antipsychotics side effeects Flashcards
acute dystonia
sustained muscle contraction (e.g. torticollis, oculogyric crisis)
neck jerking etc
managed how
procyclidine
Procyclidine acts by blocking central cholinergic receptors, and thus balancing cholinergic and dopaminergic activity in the basal ganglia.
akathisia (severe restlessness) managed how
switch to different med
tardive dyskinesia (late onset of choreoathetoid movements, abnormal, involuntary, may occur in 40% of patients, may be irreversible, most common is chewing and pouting of jaw)
managed how
Tetrabenazine
acts within the basal ganglia and promotes depletion of monoamine neurotransmitters serotonin, norepinephrine, and dopamine from stores. It also decreases uptake into synaptic vesicles.
Parkinsonism. This side effect of antipsychotic medication, such as chlorpromazine, is characterised by the presence of a resting tremor, bradykinesia (slowness of movement), rigidity and postural instability. These symptoms are due to the dopamine-blocking effects of these medications in the basal ganglia, which results in an imbalance between dopamine and acetylcholine activity.
managed how
change medication to atypical antipysochotic
what is Tapentadol and moa
dual mode of action as an agonist of the μ-opioid receptor and as a norepinephrine reuptake inhibitor. Analgesia occurs within 32 minutes of oral administration, and lasts for 4–6 hours
when is lidocanine used
tender point pain - works like a treat but no evidence
when does hepatic encephalopathy occur
Hepatic encephalopathy, also called portosystemic encephalopathy, happens when your liver isn’t filtering toxins as it should
can occur in liver cancer anything that cause failure which coudl worsen peoples confusion
Taking medications or supplements (like antibiotics, antiseizure medications or vitamin B1).
Managing any underlying health conditions.
Life support measures, including placement of a breathing tube and ventilator (breathing support).
Surgery or organ transplant.
Long-term atypical antipsychotics can lead to the development of
glucose dysregulation and diabetes - need to do fasting glucose levels
diabetes seen in what class of drugs
atypcial antipsychptics
Which class of drug have the Medicines and Healthcare products Regulatory Agency warned may be associated with an increased risk of venous thromboembolism in elderly patients?
Atypical antipsychotics
increase risk of stroke and VTE
other side effects of antip
antimuscarinic: dry mouth, blurred vision, urinary retention, constipation
sedation, weight gain
raised prolactin
may result in galactorrhoea
due to inhibition of the dopaminergic tuberoinfundibular pathway
impaired glucose tolerance
neuroleptic malignant syndrome: pyrexia, muscle stiffness
reduced seizure threshold (greater with atypicals)
prolonged QT interval (particularly haloperidol)
SSRIs and MAOIs should never be combined as there is a risk of
serotonin syndrome
difference between knights move and flight of ideas
Differentiating between Knight’s move and flight of ideas - Knight’s move thinking there are illogical leaps from one idea to another, flight of ideas there are discernible links between ideas
For more severe OCD, or if unresponsive to CBT/exposure and response prevention then add an
SSRI
severe functional imapiremnt OCD
refer to secodnary care
