PhenothiaZINE
NAMES
-zine
Ie.
Thorazine,
Compazine
Haldol
(Haloperidol)
Clozaril
(CloZAPine)
BenzodiaZEPine
Lithium
“ZEP” in
name
INFO
-1st gen antipsychotic
-typical
-MAJOR tranquilizer
-very potent
-immediate onset
-decanoate (court ordered);
long-acting IM given to noncompliant pt
-1st gen antipsychotic
-typical
-MAJOR tranquilizer
-very potent
-immediate onset
-decanoate (court ordered);
long-acting IM given to noncompliant pt
-very similar to phenothiazine
INDICATIONS
-↓ psychotic s/s
-(Lg dose) ↓psychotic
symptom
-(Sm dose) ↓n/v
-2nd gen antipsychotic
-Atypical
-NEW MAJOR tranquilizer
-used to treat severe schizo
-treat severe schizo
Agranulocytosis (low WBC)
-worse than cancer drug in susceptible pts
-1st mo need WBC count WEEKLY. STOP if
WBC low.
-antianxiety med
-MINOR tranquilizer
-prototype: Diazepam (Valium)
-induction of anesthetic
-muscle relaxant
-alcohol withdrawal
-seizure (status epilepticus)
-facilitate mechanical
ventilation
-tranquilizer works quickly
(don’t take >2-4wks; keep on
Valium (tranq) UNTIL Elavil
(antidep) kicks in)
ABCD
Anticholinergic effect (dry mouth)
Blurred vision, Bladder retention
Constipation
Drowsiness
-#1 nursing dx = SAFETY
3 P’s
Peeing (polyuria)
Pooping (diarrhea)
Paresthesia (=1st sign of lyte imbalance)
-monitor Na+ level
Low Na=prolong lithium
half-lifecause toxicity
High Na=↓effectiveness of
lithium
-electrolyte
-used for bipolar (manic
depression); ↓ mania
-↓ psychotic s/s
-(Lg dose) ↓psychotic
symptom
-(Sm dose) ↓n/v
S/E
ABCDEFG
Anticholinergic effect (dry mouth)
Blurred vision, Bladder retention
Constipation
Drowsiness
Extra pyramidal syndrome (EPS)
FPhotosensitivity
Agranulocytosis (low WBC)
ABCDEFG
Anticholinergic effect (dry mouth)
Blurred vision, Bladder retention
Constipation
Drowsiness
Extra pyramidal syndrome (EPS)
FPhotosensitivity
Agranulocytosis (low WBC)
NURSING CARE
-teach pt to report sore
throat & other s/s of
infection
-treat s/e
-#1 nursing dx = SAFETY
- teach pt to report sore
throat & other s/s of
infection
-treat s/e
-#1 nursing dx = SAFETY
-ELDERLY & YOUNG WHITE
SCHIZO develop Neuroleptic
Malignant Syndrome (NMS)
– fetal hyperpyrexia (fever)
w/ 106-108F (41-42C) from
overdose. Elderly dose
should be HALF of usual
adult dose.
Tricyclic
antidepressant
MAO Inhibitor
NAMES
Elavil,
Tofranil,
Aventyl,
Desyrel
-pram-,
-tripMar-,
Nar-,
Par-
INFO
-old class
-antidepressant
-MOOD ELEVATOR
-must take meds for 2-4wks
before beneficial effects
-antidepressant
-must take meds for 2-4wks
before beneficial effects
Prozac
(Fluoxetine)
-SSRI (antidepressant)
-similar to Elavil (tricyclic
antidepressant)
-MOOD ELEVATOR
-must take meds for 2-4wks
before beneficial effects
Zoloft
(Sertraline)
-SSRI (antidepressant)
-similar to Elavil (tricyclic
antidepressant) & Prozac
(Fluoxetine)
-MOOD ELEVATOR
-must take meds for 2-4wks
before beneficial effects
INDICATIONS
TOXIC signs (tremor, metallic taste, severe
diarrhea, other neuro signs)  HOLD &
call MD
-#1 toxic intervention=keep hydrated,
↑fluid, give electrolyte drink (NEVER free
h2o)
S/E
ABCDE
Anticholinergic effect (dry mouth)
Blurred vision, Bladder retention
Constipation
Drowsiness
Euphoria
ABCD
Anticholinergic effect (dry mouth)
Blurred vision, Bladder retention
Constipation
Drowsiness
ABCDE
Anticholinergic effect (dry mouth)
Blurred vision, Bladder retention
Constipation
Drowsiness
Euphoria
Cause insomnia – give BEFORE 12noon (if
BID-06, 12)
ABCDE
Anticholinergic effect (dry mouth)
Blurred vision, Bladder retention
Constipation
Drowsiness
Euphoria
Cause insomnia – but CAN be given in
evenings
NURSING CARE
-avoid ALL foods w
TYRAMINE to prevent fetal
hypertensive (stroke) crisis
-fruits, veges, grains, meats,
dairy, others
-teach pt NOT to take OTC
meds unless they’re Rx’d
-when changing dose for
ADOLESCENT or YOUNG
ADULT  watch for suicidal
ideation
Watch interactions w:
-St. John’s wort (serotonin
syndrome) – Sweating,
Apprehension, Dizziness,
HEADache
-Warfarin (Coumadin) –
watch for bleeding; may
need lower warfarin dose