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Psalm 23:18

,*1 mE./ %anagement: (lesser side effects): &' %onitor Buspar, Catapres serum lit#ium 2 Antihistamines level (prevents EPS, allergy, regularly' *' , motion sickness): grams of daily Benadryl, Atarax, salt' ,' *+, istaril liters of fluids 3 Side effects: per day' -' dro!siness and %annitol and sedation, poor dialysis for coordination, di""iness, lit#ium nausea, #eadac#e toxicity' /' .o 4 Contraindications: not give pregnancy, lactation, morning dose pulmonary disorders until serum 5 $ursing %anagement: sample is &' (ive at )edtime' *' taken' Avoid alco#ol and caffeine+ric# foods' ,' ANTI(ive )efore meals' -' .o not give solutions2AR3INS4NS t#at are cloudy' /'1 7sually appear after 0)serve for initial dose of t#erapeutic and anti+ adverse side effects' 1' psyc#otics' A)rupt cessation 3reats EPS causes agitation, 2 Attempts to re)ound insomnia, correct nig#tmares and sudden im)alance deat#' 2' 3eac# client )et!een to report signs of dopamine and agranulocytosis 4' (ive acetylc#oline drugs separately to prevent drug to drug3 Side effects: sedation, interactions' 4' $ever atropine mix !it# antitacids' psyc#osis, p#otosensitivi ty, anti+ c#olinergic ANTI-MANIC DRUGS side+effects,, 1 %ood sta)ili"ers' agranulocytos 2 3akes effect in &+, is, ort#ostatic !eeks or more #ypotension, 3 5ndicated for manic #ormonal episode in )ipolar c#anges' disorders 4 $ormali"es serotonin, norepinep#rine, acet#yc#oline and dopamine to prevent depression and mania 5 Side effects: mild nausea and vomiting, fine #and tremors, loss of appetite, polydipsia, polyuria, metallic taste in t#e mout#, edema, acne 6 Examples: 6it#ium (Eskalith, ithi!m Ca"#onate$, Ca"#amazepine, %alp"oi& A&id 7 No"mal se"!m le'el( )*+-,*- mE./ 8 To0i& le'el( mo"e than

1 Non-Benzodiazepines 9 $ursing

DR. CARL E. BALITA REVIEW CENTER TEL. NO. 735-4098/410-0250

Examples: Cogentin, Artane, Parlodel, 6arodopa, Benadryl 1 $ursing %anagement: &' (ive meds !it# food' *' 0)serve for t#erapeutic side effects and improvement in gait and posture' ,' 3eac# a)out ort#ostatic #ypotension' -' 6imit strenuous activities' /' Avoid taking anti+ depressants' 1' 8eekly CBC monitoring' 2' 8eig# client regularly' 4' Calorie+controlled diet and lig#t exercise' ANTI-DE2RESSANTS 1 %ood elevators9 second line agent 2 5ndications: ma:or depressive disorders, anxiety disorders, )ipolar disorders, eating disorders 3 Balances serotonin and norepinep#rine 4 T"i&5&li& Anti-dep"essants (&+, !eeks): Sine;uan, Pamelor, Elavil, $orpramine, 3ofranil' 5 Antidote: P#ysostagmine (Antilirium) only !it# life t#reatening symptoms 6 MA4I (*+- !eeks)( Parnate, $ardil, %arplan9 t#ird line agent 7 7sed for clients !#o does not respond to 3CA or cannot tolerate SS<5 8 Contraindications: pregnancy, lactation, C=>, =P$, liver and kidney pro)lems, alco#olism, sc#i"op#renia, over 1? and under &1 years of age, .% 9 Avoid tyramine+ric# food++++ causes #ypertensive crisis 10 Antidote: P#entolamine ( <egitine) for increased BP 11 SSRI (*+, !eeks): first line agent9 @oloft, Paxil, Pro"ac 12 Broad spectrum action, most popular 13 5ndications: depression, anxiety, )ulimia, alco#olism, sc#i"op#renia, 0C. 14 $ursing %anagement: &' S#ould )e taken in morning for - !eeks for full effects' *' Avoid 3CA or %A05A >A3A6BBB ,' %onitor BP )efore dosage c#ange to detect #ypo pr #ypertension' 4. Avoid altering dosage' /' .o not operate mac#ineries and driving' <eport unusual symptoms like tremors, nausea and vomiting, anorexia, nervousness and sexual dysfunctions' 6. $otify doctor of depression !orsens' E ECTR4C4N%U SI%E T6ERA27 1 5ntroduction of 2?+&/? volts for ?'*+4'? seconds producing ,?+1? seconds sei"ures, confusion and memory loss' 2 Contraindications: recent %5, ast#ma, pulmonary disorders, increase 5CP, fractures and dislocations 3 $ursing %anagement: &' 5nformed consent' 4 *' $P0 )y midnig#t )aseline S and memory a)ilities and premeds like Atropine sulfate (decreases secretions)9 Brevital ( s#ort+acting )ar)iturate)9 succinylc#oline (muscle relaxant)' 5 Post+ treatment: side lying, oxygenate, orient, ;uiet environment'

A TERNATI%E TREATMENT M4DA ITIES

t#erapy Cmodifying o)serva)le )e#avior 2 Cognitive t#erapy C replacing appropriate t#oug#ts 3 3#oug#t Stopping Cdecreases depression and anxiety of irrational provoking )e#aviors 4 <eframingD<ela)elling+ rela)els dysfunctional )e#aviors or t#oug#ts to a more reasona)le one' 5 <ational+Emotive t#erapy+ individualEs values and )eliefs control )e#avior' 6 .eep+ )reat#ing exercises+ mild to moderate anxiety 7 Ben"onEs relaxations response+ relaxes mild to moderate anxiety 8 Assertiveness training+ rig#t to c#oose oneEs response at a given situation 9 .esensiti"ation C gradual exposure to t#e feared o):ect 10 >loodingD5mplosive t#erapy+ sudden exposure to t#e feared o):ect 11 (estalt t#erapy C #ere and no! t#eory 12 >amily t#erapy+ esta)lis#es communication and family interactions 13 (roup t#erapy C 4+&? mem)ers9 #omogenous or #eterogenous 14 Aversion t#erapy+ introduction of a noxious stimuli 15 %ilieu t#erapy+ using environment for t#erapeutic purposes 16 Play t#erapy+ ideal for c#ildren 17 Art t#erapy C expression of feelings t#roug# dra!ings, etc 18 <ecreational t#erapy C involving into activities 19 ocational t#erapy C learning ne! skills 20 %usic t#erapy C soft music relaxes t#e )ody and t#e mind 21 Sex t#erapy+ maintain #ealt#y sexual functioning 22 <eminisce t#erapy+ used for older people $otes: FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF
The vision that you glorify in your mind, the ideal that you enthrone in your heart - this you will build your life by, and this you will become.

1 Be#avior

DR. CARL E. BALITA REVIEW CENTER TEL. NO. 735-4098/410-0250