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315 Cards in this Set
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Specialized treatment intervention
Led by trained leader or co-leaders Purpose is to treat clients with psychiatric disorders |
group psychotherapy
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two or more people who develop a relationship that is interactive; these people share at least one issue or common goal
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group
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****characteristics of a group
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size, rules, boundaries, climate, defined purpose, apparent content and underlying process.
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****advantages of group work
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Cost effective
Client feels less isolated Clients receive peer feedback Teach different problem-solving approaches |
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****phases of group development
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initial phase
working phase mature phase termination |
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during this phase the leader’s role is to set the atmosphere of confidentiality and respect while members are helped to relax and feel comfortable. The group task is for members to get to know one another and begin to take steps toward the working phase. |
initial phase
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during this phase members are involved in working toward the group’s goals, while the leader ties together common themes, encourages expression, and prevents hostile attacks. |
working phase
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during this phase the leader keeps the group focused on therapeutic goals of the individual members; members accept each other’s differences |
mature phase
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during this phase the group members prepare for separation and help each other prepare for the future and the leader Acknowledge the contributions of each member and the experience as a whole |
termination phase
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communication techniques frequently utilized by the group leader |
giving information, clarification, confrontation, reflection, summarization and support.
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Growth-producing roles adopted by group members include
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opinion giver,
opinion seeker information giver information seeker initiator elaborator coordinator orienter evaluator clarifier recorder summarizer A member may adopt more than one role |
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styles of group leadership
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Autocratic leader
Democratic leader Laissez-faire leader |
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therapeutic factors in groups |
Instillation of hope
Universality Imparting of information Altruism Corrective recapitulation of the primary family group Development of socializing techniques Imitative behavior Interpersonal learning Group cohesiveness Catharsis Existential resolution |
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member feel they are not alone in their problems
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universality
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leader gives information to the members and other group members give advise
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imparting of information
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defence mechanism where a person deals with stressors or emotional conflict by meeting the needs of others
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altruism
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members repeat patterns of behaviour in the group that they learned in their families. The leader gives feedback and all members learn about their own behaviours
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corrective recapitulation of the primary family group
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Each member feels a connection with other members of the group and with the leader. They can accept positive feedback and constructive criticism. |
group cohesiveness
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sharing of intense feelings
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catharsis
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Members learn to accept painful aspects of life such as loneliness and death
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existential resolution
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Measurable outcomes may be easier to accomplish with |
education and psychoeducation groups than with therapy groups
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which groups is the RN able to assume responsibility for |
Medication education
Sexuality Dual-diagnosis Multifamily Symptom management Stress management Community Self-care |
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designed to teach clients about their medications, answer their questions, prepare them for discharge, and foster medication compliance after discharge. Clients should be taught the name of the medication, reasons for taking the medication, exact dose, time to take the medication, common side effects, ways to remember to take each dose, foods or OTC medications to avoid, what to do if the client wishes to change the regimen, and the importance of informing other health care providers of the medication being used (to prevent adverse medication interactions.)
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medication education groups
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work with topics such as AIDS education, STD education, sexuality and psychotropic medication, effects of antidepressants on sexuality.
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sexuality education groups
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with such topics as psychiatric illness and substance use. The RN may colead this group with a dual-diagnosis specialist (master’s level clinician).
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dual diagnosis group work
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concentrate on a topic such as anger or psychosis. The focus is on sharing positive and negative experiences so that members learn coping skills from each other.
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symptom management groups
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teach members various relaxation techniques to reduce stress. They are usually time limited.
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stress management groups
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advanced practice nurse can assume responsibility for what type of groups
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Able to assume responsibility for the following groups:
Same groups as the basic level RN Psychotherapy—with different types of theoretical foundations |
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this type of group has as its goals increase clients’ self-esteem, decrease social isolation, encourage appropriate social behaviors, reeducate clients in basic living skills. |
therapeutic mileu group goals
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leaders of therapeutic mileu groups
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occupational or recreational therapists with nurses as co-leaders.
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designed to serve people who have a common problem; they are led by a member rather than a professional. Strategies include promoting dialogue, self-disclosure, and encouragement. Concepts: psychoeducation, self-disclosure, mutual support. Characteristics: peer support, group teaching, counseling, using shared experiences. All self-help groups with the title _______ Anonymous use a 12-step method typical of the Alcoholics Anonymous program. |
self help groups
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****Patterns of Problematic Behaviors in Group Members
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Monopolizes group
Complains but continues to reject help Demoralizes others Silent person |
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***good intervention for person who is monopolozing group
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Intervention: Ask group why they have permitted the monopolizer to go on and on. This helps the group to recognize the role of their own passivity and to disclose their own feelings. Therapist helps group use “I” statements rather than “you” statements .
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****good intervention for person who complains but continues to reject help
this person is taking pride that his problem is "insoluble"; group becomes concerned, then frustrated, then angry |
The therapist agrees with the content of the client’s pessimism and maintains detached affect. With group cohesion a therapist can help client recognize the pattern of his or her relationships.
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Narcissistic individuals have problems in group therapy because
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they are defensive and have a grandiose sense of self-importance; may be initially charming, then demanding; may devalue the therapist, then feel elated; may monopolize the group.
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intervention for narcissism
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The therapist must listen to the content that is being avoided and stay therapeutically objective. Only then can the therapist be empathetic in a matter-of-fact way.
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why is the silent person silent
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because he or she is observing intently, trying to decide whether the group is safe; out of concern that he or she may not be as competent as the others; or hoping to avoid conflict
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intervention for the silent person
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The leader should exhibit patience, but encourage each member to offer comments to the group.
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psychotherapeutic approach that focuses on altering interactions between a couple, within a nuclear or extended family, or between a family and other interpersonal systems, the goal of: alleviating problems initially presented by individual family members, family subsystems, the family as a whole, or other referral sources changing relationships through changing interactions between people |
what is family therapy
what are goals of family therapy |
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********5 functions or characteristics of a health family
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management
boundary communication emotional-supportive socialization |
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This includes the use of power for all family members,
****** clear rule making, adequate fiscal support, successful negotiation with extra familial systems, and plans for the future. It is usually the adults in the family who agree on how these functions are to be performed |
management function
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maintain a distinction between individuals in the family. Ideally, there will be clear individual boundaries, clear generational boundaries, and clear family boundaries. Diffused or enmeshed boundaries refer to a blending together of the roles, thoughts, and feelings of the individuals so that clear distinctions fail to emerge. Families with diffused boundaries are more prone to psychological or psychosomatic symptoms.
