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Most common diagnoses and meds

Psychiatric   (944 Views 6 Comments)
by dtran15 dtran15 (New) New

dtran15 has 1 years experience .

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Hello,

I am a new grad RN that will be starting my psych residency at a large university hospital next week.  Would any experienced psych nurses out there be so kind as to provide a list of top 10 most common diagnoses/prescribed medications or a list similar to it?  Also, I'm not sure how much it matters, but my hospital has both inpatient and outpatient settings.  Other new grad advice is greatly appreciated as well!

Thanks in advance

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TheMoonisMyLantern has 12 years experience as a ADN, LPN, RN and specializes in Mental health, substance abuse, geriatrics, PCU.

1 Article; 229 Posts; 8,621 Profile Views

So, there are very many different type of psychiatric units so it can certainly vary depending on the the type of floor. For instance some may specialize on intensive patients such as those that are psychotic or have severe personality disorders, or chemical dependency, adolescents, children, eating disorders, geriatrics, forensic, etc. Be that as it may I'll try to throw a general list together for you in no particular order! 

Disorders:

1. Major Depressive disorder, Substance Induced Mood Disorder, Suicidal Ideations

2. Borderline Personality Disorder

3. Bipolar disorder I/II

4. Alcohol dependency, withdrawal

5. Opiate dependency, withdrawal

6. Schizophrenia/Schizoaffective disorder (make sure to know the difference between the two.)

7. Delusional disorders

8. Antisocial Personality Disorder

9. Panic/anxiety disorders with/without agoraphobia (This usually is a co-occurring diagnosis as this is primarily managed outpatient when it's the primary diagnosis.) Also going to cluster PTSD with this (can be a primary diagnosis)

10. Somatic disorders (do some research on psychogenic seizures) 

11. Not technically a diagnosis BUT may be used in lieu of a diagnosis Malingering/Secondary Gain 

 

Medications:

1. Antidepressants- Know you different sub-types (SSRI, SNRI, TCA's, MAOI, atyptical) Prozac, Zoloft, Effexor, Wellbutrin, Cymbalta, Remeron, Amytriptiline, etc. Keep in mind some of these may manage anxiety in addition to depression, some may be used for insomnia, some may be used for migraine prophylaxis. Also, make sure you know which ones tend to be your heavy hitters versus ones that are more first line.

2. Mood stabilizers- Lithium, Depakote (may also be used to treat aggression), Lamictal, Tegretol, Topamax

3. Gabapentin- the miracle drug! Can be used to manage anxiety, alcohol withdrawal (some really interesting studies out there on this), and occasionally it'll be used as a mood stabilizer but there's not a lot support for that use last I checked.

4. Atypical antipsychotics- Seroquel (it's purpose is does dependent small doses for anxiety, sleep, medium doeses for mood stabilization, and high doses for psychosis), Abilify (its purpose is also dose dependent), Risperdal, Geodon, Zyprexa

5. Typical Antipsychotics- Thorazine, Haldol

6. EPS/TD tx drugs: Cogentin, Artane, Benadryl

7. Benzodiazepines- Ativan, Xanax, Valium, Klonopin, Librium- most psychiatrists try to limit their use to treating withdrawal sx and for emergencies

8. Vistaril- Wonderful rapid acting drug for anxiety

9. Emergency Medications: typically given in synergistic combinations such as Ativan/Haldol/Benadryl,  Geodon can also be used in an emergency as can Zyprexa (Zyprexa also comes in a oral disintegrating tablet giving it a rapid onset which can be a nice alternative to an IM) Please not that all of these emergency meds maybe given either PO or IM depending on the patient's condition.

10. Cardiac meds- Clonidine (used for anxiety, opiate withdrawal) Inderal (the stage fright drug, has a nice anxiolytic effect) Prazosin (nightmares)

 

Please note this is NOT an exhaustive list, but hopefully it's a decent place to start.  Please forgive any typos! It would be nice if some of our other experienced psych posters could chime in such as Meriwen, Davey Do, and hppygr8ful 

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hppygr8ful has 15 years experience and specializes in Psych, Addictions, Elder Care, L&D.

5 Followers; 2,830 Posts; 32,748 Profile Views

I mostly work with kids and adolescents most of whom are diagnosed with major depressive disorder, suicidal or homicidal ideations, Alcohol use disorder and othe chemical dependencies. Self harm ideations (cutting, burning), eating disorders and conduct disorders.

True psychosis  ie...Auditory/Visual hallucinations are actually quiet rare in young people. In many case hearing voices is actually revealed to be something called "negative self talk" 

I'm not a big fan or medicating kids on their first hospitalization but we use SSRI and atypical antidepressants, mood stabilizers and antipsychotics like Abilify and Haldol.

The biggest challenge you will face with this population is dealing with the parents because psychiatrically ill kids often don't fall from the trees.

Hppy

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dtran15 has 1 years experience.

