antipsychotics ppt Flashcards
(34 cards)
pscyhosis is characterized by
Disordered and often bizarre thinking
Blunted or inappropriate emotional responses
Bizarre behavior, social withdrawal
Deterioration from previous levels of occupational and social functioning
Hallucinations, paranoid delusions
Psychosis is an acute or chronic severe mental disorder.
t or f
true
what conditions do hallucinations occur in
are hallucinations pos or neg symptoms
Delirium Dementias Schizophrenia Other psychotic states -some hallucinations are typical of seizure disorder (eg they think theres someone grabbing their shoulder. Also smelling burnt toast)
positive
what are delusions
False beliefs that persist in the absence of reason or evidence
Indicate severe mental illness
Commonly associated with schizophrenia
Also occur with delirium, dementias, other psychotic disorders
t or f
men are more affected by schizophrenia
which gender does it appear in first
ales and females equally affected
Manifests earlier in males
to get a Dx of schizophrenia you must have symptoms for at least __ months
do symptoms appear gradually or suddenly or both
what are the two broad categories of symptoms
6months
Symptoms may appear gradually or suddenly
Symptoms manifest as ****positive or negative
what are positive sympoms of schizo
CNS stimulation
Agitation, behavioral disturbances
Delusions, disorganized speech
Hallucinations, insomnia, paranoia
what are neg symptoms of schizo
Lack of pleasure, motivation Blunted affect Poor grooming and hygiene Poor social skills Poverty of speech Social withdrawal
medical causes of psychosis -endocrine -autoimmune autoimmune infections neuro -other
(she said we dont need to memorize)
Endocrine: thyroid, steroid producing tumors, insulinomas, pheochromocytoma
Metabolic: acute intermittent porphyria
Autoimmune: Systemic lupus erythematosus, Hashimoto encephalopathy
Infections: cerebral malaria, toxoplasmosis, neurocysticercosis, sleeping sickness, neurosyphilis
Neurological: Narcolepsy, Seizures: temporal lobe epilepsy (video), Brain tumors, Strokes, head injury, demyelinating disease, nutritional
-substances
what are typical antipsychotics names
phenothiazines
- thioxananthenes
- holoperidol
- loxapine
- pimozide
phenothiazines
- thioxananthenes
- holoperidol
- loxapine
- pimozide
which of these holds risk of tardive dyskinesia with long term use
which are only slightly sedative but has
****phenothiazines can lead to tardive dyskinesia with long term use…also pimozide has a risk of tardive dyskinesia
thioxanthenes and haloperidol lightly sedative but high EPS
if a pt is having EPS or tardive dyskinesia what could you use to assess them
the abnormal involuntary movement scale
what are the ebenefits of atypical antipsych AAP compared to typical
Greater effectiveness treating negative symptoms
Fewer movement disorders
names of AAPs
-clozapine
olanzapine
risperidone
quetiapine
clozapine
is it used much these days?
what is the major risk
why is it used
isnt used as much
-is second line therapy d/t monitoring requirements and assoc w **agranulocytosis and ***inc risk of myocarditis especially in first month
it has these risks but it works great and is effective when other things arent
which AAP have a risk of agranulocytosis and which of these is more likely to cause EPS
clozapine and olanzapine both have this risk but olanzapine has less risk of EPS
which AAP med is invega sustenna and what is its active metabolite? this med is an offshoot of which AAP
**invega sustenna is a form of risperidone and its active metabolite is **paliperidone
which of the following drugs comes in a wafer form that is best offered to the pt from the package (dont touch it) clozapine olanzapine risperidone quetiapine
olanzapine
t or f
AAPs can lead to hypoglycemia
***f they can lead to hyperglycemia
MOA of antipsychotics
-which NTM are they working on
Most antipsychotic medications block the action of dopamine
Chronic drug administration results in up-regulation of dopamine receptors
Overall, medications “re-regulate” the abnormal neurotransmission systems associated with psychosis
indications for antipsychotics
which condition are they commonly given for but shouldnt be
Major clinical indication is schizophrenia
Other indications
Psychotic symptoms associated with head trauma
Tumor, stroke
Alcohol withdrawal
CNS stimulant overdose, other disorders
Generally not to be used for dementia
is this T or f
Antipsychotic medications are given only for psychiatric illness.
if f which conditions
Antipsychotic medications are indicated in psychiatric illness and for nausea, vomiting, intractable hiccups, sedation, etc.
if pt has the following conitions is it ok to give antipsychotics
Seizure disorders Diabetes mellitus Glaucoma Prostatic hypertrophy Peptic ulcer disease Chronic respiratory disorders
yes but use caution
contraindications for use of anitpsychotics
Liver damage Coronary artery disease Cerebrovascular disease Parkinsonism, bone marrow depression Severe hypotension, coma Hypertension, severely depressed states
