Module 14 Exam 3 part 2 Flashcards
what is tardive dyskinesia
involuntary movements of the mouth, lips, tongue, and jaws,associated with use of antipsychotic medication
what is schizophenia
complex, chronic mental disorder, disturbances in feeling, thinking, behavior significantly impair function to a level below normal for the individual
is a schizophrenic in touch or out of touch with realiy
out
what age is the onset for schizophrenics
15-24 in males
25 to 35 in women
what is the onset like of schizophrenia
it can be gradual or abrupt, patients remain chronically ill, where as others have periods of remission and recurrence
what are the phases of schizophrenia
prodromal, active, residual
what may prodromal symptoms appear as and for how long
signs of deterioration for as long as 1 year before the active phase
active phase symptoms are_______ those that reflect unusual, exaggerated behavior
positive
active phase symptoms are______ those that show absence of behavior that might be expected normally
negative
what can aggravate psychiatric symptoms
drugs and alcohol, rates of use are high in pts with schizophrenia
what are the objectives of tx of schizophenia
to reduce of alleviate the delusions, hallucinatons, and other symptoms and enable the pt to function in daily living
schizophrenia is associated with an excess of
dopamine
what are the common antipsychotic drugs in schizophrenia tx
phenothiazines, butrophenones,thioxanthenes
after an acute schizophrenic episode what is adjusted for the remission period
dosage
what is integrated with pharmacotherapy in schizophrenic patients
psychosocial therapy
what may psychosocial therapy of a schizophrenic include
vocational rehab, training in social skills
what should you do at a DH appt with some who who has schizophrenia
- plan for future
- simple, familiar organized routine
- review meds,
- decrease stimulation
- instruction on oral care
- mouth prop to assist with tardive dyskinesia
- look for signs of xerostomia
is dental care carried out during an acute exacerbatoin of schizophrenia
no, tx is done when pts symptoms are under control
what is dysotonia
muscle contractions
what is dysarthria
difficult speech
what is akathisia
restlesness, pacing
what is among the most common of the many psychiatric illnesses
depression
when does depression occur
at any age
What are characteristics of a major depressive disorder
-depressed mood diminished interest or pleasure significant weight loss or gain insomnia or hypersomnia psychomotor agitation or retardation fatigue or loss of energy feelings of worthlessness or guilt diminished ability to concentrate recurrent thoughts of death or suicide
what is the primary treatment of depression
antidepression medications, tx may also include lifestyle changes, correction of sleep disorders, new diet and eating patterns, exercise, counseling
what are antidepressive medications inicated for
major depressive disorder and depressive stage of bipolar disorder
what are SSRI’s
- initial therapy for depression
- prozac, paxil, zoloft, luvox
what is a serious side effect of tricyclic and heterocyclic antidepresents
xerostomia
what are things that need to be avoided with taking MAOIs
certain foods and drugs to prevent a hypertensive crisis
can some patients with lesser degrees of depression benefit from psychotherapy alone
yes
what are indications for patients to have electroconvulsive therapy in depression
- antidepressants contraindicated
- nonresponsive to pharmacotherapy
- delusions
- overwhelming sucidal preoccupation
- need for immediate response
What kinds of foods do depressed people turn to to help them cope which cause oral complications
alcohol, sweets- relate to periodontal breakdown
what are the side effects of antidepressants
xerostomia
what oral implications may happen in patients with depression
loss of taste perception can result in a diet high in cariogenic foods
what are the 4 apointment interventions in a patient with depression
assessment
approach-pos reinforcement
preventative instruction- dental biofilm control, xerostomia
implementation of a care plan
what is a bipolar disorder
major mood disorder in which episodes of of varying degrees of mania and depression occur
what are characteristics of a manic episode of bipolar disorder
- inflated selfesteem
- decreased need for sleep
- more talkative than ususal
- flight of ideas
- distractibily
- increase in goal directed activity
