hi guys it's me Professor Dia and welcome back to my YouTube channel on this video we're going to be doing a little bit of mental health and a little bit of um pharmarmacology so we're going to be going over mental health drugs now before we get started as always I'm going to ask you to please support me and support this channel by liking this video you're going to love it go ahead and give a thumbs up now so don't forget subscribe to my channel if you haven't done so already and be sure to check out my website nexusninginstitute.com so many great resources available there on my website almost daily you can find me covering a variety of nursing topics across my social media platforms such as Tik Tok Instagram Facebook YouTube my handle's the same everywhere Nexus Nursing so uh be sure to check that out now before we get started I want to start off with a quick prayer if you're not into that no need to send me hate mail just fast forward if you are and not operating heavy machinery please close your eyes by your head father God thank you Lord for another day on this earth thank you for everything that you've done for us Father God thank you for the breath of life in our bodies thank you for another opportunity to go over this nursing content father God thank you for this platform that you've given me Lord that you've allowed me to be able to go over this content Jesus i pray for every single viewer every single listener father God I ask that you please help them to understand this information help them to be able to retain this information Father God when they see the same concepts again Father God help them to be able to think critically Lord and answer the questions correctly jesus I pray that you help every single student that is watching or listening whatever it is that they're struggling with whatever area of nursing that they're struggling with lord I ask that you give them the discipline to study appropriately father God help them learn how they need to study how they learn Lord and help them to pass their exams and Father God I ask that you please let them remember who it was that blessed them Father God and let them uh be a blessing to someone else thank you for all you've done for us and all you continue to do in our lives in Jesus Christ we pray amen all right guys let's get started first question a client taking lithium reports excessive thirst and frequent urination which lab value should the nurse assess first a serum potassium B serum lithium C serum sodium or D serum glucose and guys the correct answer is B serum lithium so this patient's taking lithium what type of drug is lithium it's a mood stabilizer we know that with lithium you better be checking the patient's lithium levels because lithium has a very narrow um therapeutic range what is therapeutic range 0.6 to 1.2 right and then once it's 1.4 or higher that patient's in what lithium toxicity so lithium has a very a narrow therapeutic range you want to keep an eye on the lithium level you also want to keep an eye on the sodium level because if there's too much sodium remember sodium is supposed to be 135 to 145 if the sodium's too high the patient will have a sub therapeutic level of lithium in their body but if that uh sodium is too low less than 135 guess what they may have a toxic level so yes sodium is important and so if you narrowed it down to these two lithium and sodium very good but you still have to decide which one's more important how you going to pick sodium when lithium's right there in your face right lithium is what we're going to be most concerned about when it comes to those two because the reason we're even concerned about the sodium is because we don't want the uh sodium to be too low and could cause lithium what toxicity lithium that is what is going to be your priority now if lithium was not here you should have went with sodium absolutely but because lithium was there that's what we're going with we're going to be concerned about signs of toxicity and when you go back to the question look at what they said excessive thirst frequent urination those are signs of lithium toxicity along with blurred vision and those other signs and symptoms that you do need to be aware of make sure you review the signs and symptoms of lithium toxicity now let's look at the wrong answer choices uh potassium okay while potassium is important it's not directly um it doesn't directly affect lithium yes potassium has a narrow therapeutic range yes we're concerned about potassium as far as you know the heart goes but we're talking about lithium right here so that's not going to be our priority i already talked to you guys about sodium and glucose um no uh these aren't classic indicators first of all um hypoglycemia and that has no correlation with lithium this question was all about lithium and so the correct answer is lithium um serum lithium that's what we're going to be concerned about which of the following medications requires a tyramine restricted diet a fluoxitine B certilene C fenosine or D bup bupripion you guys see that word you guys see that drug abc BC or D what do you think and the correct answer guys is going to be C fenosine so let's talk about this the question is asking us about tyramine restricted diet when you see a question asking you about tyramine what's the first drug class that should be going to your mind maois maois which is um a type of um anti-depressant and guess what that's not your first or even your second go-to of um anti-depressant healthc care providers will order MAIs when nothing else works so a patient's been on an SSRI and they've been on it for such a long time that's no longer working then they're on a TCA then the TCA is no longer nothing else is working that is when they're going to be ordered an MAOI because MAOIs have so many adverse effects there are so many contraindications other drugs that you can't take with that medication other foods that you can't eat