Chapter 13 Flashcards
akathisia
continuous body movement in which an individual is restless or constantly paces about
antianxiety drug
drug used to treat anxiety these drugs are also referred to as anxiolytics
anxiety
a state of anxiousness and hyperemotionalism that occurs with uncertainty, stress and fearful situations
increased by high levels of serotonin
prolonged anxiety causes behavioral and emotional changes
dystonic reaction
reaction characterized by muscle spasms, twitching, facial grimacing, or toticollis
extrapyramidal syndrome (EPS)
movement disorders such as akathisia,dystonia,and parkinsonism caused by anti psychotic drug therapy
neuroleptic malignant syndrom (NMS)
toxic syndrome associated with the use of anti psychotic durgs
parkinsonis
disease or drug induced condition characterized by muscular rigidity, tremors, and disturbances of movement
psychosis
form of mental illness that produces bizarre behavior and deterioration of the personality
schizophrenia
major form of psychosis; behavior is inappropriate
tardive dyskinesia
drug induced involuntary movements of the lips, jaw, tongue, and extremities
antipsychotics
used to treat psychotic behavior
most produce varying degrees of anticholinergic, alpha adrenergic blocking, and antihistaminic effects
what are the “typical” anti psychotic drugs
primarily block D2 receptors. they also produce a higher incidence of EPS because they block dopamine
ex-phenothiazine/ butyrophenone/ thixanthine
what is an “atypical” anti psychotic drug
block 5HT2A receptor
reduce serotonin activity more than they reduce the activity of dopamine, and for that reason they cause a significantly lower incidence of EPS (still may cause EPS tardive dyskinesia, and neuroleptic maligant syndrom)
associated with metabolic disturbances-
weight gain
elevated trigylcerieds
development of diabetes melitius
ex- aripiprazole
clozapine
risperidone
olanzapine
phenothiazines (typical anti psychotic)
refers to the basic chemical structure of a large number of drugs similar in structure and pharmacological action.
block D2 receptors to a greater degree than 5HT2A
posses anti pyschotic,anti cholinergic, antihistaminic,alpha adrenergic blocking and antiemetic effects
reduce symptoms of psychosis without depressing intellectual functions
reduce nausea and vommiting
usually takes several weeks to develop
administered orally
ex-chlorpromazine
fluphenazine
trifluoperazine
Adverse effects of Phenothiazine
dry mouth, consstipation, visual disturbances and seddation
-reduce blood pressure and postural hypotension
-affect the bascal ganglia and cause movement disorder-EPS dystonic reactions akathisa parkinsonism tardive dyskineasia neuroleptic malignant syndrome
drug allergies that can cause skin rashes, photo sensitivity, blood disorders, and liver toxicity
skin pigmentation, ocular deposits, and endocrine disturbances
Butyrophenones (typical anti psychotic)
highly potent
differ chemically from phenothiazines but produce similar effects
block D2 receptors more than 5HT2A receptors
more potent than phenothiazines on mg basis
lower incidnece of peripheral effects, but great movement disturbances
ex-haloperidol
When are Butyrophenones used?
a patient who is highly agitated and manic / suppress morot tics and vocalizations that characterize Gilles de la Tourettes syndrome
What are the adverse effects of Butyrophenones
extrapyramidal symptoms (EPS)
tardive dyskinesia
neuroleptic malignant syndrom
Thioxanthenes (Typical Anti Psychotic)
posses chemical structures similar to phenothiazines
block D2 receptors more than 5HT2A receptors
higher potency drug that causes higher incidences of (EPS)
causes less sedation
fewer antichollinergic and alpha-blocking effects than chlorpromazine
ex- thiothixene
Adverse Effects of Thioxanthenes
drowsiness and postural hypotension
drug allergy
extrapyramidal disturbances of movement
What pregnancy category do the Atypical Anti Psychotics fall under?
Pregnancy Category B and C
When Atypical Anti Psychotics are paired with anticholinergic drugs what happens?
decrease activity in the urinary and intestinal tracts
increase cardiac activity
When Atypical Anti Psychotics are paired with Alpha- blocking drugs what happens?
cause CNS depression and mental disturbances
hypotension and orthostatic hypotention
fainting
When Atypical Anti Psychotics are paired with Sedation causing drugs what happens?
excessive CNS depression
What are Atypical Drugs preferred to treat?
schizophrenia and psychosis
What are Atypical Drugs preferred to treat?
schizophrenia and psychosis
advantages include lower incidences of EPS, sedation, and other neurological disturbances
anxiolytics
drugs used to treat anxiety
ex- benzodiazepines
buspirone
limbic system
neural pathway connecting different brain areas involved in regulation of behavior and emotion
Adverse Effects of benzos
drowsiness, confusion, atazia, minor GI disturbances and rashes
menstrual irregularities, changes in libido, agranulocytiosis, and changes in liver function
higher doses affect memory
long-term usage abuse and abrupt termination can cause dependency
must be avoided during pregnancy
What is the drug interaction between benzodiazepines and alcohol?
coma and permanent brain damage
What is the drug interaction between benzodiazepines and cimetidine?
prolongs the effects of benzodiazepines
What is the Drug Dependency correlation with Benzos
increased anxiety
tremors
hyperactivity
nervousness
what do you give someone with an overdose of benzodiazepines
flumazenil- benzo receptor antagonist
reverses depressant and sedation effects
reciprocates a withdrawal reaction
Buspirone (Buspar)
does not cause sedative, hypnotic, anti convulsant, or skeletal muscle relaxant actions (low potential for drug tolerance or dependency)
acts on serotonin receptors
anxiety is increased by high levels of serotonin
Adverse effects of Buspirone
dizziness, lightheadedness, rash and tiredness
What is Buspirone’s Pregnancy Category?
B
What is the preferred therapy for anxiety disorders (GAD)?
benzodiazepines and BURPIRONE
What is the preffered theapy for OCD & PTSD
selective serotonin reuptake inhibitors (SSRI)/ anti depressants)
