PSYCHOPHARMACOLOGY
Introduction
The
advent of psychotropic medication has generated dramatic results in the
treatment of mentally ill. The nurse needs to understand the importance and
usefulness of these medications
Recognizing
the desired actions, adverse reactions of the drugs, normal therapeutic
dosages, documenting medication administration and keeping abreast of current
literature on the psychotropic drugs are some of the responsibilities of the
nurse.
Psychopharmacology
is the study of drugs used to treat psychiatric disorders, Medications that
affect psychic function, behavior or experience are called psychotropic
medications.They have significant effect on higher mental functions.
Psychopharmacological agents are first line treatment for almost all
psychiatric ailments now a days
DEFINITION
Psychotropic
drug is any drug that has primary effects on behavior, experience, or other
psychological functions
(Logman Dictionary of Psychology
&Psychiatry).
Psychotropic
or psychoactive drugs can also be defined as chemical that affects the brain
& nervous system, alter feelings & emotions. These drugs also affect
the consciousness in various ways.
HOW
THE DRUGS AFFECT THE PROCESS OF NEUROTRANSMISSION
·
Release
·
Blockade
·
Receptor sensitivity changes
·
Blocked re-uptake
·
Interference with storage vesicles.
·
Precursor chain interference
·
Synaptic enzyme interference.
GENERAL
GUIDELINES REGARDING DRUG ADMINISTRATION IN PSYCHIATRY
·
The nurse should not administer any drug unless
there is a written order.
·
Do not hesitate to consult the doctor when in
doubt any medication.
·
All medications given must be charted on the
patient's case record sheet.
·
In giving medication:-Always address the patient
by name & make certain of his identification.
·
Do not leave the patient until the drug is
swallowed.
·
Do not permit the patient to go to the bathroom
to take medication.
·
Do not allow one patient to carry medicine to
another.
·
If it is necessary to leave the patient to get
water, do not leave the tray within the reach of the patient.
·
Do not force oral medication because of the
danger of aspiration, This is especially important in stuporous patients.
·
Check drugs daily for any change in color,
odor& number.
·
Bottle should be tightly closed & labeled.
·
Labels should be written legibly & in bold
lettering
·
Poison drugs are to be legibly labeled & to
be kept in separate cupboard
·
Make sure that an adequate supply of drugs is on
hand, but do not overstock.
·
Make sure no patient has access to the drug
cupboard.
·
Drug cupboard should always be kept locked when
not in use. Never allow a patient or worker to clean the drug cupboard. The
drug cupboard keys should not be given to
patients.
PATIENT
EDUCATION
·
Nurses assess for drug side effects, evaluate
desired effects, & make decisions about prn(pro re neta) medication.
·
Nurses must understand general principles of
psychopharmacology & have specific knowledge related to psychotropic drugs.
·
Teaching patients can decrease the incidence of
side effects while increasing compliance with the drug regimen.
SPECIFIC
AREAS OF EDUCATION
l .
Discussion of side effects:
Side
effects can directly affect the patient's willingness to adhere to the
drug regimen. The nurse should always
inquire about the patient's response to a drug, both therapeutic responses
& adverse responses
2. Drug
interactions:
Patients
& families must be taught to discuss the effects of the addition of
over-the-counter drugs, alcohol & illegal drugs to currently prescribed
drugs
3. Discussion
of safety issues:
Because
some drugs, such as tricyclic antidepressants, have a narrow therapeutic index,
thoughts of self harm must be discussed.
Discuss on abruptly discontinued effects.
Many psychotropic drugs cause sedation or
drowsiness, discussions concerning use of hazardous machinery, driving must be
reviewed
4. Instructions for older adult patients:
Because
older individuals have a different phamacokinetic profile than younger adults,
special instructions concerning side effects &drug-drug interactions should
be explained.
5.
Instructions for pregnant or breastfeeding patient:
As
pregnant or breastfeeding patients have special risks associated with
psychotropic drug therapy, special instructions should be tailored for these
individuals. Teaching patients about their medications enables them to be
mature participants in their own care & decreases undesirable side effects
CLASSIFICATION
1 .
Anti psychotics/ Neuroleptics/ major tranquilizers
2. Anti
depressants
3. Mood
stablizers
4. Anti
anxiety drugs/ Anxiolytics/ Minor tranquilizers
5. Anti
convulsants
6.
Miscellaneous agents eg. Deterrent agents, Stimulants
COMMENTS