Chapter 16: Psychotherapeutic Drugs Test, Clozapine, Pharmacology for Nurses
The key terms in this Pharmacology course include Psychotherapeutic Drugs, Depression, Clozapine, Buspirone, Drug Therapy, St. John’s Wort. Patient, Block, Adverse, Duloxetine (Cymbalta), Serotonin Syndrome, Complete blood count, Lorazepam (Ativan), Anxiolytic Medication, Buspirone (BuSpar), Monoamine oxidase inhibitors (MAOI), Pharmacology for Nurses: Practical Applications.
A patient diagnosed with depression is being discharged with a prescription for tricyclic antidepressants (TCA) after no improvement of symptoms on a selective serotonin reuptake inhibitors (SSRI). Which instruction would the nurse include specific to TCAs?
There are no drug or food contraindications with this medication.
There is a risk of toxicity when this medication is taken with alcohol.
Take St. John’s wort every day to minimize the adverse effects of the medication.
This drug does not cause problems with sleep, constipation, or low blood pressure.
There is an increased risk of toxicity with TCAs when taken with alcohol and a high rate of morbidity.
Which laboratory test would be monitored closely to assess for a potential life-threatening adverse effect to clozapine (Clozaril)?
Liver function studies
Glomerular filtration rate
Complete blood count
Immunoglobulin levels
Patients taking clozapine must be monitored for the life-threatening adverse effect of agranulocytosis, evidenced by a severe reduction in the number of white blood cells.
A patient who is prescribed duloxetine (Cymbalta) comes to the medical clinic complaining of restlessness, sweating, and tremors. The nurse suspects serotonin syndrome and questions the patient regarding concurrent use of which herbal product or dietary supplement?
St. John’s wort
Vitamin E
Zinc
Glucosamine chondroitin
Serotonin syndrome may occur with SSRIs when they are combined with herbal products such as St. John’s wort.
A patient prescribed lorazepam (Ativan) for the treatment of anxiety states, “I feel drowsy all the time, and it’s interfering with every aspect of my life.” The nurse knows that a better drug therapy option for this patient is which anxiolytic medication?
Buspirone (BuSpar)
Alprazolam (Xanax)
Chlordiazepoxide (Librium)
Hydroxyzine hydrochloride salt (Vistaril)
Buspirone (BuSpar) has the advantage of having fewer adverse effects such as sedation and lack of dependency potential. All of the other options are sedatives as well as anxiolytics.
A patient with a diagnosis of depression is being discharged with a prescription for an monoamine oxidase inhibitors (MAOI). Which instruction would the nurse include for this medication?
Explain the symptoms of tardive dyskinesia.
Emphasize that tremors are a common adverse effect.
Avoid eating aged cheese.
Encourage use of fiber supplements.
Eating foods high in tyramine, including aged cheese, can cause a hypertensive crisis in patients taking MAOIs.