Rigid or disengaged boundaries are those in which the rules and roles are adhered to no matter what. This prevents trying new roles or taking on different functions. Isolation may be marked. |
boundaries
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Function Healthy communication uses clear, direct messages, asking for what one wants, no manipulation, and expression of positive and negative feelings allowed
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communication
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*****Affection is uppermost and anger and conflict do not dominate interactions.
Healthy families: give mutual positive regard, resolve conflicts, use resources for all family members, promote growth in all family members |
emotional-suportive function of family
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****The healthy family develops in a healthy pattern, using mutual negotiation of roles by age and ability. Parents feel good about parenting, spouses are happy with each other’s role behavior. |
socialization function of family
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*****dysfunctional family patterns
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Management
An inappropriate member makes decisions Boundary Diffuse or enmeshed: roles, thoughts, and feelings of members merged together Rigid or disengaged boundaries: established roles and rules are followed no matter what Communication Manipulating, distracting, generalizing, blaming, placating Emotional-supportive Conflict and anger dominates Socialization Role change difficult, resulting in increased stress |
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Stages in the Family Life Cycle of a Traditional, Middle-Class American Family
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Launching the single young adult
Joining families through couple formation Becoming parents and caring for young children Parenting adolescents Launching children and moving on Experiencing later life |
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Family stress is often greatest
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transition points
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symptoms in a family are likely to appear when
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interruption in the unfolding of the family life cycle (illness, death, divorce
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this model of family therapy assumes Assumes that changing any single element in the family system will bring about change in the entire system
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strategic model
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this model of family therapy Based on a normative concept of a healthy family and emphasizes the boundaries between family subtypes
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structural model
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models of insight-oriented family therapy include
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Psychodynamic
Family of origin Experimental-existential |
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models of behavioral family therapy
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Structural
Strategic Cognitive-behavioral |
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basic concepts in family therapy
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Family as a system
Identified client Family triangles Nuclear family emotional system |
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central concepts of family
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Boundaries
Diffuse or enmeshed Rigid or disengaged Triangulation Scapegoating Double bind Hierarchy Differentiation |
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individual regarded by others as having the problem. He or she is usually responding to problems within the family system. The
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identified patient
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the presenting problem should be looked at from
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circular causality
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When major tension is experienced between two people, the tension is relieved by bringing in a third person to help lower the tension. In triangles there is a close side, a distant side, and a side where tension exists.
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Family Triangles
Interlocking Triangles |
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ability of the individual to establish a unique identity while still remaining emotionally connected to the family of origin:
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differentiation
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the lower the differentiation, the higher the tension and the greater the need for
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traingles
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a nurse's task in the family triangle
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A nurse’s task is to calm down the system and help the family explore alternative ways of dealing with change while avoiding being “triangled in
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the flow of emotional processes within the nuclear family; symptoms belong to the family rather than to the identified patient.
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nuclear family emotional system
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Assessment is typically intermixed with treatment and has multiple foci, including
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family system, the subsystems, the individuals
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assessment areas of consideration in family therapy
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stage of the family life cycle, multigenerational issues, and sociocultural context.
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Efficient format summarizing demographic data and functional information about family
summarizing information and relationships across three or more generations. It incorporates the stage of the family life cycle, multigenerational issues, and sociocultural context. provides a graphic display of complex patterns and becomes a source of hypotheses that indicate how the presenting problem connects to the family over time. |
genogram
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how many previous generations influence a family
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3 - 4
seek to understand how the messages and legacies relate to the presenting problem. |
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Self-assessment is necessary when working with families due to
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potential for multiple transferences and triangulations. Nurses must become aware of their own potential for forming triangles when anxious, to become defensive when personal family anxieties are aroused, and to experience role blurring when sensitive personal issues and conflicts are triggered.
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nursing diagnosis for family interventions |
Impaired parenting
Dysfunctional family processes: alcoholism Caregiver role strain Ineffective denial Defensive coping |
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examples of outcome criteria in family therapy |
To mobilize family resources and encourage adaptive family problem-solving behaviors
To strengthen the family's ability to cope with major life stressors and traumatic events, including chronic physical or psychiatric illness Feeling less anxiety and regaining or acquiring a sense of control and balance in family life Learning to accept the illness of a family member To resolve or reduce intrafamily relationship conflicts |
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******useful goals of family therapy
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reducing dysfunctional behavior of individual family members; reducing intrafamily relationship conflicts;
mobilizing family resources and encouraging adaptive family problem solving; improving family communication skills; increasing awareness and sensitivity of other family members’ emotional needs; helping family members meet needs of their members; strengthening family’s ability to cope with major life stressors and traumatic events; Improving integration of family system into societal system |
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Other goals related to psychoeducational interventions, self-help groups, or professional counseling are
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learning to accept illness of a family member;
learning to deal effectively with ill member’s symptoms; understanding what medications can and cannot do, when to seek medical advice; assisting in locating community resources |
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what helps identify most appropriate interventions
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careful analysis of assessments
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factors to be considered within family when determining interventions
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immediate and long-term needs of the family, crisis at a family developmental stage, coping mechanisms being used, and identification of new skills family members need such as conflict management, parenting, limit setting, or need for psychoeducational family interventions.
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communication guidelines include
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Develop and practice good listening skills.
View family members in a positive, nonjudgmental way. Use a nonblaming manner to keep communication open and flexible. Impart information in a clear and understandable manner. Listen to each family member’s perspective of a situation |
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family therapy has been found to be effective in what situations
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The child is the patient and the disorder is one of conduct.
• The wife of the couple is depressive. • A substance-abusing person enters treatment and then is maintained after treatment. • A schizophrenic individual is the client and family therapy is used to reduce relapse |
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possible focus of traditional family therapy
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The here and now
Family history Reports of what happened between sessions |
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psychoeducational family therapy is very effective with patients who are diagnosed with
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schizophrenia
other mental illnesses parent training for conduct disorders share info about mental health |
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2 types of self help group
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one for people suffering from a personal problem or social deprivation (e.g., AA); the other for families with a member with a specific problem or condition (e.g., Al-Anon
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most powerful group to which an individual belongs
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family
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case management involves
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involves teaching, giving appropriate referrals, offering emotional support, and making ongoing assessments of family strengths and weaknesses.
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Nurses needs to explain what in regards to meds
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Purpose of a prescribed medication
Desired effects Possible side effects Adverse reactions |
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nursing process is not concluded until
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demonstrating changes in behaviors, communication and coping skills, conflict resolution, and the family being more integrated into the societal system.
