Drug Purpose Use Contradictions Interactions Side effects Nursing implications Benzodiazepines Anxiolytic Anxiety pam suffix Alprazolam Xanax Diazepam Valium Lorazepam Ativan Decreased CNS activity in brainstem limbic system buspirone BusPar Unknown Chronic anxiety Grapefruit juice Other CNS depressants like alcohol sedatives Sedation Hypotension Drowsiness Treat overdose w Flumazenil IM very painful Habit forming Loss of coordination Paradoxical anxiety esp in elderly Never PRN always scheduled Headache Nausea 1 week for effectiveness Non habit forming lithium carbonate Eskalith Lithobid Bipolar depression mania Pregnancy NSAIDs except aspirin Renal insufficiency Toxicity 0 6 1 2 mEq L therapeutic range very narrow Regular hydration and sodium intake to prevent toxicity Mood stabilizer exact MOA unknown Serotenergic effects Low salt diet diuretics Tremor Polyuria Hypothyroidism valproic acid Depakote Antiepileptic drug Bipolar depression mania Seizures Tricyclic Block reuptake of 2nd line treatment Cardiac MAOIs Sedation give at Several weeks for antidepressants for depression dysrhythmia bedtime therapeutic effect Amitriptyline Elavil OCD Seizures norepinephrine and serotonin Anesthetics used in surgery Taper off gradually to discontinue Adjunct for pain Anticholinergic precautions Glaucoma Constipation Urinary blockage Dysrhythmia Orthostatic hypotension Impotence Anticholinergic effects dry Wean off before surgery over several weeks MAOIs Phenelzine Nardil Isocarboxazid Marplan Amines are not broken down higher levels in brain 2nd line treatment for depression after careful consideration of risks Selective serotonin reuptake inhibitor makes serotonin stay at receptors longer SSRI fluoxetine Prozac sertraline Zoloft escitalopram Lexapro 1st line depression treatment Bipolar depression PTSD Panic disorders Eating disorders Tyramine foods HTN crisis Orthostatic hypotension Taper down slowly to discontinue SSRIs Tachycardia Tricyclics Dizziness Sympathomimetic Insomnia Suicidal ideation MAOI other SS SNRI other serontenergic acting drugs risk for Serotonin Syndrome delirium agitation tachycardia within 2 weeks Sexual dysfunction Risk of suicide Weight loss gain Taper over 2 4 weeks to discontinue Take early in day to prevent insomnia SNRI velafaxine Effexor duloxetine Cymbalta desvenlafaxine Pristiq Bupropion Wellbutrin Zyban Serotonin norepinephrine reuptake inhibitor both neurotransmitters more available at receptors Block dopamine uptake make it available at receptor longer Typical antipsychotics Block dopamine receptors in brain chlorpromazine Thorazine haloperidol Haldol Tranquilizes patients Psychosis Schizophrenia Adjunct for bipolar Behavioral disorders Depression Eating disorders MAOIs N V D Substance abuse Suicidal ideation Seizure risk Antiepileptic drugs Dilantin seizure risk Smoking cessation Zyban formulation Children under 18 Delusions of grandeur psychosis Suicidal ideation Extrapyramidal symptoms EPS Tardive dyskinesia TD Neuroleptic malignant syndrome NMS mostly with Haldol Anticholinergic effects photosensitivity NMS life threatening report fever BP ASAP Psychosis Schizophrenia Block dopamine 2 D2 and serotonin2 5 HT2 receptors specifically Atypical antipsychotics Risperidone Risperdal Airprazole Abilify Olanzapine Zyprexa St John s Wort herb Improved efficacy and safety over typicals Fewer EPS than typicals Sedation Photosensitivity Dry mouth constipation Galactorrhea Weight gain Depression Sleep disorders Nervousness Anxiety SSRIs serotonin syndrome MAOIs Many other drugs Tyramine containing foods GI upset Fatigue Dizziness Confusion Dry mouth Photosensitivity