with that medication things you can't drink with that medication so when the question is asking you about tyramine restricted diet I want you to think of MAIS and so anyway the correct answer answer is C fenosine why it's an MAOI okay fenosine is an MAOI so you're going to be teaching that patient to stay away from foods that are high in tyne you have to know those foods high in tyne please make sure you review it things like you know uh uh uh pepperoni and um why can't I think uh anything pickled anything you'd put on a chuterie board chocolate red wine anything high in tyramine patient needs to stay away from now let's look at the wrong answer choices a fluoxitine well that's an SSRI not an MAI b certuline that's also an SSRI so we really don't need to worry about tyramine and last that drug I can't even pronounce bup bupropion um that is an atypical anti-depressant and again you really don't have to worry about tyramine and so that's why phenoline is your correct answer now guys these questions that I'm going over with you guys even the wrong answer choices you need to know because on your exam you may not get a question about the correct answer but you might get a question about the wrong answer so as I'm going through the wrong answer choices if I say something that you didn't know or that you don't understand make sure you go back and review it okay all right next question a client with schizophrenia is prescribed paradol what is a priority assessment for the nurse a blood pressure b extraaramidal symptoms c bowel movements or d glucose and guys the correct answer is B extraparital symptoms so let's go back to the question it tells the patient has schizophrenia and the prescribed halo paragol let's talk about this whenever you get a question and they tell you the patient's diagnosis and a medication 99% of the time the question is about the medication not the diagnosis they already have the that diagnosis they already have uh that disease the question is about that medication so whenever you see those two together when you're looking for your answer choice don't choose something that has to do with the disease choose something that has to do with the medication that chemical that is about to change or cause a change in that patient's body so the patient's got schizophrenia and they're prescribed paridol what is haloidol it's an antiscychotic agent and the question is asking us what's going to be a priority assessment extraparital symptoms yeah because um how halo paradigal that's how doll it can cause the patient to have these uncontrollable um movements and guess what it's irreversible once a patient has it they has it they have it it does not go away so that's going to be a priority assessment now let's look at the wrong answer choices a blood pressure hypotension is a possibility but um it's not as pressing as the extra paramidital symptoms are because um that would be a bigger concern uh C bowel movements no how doll really does it affect um bowel movements and then D blood glue blood glucose also no how doll really doesn't affect the patient's blood glucose either so uh B is the correct answer if you start do notice those extra permidital symptoms you need to report that to the healthcare provider right away a nurse is caring for a client on uh clausipine which laboratory test is most important to monitor a platelet count B white blood cell count C liver enzyme or D creatin and guys the correct answer is B white blood cell count so patients on clausipine what is clausipene it's an atypical antiscychotic agent we're going to be concerned about WBC's remember W normal WBC is supposed to be 5 to 10,000 well we're going to be concerned about WBC's because this drug can cause what a granuloccytosis very important so you're going to be checking those WBC's a platelet count no it really doesn't affect the platelet uh levels um see liver enzymes liver enzymes checking that is important across the board for drugs because the liver is what metabolizes drugs we want to make sure the liver is working correctly however we're looking for something specific to this medication and it would be WBC's because again we're concerned about that adverse effect of a granuloccytosis and then last creatin yes creatin is important you want to check kidney function because just like the liver is responsible for metabolizing the drugs the kidney is responsible for what excretion of the drugs so we want to make sure the kidney is working but that's across the board that's for every drug we're looking for something that is specific to clausipine and it would be the WBC's because of a granular cytosis a patient taking larazzipam is at risk for which of the following a hypertension b seizures C sedation or D mania and the correct answer is C sedation so let's talk about um laorazzipam what is a drug class of laorazza have do you notice every time I talk to you about a drug I mention the drug class why you need to know it you need to know it if you're in pharmarmacology and you're studying study your drugs by drug class there's no way you're going to know every single drug group them together know about the nursing interventions and the contra indications and the indications and the adverse effects by drug class okay it's going to make your life a lot easier so anyway laorazzipam is what a benzoazipene and so uh we're going to be concerned about sedation you're going to be concerned about sedation and what dependence right oxidation and dependence um bzzoioipines are never ordered long-term because of dependence okay it's going to be ordered short term because uh the patient will have a high risk of being addicted to it now let's look at the wrong answer choices a hypertension laorazzipam um can cause uh hypotension it can make the blood pressure low not high so that wouldn't be the answer um seizures no Larazzipam um can prevent seizures we wouldn't be concerned about it causing seizures and what