics  Antipsychotics

9.  Beta-blockers for anxiety!!!!  Please refer to Table 7-2 on page 64 Propranolol (Inderal), atenoloe (Tenormin) have been found useful in treating social anxieties. These drugs reduce palpitations, sweating, tremors, blood pressure and heart rate.

10.  Antianxiety agents are drugs that reduce the psychic tension of stress.  Side effects of benzodiazepines (commonly prescribed antianxiety medications) are usually minimal.  Because long-term use of antianxiety drugs can result in dependence, therapy for clients is usually limited to a few months.

11.  Informed consent - is the process of presenting clients with information about the benefits, risks, and side effects of specific treatments, thus enabling them to make voluntary and knowledgeable decisions about their care.

12.  Noncompliance - an informed decision made by a client not to follow a prescribed treatment program.

13.  Many outpatient clients do not take their medications as prescribed.  Even in patient clients do not take their medications consistently.

14.  What is the difference in noncompliance and informed consent?  A client has started a treatment plan and decides to stop is an example of noncompliance.  A client has entered a treatment facility and decides to not utilize the treatment teams suggestions/plan is an example of informed consent.  Make sense????

15.  Lithium must be taken on a regular basis at the same time daily.  If one misses a dose wait until the next scheduled time and take the lithium.

16.  Lithium is well absorbed into the bloodstream and execrated faster than sodium by the kidneys. For this reason clients taking Lithium must be cautioned about balancing their salt intake, fluid intake, and activity. What is the therapeutic level of Lithium? Hint: refer to page 63.

17.  Peripheral nervous system  Cranial nerves  Spinal nerves  Autonomic nerves Parasympathetic Sympathetic Understand the sympathetic nervous system prepares the body for immediate fight or flight mechanism.  Central nervous system  Brain  Spinal cord

18.  Irreversible side effect of long-term treatment that produces involuntary, repeated movements of muscles in the face, trunk, arms, and legs.

19.  Dry mouth  Blurred vision  Photophobia  Tachycardia  Hypotension  Caregivers must protect clients from falls during the first few weeks of therapy because the chance for low blood pressure (hypotension) is greatest when clients stand or changes positions suddenly.

20.  Please refer to Box 7-1 Page 65  Individuals taking MAOIs must avoid drinking alcoholic beverages.

21.  Selective Serotonin Reuptake Inhibitors (SSRIs)  SSRIs are the first choice in treatment for many physicians because their side effects are more manageable.

22.  Assessment - continuous assessment of the patient’s response to drug therapy.  Coordination – assisting in the coordination of the client's care.  Teaching - teaching client's about their medications.

23.  Psychotherapeutic medications act mainly on the:  A) nervous system  B) mind  C) emotions  D) endocrine system Answer is A.

24.  Nursing care for clients receiving psychotherapeutic drugs includes assessment, coordination, administration, monitoring, and evaluation, and:  A) compromise  B) prescription  C) forced compliance  D) teaching The Answer is D

25.  Extrapyramidal side effects are most commonly associated with which class of drugs?  A) antidepressants  B) anxiolytics  C) benzodiazepines  D) antipsychotics The answer is D

26.  Tardive dyskinesia is an extrapyramidal side effect that is characterized by:  A) the inability to sit  B) muscular rigidity  C) involuntary, repeated muscle movement of the face, trunk, arms, and legs.  D) unstable vital signs, fever, confusion, and incontinence. The answer is C.

27.  We made it to the end.  Study hard  Good luck on the FINAL. Keep on truckin the end of nursing school is near… Judith Wikel RN