I just wanted to share some of my Clinical Instructors lecture materials. I don't own this document, I wish to help you guys with the summary of Psychiatric Drugs.

1. COMMONLY ASKED PSYCHIATRIC NURSING
TOPICS in the ACTUAL EXAM.
A. PSYCHIATRIC DRUGS
1. Psychiatric drugs are preferably given after meal
except minor tranquilizers (anxiolytics).
2. Haloperidol is commonly given for psychotic
patients.
3. Extrapyramidal Syndrome (EPS) is commonly
caused by Haloperidol.
4. Cogentin and Benadryl are drugs usually
administered to decrease symptoms of EPS.
5. Clozaril causes Agranulocytosis and Leukopenia.
6. Diazepam (valium) is commonly prescribed for
individuals with anxiety disorder.
7. Sedation is a common effect of diazepam (valium)
thus, safety should be prioritized.
8. Paxil and Zoloft are antidepressants under the
category of Serotonin Selective Reuptake Inhibitors
(SSRI’s) that can cause Sexual Dysfunction.
9. Tofranil and Elavil are commonly prescribed for
depressed clients under the category of Tricyclic
Antidepressants (TCA’s).
10.
Hypotension and Urinary retention are
anticholinergic side effects of TCA’s.
11.
MAOI’s (Parnate, Nardil, Marplan) should not
be given along with Tyramine rich foods e.g.
Avocado, Banana, Cheese (except cream and cottage),
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2. and Soy sauce (hint: usually processed and fermented
foods contain tyramine).
12.
Sedation is an expected effect of antidepressants.
13.
Energizing the patient to commit suicide is a
paradoxical effect of antidepressants therefore
suicidal precaution should be instituted.
14.
Levodopa is the drug of choice for patients with
Parkinson’s disease
15.
Drowsiness and hypotension are side effects of
L-dopa.
16.
Dilantin is usually administered for patients with
grand mal seizure (tonic-clonic).
17.
Gingival hyperplasia is associated with Dilantin
use. Meticulous oral care is required.
18.
Tapering the drug is strongly required if an
anticonvulsant is withdrawn to avoid status
epilepticus (this is due to abrupt withdrawal of the
drug).
19.
Diazepam (valium) is commonly administered
to combat status epilepticus.
20.
Bone marrow depression and Steven-Johnson’s
Syndrome (severe pruritus and blood-shot eyes)
are worst effects of anticonvulsants.
21.
Lithium carbonate is the drug of choice for
manic patients.
22.
Tegretol could also be given for bipolar manic
client due to its mood stabilizing effect.
23.
3gms of Sodium and 3L of fluids per day are
recommended for patients under lithium therapy.
24.
Nausea and Vomiting are early signs of lithium
toxicity.
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3. 25.
Mannitol and Diamox are antidotes used to
lower the toxicity (lithium).
26.
Cognex and Aricept are drugs used to treat
Dementia. These drugs increases liver enzymes,
therefore liver function test is required (ALT/AST).
27.
Ritalin and Dexedrine are drugs commonly
prescribed for children with ADHD. Insomnia and
Anorexia are side effects of these drugs. Growth
suppression is the worst effect.
B. PERSONALITY THEORIES
1. Commonly asked Developmental milestones in the
board exam according to Erickson:
a. trust vs. mistrust (0-1 or Infancy).
b. initiative vs. guilt (3-6 or Preschooler).
c. identity vs. role confusion (12-19 or
Adolescence).
d. intimacy vs. isolation (20-40 or Young Adult).
2. Piaget’s Cognitive Development Theory
a. Logical thinking (Concrete Operational) is
present in ages 7-12 years old.
b. Abstract thinking (Formal Operational) is
expected for 12 years old and above.
3. Kohlberg’s Moral Theory
a. Toddlers and Preschoolers are guided by
punishment and obedience orientation
(Preconventional).
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4. b. School- age children are rules oriented and
viewed accidents as punishment for bad
behavior (Conventional Morality).
c. Teenagers and Adult individuals are guided by
ethics as a basis of our conscience.
4. Freud’s Psychosexual Theory
a. Foundation of personality, id, and stranger’s
anxiety develop during Oral Stage (0-1 year
old).
b. Toilet training (2 years old), temper tantrums,
and separation anxiety are common during the
Anal Stage (1-3 years old).
c. Fear of mutilation and Complexes (oedipal and
elektral) develop during the Phallic Stage (3-6
years old).
d. Silahis behavior (bisexuality) is associated with
the absence of a “father figure” and is only
resolved in latency stage when the child
identifies the parent of the same sex.
C. SCHIZOPHRENIA
1. Increased dopamine level is the main problem in
patients with Schizophrenia.
2. Hallucination and Delusion are positive signs of
schizophrenia.
3. Safety (self and others) and offering Sealed Foods are
main nursing interventions to Paranoid Schizophrenic
patients.
4. Major Tranquilizers (Haldol, Thorazine, Clozaril)
are drug of choice for schizophrenics.
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5. 5. Altered thought process is the priority nursing
diagnosis.
D. CHILDREN and ADOLESCENTS Psychiatric
Conditions
1. Safety and Nutrition (finger foods) should be
prioritized for ADHD.
2. Impulsiveness, Hyperactivity, and Inattention are
hallmark signs of ADHD.
