Lecture 3: Schizophrenia Flashcards
Anti-Psychotics
-Atypical -**Preferred / less side effects
- Abilify
- Zyprexa
- Resperidal
- Geodone
Anti-Psychotics
-Traditional
- Haldol
- Thorizine
- Prolixin
- Navane
Schizophrenia
-Positive Symptoms
- Hallucinations
- Delusions
- Exaggerations and distortions of normal perceptions and thinking
Schizophrenia
-Negative Symptoms
- Inexpressive facial expressions
- Monotone monosyllabic speech
- Few gestures
- Lack of interest in the world and other people
- Inability to feel pleasure
- Absence of normal emotion and social sensitivity
Mood Stabilizer
-Lithium
- When a patient is on lithium, ALWAYS get a blood lithium level
- Therapeutic range is 0.5-1.5
Anticholinergics & Traditional Anti-Psychotics
- Traditional anti-psychotics block dopamine receptors
- Anticholinergics block acetylcholine
- Dopamine causes muscle to relax, Acetylcholine causes muscles to contract
Anticholinergics
-Most Common Meds
- Cogentin (Benzatropine) Primary Med
- Benadryl (diphenhydramine)
- Artane (Trihexphyenidyl)
Anti-psychotics
-Clazaril (Clozapine)
- Monitor WBC’s before admin
- Hold if immunocompromised - Go through national registry
- Requires trial of 3 meds before pt is placed on this med
Anti-psychotics
-Clazaril (Clozapine)
Side Effects
- Severe Salivation
Anti-Psychotics
-Side Effects
- Akathisia
- Tardive Dyskinesia
- Acute Dystonia
- Neuroleptic Malignant syndrome
Anti-Psychotic Side Effects
-Akathisia
- Restless leg syndrome
- Involuntary movement of lower legs
- Manifests as urge to move the legs to stop unpleasant sensation
Anti-Psychotic Side Effects
-Tardive Dyskinesia
- Permanent neurological disorder r/t taking longterm traditional antipsychotics
- Pt will have worm-like movement of the tongue
- facial twitching, lip smacking - Non reversable
Anti-Psychotic Side Effects
-Acute Dystonia
- Sustained muscular spasms that are often painful producing twisting abnormal postures
- 1st thing you notice is muscle stiffness –tight shoulders
Treatment - IM Anticholinergic
Anti-Psychotic Side Effects
-Types of Acute Dystonia
- Occulojiro crisis – Eyes turned up in the head
2. Tordecolis - whole body contracts upwards
Anti-Psychotic Side Effects
-Neuroleptic Malignant Syndrome
- Idiosyncratic reaction to neuroleptic meds
- Pt has:
- FEVER, muscular rigidity, altered mental status, autonomic dysfunction - Cure is to stop anti-psychotic
Schizophrenia
-Catatonic
- Motionless and speechless (immobile)
- Unaware of surroundings
- Waxy flexibility and catatonic stupor
Schizophrenia
-Paranoid
- Loss of touch with reality w/ delusions that are not based in reality
- Condition can lead to suicidal and violent behavior
- SOMEONE IS AFTER ME
Schizophrenia
-Disorganized
- Marked by thoughts, behavior and speech that are inappropriate and don’t make sense
Schizophrenia
-Dx and Onset
- Lasts at least 6 months and includes at least 1 month w/ 2 or more active-phase symptoms
- Onset is at the end of high-school to the beginning of college
Schizophrenia
-Cause
- Inability to process dopamine correctly
2. # of DENDRITES which absorb neurotransmitter is a possible cause
