PSYCHOPHARMACOLOGY by: Jay Balicha

MAOI’S (MONOAMINE OXIDASE INHIBITORS) – PANAMA

ANTI PSYCHOTICS – Decrease POSITIVE and NEGATIVE
SYMPTOMS  Isocarboxazid (Marplan)
 Phenelzine (Nardil)
TYPICAL – Old, High EPS, Treat POSITIVE SYMPTOMS  Tranylcypromine (Parnate)
“ZINE” o Selegiline (Emsam)- Patch*
Chlorpromazine (Thorazine)
Chlorperazine (Compazine) *Avoid TYRAMINE RICH FOODS (cause HYPERTENSIVE
Thioridazine (Mellaril) CRISIS)
Fluphenazine (Prolixin) Preservatives (canned, sealed)
Perphenazine (Trilafon) Soy, Soya, Yoghurt
Haloperidol (HALDOL) Salami
Avocado, Banana, Papaya
ATYPICAL – New, Low EPS, Treat POSITIVE & NEGATIVE Cheese (Swiss, Cheddar, Aged, Mozzerella)
SYMPTOMS ****KNOW**** SAFE CHEESE (Processed, Cottage, Cream)
“DONE” “PINE” TCA’s (TRICYCLIC ANTIDEPRESSANT’S) ends with “PRAMINE”
Resperidone (Resperdal) Clozapine (Clozaril) “ TRIPTYLINE”
Molindone (Moban) Olanzapine Imipramine (Tofranil) Amitriptyline (Elavil)
(Zyprexia) Desipramine (Norpramin) Protrityline (Aventyl)
Ziprasidone (Geodon) Quetiapine (Seroquel) Trimipramine (Surmontil) Nortriptyline (Vivactyl,
Pamelor*)
SIDE EFECTS Clomipramine (Anafranil) –OCD*
1. Dry Mouth, Constipation Trazodone (Desyrel)
2. Photosensetivity **ANTICHOLINERGIC SIDE EFFECTS
3. Hypotenstion – Orthostatic hypotension Dry Mouth, Constipation, Decrease BP, Blurred Vision,
4. EPS Hallucination, Increase Appetite
EXTRAPYRAMIDAL SYMPTOMS
1. TARDIVE DYSKENISIA –Lip smucking, Tongue twitching SSRI’S (SELECTIVE SEROTONIN REUPTAKE INHIBITORS) –
2. PSEUDO PARKINSONISM – Tremors(reversible), Ends with INE but not PINE and PRAM
Rigidity, Mask face
3. DYSTONIA – Neck Rigidity (Dysphagia), Pupillary  Fluoxetine (Prozac) Citalopram (Celexa*)
paralysis  Paroxetine (Paxil, Pexeva) Escitalopram (Lexapro)
4. AKATHESIA – Feeling of ants under their pants, restless,  Sertraline (Zoloft)
irritable, jittery, agitated  Fluvoxamine (Luvox) –OCD*
ADJUNCT DRUGS/ANTICHOLINERGICS – muscle relaxants  Vilazodone (Viibryd)
1. Cogentin
2. Benadryl ***SIDE EFFECTS – Sexual Dysfunction, GI Symptoms
3. Akineton (H,N,V,Abd’l pain)
4. Artane

