MEDICATIONS

Question 1

name some atypical antipsychotics and explain how they work.

Answer 1

olanzapine, clozapine, risperidone
they are commonly used to treat schizophrenia, psychosis and bi polar.

they redily bind with D3 and D4 dopamine receptors and loosly bind to D2 receptors (fast off theory). blocks dopamine from binding to receptor sites. produces therapeutic effects but not EPS! effectively reduce the positive symptoms such as delusions and hallucinations.

SIDE EFFECTS: weight gain, sexual dysfunction, temp dysregulation, metabolic syndrome

NURSING CONSIDERATIONS: monitor weight, vitals monthly, (for olanzapine- 2 hour post injection monitoring period), renal or liver inpairment.

Question 2

what do SSRIS do and name some

Answer 2

fluoxetine, citalopram, sertraline
used to treat depression

Selective serotonin reuptake inhibitors (SSRI’S) blocks the reuptake of serotonin so therefore there is more serotonin in the synapse to be recieved by the receptors. therefore this improves/regulates mood.

SIDE EFFECTS: GI upset (nausea, vomiting, diarrhoea, changes in appetite, weight gain or loss, sexual dysfunction,

NURSING CONSIDERATIONS: use of other serotonin drugs (serotonin syndrome), pregnancy/child bearing age

Question 3

anti-anxiety meds and how do they work?

Answer 3

lorazepam,
commonly used to treat anxiety and insomnia

CNS depressant, acts on GABA A receptor, this results in increased GABA action, opens ion channels and allows -vely charged chloride ions to enter neuron —> therefore neuron is less likely to fire an action potential

SIDE EFFECTS: sedation, drowziness, disorientation, sexual dysfunction

NURSING CONSIDERATIONS: should be used short term, shouldnt be used to treat depression (anxiety w/ depression=risk of suicide), how much does the pt drink? what other drugs/meds do they take/use? pragnancy? liver/renal impairment?

Question 4

mode stabilisers?

Answer 4

SODIUM VALPROATE: enhances GABA,

LITHIUM:

Question 5

What should be included in pts recovery plan?

Answer 5

WELLBEING PLAN:
things that keep her well (support people, physical activity, medication, sleep, eating)
things that may trigger her
early warning signs of relapse
what to do when pt/others notice early warning signs
current meds/med contingency plan

Question 6

what should a recovery focused environment focus on?

Answer 6

1. HOPE
2. PERSON CENTRED CARE
3. STRENGTHS-BASED

Question 7

Nursing interventions for pts in manic state?

Answer 7

low stimulus environment
give firm simple directions
speak in calm, supportive tone
reinforce reality and redirect conversation

Question 8

what is the therapeutic range of lithium? what are some signs of lithium toxicity?

Answer 8

0.7-1.2mmol/l = therapeutic range

ABOVE 1.5mmol/l there is RISK OF TOXICITY

blurred vision, GI disturbances, muscle weakness, convulsions, lack of coordination, confusion