Psychotherapeutic drugs ex 4 Flashcards
positive symptoms
hallucinations
delusions
agitation
disordered speech
bizarre beahviors
negative symptoms
social withdrawal
poor self-care
lack of motivation
poverty of speech
blunted affect
cognitive symptoms
disordered thinking
lack of focus
learning disability
memory problems
first gen antipsychotics MOA
block several receptors in the CNS - dopamine, acetylcholine, histamine, norepinephrine
first gen antipsychotics take how long?
2-4 weeks, several months for full effect
inhibits positive symptoms best
first gen antipsychotics classified by?
potency; low,med,high
contributes to severity of adverse effects
Acute Dystonia
adverse effect of FGA
occurs hours to days, spasms of tongue, face, neck, back muscles
Parkinsonism
occurs within 1 month looks like parkinson’s
Akthisia
occurs within 2 months, pacing, restless, agitated, squirming
Tardive Dyskinesia
occurs within months to years
involuntary twisting, movements of tongue and face, progresses to difficulty speaking swallowing down to body
Other FGA adverse effects
neuroleptic malignant syndrome: lead pipe, muscle rigidity, sudden very high fever, labile BP
anticholinergic effect
O hypotension
FGA interactions
anticholinergic drugs
CNS depressants
Levodopa and direct dopamine receptro agonists
Second Generation Antipsychotics (SGAs) MOA
block dopamine and serotonin receptors in CNS
takes 2-4 weeks, several months for full efect
$$$
SGA adverse effects
Metabolic effects: weight gain, diabetes, HDL
Neuroleptic Malignant syndrome
myocarditis
Goals of Therapy
suppress acute episode, prevent exacerbations, promote high quality of life and function
shared properties of antidepressants
initial response 1-3 weeks max 12 weeks
4 antidepressants and protoype
SSRIS: fluoxetine
TCA: Imipramine
MAOIs: Phenelzine
Atypical: Buproprion
Selective Serotonin Reuptake Inhibitor (SSRIs) fluoxetine MOA
Prevent reuptake of serotonin
(SSRIs) fluoxetine pharmacokinetics
PO 94% protein bound 9 day half life
(SSRIs) fluoxetine adverse effects
N/V
sexual dysfunction
weight gain
withdrawal
serotonin syndrom
(SSRIs) fluoxetine interactions
MAOIs - drugs that increase serotonin activation
TCAs and lithium
Antiplatelete and anticoagulants
(SSRIs) fluoxetine nursing considerations
dont stop abruptly,
suicide risk
serotonin syndrome
serotonin syndrome
altered mental status - agitation, confusion, disorientation
increases SNS activity - sweating, termoy, fever, incoordination
Tricyclic Antidepressants (TCAs): amitriptyline (Elavil) MOA
prevent reuptake of NE and or seratonin
used for depression, insomnia, and pain
(TCAs): amitriptyline (Elavil) adverse effects
O hypoTN
sedation
anticholinergic effect
sweating
seizures
hypomania
(TCAs): amitriptyline (Elavil) interactions
MAOIs (sever HTN)
anticholinergics
CNS depressants