was the last one oh mania that's false as well it doesn't induce mania so the correct answer would be the sedation and dependence all right what is the therapeutic range for lithium in treating bipolar disorder would it be 0.1 to 0.5 0.6 to 1.2 two 1.5 to 2.5 or three to four and I actually gave you the answer when I think the first question we were talking about laazzipam so lorazzipam lithium so you all should get it right what's the correct answer B 0.6 to 1.2 please edge that in your brain that is the therapeutic range for lithium once that patient hits 1.4 four or higher they're in what lithium toxicity range okay so 0.6 to 1.2 a client on resperadone presents with a high fever muscle rigidity and confusion what condition should the nurse suspect a serotonin syndrome B tardive diskynesia C neurolleptic malignant syndrome or D steven Johnson syndrome and before I tell you what the answer is you see all four of these options you need to know all four of them because you may get a test question on one of them or all of them make sure you know them okay the correct answer is C neurolleptic malignant syndrome so let's go back to this drug respadone what type of drug is this is this this is an atypical anti-csychotic agent okay and we're going to be concerned about an adverse effect which is neurolleptic malignant syndrome this is a medical emergency and you see these signs and symptoms those are classic signs and symptoms of neurolleptic malignant syndrome high fever muscle rigidity confusion okay this is a big deal you're going to notify the health care provider right away a good pneumonic to remember for u neuralttpic malignant syndrome is fever fevr did I spell that right f E V no F E V E R fever okay the F is for fever the E is for encphylopathy you'll start seeing those CNS changes such as confusion lethargy and V is for vital sign instability where you'll see their blood pressure go up then go down you'll see the temp go up and go down you see liility in the vital signs e elevated liver enzymes and what does that R stand for rigidity f E VR that's a good pneumonic to remember for neurolleptic malignant syndrome make sure you know it now let's talk about the wrong answer choices a serotonin syndrome well serotonin syndrome the clinical manifestations are similar to neurolleptic malignant syndrome but guess what we see serotonin syndrome and what ssris again what drug are we talking about respperadone we're talking about atypical antiscychotics so when it comes to atypical antisycchotics such as respperadone we're going to be concerned about neurolleptic malignant syndrome not serotonin syndrome serotonin syndrome goes with what ssris next tardive disynesia well with tardive disynesia as I explained before you'd see the patient not have these symptoms like the high fever the confusion no you'd see involuntary movements that is the tardive disynesia and last Steven Johnson syndrome steven Johnson syndrome that also is a medical emergency is very deadly but the clinical manifestations are not the same with Steven Johnson syndrome the best way I can describe it's like their skin is falling off their body is you you got to look it up it's just the most disturbing thing one of the most disturbing things that you'll see but basically it involves the skin and you know mucosal blistering all right Google just look it up you'll see what it looks like you never forget it that's a medical um emergency but those signs and symptoms are different so when we're talking about that atypical antiscychotic neurolleptic malignant syndrome that's what you're going to be concerned about make sure you know those clinical manifestations what is a common side effect of SSRIs that patients should be educated about a urinary retention B sexual dysfunction C blurred vision or D tachardia and the correct answer is B sexual dysfunction um sexual dysfunction this is one of the most common side effects of the drug and you have to warn the patient because if you don't and they experience this guess what they're just going to stop taking the the medication and can you ever uh abruptly DC uh anti-depressants absolutely not never so this is something you have to warn them in advance and let them know if they experience this please let us know your healthcare provider will talk to you and maybe try a different medication so you have to let them know that there are going to be options if you don't they will just stop taking their their medication now let's look at the wrong answer choice a urinary retention with urinary retention we see this more with the TCAs with the um tricyclic agents okay uh blurred vision blurred vision is it's possible that is a possible um adverse effect but it's very rare very rare very rare okay and last tachicardia tachi cardia is not a typical um uh side effect that you'll see with SSRI so the correct answer is sexual dysfunction that is very common and you're going to warn that patient advance and let them know there are options if they do experience this to come and let the healthcare provider know so that maybe the uh the dosage can be changed or the drug regimen can be changed which medication is used as a mood stabilizer and also as an anti-convulsant is it olanzipene vaproic acid bperone or fluoxitine those of you who are on summer vacation but you're just such good students and you're still watching my videos kudos to you i'm so proud of you and those who are still in the nursing program during the summer cuz you guys don't get summers off that's okay this too shall pass okay just ride this wave graduation's around the corner you can do it all right the correct answer guys it what is the correct answer what was the question which medications used oh okay the correct answer is B valproic acid um this is used both as a mood stabilizer or you know an anti-seizure anti-convulsant agent that is the correct answer now let's look at the wrong answer choices a olanzipene that's