Chapter 8.3 Flashcards
State the primary cause of psychosis.
increased dopamine activity in CNS
List other neurotransmitters that may have a role in causing psychosis.
serotonin, acetylcholine and glutamate
State the specific site and action of antipsychotic drugs.
dopamine receptors D2 receptors
chlorpromazine, haloperidol are traditional or atypical antipsychotic drugs?
traditional
olanzapine, and quetiapine are traditional or atypical antipsychotic drugs?
atypical
Traditional drugs block what receptors in the CNS?
D2 dopamine receptors
Atypical drugs block what receptors in the CNS?
Weak D2 dopamine receptor blockage but strong serotonin receptors
List the proposed benefits of using atypical antipsychotics.
Fewer and less serious side effects
State the common adverse effects of traditional antipsychotic drugs.
Orthostatic hypotension, sedation, anticholinergic effects and motor effects
State the common adverse effects of atypical antipsychotic drugs.
weight gain, increased LDL and glucose metabolism resembling type 2 diabetes and motor effects
Tardive dyskinesia
facial movements, movements of tongues, lips, jaws and rarely involves trunk.
Akathisia
can’t sit still and can’t stop moving (fidgety)
Dystonia’s
jerky like movements of extremities and head
List the risk factors for developing tardive dyskinesia.
Mood disorders like depression. DM is diabetes, age, genetics and alcohol abuse
State the best treatment for tardive dyskinesia.
Early recognition and change of drugs
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.
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
List the symptoms of neuroleptic malignant syndrome.
rigidity, tremors and fever
State the major concerns for the physical therapist treating a patient using antipsychotic drug therapy.
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.
Name one irreversible dementia.
Alzheimers
List the goals of therapy in a patient with dementia.
improve cognitive and intellectual function and improve behavior
State the neurotransmitter defect that is primarily responsible for impaired cognitive function in a patient with dementia.
acetylcholine
State the mechanism of action for the following drugs: donepezil, tacrine, memantine.
all of them: to inhibit the acetylcholinesterase but the side effects are different
State three categories of medications (beyond those intended to improve cognition) that may be used to modify behavior in patients with dementia.
anti depressants, anxiety and psychotic drugs
anticholinergic activity
blurred vision, dry mouth, constipation, and urinary retention
