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
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
· 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.
· 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
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