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****Blending of conventional or allopathic (mainstream) medical practices with those of complementary and alternative medicine
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integrative care
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conventional medicine is also called
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Allopathic
Mainstream Orthodox Regular medicine Biomedicine Western medicine |
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****Used as a substitute for conventional therapies
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alternative tehrapies
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****In tandem with conventional treatments
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complementary therapies
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****why are complementary and alternative medicine forms beings sought
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by individuals to help manage or sometimes prevent the onset of chronic illness, increase longevity, improve cognitive function, or increase feelings of well-being.
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The dominant health care system of biomedicine in the United States
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allopathy - research based
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****CAM or complementary or alternative medicine is based on
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cultural or historical beliefs that do not necessarily have scientific underpinnings.
covers a broad range of healing philosophies that are not widely taught in medical schools, not generally used in hospitals, and usually not reimbursed by insurance companies. Such therapies used alone are called alternative therapies, whereas those used with conventional treatments are called complementary. |
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****Conventional medicine often focuses on treating ___________, whereas CAM focuses on __________________
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conventional treating a disease
CAM on treating whole person |
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****what percent of people are using herbal medicine
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1/3
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****where can nonbiased info be found on herbal medicine
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NIH center sites
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****reasons consumers are attracted to CAM
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be an active participant in his or her health care and engage in holistic practices; find lower-risk therapeutic approaches; find health care less expensive than conventional health care. Additional reasons include dissatisfaction with the practice style of conventional medicine and positive experiences with CAM practitioners
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****OAM
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Office of Alternative Medicine
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****OAM was mandated to
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Facilitate evaluation of alternative treatments
Serve as an information clearinghouse Support research training in CAM |
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In 1998 OAM was renamed
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National Center for Complementary and Alternative Medicine (NCCAM)
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What does the National Center for Complementary and Alternative Medicine
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Supports fair and scientific evaluation of CAM therapies
Provides information to health care providers so that they can make safe and appropriate decisions about the use of CAM |
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****when CAM includes prayer and megavitamins, what percent of Americans indicate they use some form of it
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62%
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****concerns about CAM therapies
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Most Americans who use CAM do not report this to their primary health care provider.
United States has no standards or regulations that guarantee safety or efficacy of herbal product. "Natural" does not mean "harmless |
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****why consumers are attracted to CAM
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Want safer treatments than current available medications
Need less-expensive alternatives to conventional care CAM practitioners spend more time with clients and learn about all facets of their life Dissatisfaction with practice style of conventional medicine (rushed office visits, short hospital stays) |
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****role of nurses with CAM
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Stay knowledgeable about CAM treatments.
Evaluate scientific research findings about the safety and efficacy of CAM. Be able to guide patients in the safe use of CAM treatments |
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in this form of medicine Originated in India around 5000 BC Individual has responsibility for his or her own health Promotes prevention Natural methods of treatment |
Ayurvedic medicine
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****in this form of medicine
Derived from Taoism Qi, or yin and yang = life force Health is the balance between yin and yang |
Traditional Chinese medicine
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5 element theory of traditional Chinese medicine |
Everything classified as one of the five primordial elements: wood, fire, earth, metal, and water.
These elements act on one another as part of a dynamic system. The transition of the five elements reflects the human condition of transformation. Transformation is the essence of healing |
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how is pulse diagnosis conducted and used in Traditional Chinese medicine |
Practitioner palpates six pulses in each wrist by using both a light and a firm touch.
Qualities of the pulse are described as fast, slow, weak, slippery. Practitioner then able to characterize the client's current, past, and future health |
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Eastern view of the mind-body-spirit |
Acupuncture
Imagery Therapeutic touch Therapeutic massage Relaxation Bioenergetics Biofeedback Qi gong Yoga |
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Uses small doses of specially prepared plant extracts and minerals to stimulate the body's defense mechanisms and healing processes to treat illness |
homeopathy
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Belief that the individual assumes responsibility for his or her own recovery Emphasizes health restoration Therapies used: nutrition, homeopathy, herbal medicine, hydrotherapy, light therapy, therapeutic counseling |
naturopathy
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Interventions designed to facilitate the mind's capacity to affect bodily function and symptoms |
mind-body interventions
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****mind body interventions include
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Cognitive-behavioral approaches
Support groups Education Meditation Prayer Spiritual healing Therapies using dance, music, art therapy |
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Originated in late 1800s by Daniel David Palmer Focus on relationship between structure and function: the way in which relationship affects the preservation and restoration of health by using manipulative therapy Refers to misalignments as subluxations |
Manipulative and Body-Based Methods: Chiropractic
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Includes a broad group of medically valid therapies Involves rubbing or moving the skin Four basic techniques: Effleurage Pétrissage Vibration and percussion Friction |
massage therapy
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Provides soothing relaxation and increase in circulation |
Swedish massage
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Japanese origin Used to detect and treat problems in the flow of life energy (ki) Use of fingers, thumbs, elbows, knees, or feet to apply pressure by massaging parts of the body known as acupoints |
Shiatsu massage
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Focus on treatment of connnective tissue and fascia Thought to lose elasticity under stress sessions reset body |
Rolfing
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Focus on feet Based on belief that zones and points on the feet correspond to other parts of the body Treatments are to open blocked nerve pathways and improve circulation in the feet to treat problems that may exist elsewhere |
refelxology
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Belief that a nonphysical energy force pervades the universe |
energy therapies
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What is energy referred to in: traditional Chinese medicine Indian ayurvedic medicine Japanese medicine NCCAM |
qi in traditional Chinese medicine
prana in Indian ayurvedic medicine ki in Japanese medicine biofield by the NCCAM |
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human energy field is called |
aura
takes a particular form in each person |
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energy field contains |
number of layers, each with energy of different frequencies.
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Energy is transferred between _________ and into the physical body through structures called ____________ |
energy is transferred between layers and into the physical body through structures called chakras
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disturbances of the energy field cause |
illnesses
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healing occurs
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energy field is balanced and energy is flowing freely.
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****orthomolecular therapy
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megavitamin therapy
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Involves taking large amounts of vitamins, minerals, and amino acids to treat physical and psychological illnesses Based on belief that the inability to absorb nutrients form a proper diet alone may lead to illness |
megavitamin therapy
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The use of some vitamins and medications together is
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contraindicated
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Therapy used in traditional Chinese medicine
Placement of needles into the skin at certain points on the body to modulate the flow of energy (qi) Qi moves through the body along specific nonvisible pathways called meridians |
acupuncture
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medical research indicates acupuncture
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Regulate blood cell counts
Trigger endorphin production Control blood pressure |
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acupuncture is used to
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Used for pain relief, and to treat substance abuse and emotional disorders
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Developed in the 1970s by Dolores Krieger, a nursing professor, and Dora Kunz, a healer from Canada
Many nurses have been trained in this therapy Based on belief that the healing force of the practitioner affects the client's recovery Practitioners pass their hands over the client to identify energy imbalances and promote healing by balancing the energy Practitioner's hands do not touch the client |
therapeutic touch
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is there research that supports therapeutic touch
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no - there is a lack of research
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Use of essential oils for inhalation to activate the body's healing energy to balance mind, body, and spirit
Based on theory that essential oils stimulate the release of neurotransmitters in the brain |
aromatherapy
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risks of aromatherapy
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Some individuals are sensitive or allergic to essential oils when they come into contact with the skin or are inhaled.
