Page 2353 - Saunders Comprehensive Review For NCLEX-RN

CHAPTER 68

Psychiatric Medications

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Priority Concepts
Anxiety; Mood and Affect

I. Selective Serotonin Reuptake Inhibitors (SSRIs) (Box 68-1)
A. Description
1. Inhibit serotonin uptake and elicit an antidepressant
response
2. Effective for depression with anxiety features as well
as depression with psychomotor agitation
3. Relatively low side-effect profile compared with older
antidepressants (tricyclics)
4. Do not create anticholinergic effects, dry mouth,
blurred vision, or urinary retention
5. May interact with other medications (e.g., digoxin,
warfarin).
6. The potential for medication interactions is greatest
when administered with second serotonin-enhancing
agent, such as a monoamine oxidase inhibitor
(MAOI). A complete medication assessment must be
obtained and evaluated; inquire about the use of
herbal therapies, especially St. John’s wort.
B. Side and adverse effects
1. Dry mouth
2. Blood pressure changes
3. Insomnia, somnolence (sleepy, drowsy), apathy
4. Nervousness
5. Weight loss or gain
6. Decreased libido
7. Apathy
8. Tremors
9. Seizure activity
10. Potential toxic effects (too high dose or interaction
with other drugs)
a. Abdominal pain, diarrhea
b. Sweating, fever
c. Tachycardia, elevated blood pressure
d. Altered mental state (delirium)

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