3. Ritalin and Dexedrine are drugs commonly
administered for ADHD.
4. Provide helmet for Autistic children, head banging is
common.
5. Poor-mother child relationship is the possible
etiology of Autism (most accepted psychobehavioral
theory).
6. Involuntary muscle movements (motor tics) and
vocalizations (vocal tics) are hallmark signs of
Tourette Syndrome (TS).
7. TS is genetically transmitted.
E. COMMONLY ASKED PSYCHIATRIC
PROBLEMS in ELDERLY
1. Parkinson’s disease (PD) results from decreased
dopamine and increased level of acetylcholine due
to degeneration of substantia nigra.
2. Tremors (pill rolling and resting), Rigidity (cog
wheel), and Shuffling gait (scissors gait) are common
symptoms of Parksonism.
3. L-dopa is the drug of choice for PD.
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6. 4. Alzheimer’s disease (AD) is due to decrease
Acetylcholine (Ach) and Cognex
(or Aricept as another drug of choice) is usually
administered to improve memory.
5. Altered thought process is the priority nursing
diagnosis for AD.
6. Confabulation and hyperorality are commonly seen
in patients with AD.
F. ANXIETY and ANXIETY DISORDERS
1. Alertness is a characteristic of mild anxiety.
2. Client with moderate anxiety will have narrowed
perception and selective inattention.
3. Greatly reduced perception and many scattered
detail are manifestations of severe anxiety.
4. During Panic-attack, reality is distorted.
5. Flashback is the hallmark symptom of Posttraumatic Stress Disorder (PTSD).
6. Systematic Desensitization (gradual exposure to
specific fear) is the best management for Phobic
Disorders (Phobias).
G. EATING DISORDERS (Anorexia nervosa and
Bulimia nervosa)
1. Refusal to eat is the main problem in Anorexia
nervosa.
2. Amenorrhea and Lanugo are symptoms of Anorexia
nervosa.
3. Lack of control over eating (binge eating and
purging) is the main problem in Bulimic clients.
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7. 4. Russel signs (callus on fingers) and Perimyolysis
(front teeth erosion) are commonly seen in Bulimia
nervosa.
5. Altered nutrition: less than body requirement is the
priority nursing diagnosis for eating disorders.
6. Socialization and staying with the client during snack
or meal prevents them from exercising or inducing
vomiting.
7. Weight gain is an indication that nursing
intervention(s) especially for anorexic client is(are)
effective.
H. MOOD DISORDERS (Bipolar manic and Major
Depression)
1. All depressed clients are potentially suicidal.
2. Depression is associated with decreased level of
norepinephrine and serotonin.
3. Introjection (blaming self) is a common defense
mechanism used during depression.
4. Antidepressants and ECT are therapies used to treat
depression.
5. Mania is associated with increased level of
norepinephrine and serotonin.
6. Projection (blaming others) is commonly used as
defense mechanism by manic patients.
7. Lithium is the drug of choice to lessen symptoms of
mania.
8. Finger foods (usually in tetra packs) and avoidance of
stimulants are recommended diets for manic clients.
I. SUBSTANCE ABUSE and DEPENDENCE
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8. 1. Alcohol is a CNS depressant by nature and the most
widely abused drug according to WHO.
2. Normal alcohol blood level is less than 1 % or 100
mg%.
3. Narcotics are the second widely abused drugs (next
to alcohol).
4. Wernicke’s-Korsakoff’s Syndrome is (are)
neurologic complication(s) of alcoholism that results
from severe vit. B1 deficiency (thiamine).
5. Antabuse (disulfiram) is the drug used for alcohol
Aversion Therapy.
6. Narcotics usually constrict pupils.
7. Yawning indicates brain hypoxia and is common in
heroin withdrawal.
8. Perforated nasal septum is a physical complication
of cocaine, a stimulant.
9. Hallucination, Pica, and Blood-shot eyes are
common manifestations of a person using Marijuana.
10.
Amotivational Syndrome (absence of
motivation) is a withdrawal effect of Marijuana.
J. CRISES INTERVENTIONS
1. Safety and Reporting of cases within 48 hours to
authorities are highest in priority for child abuse case
(Brgy. Captain, Police Station, DSWD, Bantay Bata).
2. Provide shelter for battered wives.
3. Gather evidence (no bathing nor changing of
clothes) for a suspected rape case for legal purposes.
4. Ineffective individual coping is the priority nursing
diagnosis for victims of abuses.
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9. K. CONCEPTS ON DEATH and DYING
1. Denial, Anger, Bargaining, Depression, and
Acceptance (DABDA) are grief reactions according to
Kubler-Ross.
2. Hearing ability is the last to disappear in a dying
person.
3. Flat EEG is the most accepted criterion or definition
of death
4. Between 9-10 years old develops the universal
concept of death, that it is a permanent biology
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10. K. CONCEPTS ON DEATH and DYING
1. Denial, Anger, Bargaining, Depression, and
Acceptance (DABDA) are grief reactions according to
Kubler-Ross.
2. Hearing ability is the last to disappear in a dying
person.
3. Flat EEG is the most accepted criterion or definition
of death
4. Between 9-10 years old develops the universal
concept of death, that it is a permanent biology
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