Essential oils are flammable. Essential oils can be harmful if ingested. |
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do health insurance companies cover CAM
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some have begun to
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lithium has greater toxicity in what population |
African Americans
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plasma cocnentrations of Haloperidol are 50% higher in |
Asians
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life threatening side effect of clozapine |
clozapine
higher in Ashkenazi Jews |
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Neurotransmitters that have most consistently been linked to mental activity are
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norepinephrine, dopamine, serotonin, GABA, glutamate, and CRH
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Alterations in mental status, whether arising from disease or medication, are often accompanied by changes
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basic drives, sleep patterns, body movement, and autonomic functions.
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*****
Standard (First-Generation) Antipsychotic Drugs include |
phenothiazines, thioxanthenes, butyrophenones, and so on.
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Blocking dopamine reduces |
positive symptoms of schizophrenia such as delusions and hallucinations
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antipsychotic drugs are antagonists of |
Block attachment of dopamine
Reduce dopaminergic transmission Acetylcholine Norepinephrine Histamine |
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major side effects of antipsychotic drugs |
dopamine blockade gives rise to motor disturbances, including parkinsonism, akinesia, akathisia, dyskinesia, and tardive dyskinesia.
Muscarinic receptor blockage leads to anticholinergic effects such as blurred vision, dry mouth, constipation, and urinary hesitancy Blockade of 1 receptors for norepinephrine is responsible for vasodilation and a consequent orthostatic hypotension, and for ejaculatory failure as well. Blockade of H1 receptors contributes to sedation and substantial weight gain. |
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what is AIMS used for |
Involuntary motor movement can be monitored via the abnormal involuntary movement scale
(may be used when on antipsychotic drugs) |
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what does dopamine do |
Inhibits release of prolactin from the anterior pituitary gland
Leads to increased pituitary secretion of prolactin In women Amenorrhea (absence of menses) Galactorrhea (milk flow) In men Gynecomastia (development of male mammary glands) |
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side effects of dopamine blocakade |
gives rise to motor disturbances, including parkinsonism, akinesia, akathisia, dyskinesia, and tardive dyskinesia.
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Muscarinic receptor blockage leads to |
anticholinergic effects such as blurred vision, dry mouth, constipation, and urinary hesitancy
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Blockade of 1 receptors for norepinephrine |
vasodilation and a consequent orthostatic hypotension, and for ejaculatory failure as well
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Blockade of H1 receptors |
contributes to sedation and substantial weight gain.
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what do atypical antipsychotic drugs do |
Bind to dopamine receptors in the limbic system
Preferentially over dopamine receptors in the limbic system Decrease motor side effects |
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what class of antipsychotics target both negative and positive symptoms of schizophrenia |
typical antipsychotics
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antagonists at the 5-hydroxytryptamine 2 (5-HT2) receptors for serotonin of atypical antipsychotics help treat the |
negative symptoms
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possible fatal side effects of clozapine |
Agranulocytosis, convulsions, myocarditis
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other side effects of clozapine |
Drowsiness, sedation, hypersalivation, tachycardia, dizziness
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examples of atypical antipsychotics |
clozapine
risperidone Quetiapine Olanzapine (Zyprexa) Ziprasidone (Geodon) Aripiprazole (Abilify) Paliperidone (Invega) |
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what does rsiperidone do |
reduce hallucinations and delusions
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possible side effects of risperidone |
orthostatic hypotension and sedation.
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Quetiapine broad receptor binding profile produces |
sedation
weight gain BUT NOT AGRANULOCYTOSIS |
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major negative of quetiapine |
weight gain
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major side effects of ziprasidine |
hypotension
sedation |
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one mjor concern of ziprasidine |
prolongation of the QTc interval, which can be fatal if a client has a history of cardiac arrhythmia.
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side effects of aripiprazole |
sedation, hypotension, and anticholinergic effects
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drug effects of antipsychotics |
Block dopamine receptors in CNS
Block alpha receptors (causing hypertension, other cardiovascular effects) Block histamine receptors (causing anticholinergic effects) Block serotonin Also function as antiemetics Antianxiety effects |
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therapeutic uses of antipsychotics
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Bipolar affective disorder
Depressive and drug-induced psychoses Schizophrenia Autism Movement disorders (such as Tourette’s syndrome) Some medical conditions Nausea, intractable hiccups |
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antipsychotic side effects |
CNS Sedation, delirium
Cardiovascular Orthostatic hypotension, syncope, dizziness, ECG changes Dermatologic Photosensitivity, skin rash,hyperpigmentation, pruritus GI Dry mouth, constipation GU Urinary hesitancy or retention, impaired erection Hematologic Leukopenia and agranulocytosis Metabolic/Endocrine Galactorrhea, irregular menses increased appetite, polydipsia |
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mood stabilizers include |
Lithium
Antiepileptic drugs Carbamazepine (Tegretol) Divalproex (Depakote) Lamotrigine (Lamictal) Gabapentin (Neurontin) Topiramate (Topamax) Clonazepam (Klonopin) |
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side effects of lithium includes |
induce cardiac dysrhythmias, convulsions, and tremor.
fluid balance disturbances. |
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why is close monitoring of lithium required |
Such a mechanism of action would explain its ability to induce cardiac dysrhythmias, convulsions, and tremor. Lithium can also create fluid balance disturbances. For these reasons it has a low therapeutic index (ratio of lethal dose to effective dose) and requires close monitoring of serum lithium level.
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what do antiepileptic drugs do |
alter electrical conductivity in membranes and reduce the firing rate of very-high-frequency neurons in the brain
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Carbamazepine (Tegretol |
treats unipolar depression
similar to tricyclic antidepressants |
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side effects of Carbamazepine (Tegretol) |
nausea, sedation, and ataxia. The therapeutic blood level is monitored regularly.
