psychopharmacology

Question 1

metabolic syndrome and what type of medications does this apply to

Answer 1

Cluster of conditions that increase risk for diabetes, stroke and heart disease. This includes increased waist circumference, high BSL, high triglycerides and increased BP

ATYPICAL MEDICATIONS. clozpaine, olanzapine

Question 2

Serotonin Syndrome - and what type of psychotic medicatoin causes this

Answer 2

Group of symptoms that can occur following use of serotonergic medications including high body temperature, agitation, increased reflexes, tremor, sweating, dilated pupils, and diarrhoea.

SSRI’s fluxotine, citalopram

Question 3

neuroleptic malignant syndrome

Answer 3

Rare, life threatening condition as a result of some antipsychotic medications (or combination of medications) including fever, muscle rigidity, altered MSE and autonomic dysfunction

Question 4

1. What are the legal and ethical issues that a nurse needs to consider when administering psychotropic medications?

Answer 4

• This can be done when a patient is involuntary
• Can be done often via IMI or oral medications- least restrictive practice, site, trauma history etc
• Consent
• Education re lifestyle effects and side effects
• Rights of medication administration

Question 5

2. What are some of the factors that contribute to non-adherence with psychotropic medication? What are some strategies that nurses can use to address these factors?

Answer 5

• Stigma and discrimination
• Side effects
• Getting better (then discontinuing use)
• Cost and pharmacy access
• Fear of addiction

Question 6

4. What are depot antipsychotic drugs? When might these be used?

Answer 6

IMI often administered 2/52. Used when orally non adherent.

Question 7

5. What considerations need to be made related to psychotropic drug use with:

• Pregnant and lactating women

Answer 7

• Haemodilution
• Foetal addition
• Foetal development
• Medication transference through breast milk

Question 8

5. What considerations need to be made related to psychotropic drug use with:

• Children and adolescents

Answer 8

• Dosaging (lower doses due to drug naivety and lowered body weight)
• Contraindications with other medications

Question 9

5. What considerations need to be made related to psychotropic drug use with:
   • Older people

Answer 9

Metabolising may be altered due to liver and kidney function potentially decreasing with age
Falls risk
Frailty 
Dementia and/ or delirium
Polypharmacy and drug interactions

Question 10

atypical antipsychotics / examples, side effects and nursing considerations

Answer 10

Clozapine
Risperidone
Olanzapine

	drowsiness
postural hypotension
weight gain
dry mouth
gastrointestinal upset

May lead to metoblic syndrome. Do not stop suddenly. Clozapine- agranulocytosis, monitor for flu like symptoms. Weekly blood tests for first 18 weeks then monthly.

Question 11

Typical antipsychotics / examples, side effects and nursing considerations

Answer 11

chlorpromazine
haloperidol	
Weight gain
Dry mouth
Muscle cramping
Sedation

EPS Tardive dyskinesia NMS Do not stop suddenly

Question 12

Mood stabilising / / examples, side effects and nursing considerations

Answer 12

Lithium

Lithium carbonate

Tremor
Increased thirst
Drowsiness
Nausea

Keep well hydrated.
Do not use if pregnant or hoping to become pregnant. Use with caution if breastfeeding.
Avoid overheating and replace fluids if exercising/ hot.
Blood tests required.
Seek urgent medical attention if toxicity suspected or vomiting/ diarrhoea

Question 13

2. State THREE (3) common side-effects and THREE (3) related nursing interventions for mood stabilising medication. (3 marks)

Answer 13

gastric irritation/nausea (Sodium Valporate)

tremor, stomach upset, polyuria, polydipsia. (Lithium Carbonate)

diplopia, dizziness, drowsiness (Carbamazapine)

Take with food, education around medication use, side effects and toxicity, operating machinery, interactions with other medications, avoid alcohol, monitor hepatic and renal function.