Final Exam Part 3 Flashcards
MOA of 1st generation antipsychotics
Dopamine receptor antagonists (DRAs)
D2 receptor blockers
dopamine pathway responsible for positive symptoms of schizophrenia
Mesolimbic
dopamine pathway responsible for negative symptoms of schizophrenia
mesocortical
mesocortical pathway:
dorsolateral prefrontal cortex regulate ______
cognition and executive function
mesocortical pathway:
Ventromedial prefrontal cortex regulate _______
emotions and affect
neurotransmitters involved in psychosis
dopamine, serotonin, GABA
MOA of atypical antipsychotics
Block D2 receptors at lower affinity
5HT2A antagonist
serotonin and dopamine
typical antipsychotics
Haldol - Mellaril. stelazine
Prolixin - thorazine Loxitane - compazine
Treatment for Acute dystonia
Benztropine (cogenitn) - anticholinergic
Treatment for pseudoparkinsonism
Benztropine (cogentin) - anticholinergic
Treatment for akathesia (restless)
Benzodiazepine or betablocker
Treatment for tardive dyskinesia
Switch to atypical or clozapine
VMAT2 inhibitor
side effects of typical antipsychotics
S - sedation/sunlight sensitivity/sexual SE
T - Tardive dyskinesia
A - Anticholinergic effects & Agranulocytosis
N - neuroleptic syndrome
C - Cardiac arrythmias
E - Extrapyramidal symptoms
Treatment of neuroleptic malignant syndrome
early detection - increased muscle tone, autonomic dysfunction - reduced consciousness
d/c med
manage symptoms
atypical antipsychotic with less sedating side effects
aripiprazole, iloperidone, lurasidone, paliperidone, risperidone, ziprasidone
*pines more sedating than dones
atypical antipsychotic with less metabolic side effects
ziprasidone, aripiprazole, lurasidone
high risk of weight gain and sedation
clozapine, then olanzapine (Zyprexa)
2nd gen antipsychotics with potent antihistamine actions
clozapine, quetiapine, olanzapine
labs to monitor with atypical antipsychotics
CBC, LFTs, EKG
labs to monitor with clozaril
ANC, BMI, LFTs
EKG
interventions if patient becomes ill with clozaril
slowly taper. Watch for cholinergic rebound. Treat with anticholinergic if warranted.
buprenorphine/naloxone (Suboxone) patient education
Must be in mild state of withdrawal
Naloxone poorly absorbed and present only to prevent misuse.
partial mu opioid agonist
buprenorphine
used to treat alcohol withdrawal
disulfiram (Antabuse)
acamprosate (Campral)
naltrexone
Benzos used to treat alcohol withdrawal
Ativan
Signs of Wernicke’s encephalopathy
decreased mental functioning
Muscle weakness
ataxia (unsteady gait)
nystagmus
Treatment for Wericke’s encephalopathy
thiamine and food
Education on disulfiram
Do not drink alcohol or consume any products with alcohol including cough medicine
Wait at least 12 hours after last drink
MOA of amphetamine
Dopamine and norepinephrine reuptake inhibitor
VMAT inhibitor
MOA of methylphenidate
Dopamine and Norepinephrine reuptake inhibitor
Non-stimulant drugs for ADHD
Strattera and Wellbutrin
Treatment of anxiety in children
Luvox
Prozac
Zoloft
Paxil
Treatment of depression in children
Prozac
Celexa
Zoloft
lexapro - if older than 12
