NCLEX-RN 이것만이라도 보고 가자! : Emergency / Critical Care │ Nurse Haley

날짜:

NCLEX-RN 이것만이라도 보고 가자! : Anxiety & Mood Disorders Medications (불안·우울·양극성 약물 총정리) │ Nurse Haley

날짜:

🧠 Anxiety & Mood Disorders Medications (불안·우울·양극성 약물 총정리)



안녕하세요! 오늘의 간호사 Haley 입니다 😊
오늘은 불안(Anxiety), 우울(Depression), 양극성장애(Bipolar Disorder)에 사용되는 대표 약물들을 간호 포인트 중심으로 정리했습니다.
Each medication includes Korean and English descriptions for nurses and students.

📖 Table of Contents

💊 Anxiety Medications (항불안제)

Class (분류) Examples (대표 약물) Key Points (핵심 포인트) Cautions (주의사항)
Benzodiazepines
(-lam, -pam)		 Diazepam, Lorazepam, Alprazolam • Fast onset (효과 빠름)
• Used for anxiety, seizure, alcohol withdrawal
• Causes sedation/drowsiness (진정, 졸림) 		🚫 Avoid driving or machinery (운전/기계 금지)
🌙 Take before sleep (취침 전 복용)
🧯 Antidote: Flumazenil
Barbiturates Phenobarbital • Long duration (효과 오래감, 5일 정도 지속)
• Slow excretion from the body 		⚠️ Causes hypotension ↓, RR ↓ (혈압·호흡 저하)
🛑 Risk of death if over-sedated → Notify immediately
Buspirone Buspirone • Non-sedative, non-addictive (비진정성, 의존성 없음)
• Takes 2–4 weeks for full effect (효과 느림) 		✅ Can drive safely (운전 가능)
❌ Not for acute anxiety (급성 불안엔 부적절)
🚫 No alcohol (알코올 금지)
Common Rule: Avoid alcohol with all anti-anxiety drugs.
모든 항불안제는 알코올 병용 시 진정·호흡억제 위험이 증가합니다.

💊 Antidepressants (항우울제)

⚠️ Initial Risk: Suicidal thoughts may increase during first few weeks.
약 시작 초기 몇 주간 자살사고 증가 가능 → 즉시 보고.
Do not stop abruptly — taper gradually (급중단 금지, 서서히 감량).
  • 🚫 SSRI + St. John’s Wort → Serotonin Syndrome
  • 🚫 MAOI + Other antidepressants → 2-week washout needed
  • 📉 BP drop, ⚖️ weight gain common

1️⃣ SSRI (Selective Serotonin Reuptake Inhibitors)

Fluoxetine, Sertraline, Paroxetine, Citalopram, Escitalopram (-ine, -pram)

  • Slow onset (2–4 weeks), taper gradually
  • Side effects: sexual dysfunction, ↑ suicide risk
  • Serotonin Syndrome: sweating, fever, tremor, hyperreflexia, mydriasis, agitation, tachycardia, HTN
  • ⚠️ Energy ↑ but still depressed → Notify immediately

2️⃣ SNRI (Serotonin–Norepinephrine Reuptake Inhibitors)

Duloxetine, Venlafaxine

  • Improves pain & sleep (통증·수면 개선)
  • Used for fibromyalgia, neuropathic pain

3️⃣ TCA (Tricyclic Antidepressants)

Amitriptyline, Imipramine

  • For depression, anxiety, neuropathy
  • Anticholinergic effects: photophobia, urinary retention, dry mouth, constipation
🕶️ Sunglasses & artificial tears
🍬 Chewing gum for dry mouth
🥗 High-fiber diet for constipation
🚶‍♀️ Change position slowly (기립성 저혈압 주의)

4️⃣ MAOI (Monoamine Oxidase Inhibitors)

Phenelzine, Selegiline, Isocarboxazid

  • 💣 Risk of hypertensive crisis: headache, agitation
  • 🚫 Avoid tyramine foods: wine, cheese, beer, sausage, chocolate (2w before & after)
  • 🚫 Avoid OTC meds (NSAIDs, antacids, etc.)
  • 🧠 2-week washout before switching antidepressants

🌙 Atypical Antidepressants (비전형 항우울제)

Drug (약물) Key Points (특징 / 간호 포인트)
Trazodone • Sleepy (졸림 많음) → useful for insomnia
• Avoid alcohol / other sedatives
• Risk of hypotension
⚠️ Priapism ≥4hrs → Notify immediately
Bupropion (XL/SR) • Side effects: headache, insomnia
• Don’t double up if missed dose
• ❌ Don’t crush, chew, or cut XR/SR tablets

💫 Bipolar Disorder (양극성 장애)

1️⃣ Carbamazepine

  • Used for bipolar & trigeminal neuralgia
  • Fever/sore throat → agranulocytosis → Notify
  • Decreases oral contraceptive effectiveness → use alternative

2️⃣ Valproic Acid

  • Liver toxicity: jaundice, ↑AST/ALT
  • Thrombocytopenia (low PLT)
  • ❌ Contraindicated in pregnancy
  • ❌ Do not stop abruptly

3️⃣ Lithium ★★★★★

  • Therapeutic: 0.6–1.2 mEq/L (≥1.5 → Toxic)
  • Monitor Cr >1.3, urine output <30ml hr="" li="" toxic="">
  • 🚫 Avoid in dehydration, hyponatremia, diarrhea/vomiting
  • 🚫 Avoid diuretics, anticholinergics, NSAIDs
  • 💧 Maintain hydration & sodium intake
  • For dry mouth → ice chips, gum, water, oral care
  • ⚠️ Extreme urination/thirst → Notify immediately

📋 Summary Table (요약)

Category Key Nursing Point Must Remember
Benzodiazepine Fast effect, sedation 🚫 Driving / Flumazenil antidote
Barbiturate Long duration, risk of over-sedation Monitor BP↓, RR↓ → Notify
Buspirone Non-sedative, low dependence Onset 2–4 weeks
SSRI Slow onset, ↑ suicide risk ❌ St. John’s Wort
SNRI Pain & sleep improvement Fibromyalgia use
TCA Anticholinergic s/e Dry mouth, constipation care
MAOI Avoid tyramine foods Hypertensive crisis risk
Lithium Hydration & Na balance crucial ❌ Diuretics, NSAIDs
💡 Nursing Tips:
Monitor for suicidal thoughts early weeks.
Do not stop suddenly — taper gradually.
Avoid alcohol and report abnormal symptoms immediately.

정리: 오늘의 간호사 Haley ·

📌 본문 내용은 오늘의 간호사 Haley의 저작물로 무단 복제·배포를 금합니다.

#MentalHealth #NursingPharmacology #AnxietyMeds #Antidepressants #Lithium #간호약물정리 #정신과간호