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Divalproex (Depakote) is effective in treating |
manic depression
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common side effects of Divalproex (Depakote) |
hair loss, tremor, weight gain and sedation
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what is needed before beginning Divalproex (Depakote) |
baseline of liver function tests and CBC are done before an individual is started on this medication and periodically. Monitoring of the therapeutic blood level is done regularly
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has strong sedating properties, which may account for its ability to calm a patient in the manic phase of a bipolar disorder. It may be used with lithium to increase the time between mood cycles, and it may also be used as part of a multiple-drug regimen to treat clients who show a mixture of anxious and depressive symptoms concomitantly |
clonazepam
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serious draw back of clonazepam |
clients can develop tolerance and dependence. Baseline lab studies include CBC, liver function, and renal function tests.
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how does lithium act |
Lithium is a salt that may modify second messenger systems.
Lithium may alter G-proteins or enzymes that interact with the second messenger system |
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how do anticonvulsants act |
Anticonvulsants cause a decrease in the catabolism of GABA which results in an increased concentration of GABA in the central nervous system
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therapeutic uses of mood stabilizers |
Bipolar disorder (maintenance)
Mania in bipolar disorder Reduction in mood swings Schizoaffective disorder Impulse control disorders & Aggression Conduct disorder Pervasive developmental disorders Depakote & Tegretol are useful for rapid-cycling bipolar disorder |
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side effects of mood stabilizers |
Motor Fine hand tremmor
GI Nausea, polydipsia, dry mouth, weight gain CNS Confusion, anxiety, sedation, diplopia, visual disturbances, headache, dizziness, memory impairment Motor Tremmor, ataxia Dermatological Alopecia, jaundice, skin rash GI Nausea, diarrhea, weight gain, vomiting |
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therapeutic blood of lithium |
Therapeutic level between 0.4 and 1.3 mEq/L
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early signs of toxicity with lithium |
Early signs of toxicity can occur at levels above 1.5 mEq/L
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advanced signsof toxicity with lithium |
Advanced signs of toxicity may be seen at levels of 1.5 to 2.0 mEq/L
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severe toxicity of lithium |
levels of 2.0 to 2.5 mEq/L and emergency measures should be taken immediately
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Lithium serum concentrations are increased by |
fluoxetine, ACE inhibitors, diuretics, and NSAIDS.
start slow, go slow especially with elderly check every 3-4 days |
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Lithium serum levels are decreased |
theophylline, osmotic diuretics and urinary alkalinizers.
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how often should blood lithium levels be checked and when should they be checked |
Initially every week until therapeutic level is reached then monthly.
After 6 months then may do every 3 months. Blood should be drawn 8-12 hours after the last dose of lithium is taken. |
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early signs of lithium toxicity |
Early Signs: Level < 1.5 mEq/L
Nausea, vomiting, diarrhea, thirst, polyuria, slurred speech, muscle weakness |
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advanced signs of lithium toxicity |
Coarse hand tremmors, persistent GI upset, mental confusion, muscle hyperirritability, EEG changes, Incoordination
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signs of severe lithium toxicity |
Ataxia, serious EEG changes, blurred vision, clonic movements, large output of dilute urine, por, severe hypotension, seizures, coma and death which is usually due to pulmonary complications
Severe Toxicity: Levels > 2.5 mEq/L -Confusion, incontinence of urine or feces, coma, cardiac arrythmia, peripheral circulatory collapse, abd. Pain, proteinuria, oliguria and death |
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4 classes of typical or standard antidepressants |
Tricyclic antidepressants (TCAs)
Amitriptyline (Elavil) Imipramine (Tofranil) Nortriptyline (Pamelor |
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cause of depression |
transmission deficiency of norepinephrine or serotonin or both within the limbic system
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cyclic antidepressants mechanism of action |
Block reuptake of neurotransmitters, causing accumulation at the nerve endings.
It is thought that increasing concentrations of neurotransmitters will correct the abnormally low levels that lead to depression. |
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Typical or Standard Antidepressants Amitriptyline, imipramine, and nortriptyline—tricyclic antidepressants (TCAs)—act primarily by |
blocking reuptake of norepinephrine and, to a lesser degree, serotonin; thus norepinephrine is not degraded by monoamine oxidase (MAO), and more stays at the synapse.
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hos do TCAs work |
block muscarinic receptors, giving anticholinergic effects. Some TCAs block H1 receptors in the brain, producing drowsiness
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Cyclic Antidepressants Therapeutic Uses |
Depression
Childhood enuresis (imipramine) Obsessive-compulsive disorders (clomipramine) Adjunctive analgesics Trigeminal neuralgia |
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side effects of cyclic antidepressants |
Sedation
Impotence Orthostatic hypotension Older patients: dizziness, postural hypotension, constipation, delayed micturation, edema, muscle tremors |
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what happens with a tricyclic antidepressant overdose |
Lethal—70 to 80% die before reaching the hospital
CNS and cardiovascular systems are mainly affected Death results from seizures or dysrhythmias |
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treatment of tricyclic antidepressant overdose |
Decrease drug absorption with activated charcoal
Speed elimination by alkalinizing urine Manage seizures and dysrhythmias Basic life support |
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examples of Monoamine oxidase inhibitors (MAOIs) |
Isocarboxazid (Marplan)
Phenelzine (Nardil) Tranylcypromine (Parnate Monoamines (norepinephrine, epinephrine, dopamine, tyramine) Monoamine oxidase Monoamine oxidase inhibitors |
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what is considered Considered second-line treatment for depression not responsive to cyclics |
MAOIs
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disadvantage of MAOIs |
potential to cause hypertensive crisis when taken with tyramine. In the presence of MAO inhibitors (MAOIs), tyramine is not destroyed in the liver, resulting in hypertensive crisis. Thus when MAOIs are taken, the client must observe a tyramine-free diet.
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how does tyramine effect use of MAOIs |
Ingestion of foods and/or drinks with the amino acid TYRAMINE leads to hypertensive crisis, which may lead to cerebral hemorrhage, stroke, coma, or death
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foods that contain tyramine need to be avoided with and include what foods |
avoid with MAOIs
Aged, mature cheeses (cheddar, blue, Swiss) Smoked/pickled or aged meats, fish, poultry (herring, sausage, corned beef, salami, pepperoni, paté) Yeast extracts Red wines (Chianti, burgundy, sherry, vermouth) Italian broad beans (fava beans) |
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action of MAOIs
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Inhibit the MAO enzyme system in the CNS
Amines (dopamine, serotonin, norepinephrine) are not broken down, resulting in higher levels in the brain Result: alleviation of symptoms of depression |
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most common side effect of MAOIs |
orthostatic hypotension
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otehr side effects of MAOIs |
Tachycardia Palpitations
Dizziness Drowsiness Insomnia Headache Anorexia Nausea Blurred vision Impotence |
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symptoms of MAOIs overdose |
Symptoms appear 12 hours after ingestion
Tachycardia, circulatory collapse, seizures, coma |
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treatment of MAOIs overdose |
protect brain and heart, eliminate toxin
Gastric lavage Urine acidification Hemodialysis |
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examples of Selective serotonin reuptake inhibitors (SSRIs) |
Fluoxetine (Prozac)
Sertraline (Zoloft) Paroxetine (Paxil) Citalopram (Celexa) Escitalopram (Lexapro |
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what do SSRIs do |
block the reuptake of serotonin with little or no effect on the other monoamine transmitters. These drugs have less ability to block muscarinic and H1 receptors than do the tricyclics (TCAs).