3 Posts; 74 Profile Views

On 2/20/2019 at 12:43 PM, TheMoonisMyLantern said:

So, there are very many different type of psychiatric units so it can certainly vary depending on the the type of floor. For instance some may specialize on intensive patients such as those that are psychotic or have severe personality disorders, or chemical dependency, adolescents, children, eating disorders, geriatrics, forensic, etc. Be that as it may I'll try to throw a general list together for you in no particular order! 

Disorders:

1. Major Depressive disorder, Substance Induced Mood Disorder, Suicidal Ideations

2. Borderline Personality Disorder

3. Bipolar disorder I/II

4. Alcohol dependency, withdrawal

5. Opiate dependency, withdrawal

6. Schizophrenia/Schizoaffective disorder (make sure to know the difference between the two.)

7. Delusional disorders

8. Antisocial Personality Disorder

9. Panic/anxiety disorders with/without agoraphobia (This usually is a co-occurring diagnosis as this is primarily managed outpatient when it's the primary diagnosis.) Also going to cluster PTSD with this (can be a primary diagnosis)

10. Somatic disorders (do some research on psychogenic seizures) 

11. Not technically a diagnosis BUT may be used in lieu of a diagnosis Malingering/Secondary Gain 

 

Medications:

1. Antidepressants- Know you different sub-types (SSRI, SNRI, TCA's, MAOI, atyptical) Prozac, Zoloft, Effexor, Wellbutrin, Cymbalta, Remeron, Amytriptiline, etc. Keep in mind some of these may manage anxiety in addition to depression, some may be used for insomnia, some may be used for migraine prophylaxis. Also, make sure you know which ones tend to be your heavy hitters versus ones that are more first line.

2. Mood stabilizers- Lithium, Depakote (may also be used to treat aggression), Lamictal, Tegretol, Topamax

3. Gabapentin- the miracle drug! Can be used to manage anxiety, alcohol withdrawal (some really interesting studies out there on this), and occasionally it'll be used as a mood stabilizer but there's not a lot support for that use last I checked.

4. Atypical antipsychotics- Seroquel (it's purpose is does dependent small doses for anxiety, sleep, medium doeses for mood stabilization, and high doses for psychosis), Abilify (its purpose is also dose dependent), Risperdal, Geodon, Zyprexa

5. Typical Antipsychotics- Thorazine, Haldol

6. EPS/TD tx drugs: Cogentin, Artane, Benadryl

7. Benzodiazepines- Ativan, Xanax, Valium, Klonopin, Librium- most psychiatrists try to limit their use to treating withdrawal sx and for emergencies

8. Vistaril- Wonderful rapid acting drug for anxiety

9. Emergency Medications: typically given in synergistic combinations such as Ativan/Haldol/Benadryl,  Geodon can also be used in an emergency as can Zyprexa (Zyprexa also comes in a oral disintegrating tablet giving it a rapid onset which can be a nice alternative to an IM) Please not that all of these emergency meds maybe given either PO or IM depending on the patient's condition.

10. Cardiac meds- Clonidine (used for anxiety, opiate withdrawal) Inderal (the stage fright drug, has a nice anxiolytic effect) Prazosin (nightmares)

 

Please note this is NOT an exhaustive list, but hopefully it's a decent place to start.  Please forgive any typos! It would be nice if some of our other experienced psych posters could chime in such as Meriwen, Davey Do, and hppygr8ful 

Thank you for taking out the time! I’ll study up on the list before my start date

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dtran15 has 1 years experience.

3 Posts; 74 Profile Views

22 hours ago, hppygr8ful said:

I mostly work with kids and adolescents most of whom are diagnosed with major depressive disorder, suicidal or homicidal ideations, Alcohol use disorder and othe chemical dependencies. Self harm ideations (cutting, burning), eating disorders and conduct disorders.

True psychosis  ie...Auditory/Visual hallucinations are actually quiet rare in young people. In many case hearing voices is actually revealed to be something called "negative self talk" 

I'm not a big fan or medicating kids on their first hospitalization but we use SSRI and atypical antidepressants, mood stabilizers and antipsychotics like Abilify and Haldol.

The biggest challenge you will face with this population is dealing with the parents because psychiatrically ill kids often don't fall from the trees.

Hppy

Thank you so much! I’ll keep this in mind 

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ruby_jane has 10 years experience as a BSN, RN and specializes in ICU/community health/school nursing.

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On 2/20/2019 at 6:16 PM, hppygr8ful said:

 

The biggest challenge you will face with this population is dealing with the parents because psychiatrically ill kids often don't fall from the trees.

 

Amen. Also you will realize that our inpatient system is like a car with three bald tires....this is not a critique of the nursing personnel who work there by any means. You will have to suspend your disbelief that someone who is in crisis can stay for three days, meds have started to work, group and individual therapy is making a difference, and then they're "well" enough to be discharged into the same milieu from whence they came.

 

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