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Point-of-Care Clinical Guide

SECOND EDITION
7578_FM_i-viii 22/12/17 5:36 PM Page i
7578_FM_i-viii 22/12/17 5:36 PM Page ii

Legend/Explanation for Drugs A-Z/Alert

Following are explanations of information used throughout and applies to all
psychotropic drugs A-Z:

In the Alphabetical Psychotropic Drug Tabs, each drug’s half life is noted by T1/2;
Canadian drug trade names are listed in italics; most frequent side effects are
underlined; and LIFE-THREATENING side effects are listed as ALL CAPS. In the avail-
ability section, all Canadian doses will have Canadian noted just before each and
every dose.

Legend for DRUG COSTS (based on 30-day supply)

$ = $0–$50 per month; $$ = $50–$100 per month; $$$ = $100–$200 per month;
$$$$ = more than $200 per month.

TALL MAN LETTERING: The FDA has asked manufacturers to update 33 look-alike
generic drug names. If a psychotropic drug uses tall man lettering, it will be used in
the psychotropic alphabetical sections, such as chlorproMAZINE (as compared with
chlorproPAMIDE). (US FDA Center for Drug and Research; www.fda.gov/cder/
index/html)

ALERT: Refer to the Physicians Desk Reference or product insert (prescribing

information) for complete and current drug information (dosages, warnings,
indications, adverse effects, interactions, etc.) needed to make appropriate choices
in the treatment of clients before administering any medications. Although every
effort in this volume has been made to provide key information about medications
and classes of drugs, such information is not and cannot be all-inclusive in a
reference of this nature, and this information should not be used for prescribing or
administering medications. Professional judgment, training, supervision, relevant
references, and “current” drug information is critical to the appropriate selection,
evaluation, and use of drugs, as well as the monitoring and management of clients
and their medications.

Pocket Psych Drugs is dedicated to my son, Jorgen David, to Jessica, Isaac, and Miles.
7578_FM_i-viii 22/12/17 5:36 PM Page iii

Darlene D. Pedersen, MSN, APRN, PMHCNS

Purchase additional copies of this book at your health science bookstore or directly from
F.A. Davis by shopping online at www.fadavis.com or by calling 800-323-3555 (US) or
800-665-1148 (CAN)
7578_FM_i-viii 22/12/17 5:36 PM Page iv

F. A. Davis Company
1915 Arch Street
Philadelphia, PA 19103
www.fadavis.com

Copyright © 2018 by F. A. Davis Company

All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a
retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying,
recording, or otherwise, without written permission from the publisher.

Printed in China by Imago

Last digit indicates print number: 10 9 8 7 6 5 4 3 2 1

Senior Acquisitions Editor: Susan Rhyner

Editorial Assistant: Sean West
Manager of Art & Design: Carolyn O’Brien
Consultant to the First Edition: Thanks to Laura G. Leahy, MSN, APN, CNS, FNP, BC for her consultation
on pediatric drugs in the first edition.
First Edition Reviewers: Lois Angelo, APRN, MSN; Laura Aromando, ARNP, MSN; Barbara Braverman,
MSN, CRNP, BC-CNS; Arleen F. Briggs, RN, MSN, RNC, APRN; Barbara Chamberlain, PhD, APRN, CCRN,
WCC; Perri-Anne Concialdi, RN, MSN, CNS; Karen I. Curlis, PMHCNS-BC; Margie Eckroth-Bucher, PhD,
RN, PMHCNS-BC; Kathryn Farwell, PhD, RN; Elizabeth A. Favreau, MSN, RN, CNE; Linda S. Forte; Carlie
Frederick, ARPN, PMH-BC, CPNP; Melissa Garno, EdD; Sheila Hart, MSN, RN; Joan Hoover, RN, BSN,
MSEd; Dottie Irvin, DNS, APRN, BC; Florence Keane, DNSc, MBA, ARNP-ANP-C; Michelle Link, RN, MSN;
Angela Luciani, RN, BScN, MN; Robin Murray, RN, MSN; Ketankumar V. Patel, MD; Catherine Ann Weitzel,
RN, MSN, ARNP

