Management of Psychiatric Patient Flashcards
What type of drugs are noted to reduce delusions , hallucinations and to have a sedating/calming effect
Antipsychotics
What are the two types of Antipsychotics
Typical, Atypical
List the Typical Antipsychotics
Phenothiazines eg: Chlorpromazine Butyrophenones eg: haloperidol Thioxanthines eg: clopixol Diphenylbutylpiperidines eg: pimozide Substituted benzamides eg: Amilsulpride
List the Atypical Antipsychotics
Clozapine(Clozaril) Olanzapine (Zyprexa) Quetiapine (Seroquel) Risperidone (Risperdol) Zisprasidone (Geodon) Aripripazole (Abilify)
What do Typical Antipsychotics block
serotonin, dopamine, adrenergic, histaminergic and cholinergic receptors
What do Atypical Antipsychotics block
serotonin receptors
Some atypicals block dopamine receptors in the limbic system only
What are some side effects of Antipschotics
acute dystonias –( torticollis, increases muscle tone /spasm
Parkinsonism – shuffling gait, dificulty initiating mvt, masked facies
Akathesia – a subjective feeling of restlessness
Tremors – trembling at rest or during activity
Tardive dyskinesia – abnormal mvts of face/mouth / chorea form mvts of body / limbs – may be irreversible in 50% of pts
How can EPS side effects be minimised
use of anticholinergic agents
What are the drugs used in Antidepressants
Tricyclics eg: amitryptiline, imipramine
Monoamine oxidase inhibitors (MAOI)
New reversible MAOI eg: moclobemide
Selective serotonin reuptake inhibitorseg: fluoxetine , paroxetine
Selective serotonin and noradrenalin reuptake inhibitors (SNRI) eg: venlafaxine , duloxetine
Noradrenaline selective reuptake inhibitor (NaSSA ) eg: reboxetine
Atypical antidepressants eg: trazadone,nefazadone
St johns wort (hypericum)
What is the mechanism of action for Antidepressants
Most block the reuptake of serotonin and norepinephrine into the presynaptic neuron
SSRI block reuptake of serotonin only
MAOI prevent breakdown of serotonin at the synapse
What is the Mode of Administration for Anti depressants and how long does it take to work
Orally
2 weeks
What are the side effects for Antidepressants
Nausea Weight gain /loss Insomnia Sexual side effects / delayed ejaculation Cardiac arrythmias Increase in suicidal thoughts (bbw24) hypertension Headache Agitation Withdrawal symptoms if not tapered down before cessation
What drug is used mainly for Bipolar disorder and agression
Mood Stabilizers
What is an example of a mood stabilizer
Lithium, anticonvulsants
What are some examples of Anticonvulsants
Sodium valproate (epilim)
Gabapentine (topamax)
Carbamazepine (tegretol)
What is the mode of administration for Lithium and Anticonvulsants
Orally
Why must Mood Stabilizer drugs be monitered
the therapeutic level and the toxic level are very close
What is the mechanism of action for Lithium and Anticonvulsants
the sodium and potassium and GABA inhibitory systems
What are the side effects of Mood Stabilizers
Nausea Fine tremor Weight gain Polydipsia/ polyurea Thyroid abnormalities Blood dyscrasias /rash
What type of drugs are used to treat anxiety, insomnia, muscle relaxation, anticonvulsant activity, treatment of phobias
Minor Tranquilizers
What drug is associated with Minor Tranquilizers
Benzodiazepine
eg: Alprazolam
True or False, Minor Tranquilizers are highly addictive with severe withdrawal states
True
What is the Mode of Administration for Minor Tranquilizers
Mainly Oral
Can be given intravenously
Intrmuscularly
Rectally
What is the Mechanism of action for Minor Tranquilizers
Potentiation of the inhibitory effects of gamma aminobutyric acid (GABA)
What are the Side Effects for Minor Tranquilzers
Drowsiness/sedation
Ataxia/respiratory depression
Aggression
Withdrawal symptoms
What is used in serious situations of Severe Depression, Severe Maina, High Risk of Suicide, Refractory illnesses,
Pts not eating or drinking, Severe mental illness in pregnancy
Electroconvulsive therapy
