Psychotherapeutic

Question 1

What are the Typical Antipsychotics

Antipsychotic/Neuroliptic

Answer 1

“-azine”
Prochlorperazine
Thioridazine
Chlorpromazine

Haloperidol

Question 2

What are the Atypical Antipsychotics

Antipsychotic/Neuroleptic

Answer 2

Aripiprazole

“-apine”
Quetiapine
Olanzapine
Clozapine

“-idone”
Risperidone
Ziprasidone

Question 3

Whats the difference in action between Typical and Atypical Drugs
(Antipsychotic/Neuroleptic)

Answer 3

Typical: block dopamine receptors
Atypical: block both dopamine and serotonin receptors

Both limit the stimuli coming to the brain

Question 4

Pharmacokinetics of administration for Antipsychotic/Neuroleptic’s

Answer 4

for injection we give smaller doses compared to oral doses

IM dose is 4-5 times the active dose of orals

Question 5

Antipsychotic/Neuroleptic

Indications

Answer 5

schizophrenia
hyperactivity
combative and agitated behavior
severe behavioral problems in children

Question 6

Antipsychotic/Neuroleptic

Contra/Caution

Answer 6

allergy/hypersensitivity
CNS depression
blood dyscrasias
parkinsons (made worse)
prolonged QT interval
conditions worsened by anticholinergic effects due to suppressing dopamine
liver, renal, cardiac disease (metabolized/excretion)

Question 7

Antipsychotic/Neuroleptic

Adverse effects

Answer 7

CNS: drowsiness/sedation, weak, tremor
- Extrapyramidal effects: pseudoparkinsonism, dystonia, akathisia, tardive dyskinesia, neuroleptic malignant syndrome

Antiandrogen effects: galactorrhea, gynecomastia

Anticholinergic: constipation, dry mouth, nasal congestion

Hypotension

Question 8

Antipsychotic/Neuroleptic

Drug-Drug

Answer 8

beta blockers: increased betablocker effect

alcohol: increase CNS effects
anticholinergics: worsen effects

Question 9

Antipsychotic/Neuroleptic

Assessment

Answer 9

severe CNS or respiratory depression 
heart disease risk for prolonged QT interval
bone marrow suppression
glaucoma/urinary retention
vitals, EKG, CNS assessment 
renal/hepatic labs with CBC

Question 10

Antipsychotic/Neuroleptic

Nursing diagnosis

Answer 10

impaired physical mobility r/t EPS
decreased CO r/t hypotension effects
risk for injury r/t CNS effects and sedation
impaired urinary elimination r/t anticholinergic effects

Question 11

Antipsychotic/Neuroleptic

implementation

Answer 11

parenteral forms needs pt to stay laying down for 30mins to avoid orthostatic hypotension
monitor CBC for bone marrow depression
gradual stopping to avoid quick withdrawal
comfort for dyskinesia
sugarless candy and ice chips for GI effects
void before taking
provide vision exams
takes WEEKS to take effect

Question 12

Drugs for Bipolar Disorder

Answer 12

Lithium
Aripiprazole
Lamotrigine
Olanzapine
Quetiapine
Ziprasidone

Question 13

Lithium

Action

Answer 13

unknown how it works on manic phase

alters sodium transport to influence reuptake of neurotransmitters

Question 14

Lithium

Pharmacokinetics therapeutic range

Answer 14

0.6 - 1.2 mEq/L

can experience toxicity

Question 15

Lithium

Contra/Caution

Answer 15

allergy
pregnancy/Lact
significant renal or cardiac disease
dehydration/risk for dehydration
hyponatremia

Question 16

Lithium

Adverse effects

Answer 16

L I T H:
Leukocytosis
Insipidus (urinating large amounts)
Tremors/teratogenic
Hypothyroidism

Question 17

Lithium

Drug-Drug

Answer 17

haloperidol: increases risk for encephalopathy
carbamazepine: increases risk for CNS toxicity
diuretics: increase lithium toxicity
psyllium: binds and prevent absorption of lithium

Question 18

Lithium

Assessment

Answer 18

labs: renal function, CBC, thyroid, lithium levels, sodium levels
physical: bowel sounds, urine output, EKG, CNS
history

Question 19

Lithium

Nursing Diagnosis

Answer 19

acute pain r/t GI and CNS effects
risk for injury r/t CNS effects
impaired urinary elimination r/t renal toxic effects
disturbed thought process r/t CNS effects

Question 20

Lithium

Implementation

Answer 20

monitor serum levels closely every (daily then q3-6mo)
may take with food or milk
decrease dose after acute manic episodes
adequate intake of salt/fluid
sugarless lozenges and mouth care
avoid pregnancy