As new scientific information becomes available through basic and clinical research, recommended
treatments and drug therapies undergo changes. The author(s) and publisher have done everything
possible to make this book accurate, up to date, and in accord with accepted standards at the time of
publication. The author(s), editors, and publisher are not responsible for errors or omissions or for conse-
quences from application of the book, and make no warranty, expressed or implied, in regard to the con-
tents of the book. Any practice described in this book should be applied by the reader in accordance
with professional standards of care used in regard to the unique circumstances that may apply in each
situation. The reader is advised always to check product information (package inserts) for changes and
new information regarding dose and contraindications before administering any drug. Caution is espe-
cially urged when using new or infrequently ordered drugs.

Authorization to photocopy items for internal or personal use, or the internal or personal use of specific
clients, is granted by F. A. Davis Company for users registered with the Copyright Clearance Center (CCC)
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Transactional Reporting Service is: 978-0-8036-7578-0/18 0 + $.25.
7578_FM_i-viii 22/12/17 5:36 PM Page v

Contents
Tab 1: Basics of • Side Effects Associated With
Psychopharmacology/ Therapeutic Classes 12
Biology and Drug • Black Box Warnings 13
Classes 1
Tab 2: Psychotropic
• Pharmacokinetics/
Drugs A–C 15
Pharmacodynamics 1
• ALPRAZolam 15
• The Limbic System (Figure) 2
• Amitriptyline 17
• Synapse Transmission (Figure) 3
• Amphetamine Mixtures 19
• Autonomic Nervous System:
• ARIPiprazole 21
Sympathetic and
• Atomoxetine 24
Parasympathetic Effects 3
• Benztropine 26
• Neurotransmitters 4
• Brexpiprazole 28
• Medication and the Elderly 4
• BuPROPion HCl 31
• Pharmacokinetics in the
• BusPIRone 34
Elderly 5
• CarBAMazepine 35
• Medications and Children 6
• Cariprazine 39
• Indications/Off-Label Uses 6
• ChlordiazePOXIDE 41
• Pediatric Dosing 7
• ChlorproMAZINE 43
• Psychotropic Adverse Effects 7
• Citalopram 46
• Extrapyramidal Symptoms
• ClomiPRAMINE 48
(EPS) 7
• ClonazePAM 50
• Tardive Dyskinesia 8
• CloZAPine 52
• Neuroleptic Malignant
Syndrome (NMS) 8 Tab 3: Psychotropic
• Serotonin Syndrome 8 Drugs D–G 55
• Treatment-Emergent • Desipramine 55
Diabetes 9 • Desvenlafaxine 57
• Antiparkinsonian Agents 9 • Dextroamphetamine 59
• Drug-Herbal Interactions 10 • Diazepam 61
• Therapeutic Drug Classes 10 • Donepezil 63
7578_FM_i-viii 22/12/17 5:36 PM Page vi

• Doxepin 65 • Oxazepam 126

• DULoxetine 68 • Paliperidone 128
• Escitalopram 70 • Paroxetine HCl 131
• Eszopiclone 72 • Perphenazine 135
• FLUoxetine 73 • Phenelzine 137
• FluPHENAZine 76 • Pimozide 139
• Flurazepam 79 • Propranolol 142
• FluvoxaMINE 81 • QUEtiapine 144
• Gabapentin 83
Tab 6: Psychotropic
• Galantamine 85
Drugs R–Z 147
Tab 4: Psychotropic • Ramelteon 147
Drugs H–M 87 • Risperidone 148
• Haloperidol 87 • Rivastigmine 151
• HydrOXYzine 89 • Selegiline Transdermal 153
• Imipramine 91 • Sertraline 155
• Isocarboxazid 94 • Temazepam 160
• LamoTRIgine 96 • Thiamine [Vitamin] 162
• Levomilnacipran 99 • Thioridazine 164
• Lisdexamfetamine 101 • Thiothixene 166
• Lithium 103 • Topiramate 168
• LORazepam 106 • Tranylcypromine 170
• Loxapine 108 • Trazodone 172
• Lurasidone 110 • Triazolam 174
• Memantine 112 • Trihexyphenidyl 176
• Methylphenidate 114 • Valbenazine 178
• Mirtazapine 117 • Valproates 179
• Molindone 119 • Venlafaxine 182
• Vortioxetine 185
Tab 5: Psychotropic
• Zaleplon 187
Drugs N–Q 121
• Ziprasidone 189
• Nortriptyline 121
• Zolpidem 191
• Olanzapine (with fluoxetine) 123
7578_FM_i-viii 22/12/17 5:36 PM Page vii