- exessive involvement of pleasureable activity
what is mania
characterized by excessive elation, hyperactivity, and accelerated thinking and speaking
what kind of tx is used in bipolar disorder
pharmacotherapy and psychosocial therapy
what kind of pharmacotherapy is used in tx of bipolar disorder
three pronged approach
in an acute manic phase what is done to stablize the patients mood
- sedation
- anticonvulsants
- antipsychotics
- lithium carbonate- mood stablizer
what is maintenence therapy of bipolar patients
goal is to obtain long term mood stablilzatoin and prevent the occurrence of both manic and depressive episodes
what meds are used in maintenence of bipolar disorder
lithium carbonate and anticonvulsants
what do psychosocial interventions do in a patient with bipolar disorder
- educates family
- encourages aherence to drug regimens
- recognize early warning signs of mood
- develop stress coping technique
what are the oral health implications of bipolar disorder
- oh needs unmet
- unlikely to report injury or illness
- tissues may appear abraded and lacerated from brushing
- xerostomia
- lithium may cause disgeusia, metallic taste in mouth
what should you do at an appointment with a patient with bipolar disorder
- dont rush pt
- simplify surroundings
- help pts caregiver to learn procedures
- 3-4 month maintenence
- pt instruction may be difficult due to short attention span
what are the postpartum blues
nonpsychotic depression for few days after giving birth, not uncommon, crying irritability mood shifs
what is post partum depression
moderate to severe depression may being by the 2nd to 3rd week post partum
what are symptoms of post partum depression
-excessive fatigue, insomnia, loss of appetite, loss of interest and enthusiasm
what is post partum psychosis
mood disorder and may be of a depressive or manic state
what are risk factors for postpartum psychosis
- prexisting mental illness
- stress
- conflicts about motherhood
what are early symptoms of post partum psychosis
complaints of insomnia, restlessness, tearfulness, fatigue, emotional unsteadness
what are the progressive symptoms of postpartum psychosis
confusion, irrationality, delirium, obsessive concerns about the baby
with out tx of postpartum psychosis what can happen
risk of sucicide, infanticide or both
what kind of sucicidal precautions should be taken with postpartum psychosis
dont leave baby alone with mother
what is anxiety
apprehension, tension, or dread that results from the anticipation of danger, the source of which is unknown or unrecognized.
what is a panic attack
-overwhelming sense of impending doom is the cardinal symptom of the attack, may be unexpected or situationally bound
what are symptoms of a panic attack
-shortness of breath
-diziness
-palpitatons
-trembling
sweating
choking
nausea
numbness
flushes or chills
chest pain
fear of dying, going crazy, losing control
what is a panic disorder characterized by
recurrent panck attacks that are usually unexpected
what is agoraphobia
fear of being in places or situation from which escabe might be difficult or emarassing or in which help might not be available in the event of a panic attach
what is post traumatic stress disorder
- an intiating traumatic event has occurred outside the range of unusual human expereince, a child may have this brought on by abuse
what is generalized anxiety disorder
persistent, pervasive anxiety and exessive worry but they are not associated with life threatenting fears or attacks
what is the basic theraputic approach to the treatment of anxiety disorders
- elimiante intake of caffine alcohol and other drugs of abuse
- diagnose and treat other med ical and psychiatric problems
- exercise
what is cognitive behavioral therapy
skilled behavior therapist is needed,
what is pharmacotherapy in the tx of anxiety disorders
- as few meds a possible
- tx can best be focused on pts sleep habits, physical activity, and attainment of personal control
when drug tx in anxiety is indicated what kinds of meds are used
antianxiety and antidepressants
what are antianxiety medications
benzodiazepines
what are oral implicaitons of anxiety disorders
hypersensistive of teeth associated with patients general tenderness and irritability
xerostomia from meds
oral clealniness may not be present
what can you do during appointments in patients with anxiety disorder
- help pt feel in control
- explain each step to pt, keep communication open
