Mental Health Drugs Flashcards
is schizophrenia curable?
what is the thought for how it happens
no
excessive activation of CNS receptors for Dopamine
T/F pts with schizophrenia are treated with CNS stimulants
false
first generation anti-psychotic ADR: CHOOSE
anticholinergic effects, teeth grinding, hyperglycemia, compulsive restless movement, dysrhythmias, dizziness light headeness
anticholinergic effects, compulsive restless movement, dysrhythmias, dizziness lightheadeness
pt has dementia and is extremely agitated. can we use antipsychotics in this patient?
no , there is an increase in mortality when antipsychotics are used in dementia related psychosis – CV death, pneumonia
Haloperidol
is a first generation antipsychotic, which decreases and suppresses symptoms during acute episodes
ADRs: toursades de pointes, agranulocytosis, seizures, neuroleptic malignant syndrome
extrapyramidal effects? YES, tardive dyskinesia rigid/cogwheel movements
alternate use? substance withdrawal , tourettes ,
Quetiapine (seroquel)
is an atypical antipsychotic
ADRs: exanthematous pustulosis, DRESS, steven johnson syndrome, GI obstruction, pancreatitis, agranulocytosis, neuroleptic malignant syndrome, seizures , weight gain , dyslipidemia , prolonged QT
extrapyramidal effects ? Not really
alternate use? sleep , agitation
how best to describe a second gen antipsychotic?
strong blockade of serotonin, carry a lower risk for EPS, pt likely to gain weight, pt likely to have an increase in cholesterols
what will the nurse include in the teaching for Quetiapine (Seroquel) –
avoid getting out of bed quickly and drinking alcoholic beverages
how long does it take for antidepressant medications to work?
6-8 weeks
which of the following will pose the greatest risk for suicide with the new med for mental health disorder
antidepressants
which of the following meds might place the pt at risk for serotonin syndrome
Selective Serotonin Reuptake inhibitors
pt has been taking Fluoxetine (Prozac) for 2 years and reports feeling great. what will the nurse tell this patient?
good news we will gradually decrease your dose
a pt will switch from a SSRI to the MAOI. what precautions will need to be taken why
stop the SSRI at least two weeks before starting MAOI
why: you could cause a hypertensive crisis
pt on SSRI for depression compl;ains of waking up with jaw pain and headaches . what will the nurse recommend
continue the ssri, this is bruxism and schedule a dental appt for the recommended mouth gaurd
pt is taking SSRI Paroxwtine. they complain that the headaches, weight gain and sexual dysfunction are too much to handle. what is another drug they could use
Bupropion (Wellbutrin)
Match to ADRs:
TCA, SSRI, MAO-I. with Serotonin Syndrome, Hypertensive Crisis with dietary tyramine, dry mouth ,urinary retention , blurred vision
TCA has anti cholinergic,
ssri has serotonin syndrome
MAO-I is hypertensive crisis with dietary tyramine
when do we use Lithium?
NSAIDs can _____ lithium levels
Lithium induces polyuria or oliguria
antihistamines have anticholinergic effects T/F
bipolar disorder
increase (so they should not be used and use tylenol instead)
polyuria , they should drink extra fluids
True, they have anticholinergic effects
blocking adrenergic receptors will cause
hypotension, dizziness, drowsiness
blocking muscarinic receptors will cause
constipation, blurred vision, dry mouth
blocking histamine type 1 receptors will cause
drowsiness, sedation
blocking dopamine 2 receptors will cause
extrapyramidal symptoms such as tardive dyskinesia
acute dystonia onset, features, and management
- onset in a few hours to five days
- features are spasm of muscles of tongue, face, neck and back, as well as opisthotonus, LARYNGEAL SPASMS
- management with anticholinergic drugs IM or IV
Parkinsonism onset, features, and management
- onset is 5-30 days
- features are bradykinesia, mask-like facies, tremor, rigidity, cogwheeling, shuffleling gait, drooling, stooped posture
- management with anticholinergic drugs and amantadine
Akathisisa onset, features, and management
- onset is 5-60 days
- features compulsive, restless movement, anxiety, agitation
- managed with a reduced dosage or switching the antipsychotic , treat with benzodiazepine, a beta blocker, or anticholinergic drug
tardive dyskinesia onset, features, and management
- late onset, months to years
- features oral facial dyskinesias, choreoathetoid movements (work like movements of the tongue)
- best approach is prevention b/c there is no treatment, discontinue drugs