Tab 7: Labs/Protocols 195 Tab 8: Tools 203

• Therapeutic Plasma Levels: • Trade Names to Generic
Mood Stabilizers 195 Names (Drugs A–Z) 203
• Plasma Levels/Laboratory • Abbreviations 204
Test Monitoring 195 • Psychotropic Approximate
• Disorders and Labs/Tests Dose Equivalences 207
Performed 195 • Pregnancy Categories and
• Clozapine Risk Evaluation Controlled Substances
and Mitigation Strategy Schedules 209
(REMS) Program 197 • BMI/Metabolic Syndrome 211
• Common Laboratory Values 197 • MAOI Diet (Tyramine)
• General Chemistry 197 Restrictions 213
• Hematology 199 • Nonpharmacological
• Treatment Algorithms in Treatments of Depression/
Psychopharmacology 200 Other Disorders 214
• IPAP Schizophrenia • References 215
Algorithm 201 • Index 218
7578_FM_i-viii 18/12/17 1:39 PM Page viii

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7578_Tab01_001-014 22/12/17 11:22 AM Page 1

Pharmacokinetics/Pharmacodynamics 1
Basics of Psychopharmacology/Biology
and Drug Classes
Pharmacokinetics/Pharmacodynamics
Pharmacokinetics (PK) can be defined as “how the body processes a drug” result-
ing in a drug’s concentration in the body. This is done through absorption, distribu-
tion, metabolism, and excretion (ADME).
Absorption: Describes the drug’s movement from point of administration (oral,
injection, skin) until it reaches the bloodstream. In oral administration, first-pass
metabolism refers to how much of the drug is metabolized by the liver and there-
fore is not available to the bloodstream (bioavailability of drug). This determines the
dose needed for oral administration or the need for an alternative route of entry (such
as parenteral).
Distribution: Movement of drug from the bloodstream to the rest of the body.
Concerned with movement over the blood-brain barrier (may affect the brain) or
crossing the placenta (may affect the fetus). Also concerns highly protein-bound
drugs that may cause drug interactions.
Metabolism and Excretion: The primary organ of metabolism is the liver, and excre-
tion of drugs takes place through the kidneys. Dosing considerations are based on
how well the liver and kidneys are functioning. Half-life is also a factor as drugs with
long half-lives may accumulate, resulting in overdose or toxicity.
Half-life is the time (hours) that it takes for 50% of a drug to be eliminated from the
body. Time to total elimination involves halving the remaining 50%, and so forth,
until total elimination. Half-life is considered in determining dosing frequency and
in determining time to steady state. The rule of thumb for steady state (stable
concentration/manufacture effect) attainment is 4–5 half-lives. Because of fluox-
etine’s long half-life, a 5-week washout is recommended after stopping fluoxetine
and before starting an MAOI to avoid a serious and possibly fatal reaction.
Protein Binding is the amount of drug that binds to the blood’s plasma proteins; the
remainder circulates unbound. It is important to understand this concept when pre-
scribing two or more highly protein-bound drugs as one drug may be displaced,
causing increased blood levels and adverse effects.
Pharmacodynamics is usually defined as “what the drug does to the body” and
therefore the effect the drug has on the body (positive effects and side effects).

