Mental Health Drugs

Question 1

is schizophrenia curable?
what is the thought for how it happens

Answer 1

no
excessive activation of CNS receptors for Dopamine

Question 2

T/F pts with schizophrenia are treated with CNS stimulants

Answer 2

false

Question 3

first generation anti-psychotic ADR: CHOOSE
anticholinergic effects, teeth grinding, hyperglycemia, compulsive restless movement, dysrhythmias, dizziness light headeness

Answer 3

anticholinergic effects, compulsive restless movement, dysrhythmias, dizziness lightheadeness

Question 4

pt has dementia and is extremely agitated. can we use antipsychotics in this patient?

Answer 4

no , there is an increase in mortality when antipsychotics are used in dementia related psychosis – CV death, pneumonia

Question 5

Haloperidol

Answer 5

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 ,

Question 6

Quetiapine (seroquel)

Answer 6

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

Question 7

how best to describe a second gen antipsychotic?

Answer 7

strong blockade of serotonin, carry a lower risk for EPS, pt likely to gain weight, pt likely to have an increase in cholesterols

Question 8

what will the nurse include in the teaching for Quetiapine (Seroquel) –

Answer 8

avoid getting out of bed quickly and drinking alcoholic beverages

Question 9

how long does it take for antidepressant medications to work?

Answer 9

6-8 weeks

Question 10

which of the following will pose the greatest risk for suicide with the new med for mental health disorder

Answer 10

antidepressants

Question 11

which of the following meds might place the pt at risk for serotonin syndrome

Answer 11

Selective Serotonin Reuptake inhibitors

Question 12

pt has been taking Fluoxetine (Prozac) for 2 years and reports feeling great. what will the nurse tell this patient?

Answer 12

good news we will gradually decrease your dose

Question 13

a pt will switch from a SSRI to the MAOI. what precautions will need to be taken why

Answer 13

stop the SSRI at least two weeks before starting MAOI
why: you could cause a hypertensive crisis

Question 14

pt on SSRI for depression compl;ains of waking up with jaw pain and headaches . what will the nurse recommend

Answer 14

continue the ssri, this is bruxism and schedule a dental appt for the recommended mouth gaurd

Question 15

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

Answer 15

Bupropion (Wellbutrin)

Question 16

Match to ADRs:
TCA, SSRI, MAO-I. with Serotonin Syndrome, Hypertensive Crisis with dietary tyramine, dry mouth ,urinary retention , blurred vision

Answer 16

TCA has anti cholinergic,
ssri has serotonin syndrome
MAO-I is hypertensive crisis with dietary tyramine

Question 17

when do we use Lithium?
NSAIDs can _____ lithium levels
Lithium induces polyuria or oliguria
antihistamines have anticholinergic effects T/F

Answer 17

bipolar disorder
increase (so they should not be used and use tylenol instead)
polyuria , they should drink extra fluids
True, they have anticholinergic effects

Question 18

blocking adrenergic receptors will cause

Answer 18

hypotension, dizziness, drowsiness

Question 19

blocking muscarinic receptors will cause

Answer 19

constipation, blurred vision, dry mouth

Question 20

blocking histamine type 1 receptors will cause

Answer 20

drowsiness, sedation

Question 21

blocking dopamine 2 receptors will cause

Answer 21

extrapyramidal symptoms such as tardive dyskinesia

Question 22

acute dystonia onset, features, and management

Answer 22

• 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

Question 23

Parkinsonism onset, features, and management

Answer 23

• 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

Question 24

Akathisisa onset, features, and management

Answer 24

• 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

Question 25

tardive dyskinesia onset, features, and management

Answer 25

• 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