Anti-Psychotic Medications Flashcards
What is psychosis?
A characteristic of some types of mental illness in which a patient has lost contact w reality
What are some characteristics of psychosis?
- delusions
- hallucinations
- lack of insight or judgement
What are delusions?
Firm ideas or beliefs that are false and not founded in reality
What are hallucinations?
Hearing, seeing, or perceiving something that is not present
What are some characteristics of psychosis?
- inappropriate mood and affect
- inactivity or extreme agitation
- can be acute or chronic
What is Schizophrenia?
A type of psychosis in which the patient exhibits a set of diverse symptoms over time such as: abnormal thoughts, disordered communication, withdrawal from people, inability to perform ADLs
What are symptoms characterized as being in Schizophrenia?
Positive or negative
What are positive symptoms?
Behaviours that are in addition to normal behaviours.
What are negative symptoms?
Behaviours that take away from normal behaviours.
What causes Schizophrenia?
- genetic
- neurotransmitter imbalance
What is the neurotransmitter imbalance that can occur w Schizophrenia?
Overactive dopaminergic pathways leads to overstimulation of dopamine type 2 receptors
What do antipsychotics do to overstimulation of D2 receptors?
They block them
What are the 2 classes of antipsychotics?
- first generation antipsychotic drugs
2. second generation antipsychotic drugs
What are first generation antipsychotic drugs?
- include phenothiazines and non-phenothiazines
- effective but w many side effects
What are second generation antipsychotic drugs?
- fewer side effects, much better adherence
- better for managing negative symptoms
What are the symptoms associated with extrapyramidal side effects?
- acute dystonia (muscle spasms of back, neck, and tongue)
- akathisia (restlessness)
- tardive dyskinesia (unusual tongue and face movements associated w long-term use)
What are phenothiazines?
- similar potency, efficacy and range of adverse effects within class
- indicated for use as anti-emetic for tourette’s syndrome
- effective for positive symptoms
What are non-phenothiazines?
- similar potency and efficacy to phenothiazines
- produce less sedation and anticholinergic effects than phenothiazines but more EPS
Name a phenothiazine:
Chlorprom
What are some adverse effects of Chlorprom?
- EPS
- dizziness, headaches, drowsiness
- orthostatic hypotension
- weight gain
- altered cell blood counts (WBCs)
Who does EPS mostly occur in?
- females
- older adults
- pediatrics
Name a nonphenothiazine:
Haldol
What is Haldol used for?
- treat acute and chronic psychotic disorders
- tourrette’s syndrome
What are the adverse effects of Haldol?
- EPS (much more common and pronounced than with phenothiazines)
- less sedation and hypotension than with phenothiazines
- headache
- weight gain
- altered cell blood counts
What is another name for second generation antipsychotic drugs?
Atypical antipsychotics
Have second generation antipsychotics become the drug of choice for severe mental illness?
Yes
Do second generation antipsychotic drugs have a lower incidence of adverse effects like EPS than first generation drugs?
yes
Name a second generation antipsychotic drug:
Clozapine
What are the adverse effects of Clozapine
- dizziness, headache
- drowsiness
- orthostatic hypotension
- tachycardia
- anticholinergic effects
- flu-like symptoms
- bone marrow suppression
Name another second generation antipsychotic drug:
Olanzapine
Does Olanzapine have more EPS than other second generation drugs?
Yes
What is Risperidone used for?
- acute maintenance treatment of schizophrenia
- management of inappropriate behaviour due to dementia
- manic phase of bipolar disorder
Is Risperidone a 1st line agent?
Yes
What is a side effect of Risperidone?
Parkinsonism
What is bipolar disorder?
Patients alternate between extreme feelings of sadness and mania
What are some symptoms of mania?
- agitation, intense excitement, elevated mood, talkativeness
- impulsive behaviour, short attention span
- no thought about consequences of actions
What is mania associated with?
- too much NE and glutamate
- too little inhibitory NTs such as GABA
Name a drug used for bipolar disorder:
Carbolith
How does Carbolith work?
It inhibits glutamate (excitatory NT) action
What are the adverse effects of Carbolith?
- muscle weakness
- lethargy
- nausea, vomiting
- polyuria, nocturia
- headache, dizziness
- tremors
- confusion
What are some long-term effects of Carbolith?
- kidney impairment
- dysrhythmias
- circulatory collapse
- leukocytosis
- hypothyroidism, goiter