an um atypical antiscychotic agent uh C busperone that's an anxolytic we see this order for patients like with um bipolar disorder and then I'm saying bipolar disorder anxiety excuse me it's an anxolytic agent we see it for patients with anxiety and then last fluoxitine that's an SSRI so we see that given for patients with depression not mood disorder such as bipolar disorder the correct answer is valproic acid again it's used as an anti-seizure drug but it's also used as a med mood stabilizer okay a patient on peroxitine reports tremors agitation and confusion what should the nurse suspect a serotonin syndrome B lithium toxicity C hypertensive crisis or D neurolleptic malignant syndrome what do you guys think well remember I told you that the symptoms of serotonin syndrome was very similar to um that of neurollectic neurolleptic malignant syndrome and here we're talking about serotonin syndrome because that drug peroxitine what kind of drug is that what's a drug class an SSRI okay so um tremors agitation confusion those are the classic the hallmark symptoms of uh serotonin syndrome make sure you guys know this let's look at the wrong answer choices lithium toxicity if the patient had lithium toxicity I talked about this already patient would have like headache um nausea tremor blurred vision a taxia right make sure you know those symptoms of um lithium toxicity hypertensive crisis well the blood pressure would be high the patient would have a sudden severe headache and the blood pressure would be high and of course neurolleptic malignant syndrome that is related to antiscychotic agents don't forget the pneumonic I taught you fevr let's see why do I keep saying fe i can't spell fe i keep forgetting the e so f is for fever e for I don't remember what the e is for [Music] v f is for fever i remember the F is for fever r is for rigidity e is for elevated liver enzyme f E Oh V is for vital sign instability because the vital signs keep going up and down and there's another E fever elevated liver enzyme vital sign instability r is rigidity i don't remember what that other E is for if somebody remembers in the comment just let me know i I don't remember oh and seephalopathy where you see those CNS changes that's the other E all right next question if you are new to my channel this is your first time watching my videos i'm apologize now because um when I do videos very late in the evening or the day I tend to be scatterbrain i'm tired forgive me all right which of the following is a tricyclic anti-depressant agent a TCA is it deluxitine amatipptalene certuline or escatopramg the correct answer is B b amitryptalene so we're talking about TCAs what is a TCA it's an anti-depressant agent and the correct answer is am amitryptalene a duloxitine what's that it's an SNR II c certillene that's an SSRI and last that drug I can't pronounce satalopragm that's an SS excuse me SSRI so let's go back to amitryptippalene which is a TCA this is used for depression because it is an anti-depressant agent but something else you got to know about this drug it's also helpful it's used for chronic pain okay so please write that down make sure you know it a patient with bipolar disorder is prescribed carbomaszopene which condition should the nurse monitor for a hypercalemia B hpatoxicity uh C hyperglycemia or D renal failure this is the last question by the way and the last the last the correct answer guys is hpat toxicity so they tell us if the patient has bipolar disorder and the prescribed carbamezipene what's this question about is it about the bipolar disorder or is it about the carbsene it's about the carbsene we're going to focus on that drug what's the drug class of carbamezipene it's an anti-convulsant and a mood stabilizer it's used as both okay and so the question is what are we going to monitor for we're going to monitor for hpat toxicity we're going to be concerned about that we're going to be concerned about when it comes to the drug hypattoxicity and alastic um anemia those are some serious adverse effects you're going to be concerned about um when I say alastic anemia we're going to be concerned about a granuloscytosis you're going to be looking at the WBC's something else about this drug that's very concerning you're going to watch out for is Steven Johnson syndrome remember I told you it's deadly it is lethal that is a medical emergency so there are a couple serious adverse effects you're going to be very concerned about when it comes to this drug let's look at the wrong answer choices hypercalemia no hyp potassium isn't commonly seen with this drug it doesn't cause that c hyperglycemia nope that drug doesn't cause the blood sugar to be high d renal failure very rare yes this drug can affect the kidneys because remember the kidneys responsible for excreting it but renal failure very rare but hpattoxicity we see that more common we're going to be concerned about hpattoxity toxicity we're going to be concerned about alastic anemia we're going to be concerned about a granuloccytosis we're going to be concerned about um Steven Johnson syndrome all of those are serious adverse uh effects that we're going to be concerned about when it comes to this drug okay so make sure you guys know that and that is the end of this video guys please let there are so many more psych or mental health drugs that you do need to know so if you'd like to see a part two just let me know in the comment section i can't respond to everyone but I do read the comments and I'd be more than happy to uh make a part two for you uh let me know what you guys thought about this video and what you'd like to see more of don't forget guys I take the summers off june July August I am on vacation anything you get is out the goodness of my heart okay because I'm trying to live my best life okay so um please let me know what you guys thought about this video thank you so much for watching and you guys will catch me on the next video