Chapter 8.3

Question 1

State the primary cause of psychosis.

Answer 1

increased dopamine activity in CNS

Question 2

List other neurotransmitters that may have a role in causing psychosis.

Answer 2

serotonin, acetylcholine and glutamate

Question 3

State the specific site and action of antipsychotic drugs.

Answer 3

dopamine receptors D2 receptors

Question 4

chlorpromazine, haloperidol are traditional or atypical antipsychotic drugs?

Answer 4

traditional

Question 5

olanzapine, and quetiapine are traditional or atypical antipsychotic drugs?

Answer 5

atypical

Question 6

Traditional drugs block what receptors in the CNS?

Answer 6

D2 dopamine receptors

Question 7

Atypical drugs block what receptors in the CNS?

Answer 7

Weak D2 dopamine receptor blockage but strong serotonin receptors

Question 8

List the proposed benefits of using atypical antipsychotics.

Answer 8

Fewer and less serious side effects

Question 9

State the common adverse effects of traditional antipsychotic drugs.

Answer 9

Orthostatic hypotension, sedation, anticholinergic effects and motor effects

Question 10

State the common adverse effects of atypical antipsychotic drugs.

Answer 10

weight gain, increased LDL and glucose metabolism resembling type 2 diabetes and motor effects

Question 11

Tardive dyskinesia

Answer 11

facial movements, movements of tongues, lips, jaws and rarely involves trunk.

Question 12

Akathisia

Answer 12

can’t sit still and can’t stop moving (fidgety)

Question 13

Dystonia’s

Answer 13

jerky like movements of extremities and head

Question 14

List the risk factors for developing tardive dyskinesia.

Answer 14

Mood disorders like depression. DM is diabetes, age, genetics and alcohol abuse

Question 15

State the best treatment for tardive dyskinesia.

Answer 15

Early recognition and change of drugs

Question 16

State a way that a physical therapist might be able to distinguish whether a patients symptoms are true Parkinsonism or pseudo-parkinsonism from antipsychotic use.

Answer 16

all about timing. If the symptoms occur in about 30-60 minutes after the drug, it maybe pseudo-PD. But if they are random, then it is true PD

Question 17

List the symptoms of neuroleptic malignant syndrome.

Answer 17

rigidity, tremors and fever

Question 18

State the major concerns for the physical therapist treating a patient using antipsychotic drug therapy.

Answer 18

Sedation, be alert for orthostatic hypotension (dizziness) and recognize the extrapyramidal side effects. The PT is in the best position to detect these side effects.

Question 19

Name one irreversible dementia.

Answer 19

Alzheimers

Question 20

List the goals of therapy in a patient with dementia.

Answer 20

improve cognitive and intellectual function and improve behavior

Question 21

State the neurotransmitter defect that is primarily responsible for impaired cognitive function in a patient with dementia.

Answer 21

acetylcholine

Question 22

State the mechanism of action for the following drugs: donepezil, tacrine, memantine.

Answer 22

all of them: to inhibit the acetylcholinesterase but the side effects are different

Question 23

State three categories of medications (beyond those intended to improve cognition) that may be used to modify behavior in patients with dementia.

Answer 23

anti depressants, anxiety and psychotic drugs

Question 24

anticholinergic activity

Answer 24

blurred vision, dry mouth, constipation, and urinary retention