Ch. 12
Psychopharmacology, Dietary Suppl., Biologic Interventions
Psychopharmacology
o Target symptoms
Measurable symptoms expected to improve with treatment.
o Side effects (untoward effects)
Unwanted effects of medications
Blurred Vision Reassurance (generally subsides in 2–6 wk).
Artificial tears may be required; increased use of wetting
solutions for those wearing contact lens.
Dry Eyes
Alert ophthalmologist; no eye examination for new glasses for at
least 3 wk after a stable dose.
Frequent rinsing of mouth, good oral hygiene, sucking sugarless
Dry mouth & lips candies or lozenges, lip balm, lemon juice, and glycerin mouth
swabs.
High-fiber diet; encourage bran, fresh fruits, and vegetables.
Metamucil (must consume at least 16 oz of fluid with dose).
Constipation Increase hydration.
Exercise; increase fluids.
Mild laxative.
Monitor frequently for difficulty with urination, including
Urinary hesitancy or changes in starting or stopping stream.
retention Notify prescriber if difficulty develops.
A cholinergic agonist, such as bethanechol, may be required.
Nasal congestion Nose drops, moisturizer, NOT nasal spray
Assess for Ninfections.
Monitor pulse for rate and irregularities.
Sinus tachycardia
Withhold medication and notify prescriber if resting rate
exceeds 120 bpm.
⬇libido, anorgasmia,
Reassurance (reversible); change to another medication.
ejaculatory inhibition
, Change to less antiadrenergic drug
Advise patient to get up slowly, sit for at least 1 min before
standing (dangling legs over side of bed), and stand for 1 min
before walking or until lightheadedness subsides.
Elastic stockings if necessary.
Postural hypotension Notify prescriber if symptoms persist or significant blood
pressure changes are present; medication may have to be
changed if patient does not have impulse control to get up
slowly.
⬆Fluids ⬇caffeine
Photosensitivity Clothes, sunglasses, & sunblock
Dermatitis
Consider medication change; may require a systemic
antihistamine.
Initiate comfort measures to decrease itching.
Impaired psychomotor
Ǿ ETOH & Ǿ Driving
functions
⬆Activity
Avoid driving or operating dangerous equipment
May need to adjust dosing schedule or, if possible, give a single
daily dose at bedtime.
Drowsiness or sedation
May need a cholinergic medication if sedation is the problem.
May need change to less sedating medication.
Provide quiet and ⬇ stimulation when sedation is the desired
effect.
Weight gain and metabolic Exercise and diet teaching.
changes Caloric control.
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