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\mechanism of action for SSRIs |
Selectively inhibit serotonin reuptake
Little or no effect on norepinephrine or dopamine reuptake Results in increased serotonin concentrations at nerve endings |
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advantage of tricyclics over MAOIs |
Little or no effect on cardiovascular system
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therapeutic uses of SSRIs |
Used for depression—very few serious side effects
Bipolar affective disorder Obesity Eating disorders Obsessive-compulsive disorder Panic attacks Myoclonus |
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side effects of SSRIs |
CNS Headache, dizziness, tremor, nervousness, insomnia, fatigue
GI Nausea, diarrhea, constipation, dry mouth Other Sweating, sexual dysfunction |
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side effects of SSRIs |
CNS Headache, dizziness, tremor, nervousness, insomnia, fatigue
GI Nausea, diarrhea, constipation, dry mouth Other Sweating, sexual dysfunction |
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atypical or novel antidepressants include |
Serotonin-norepinephrine reuptake inhibitor (SNRIs)
Venlafaxine (Effexor) Duloxetine (Cymbalta) Mirtazapine (Remeron) Trazodone (Desyrel) Dopamine-norepinephrine reuptake inhibitor Bupropion (Wellbutrin/Zyban |
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this atypical antidepressant weak antagonist of muscarinic receptors so produces few anticholinergic effects. However, it blocks 1 and H1 receptors, causing orthostatic hypotension and sedation |
trazodone
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a relative of trazodone It exerts no 1 and H1 receptor blockade. |
nefazodone
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this atypical antidepressant blocks reuptake of both norepinephrine and serotonin, but does not block muscarinic, 1, or H1 receptors. It may produce feelings of anxiety, nausea, vomiting, and dizziness. |
venlafaxine
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acts on 5-HT2 and 2 presynaptic norepinephrine receptors, accounting for its antidepressant effect. Side effects of sedation, weight gain, dry mouth, and constipation are related to its actions as an antagonist at H1 and muscarinic receptors. |
mirtazapine
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Bupropion’s major side effects |
headache
insomnia nausea restlessness |
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therapeutic uses of atypical (novel) antidepressants |
Treatment resistant depression
Bipolar depression Depression with ADHD Medical Illness and depression Anxiety Panic attacks SSRI induced insomnia (Trazodone, Desyrel) Nicotine addiction (Wellbutrin, Zyban) |
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action of wellbutrin and zyban |
Blocks norepinephrine and dopamine reuptake
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(Venlafaxine or Effexor) and (Duloxetine or Cymbalta) |
Inhibits reuptake of serotonin, norephinerine and dopamine
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action of (Mirtazapine or Remeron) |
Blocks serotonin, histamine and enhances nonadrenergic and serotonergic transmitters
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side effects of atypical (novel) antidepressants |
Cardiac Postural hypotension (Trazadone) and Possible increase in blood pressure (Effexor)
CNS Headache, dizziness, tremor, nervousness, insomnia, fatigue, Medication induced seizures, Memory disturbances GI Nausea, diarrhea, constipation, dry mouth, decreased appetite,weight gain Other Sweating, sexual dysfunction |
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examples of antianxiety or antianxiolytic drugs |
Benzodiazepines
Diazepam (Valium) Clonazepam (Klonopin) Alprazolam (Xanax) Flurazepam (Dalmane) Triazolam (Halcion |
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what does GABA do |
exerts an inhibitory effect on neurons in many parts of the brain
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**** what do drugs that enhance effect of GABA do
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Drugs that enhance this effect exert a sedative-hypnotic action on brain function and reduce anxiety.
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what does benzodiazepine do |
binding at sites adjacent to GABA binding allows GABA to inhibit more forcefully than it would if binding alone. Benzodiazepine potentiation of GABA accounts for its use as an anticonvulsant and its efficacy in reducing neuronal overexcitement in alcohol withdrawal.
These drugs can also interfere with motor ability, attention, and judgment. |
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*** what does benzodiazepine also interfere with
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These drugs can also interfere with motor ability, attention, and judgment
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what determines whether teh antianxiety determines whether the agent relieves anxiety or acts as a sedative-hypnotic |
dosage
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what is GABA |
an inhibitory neurotransmitter and increased effects produce CNS depression
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how does benzodiazepine act |
Acts at the subcortical level of the CNS and increases the effects of GABA which causes CNS depression
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what do zolpidem and ambien do |
Modulate GABA receptors to cause suppression of neurons which leads to sedation and anticonvulsant and relaxant properties
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therapeutic uses of antianxiety/anxiolytic drugs |
Sedation in low doses and induced sleep at higher doses
Treatment of acute anxiety and panic attacks Pre-operative and post-operative for sedation |
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side effects of antianxiety/antianxiolytic drugs |
CNS Drowsiness, Confusion, Hangover effect, sudden mood swings, dizziness, blurred vision lightheadedness
Motor Ataxia, Fatigue GI Weight loss, GI upset Respiratory depression and other CNS depression leading to death Seizures Ataxia Hallucination |
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what can sudden stop of antianxiety meds cause |
Abrupt withdrawal can cause seizures, delirium, depression and paranoia, Always taper dose carefully!!!
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Benzpdiazepines should be used for how long |
short periods
1 -2 weeks can lead to tolerance and physiological dependence |
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benzodiazepines should not be taken |
Do not take with alcohol or other CNS depressants. Contraindicated in Hepatic or renal impairment, pregnancy, lactation, cardiac disease and addiction.
