HESI MENTAL HEALTH MEDICATIONS EXAM QUESTIONS AND
ANSWERS WITH COMPLETE SOLUTIONS VERIFIED GRADED A+
Benzodiazepines
Chlordiazepoxide HCL (lithium), diazepam (valium), prazepam (centrax), oxazepam
(serax), alprazolam (xanx), clorazepate dipotassium (tranxene), lorazepam (ativan)
Benzodiazepine indications
reduce anxiety; induce sedation, relax muscles, inhibit convulsions; safer than sedative
hypnotics
Benzodiazepine reactions
sedation, drowsiness, ataxia, dizziness, irritability, blood dyscrasias, habituation and
increased tolerance
Benzodiazepine nursing care
administer at bed time to alleviate daytime sedation, greatest harm occurs when
combined with CNS depressants and alcohol, avoid driving or working on equipment,
gradually taper, short term drug
Buspirone - nonbenzo
Indications: Reduce anxiety, Helps control symptoms such as sweating, insomnia,
palpitations associated with anxiety
Reaction: Dizziness
Nursing care: takes several weeks to work, short term use
Nonbenzodiazepines
Buspirone (BuSpar)
Zolpidem (Ambien)
Ramelteon (Rozerem)
Zolpidem - Nonbenzo
, Indication: Used for short term insomnia tx
Reactions: drowsiness
Care: Give with food 1-1 1/2 hr before bedtime
Ramelteon - nonbenzo
Indication: approved for long-term treatment of insomnia, binds to melatonin receptors
Reaction: dizziness
Care: appropriate with clients with delayed sleep onset
Tricyclics
Amitriptyline HCl
Desipramine HCl
Imipramine HCl
Nortriptyline HCl
Protriptyline HCl
Maprotiline
Tricyclic indications
depression, clients with morbid fantasies do not respond well to these drugs
Tricyclic adverse reactions
-anticholinergic effects: dry mouth, blurred vision, constipation, and urinary retention
-CNS effects: sedation, psychomotor slowing, and poor concentration
- Cardiovascular effects: tachycardia, orthostatic hypotension, quinidinelike effect
(assess for hx of MI), prolongation of QT interval
- GI effects: nausea and vomitting
- Narrow therapeutic index (lethal in OD)
Tricyclic Nursing Implications
-Administer at bedtime to minimize sedative effect
- Takes 2-6 weeks to work
- 1-3 weeks should elapse between discontinuing tricyclics and initiating MAO inhibitors
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