BASICS
7578_Tab01_001-014 22/12/17 11:22 AM Page 2

BASICS

Cytochrome P-450 Enzyme System is involved in drug biotransformation and

metabolism. It is important to develop a knowledge of this system to understand
drug metabolism and especially drug interactions. Over 30 P-450 isoenzymes have
been identified. The major isoenzymes include CYP1A2/2A6/2B6/2C8/2C9/2C18/
2C19/2D6/2E1/3A4/3A5-7.

Septum
pellucidum
Cingulate Thalamus
gyrus Fornix

Hypothalamus

Olfactory
Tract

Hippocampus
Mammillary Body

Amygdala
The limbic system and its structures (Adapted from Scanlon VC, Sanders T: Essentials of Anatomy and
Physiology, ed. 7 FA Davis, Philadelphia 2014, with permission)

Pharmacokinetics/Pharmacodynamics/Limbic System 2
7578_Tab01_001-014 22/12/17 11:22 AM Page 3

Synapsis/Autonomic Nervous System 3

Vesicles of neurotransmitter

Axon of presynaptic Dendrite of

neuron postsynaptic
neuron
Na+

Na+

Mitochondrion Neurotransmitter
(acetylcholine)
Inactivator
Receptor site (cholinesterase)
Impulse transmission at a synapse. Arrow indicates direction of electrical impulse. (From Scanlon VC,
Sanders T: Essentials of Anatomy and Physiology, ed. 7 FA Davis, Philadelphia 2014, with permission)

Autonomic Nervous System

SYMPATHETIC AND PARASYMPATHETIC EFFECTS
Structure Sympathetic Parasympathetic
Eye (pupil) Dilation Constriction
Nasal mucosa Mucus reduced Mucus increased
Salivary gland Saliva reduced Saliva increased
Heart Rate increased Rate decreased
Arteries Constriction Dilation
Lung Bronchial muscle relaxation Bronchial muscle
contraction
Gastrointestinal tract Decreased motility Increased motility
Liver Conversion of glycogen Glycogen synthesis
to glucose increased
Continued

BASICS
7578_Tab01_001-014 22/12/17 11:22 AM Page 4

BASICS

SYMPATHETIC AND PARASYMPATHETIC EFFECTS—cont’d

Structure Sympathetic Parasympathetic
Kidney Decreased urine Increased urine
Bladder Contraction of sphincter Relaxation of sphincter
Sweat glands ↑ Sweating No change
(From Pedersen: PsychNotes, 5e, 2018, with permission)

Neurotransmitters
NEUROTRANSMITTER FUNCTIONS AND EFFECTS
Neurotransmitter Function Effect
Dopamine Inhibitory Fine movement, emotional behavior.
↑ in schizophrenia and ↓ Parkinson’s.
Implicated in addiction.
Serotonin Inhibitory Sleep, mood, eating behavior.
Implicated in mood disorders, anxiety,
and violence.
Norepinephrine Excitatory Arousal, wakefulness, learning.
Implicated in anxiety, ADHD, and
“fight or flight reaction.”
GABA Inhibitory Anxiety states.
Acetylcholine Excitatory Arousal, attention, movement.
Increase = spasms and decrease =
paralysis.
(From Pedersen: PsychNotes, 5e, 2018, with permission)

Medication and the Elderly

● Relevant drug guides provide data about dosing for the elderly and debilitated
clients. (See also Drug/tabs.)
● Elderly and debilitated clients are started at lower doses, often half the
recommended adult dose. This is due to:
• Decreases in GI absorption
• Decrease in total body water (decreased plasma volume)
• Decreased lean muscle and increased adipose tissue
Autonomic Nervous System/Neurotransmitters 4
7578_Tab01_001-014 22/12/17 11:22 AM Page 5

Neurotransmitters/Pharmacokinetics in the Elderly 5

• Reduced first-pass effect in the liver and cardiac output
• Decreased serum albumin
• Decreased glomerular filtration and renal tubular secretion
• Time to steady state is prolonged
Because of decrease in lean muscle mass and increase in fat (retains lipophilic
drugs [fat-storing]), reduced first-pass metabolism, and decreased renal function,
drugs may remain in the body longer and produce an additive effect.