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meds for ADHD |
Methylphenidate (Ritalin)
Dextroamphetamine (Adderall) Atomoxetine hydrochloride (Strattera |
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Buspirone (BuSpar) Used for |
anxiety
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therapeutic uses of antianxiety/anxiolytic drugs |
Sedation in low doses and induced sleep at higher doses
Treatment of acute anxiety and panic attacks Pre-operative and post-operative for sedation |
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side effects of antianxiety/antianxiolytic drugs |
CNS Drowsiness, Confusion, Hangover effect, sudden mood swings, dizziness, blurred vision lightheadedness
Motor Ataxia, Fatigue GI Weight loss, GI upset Respiratory depression and other CNS depression leading to death Seizures Ataxia Hallucination |
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what can sudden stop of antianxiety meds cause |
Abrupt withdrawal can cause seizures, delirium, depression and paranoia, Always taper dose carefully!!!
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Benzpdiazepines should be used for how long |
short periods
1 -2 weeks can lead to tolerance and physiological dependence |
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benzodiazepines should not be taken |
Do not take with alcohol or other CNS depressants. Contraindicated in Hepatic or renal impairment, pregnancy, lactation, cardiac disease and addiction.
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meds for ADHD |
Methylphenidate (Ritalin)
Dextroamphetamine (Adderall) Atomoxetine hydrochloride (Strattera |
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Buspirone (BuSpar) Used for |
anxiety
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meds for Alzheimer's disease |
Tacrine (Cognex)
Donepezil (Aricept) Memantine (Namenda |
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Much of the memory loss of Alzheimer’s disease has been attributed to |
dysfunction of neurons that secrete acetylcholine
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The anticholinesterase drugs tacrine and donepezil work by |
inactivating the enzyme that destroys acetylcholine.
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extrapyramidial side effects |
painful and frightening spasms of the tongue, throat, face, jaw, eyes, neck or back muscles. Occurs in 10% of clients. Symptoms may present as eye closing, severe upward deviation of the eyeballs, neck muscle contraction that pulls the neck to one side, severe dorsal arching of the neck and back, and difficulty swallowing
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very effective in relieving acute dystonia. IM or orally |
anticholinergic drugs
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Occurs in 25 % of persons taking antipsychotics. Clients verbalize an inner restlessness described as irritability or tension. Outward signs are motor restlessness, pacing, foot tapping, rocking, and inability to remain still |
akathisia
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Bradykinesia, or akinesia, rigidity, resting tremor, hypersalivation with drooling, flat affect, cogwheel rigidity, postural instability, hunched and shuffling gait and mask-like faces. |
pseudoparkisonism
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slow movements |
bradykinesia
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Impaired body movement; without movement (or without much movement |
akinesia
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extrapyramidial side effetcs |
akathisa
pseudoparkisonism dystonia Tardive Dyskinesia |
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is described as involuntary perioral movements that mimic the chewing motions of a rabbit |
rabbit syndrome
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Rigidity in which the muscles respond with cogwheel-like jerks to the use of force in bending the limb, as occurs in Parkinson's disease |
Cogwheel rigidity
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An abnormal condition characterized by involuntary repetitious movements of the muscles of the face, limbs, and trunk. Facial movements may include tongue thrusting and writhing, lip pursing or smacking, facial grimaces, and chewing movements. Rapid, jerking and slow, writhing movements occurring anywhere in the body. Occurs in 4% of clients. Symptoms may decrease or disappear for awhile but usually are permanent. Family is usually the first to notice these. |
tardive dyskinesia
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antimuscarinics/antihistaminics/dopamine agonists are used to treat |
extrapyramidial side effects
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block the effects of histamine and have anticholinergic effects |
antihistamines
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increase dopamine release |
antiparkinsonian
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normalize the imbalance of cholinergic / dopaminergic neurotransmission in the basal ganglia of the brain. |
anticholinergics
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types of antimuscarinics |
Benztropine (Cogentin)
Trihexyphenidyl (Artane) Biperiden (Akineton) Procyclidine (Kemadrin |
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before beginning therapy with psychotherapeutic agents |
Before beginning therapy, assess both the physical and emotional status of patients
Obtain baseline VS, including postural BP readings Obtain liver and renal function tests (and baseline platelet levels for MAOIs) Assess for possible contraindications to therapy, cautious use, and potential drug interactions Assess LOC, mental alertness, potential for injury to self and others |
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what should be taught to pts using psychotherapeutic agents |
Provide simple explanations about the drug, its effects, and the length of time before therapeutic effects can be expected
Abrupt withdrawal should be avoided Advise patients to change positions slowly to avoid postural hypotension and possible injury |
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nursing implications with psychotehrapeutic meds |
The combination of drug therapy and psychotherapy is emphasized because patients need to learn and acquire more effective coping skills
Only small amounts of medications should be dispensed at a time to minimize the risk of suicide attempts Simultaneous use of these agents with alcohol or other CNS depressants can be fatal Encourage patients to wear medication ID badges naming the agent being taken Instruct patients and family regarding tyramine-containing foods and signs and symptoms of hypertensive crisis |
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Can occur in theraputic dosages. Can lead to death in 20 % of patients. Autonomic instability. Confusion, looks ill. No urine output or very little output. Fever and decreased appetite. Increased heart rate and decreased blood pressure. CPK is elevated and serum iron is decreased. |
neuroleptic malignant syndrome
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how long may it take to see effects of antidepressants |
1 to 3, even 4, weeks to see therapeutic effects.
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what should be done if sedation from tricyclic antidepressant last longer than 3 weeks |
notify dr
Assist elderly or weakened patients with ambulation and other activities as falls may occur due to drowsiness or postural hypotension |
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before undergoing surgery if using tricyclic antidepressant |
may need to be weaned 1st
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what may decrease effectiveness of antidepressant |
smoking
caffeine |
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precautions with phenothiazines |
Instruct patients to wear sunscreen due to photosensitivity
Avoid taking antacids or antidiarrheal preparations within 1 hour of a dose Do not take alcohol or other CNS depressants with these medications |
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Long-term haloperidol therapy may result |
tremors, nausea, vomiting, or uncontrollable shaking of small muscle groups;
these symptoms should be reported to the physician |
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phenothiazines may cause |
drowsiness, dizziness, or fainting; instruct patients to change positions slowly
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what should be monitored for when using psychotherapeutic agents |
Monitor mental alertness, cognition, affect, mood,ability to carry out activities of daily living, appetite, and sleep patterns
Monitor the patient’s potential for self-injury during the delay between the start of therapy and symptomatic improvement |
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what should be monitored for with antidepressants |
Improved sleep patterns and nutrition,
increased feelings of self-esteem, decreased feeling of hopelessness, increased interest in self and appearance, increased interest in daily activities, fewer depressive manifestations or suicidal thoughts or ideations |
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what should be monitored for in use of antipsychotics |
Improved mood and affect, alleviation of psychotic symptoms and episodes
Decrease in hallucinations, paranoia, delusions, garbled speech, inability to cope |
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positive symptoms |
the presence of something such as hallucinations
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***negative symptoms
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the absence of something needed uch as hygiene
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Deliberate Artificially induced tonic-clonic seizure (grand mal or generalized seizure) |
electroconvulsive tehrapy
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how long does electroconvulsive therapy last |
about 1 minute
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how successful is electroconvulsive therapy |
Very successful, can achieve > 90% remission rate within 1-2 weeks
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how does ECT work |
Enhances dopamine sensitivity
Reduces uptake of seratonin Increases gamma-aminobutyric acid (GABA) Activates the system in the brain that uses norepinephrine Reduces regional cerebral blood flow and glucose metabolism Increases blood-brain permeability |
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ECT is used for |
Severe depression that does not respond to medication or other therapy.
