Professional Documents
Culture Documents
NURSING
By: Meeko Videa, RN
Psychopharmacology
Psychotropic drugs
Includes:
antipsychotics
antidepressants
mood stabilizers
anxiolytics
stimulants
Efficacy
Potency
Half-life
Antipsychotic Drugs
Neuroleptics
Treatment of symptoms in schizophrenia
and manic phase of bipolar disorder
Blocks dopamine receptors
Examples:
Chlorpromazine (Thorazine)
Haloperidol (Haldol)
Loxapine (Loxitane)
Risperidone (Risperdol)
Side Effects
Extrapyramidal Side Effects:
Acute dystonia
Pseudoparkinsonism
akathisia
Antidepressant Drugs
Interacts with norepinephrine and
serotonin
Four Groups:
Tricylic antidepressants
Selective serotonin reuptake inhibitors
(SSRIs)
Monoamine oxidase inhibitors (MAOIs)
Others such as venlafaxine (Effexor) and
bupropion (Wellbutrin)
Side Effects
SSRIs
Anxiety
Agitation
Akathisia
Nausea
Insomnia
Sexual dysfunction
Weight gain
Sweating
Sedation
Diarrhea
HA
Side Effects
MAOIs
Daytime sedation
Insomnia
Weight gain
Dry mouth
Orthostatic hypotension
Sexual dysfunction
Hypertensive crisis
Side Effects
Cyclic antidepressants
Dry mouth
Constipation
Urinary hesitancy or retention
Dry nasal passages
Blurred near vision
Weight gain
Sexual dysfunction
Side Effects
Other antidepressants
HA (nefazodone and trazodone)
Dry mouth and nausea (nefazodone)
Loss of appetite, nausea, agitation and
insomnia (bupropion and venlafaxine)
Dizziness, sweating or sedation (venlafaxine)
Priapism (trazodone)
Liver damage (nefazodone)
Seizures (bupropion)
Drug Interactions
Taking MAOI and SSRI at the same time
can cause serotonin or serotonergic
syndrome
Symptoms:
Agitation
Sweating
Fever
Tachycardia
Hypotension
Rigidity
Hyperreflexia
Coma
Death
Side Effects
Lithium
Mild nausea or diarrhea
Anorexia
Fine hand tremor
Polydipsia
Polyuria
Metallic taste in mouth
Fatigue or lethargy
Weight gain
Acne
Side Effects
Lithium Toxicity
Severe diarrhea
Vomiting
Drowsiness
Muscle weakness
Lack of coordination
If untreated can lead to renal failure, coma
and death
Side Effects
Carbamazepine
Drowsiness
Sedation
Dry mouth
Blurred vision
Rashes
Orthostatic hypotension
Aplastic anemia
Agranulocytosis
Side Effects
Valproic acid
Drowsiness
Sedation
Dry mouth
Blurred vision
Weight gain
Alopecia
Hand tremor
Hepatic failure
Teratogenic effects
Pancreatitis
Side Effects
Physical and psychological dependence
Drowsiness
Sedation
Poor coordination
Impaired memory
Clouded sensorium
Next day sedation (hangover effect)
Dizziness, sedation, nausea and HA
(Buspirone)
Stimulants
ADHD
Residual attention deficit disorder
Narcolepsy
Amphetamines
Methylphenidate (Ritalin)
Pemoline (Cylert)
Dextroamphetamine
Side Effects
Dependence
Anorexia
Weight loss
Nausea
Irritability
Dizziness
Dry mouth
Blurred vision
Palpitations
Growth and weight suppression in children
Disulfiram (Antabuse)
Treatment for alcoholism
Causes reaction to alcohol in the body:
Facial and body flushing
Throbbing HA
Sweating
Dry mouth
N&V
Dizziness
Weakness
Chest pain
Dyspnea
Severe hypotension
Confusion
Death
Pregnancy
Signs of Pregnancy
1. Presumptive (Subjective) Signs
Pregnancy
Signs of Pregnancy
2. Probable Signs
Serum HCG
Chadwicks sign
Goodells sign
Hegars sign
Ultrasound (gestational sac)
Ballottement
Braxton Hicks contractions (at least 12 th wk)
Fetal outline felt by examiner
Pregnancy
Signs of Pregnancy
2. Positive signs
Ultrasound (fetal outline)
Fetal heart is audible
Fetal movement felt by examiner
Pregnancy
Circulatory System During Pregnancy
Increase in blood volume (30-50%)
Pseudoanemia (first trimester)
Increase in heart rate (10 beats)
BP decreases slightly (second trimester),
but rises again (third trimester)
Blood fibrinogen increases
Blood lipids increase by one third
Serum cholesterol level increase by 90100%
Pregnancy
Pregnancy Related Problems
Ectopic Pregnancy
Implantation occurs outside the uterus
Can cause bleeding in pregnancy
Most common site is the fallopian tube
(95%)
Tubal scarring due to PID
Common to women who smoke
Pregnancy
Pregnancy Related Problems
Hyperemesis Gravidarum
N & V past the 12th week of pregnancy
Severe N &V that dehydration, ketonuria
and significant weight loss occurs within the
first 12 wks of pregnancy
NPO
IVF with vitamin B
If no vomiting after the first 24 hrs of NPO,
small amounts of clear fluid may be given
Pregnancy
Pregnancy Related Problems
Hyperemesis Gravidarum
N & V past the 12th week of pregnancy
Severe N &V that dehydration, ketonuria
and significant weight loss occurs within the
first 12 wks of pregnancy
NPO
IVF with vitamin B
If no vomiting after the first 24 hrs of NPO,
small amounts of clear fluid may be given
Pregnancy
Pregnancy Related Problems
PIH
Cause is still unknown
Occurs in 5-7% of pregnancies
Multiple pregnancies
Primipara younger than 20 and older than
40
Five or more pregnancies
Have underlying disease like heart diseases
or diabetes
Pregnancy
Pregnancy Related Problems
Gestational HPN
BP 140/90
Increase in systolic 30mmHg or diastolic
15mmHg above prepregnancy level
No proteinuria or edema
Returns to normal after birth
Pregnancy
Pregnancy Related Problems
Mild pre-eclampsia
BP 140/90
Increase in systolic 30mmHg or diastolic
15mmHg above prepregnancy level
Proteinuria 1-2+
Weight gain of 2lbs/wk (2nd trimester),
1lb/wk (3rd trimester)
Mild edema in upper extremities and face
Pregnancy
Pregnancy Related Problems
Severe pre-eclampsia
BP 160/110
Proteinuria 3-4+
Oliguria (500ml or less in 24hrs)
Cerebral or visual disturbances (headache,
blurred vision)
Epigastric pain
thrombocytopenia
Pregnancy
Pregnancy Related Problems
Eclampsia
Seizure or coma accompanied by symptoms
of pre-eclampsia
Cerebral edema
Complete flexion
Head is flexed (chin touching the sternum)
Arms flexed and folded into chest
Thighs flexed into abdomen
Calves are pressed against posterior aspect of
thighs
b) Active Phase
4. Fourth Stage
First 1 to 4 hrs after birth of the placenta
Oxytocin is given
Pulmonary stenosis
VSD
Overriding aorta (dextroposition)
RV hypertrophy
Cyanosis
Polycythemia
Dyspnea