[ Clinical Tips/Alert: With the elderly, start doses low and titrate slowly. Drugs
that result in postural hypotension, confusion, or sedation should be used
cautiously or not at all. ]
● Poor Drug Choices for the Elderly - Drugs that cause postural hypotension or
anticholinergic side effects (sedation).
• TCAs - anticholinergic (confusion, constipation, visual blurring); cardiac (con-
duction delay; tachycardia); alpha-1 adrenergic (orthostatic hypotension [falls])
• Benzodiazepines - longer the half-life, the greater the risk of falls. May also
increase agitation and confusion. Choose a shorter half-life. Lorazepam
(T 1/2 12-15 hr) is a better choice than diazepam (T 1/2 20-70 hr; metabo-
lites up to 200 hr).
• Sedatives/hypnotics - Always start with a lower dose and monitor for seda-
tion, confusion, cognitive impairment, amnesia, and daytime drowsiness.
Caution against next day driving and until adequate adjustment to medication
has been observed. Increased visits to EDs have happened due to falls and
adverse reactions.
• Lithium - use cautiously in elderly, especially if debilitated. Risk of dehydration
may yield lithium toxicity.
• Diphenhydramine (Benadryl; Canada: Allerdryl) – ↑ susceptibility to adverse
reactions/anticholinergic effects (delirium, dizziness, confusion).
• Consider age, weight, mental state, and medical disorders and compare with
side-effect profile in selecting medications.

Pharmacokinetics in the Elderly

Pharmacokinetics is the way that a drug is absorbed, distributed and used, metab-
olized, and excreted by the body. Age-related physiological changes affect body
systems, altering pharmacokinetics and increasing or altering a drug’s effect.

BASICS
7578_Tab01_001-014 22/12/17 11:22 AM Page 6

BASICS

Physiological Change Effect on Pharmacokinetics

Absorption • Decreased intestinal motility • Delayed peak effect
• Diminished blood flow to • Delayed signs/symptoms of
the gut toxic effects
Distribution • Decreased body water • Increased serum concentra-
tion of water-soluble drugs
• Increased percentage of • Increased half-life of fat-
body fat soluble drugs
• Decreased amount of • Increased amount of active
plasma proteins drug
• Decreased lean body mass • Increased drug concentration
Metabolism • Decreased blood flow to liver • Decreased rate of drug
clearance by liver
• Diminished liver function • Increased accumulation of
some drugs
Excretion • Diminished kidney function • Increased accumulation of
• Decreased creatinine drugs excreted by kidney
clearance
(From Myers, RNotes, 4e, 2014, with permission)

Medications and Children

Indications/Off-Label Uses: The majority of psychotropic medications are used “off-
label” in children. The exceptions to this are those with the following FDA-Approved
Clinical Indications:
Attention-Deficit Hyperactivity Disorder (ADHD) Medications: amphetamine
salts (ages ≥3), methylphenidate (ages ≥6), lisdexamfetamine (ages ≥6), atomoxetine
(ages ≥6)
Selective Serotonin Reuptake Inhibitor (SSRI) Antidepressants: fluoxetine for
depression (ages 8-18) and obsessive compulsive disorder (ages 7–18) and sertra-
line for obsessive compulsive disorder (ages 6–17)
Atypical Antipsychotic Medications: aripiprazole for adolescent schizophrenia
(ages 3–17), bipolar mania (ages 10–17), adjunct treatment of bipolar mania
(ages 10–17), and [risperidone] irritability related to autistic disorder (ages 5–16)
Although the majority of psychotropic medications do not have an FDA-approved
indication, there is significant research and data on most of these medications
providing a base of evidence to guide the clinician in his/her decision making when
prescribing for children and adolescents (Martin & Lewis 2006).
Pharmacokinetics in the Elderly/Medications and Children 6
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