Published Feb 23, 2015
caughtbuckinoff
62 Posts
Hello! For those of you in acute care/emergency psych facilities, would you mind sharing some of your commonly administered medications, both for emergency treatment, as well as maintenance for the patient's length of stay? I just interviewed with the local CSU and will hopefully be starting next month. I would like to become more familiar with the medication side effects, lab values, etc. (no need to share more than just a name, I'll be researching the rest of the information once I narrow down which meds) before I start administering them. I remember basic ones from nursing school (Halidol, Ativan) but I know there are many more that we never touched on.
I will be working emergency intake and acute care, so if you have an additional pearls of wisdom, I would love to hear them!
Jules A, MSN
8,864 Posts
Some of the ones I use include Zyprexa, Abilify, Risperdal, Haldol, Prolixin, Depakote, Lithium, Trileptal, Lamictal, Prozac, Zoloft, Lexapro, Wellbutrin, Cymbalta, Vistaril, Benadryl, Trazodone-sleep not antidepressant
fawnmarie, ASN
284 Posts
In an emergency situation we give Thorazine, Haldol, Ativan, Prolixin, Geodon, and Benadryl, to name a few. Most of my patients have a diagnosis of schizophrenia. Some of the meds they take daily include Abilify, Seroquel, Zyprexa, Thorazine, Risperdal, and Haldol. Patients with a diagnosis of bipolar disorder commonly take Lithium, Depakote, Tegretol, Lamictal, and Trileptal. For depression, the patients may be prescribed Celexa, Effexor, Paxil, or Prozac.
xsnurse
23 Posts
When I worked in psych the most common emergency meds ( or ETOs) were IM Haldol, Benadryl and Ativan. But we also used Thorazine, Zyprexa and Cogentin and sometimes Abilify.
We gave a lot of Invega shots. They are long acting and only taken monthly.
I think the most common pill I saw was Seroquel. I think just about everyone was on some dose of that. We gave Latuda to pregnant patients.
Good luck.
302queenpa
11 Posts
IM Haldol and Ativan are our most common for emergency use. Geodon on occasion.
So what I don't understand about using Geodon in an emergency setting is that #1 have you ever tried reconstituting that stuff? your staff will be getting their brains bashed in while you are shaking the vial for hours and #2 the pharm company really pushed it as a great med because it isn't as sedating. Well news flash folks that is usually one of my goals when ordering emergency IM meds.
marshmallowstar, BSN, RN
83 Posts
IM Geodon, Ativan are our go to emergency meds. I work on a trauma unit where pt's can become highly escalated with flashbacks or selfharm/SI impulses, but not typical acute psychosis. Our docs choose Geodon because they want to take the edge off so the patient can work through the experience not just give them a quick fix, have them sleep and have the whole situation restart when they wake up. Although we definitely using Halodol sometimes when things are just out of control.
The trick I've learned with reconstituting the geodon is to NOT SHAKE. It dissolves by effervescing, you can normally see the air bubbles come off of the disc when you add the water. So I add the sterile water and let it sit while I'm drawing up the ativan, since that's going to take a hot minute itself, and then go back to the geodon. By then most of it has dissolved, I find that a swirling or rolling method works best for the last little bit.
Hope this helps.
greenbeanio
191 Posts
Emergency meds Risperdal (liquid) 2mg with Ativan 2mg.
Or IM Haldol 5mg, Ativan 2mg & Cogentin 1mg.
Psych meds in no particular order:
Wellbutrin
Zoloft
Prozac
Paxil
Effexor
Cymbalta
Celexa
Lexapro
Buspar
Ativan
Librium
Klonopin
Xanax
Valium
hydrocodone
oxycodone
tramadol
toradol
Suboxone
Subutex
Methadone
gabapentin
Vistaril
Seroquel
clonidine
prazosin
trazadone
Remeron
Requip
Ambien
lithium
Lamictal
Tegretol
Trileptal
Zyprexa
Keppra
Depakote,
Risperdal
Clozaril
Abilify
Haldol
Thorazine
Prolixin
Geodon
Trilafon
Compazine
Topamax
Risperdal Consta
Invega
Haldol decanoate
Adderal, Vyvanse
Ritalin, Concerta
And then of course all the other commonly prescribed general meds like
BP meds,
asthma meds
oral hypoglycemics
insulins
statins
laxatives
Tylenol & NSAIDS
proton pump inhibitors
etc
I would suggest making up your own index cards with only the most common and most serious side effects written down - it's impossible (and unnecessary) to try and remember every single side effect. Also, the most important nursing considerations, parameters and administration guidelines (e.g.. empty stomach or with food, etc)
DanaerysTargaryen
42 Posts
Others have touched on most of the meds I would have mentioned… Common psych meds that patients need blood levels for are depakote, lithium, and tegretol. Patients on clozaril need their WBC count monitored closely. Maybe others can add more re: lab values, but these are the ones that come to mind for me right now.
Curious that the OP hasn't taken the time to respond but in any event for the rest of us we can add Tricyclics to the list of meds we monitor labs. Although they aren't used much any more they can be helpful if there have been treatment failures for patients with OCD or treatment resistant depression.
Not at all curious that someone had something sarcastic to say. God forbid I don't check the online forum every day. Shame on me.
Thank you to all that replied, I really appreciate it! I got the job and am really looking forward to starting. You've given me plenty to research 😄
Not at all curious that someone had something sarcastic to say. God forbid I don't check the online forum every day. Shame on me.Thank you to all that replied, I really appreciate it! I got the job and am really looking forward to starting. You've given me plenty to research ������
Thank you to all that replied, I really appreciate it! I got the job and am really looking forward to starting. You've given me plenty to research ������
Interesting that after 12 days of nothing on the exact day I inquired you respond with this and call me sarcastic. Oh well. Best of luck with your new job.