Chapters 22, and 23 Flashcards
anxiolytics are classified as
anti anxiety or sedative hypnotics
this atypical antipsychotic is useful in treating negative symptoms and interferes with binding of dopamine to dopamine 2 and serotonin receptors
aripiprazole (Abilify)
Why are atypical antipsychotics prescribed more frequently?
less risk of EPS symptoms
Which receptors do antipsychotics block
dopaminergic
if antipsychotics block dopamine, what effects can you anticipate?
EPS like symptoms
how does dystonia present
muscle spasms of face, tongue, neck, and back, facial grimacing, abnormal or involuntary upward eye movement, laryngeal spasms
how does akathisia present
trouble standing still, restless, pacing floor in constant motion
what is tardive dyskinesia
chewing motion, protrusion/rolling of tongue, smacking lip movements, involuntary movements of upper extremities
what is neuroleptic malignant syndrome?
potentially fatal condition associated with use of antipsychotics presents as: high fever, altered mental status, tachycardia, blood pressure fluctuation
this drug causes more EPs symptoms than other phenothiazines and can cause urinary retention and dry mouth
fluphenazine (Prolixin)
this butyrophenone alters the effects of dopamine on the CNS and is used commonly in management of psychoses, Tourette’s and dementia in older adults
haloperidol (Haldol)
what must you observe for with the use of Haldol
EPS and NMS
what is the reversal agent for benzodiazepines
flumazenil (Romazicon)
what is the most commonly prescribed class of antidepressants
TCAs - tricyclic antidepressants
when is the best time to take an antidepressant
at night - to reduce sedative effects
what is a very important teaching point with MAO-Is
dietary restrictions: no foods containing tyramine including: cheese, creams, yogurt, chocolate, coffee, bananas, raisins, green beans, liver, pickled foods, sausage, soy, yeast, beer, and red wine
what is an important teaching point if your patient is on a MAO-I and will be starting a tricyclic antidepressant
must stop MAO-I for 14 days
what are your therapeutic levels for lithium
therapeutic: 0.8-1.2 mEq/L toxicity presents >1.5
if your patient is on lithium, do we want to promote fluid or restrict fluid
promote - prevents dehydration and elevating lithium levels
what are the positive symptoms of schizophrenia
exaggeration of normal function, incoherent speech, hallucinations, delusions, paranoia
what are the negative symptoms of schizophrenia
decrease or loss of function or motivation, poor self-care, social withdrawal with more persistent and chronic symptoms
which antipsychotics are more helpful in managing positive symptoms
traditional or typical antipsychotics
what can happen if you abruptly stop taking benzodiazepines, and how might your patient present
withdrawal
short-term: agitation, nervousness, insomnia, tremors, anorexia, muscle cramps, sweating
long-term: paranoia, delirium, panic, hypertension
what is pseudparkinsonism
- resembles parkinson’s disease
- side effect of typical antipsychotics
- symptoms: rigidity, bradykinesia, shuffling gait, mask-like face, tremors at rest, stooped posture, pill-rolling motion of the hand