Suicidal patients Bipolar disorder-Used in both the depressive phase and the manic phase. Especially rapid cycling bipolar disorder. Schizophrenia, schizoaffective syndromes not responsive to lithium and antipsychotics. Psychotic patients who are pregnant. Parkinsons Disease |
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ECT is not usually effective in |
With drug dependence
depression secondary to situational or social difficulties. With developmental disorders Personality Disorders |
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how often are ECT treatments
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Usually a client will have 2-3 treatments in one week for a total of 6-12 treatments
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ECT is contraindicated in |
Person with a recent MI or CHF
Person with a CVA Intracranial mass or lesion Subdural hematoma |
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procedure for ECT |
Explain procedure and answer all questions as fully as possible.
Obtain written consent (requires anesthesia) NPO for at least 4 hours before treatment (8-12 is better) Just prior to treatment have patient void and remove all jewelry, dentures, contacts etc. Assess vital signs |
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****Anesthesia preparation usually consists of what for an ECT
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atropine like medication to decrease secretions and block cardiac vagal reflexes during the seizure.
short acting anesthetic administered |
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****what is administered to prevent injuries from seizure during ECT
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muscle relaxant
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during ECT what is the client's needs for respiration |
The client must be artificially ventilated and oxygen is administered
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what is passed through brain during ECT |
An electrical current is passed through the brain by means of a unilateral or bilateral electrode placed on the temples.
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what is usually only visible part of seizure during ECT |
Generalized seizure (tonic-clonic) is produced but is masked by the muscle relaxant. Usually the only visable sign of the seizure are the eyelids fluttering
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what is true for recovery from ECT |
should be in lateral recumbent position to prevent aspiration.
disoriented and have some confusion initially. may have a headache and muscle aches but they usually subside within one hour. |
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what happens to memory due to ECT |
retrograde amnesia
Memory loss is a common occurance after ECT. This usually occurs for a few weeks. Short term memories are usually the most lost as they have not been stored in long term memory. After 6-9 months most of the memories have been recovered. |
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involves the application of an electromagnetic coil to the brain; this creates electromagnetic pulses that result in an antidepressant effect. This is not a treatment that is widely available. It has not yet been approved by the FDA for the treatment of depression, so is still experimental.
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Transcranial magnetic stimulation
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TMS is used in patients with |
severe treatment resistant depression
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*** TMS is contraindicated with |
Pregnancy and having metal clips or other surgical metal in the brain
high risk for seizures |
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advantage of TMS |
does not require anesthesia
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side effects of TMS |
usually minimal and may include a tingling sensation at the treatment site or a headache. As the machine is quite loud, protective hearing equipment is supplied
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treatment time for TMS |
Each treatment takes a couple of hours to administer and usually requires 5 treatments per week for up to six weeks. Therefore, this is a considerable time commitment.
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The electrical stimulation of the vagus nerve results in boosting the level of neurotransmitters which improves the mood. A pacemaker like device is implanted surgically into the left chest wall. It is then connected to a thin flexible wire and threaded up and wrapped around the vagus nerve on the left side of the neck. A PDA is used to program how often the pulses are delivered. |
Vagus Nerve STimulation
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how long are Vagus Nerve Stimulation treatments |
They are usually delivered for 30 seconds, every 5 minutes for 24 hours a day. It usually takes several weeks to be effective.
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side effects of Vagus Nerve STimulation |
Problems that occur are those associated with any surgical procedure but also 60 % of patients have voice alterations. Neck pain, cough, parasthesia, dyspnea are also side effects that usually diminish over time
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use of Narcan |
Naloxone is an special narcotic drug that reverses the effects of other narcotic medicines.
Naloxone is used to reverse the effects of narcotic drugs used during surgery or to treat pain. Naloxone may also be used to treat narcotic drug overdose or to diagnose narcotic drug addiction. Read more at http://www.drugs.com/mtm/narcan.html#5O3GBCcXz1w6uhoC.99 |
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prescription medicine that belongs to a class of drugs known as "atypical antipsychotics" used for schizophrenia and bipolar and have teh following side effects Drowsiness -- in up to 31 percent of people Headaches -- up to 18 percent Dizziness -- up to 16 percent Nausea -- up to 10 percent Weight gain -- up to 10 percent (see Geodon and Weight Gain) Constipation -- up to 9 percent Indigestion or heartburn -- up to 8 percent Respiratory tract infections -- up to 8 percent. |
Geodon (ziprasidone)
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mproves the function of nerve cells in the brain. It works by preventing the breakdown of a chemical called acetylcholine (ah see til KO leen). People with dementia usually have lower levels of this chemical, which is important for the processes of memory, thinking, and reasoning. is used to treat mild to moderate dementia caused by Alzheimer's disease. |
aricept
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possible side effects of aricept |
black, bloody, or tarry stools;
coughing up blood or vomit that looks like blood or coffee grounds; painful or difficult urination; seizure (black-out or convulsions); Less serious side effects may include: nausea, vomiting, diarrhea; loss of appetite; muscle cramps; tired feeling; or sleep problems (insomnia). |
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sed for the treatment of manic/depressive (bipolar) and depressive disorders. It is a positively charged element or particle that is similar to sodium and potassium. It interferes at several places inside cells and on the cell surface with other positively charged atoms such as sodium, potassium, calcium, and magnesium which are important in many cellular functions. IT interferes with the production and uptake of chemical messengers by which nerves communicate with each other (neurotransmitters). It also affects the concentrations of tryptophan and serotonin in the brain. In addition, lithium increases the production of white blood cells in the bone marrow. |
Eskilath or lithobid (lithium)
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side effects of eskilath or lithobid |
fine hand tremor, dry mouth, altered taste perception, weight gain, increased thirst, increased frequency of urination, mild nausea or vomiting, impotence, decreased libido, diarrhea, and kidney abnormalities.
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