TOXIC SIDE EFFECTS St. John's wort (Hypericum perforatum) – US Herbal

1. NEUROLEPTIC MALIGNANT SYNDROME
High fever (1st sign), Musle rigidity, spasm, Antidepressant
Decrease LOC.
2. AGRANULOCYTOSIS – Sorethroat
ANTI-MANIC AGENTS/MOOD STABILIZERS
3. Leukopenia – check CBC
LITHIUM CARBONATE (Eskalith)
4. Hepatotoxic
VALPROIC ACID (Depakote)
CARBAMAZEPINE (Tegretol)
***KNOW***DECANOATE- IM/IV Antipsychotics
ANTIPSYCHOTIC
LITHIUM CARBONATE – oral
ANXIOLYTIC/BENZODIAZEPINES – Decrease Anxiety, Muscle
Therapeutic level : 0.5-1.5 meq/L
relaxant
Below 0.5 : Manic
‘ZEPAM” “ZOLAM”
Above 1.5: Toxic
Diazepam (Valium) Alprazolam (Xanax)
TOXIC SIDE EFFECTS:
Lorazepam (Ativan) Estazolam (Prosom)
 Diarrhea (1st sign)
Oxazepam (Serax) Midazolam (Versed)
Flurazepam (Dalmane) *Chlorazepate Dipotassium (Tranxene)  Muscle rigidity/spasm
Clonazepam ( Rivotril) *Buspirone (Buspar)  Decrease LOC (lethargy, stupor, coma)
Temazepam (Restoril) *Chlordiazepoxide (Librium) *****Antidote: Diuretics (Mannitol, Diamox)
SIDE EFFECTS:
ANTIDOTE – Flumazenil (Romazicon)  GI SYMTOMS (H,N,V, Abd’l pain)
SIDE EFFECTS – DIZZINESS (Common), H,N,V, Clumsy, Hang  Depression –Suicide risk
over effect DIET:
DANGER :  Regular Na (2-3g/day)
1. Dependence/Addiction  High Fluids (2-3 L/day)
2. CNS Depression ***Avoid activities that causes excessive perspiration

ANTI-DEPRESSANTS – effective after 2-3 weeks

1
SUBSTANCE ABUSE – Use of substance other than its medical 4. EUPHORIA
purpose. WITHDRAWAL SIDE EFFECTS:
TOLERANCE – Need to increase dose of substance 1. Sweating &Yawning (1st sign)
DEPENDENCE –Physical and Psychological, Withdrawal S/Sx 2. GI Symptoms (H,N,V,Abd’l pain)
3. Coryza symptoms (Teary eyes, runny nose)
CNS STIMULANTS 4. Tremors
1. Methamphetamine HCL *ANTIDOTE: SEDATIVES 5. Irritable
2. Cocaine
3. Ecstacy ALCOHOLISM – alters a person’s Health, Career, Family &
SIDE EFFECTS Financial status
1. Pupil (Dilated) BAL- 0.1%
2. Palpitaion – arrest ALCHOL WITHDRAWAL S/Sx (BAL below 0.1%)
3. Weight Loss, Decrese appetite Confusion
4. Hyperactive Hallucination (Visual,tactile)
5. Increse V/s Increase v/s
6. EUPHORIA Tremors
7. Increase Libido Sweating (1st sign)
8. Insomnia Seizure (last sign)
WITHDRAWAL S/Sx Defense Mechanism: Denial (underestimate use)
1. Depression ALCOHOL WOTHDRAWAL SYNDROME (AWS)
2. Hypersomnia 1. DELERIUM TREMENS – alcohol in the brain
3. Increase Appetite S/Sx CHITS
4. Schizophrenia *Mgt: Diazepam, Librium, Tranxene
PSYCHO STIMULANTS/HALLUCINOGENS 2. KORSAKOFF’s – Deficiency in THIAMINE and NIACIN
1. Cannabis Sativa *ANTIDOTE –Vit. C rich juice S/Sx: MEMORY DISTURBANCE
2. LSD (Lysergiec Acid Diethylamide) -Amnesia (antero,retro)
3. PCP (Phencylidine) - Confabulation
SIDE EFFECTS 3. WERNICK’S – Deficiency in THIAMINE
1. Pupil (Dilate) S/Sx: EYE & BALANCE PROBLEM (Opthalmoplegia,Ataxia)
2. Blotchy, Red eye
3. Increase Libido AVERSION THERAPY
DANGER – Acute Psychosis (Hallucinations) Introduction of painful stimuli to prevent another stimuli
NARCOTICS/OPIATES DISULFIRAM (ANTABUSE)
1. Heroine - Avoid alcohol 12 hours prior to intake
2. Morphine *Antidote- Naloxone (Narcan) EFFECT OF ALCOHOHOL: Severe GI Symptoms
3. Demerol Nalbuphine (Nalline) SUBSTANCES WITH ALCOHOL – Read label of Mouthwash,
4. Paregoric Acid Cold remedies,
5. Codeine Fruit extracts (wine, skin products,
SIDE EFFECTS aftershave lotion)
1. Pupil (Constricted)
2. Piloerection (Goose bumps/flesh)
3. Constipation

NURSE PATIENT INTERACTION