1. Mosby items and derived items © 2006 by Mosby, Inc. Slide 1 CHAPTER 6 Psychotherapeutic Drug Therapy

2. Mosby items and derived items © 2006 by Mosby, Inc. Slide 2 Chapter 6 Lesson 6.1

3. Mosby items and derived items © 2006 by Mosby, Inc. Slide 3 Learning Objectives Briefly explain how psychotherapeutic medications affect human beings. Identify four classifications of psychotherapeutic medications. Discuss three classes of antianxiety agents and the side effects associated with each. (Cont'd...)

4. Mosby items and derived items © 2006 by Mosby, Inc. Slide 4 Learning Objectives (...Cont'd) Prepare a list of three teaching points for clients who are beginning antidepressant therapy. Explain the three major guidelines for care of clients taking lithium. Identify one central nervous system and three peripheral nervous system side effects of antipsychotic (neuroleptic) drug therapy.

5. Mosby items and derived items © 2006 by Mosby, Inc. Slide 5 Psychotherapeutic Drugs Powerful chemicals produce profound effects on mind, emotions, and body. Act mainly on CNS by altering its chemical modulators Interrupt neurotransmission by suppressing major nerve pathways that connect brain to frontal lobes and limbic system

6. Mosby items and derived items © 2006 by Mosby, Inc. Slide 6 Classifications of Psychotherapeutic Drugs Antianxiety agents  Reduce psychic tension of stress Antidepressants  Act by increasing certain neurotransmitter activities Antimanics  Work as naturally occurring mood stabilizers Antipsychotics  Have profound effects on brain and nervous system

7. Mosby items and derived items © 2006 by Mosby, Inc. Slide 7 Antianxiety Agents Azaspirones  Take 2 to 4 weeks to relieve symptoms of anxiety  Minimal side effects Benzodiazepines  Oldest anxiolytics  Fast-acting  Major side effect is drowsiness  Potential for dependency  Withdrawal occurs if stopped abruptly Beta-blockers  Used to treat phobias

8. Mosby items and derived items © 2006 by Mosby, Inc. Slide 8 Antidepressant Medications Classes  Tricyclics  Monoamine oxidase inhibitors (MAOIs)  Selective serotonin-reuptake inhibitors (SSRIs) Teaching points  One to four weeks before effects are noted  Some side effects may be experienced soon after medication is started  Medication must be taken regularly despite side effects  Client instruction: Contact physician if side effects become bothersome

9. Mosby items and derived items © 2006 by Mosby, Inc. Slide 9 Caring for Clients on Lithium Help with prelithium workup  Complete physical, history, ECG, and several blood studies Teach client to maintain stable blood level of drug  Teach client and family about expected side effects and difference between common side effects and those requiring immediate notification of physician Monitor client for side effects and toxic reactions  Reinforce information about side effects with written instructions

10. Mosby items and derived items © 2006 by Mosby, Inc. Slide 10 Chapter 6 Lesson 6.2

11. Mosby items and derived items © 2006 by Mosby, Inc. Slide 11 Learning Objectives Describe five care guidelines for clients receiving psychotherapeutic drugs. Discuss three topics for teaching clients about their medications. Explain how informed consent and noncompliance relate to psychotherapeutic medications.

12. Mosby items and derived items © 2006 by Mosby, Inc. Slide 12 Nursing Guidelines for Clients Receiving Psychotherapeutic Drugs Assess client for physical and psychosocial effects Coordinate care  Ensure that each component of treatment plan is carried out Administer medications Monitor clients for drug effectiveness Teach client about new medications