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Pharm 2 > psychotic disorders > Flashcards

psychotic disorders Flashcards

1
Q

describe psychosis

A

psychosis can be acute or chronic

acute:
- also called confusion or delirium
- sudden onset over hours to days
- may be precipitated by physical disorders (metabolic or infectious)
- may be superimposed on chronic dementias and psychoses such as schizophrenia

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2
Q

name some different possible pathophysiologies of psychosis

A
  • neutransmitter theories
  • abnormal brain development
    others i dont care enough about
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3
Q

what are two drug therapies for psychosis

A
  • first generation antipsychotics (typical): haloperidol, more adverse effects
  • second generation antipsychotics (atypical): clozapine, more weight gain, more expensive
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4
Q

give an example of first generation antipsychotics

A

haloperidol

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5
Q

describe the action of first generation antipsychotics (haloperidol)

A

blocks postsynaptic dopamine receptors in the brain

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6
Q

what are first generation antipsychotics (haloperidol) used for

A

schizophrenia

psychotic symptoms associated with brain impairment

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7
Q

what are the different onsets for IM and PO first generation antipsychotics (haloperidol)

A

IM: 10-15min
PO: 30-60min

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8
Q

what are some adverse effects of first generation antipsychotics (haloperidol)

A

CNS: EPS - tardive dyskinesia, akathisia, dystonia, drug induced parkinsonism
CV: prolonged QT
heme: agranulocytosis

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9
Q

what is tardive dyskinesia

A

drug induced movement disorder, typically facial tics

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10
Q

what is akathisia

A

feeling of muscles quivering, extremely restless, inability to sit still

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11
Q

what is dystonia

A

causes muscles to contract involuntarily, repetitive twisting movements

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12
Q

what are some contraindications of first generation antipsychotics (haloperidol)

A
  • liver damage
  • coronary artery disease
  • cerebrovascular disease
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13
Q

describe administration of first generation antipsychotics (haloperidol)

A
  • need baseline EKG
  • gradual reduction prior to discontinuation
  • IM injections given in ventrogluteal with 1.5 inch needle
  • check injection site
  • monitor for orthostatic hypotension
  • pre/post mood assessment
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14
Q

what are some nursing implications for first generation antipsychotics (haloperidol)

A
  • do NOT give with herbals such as KAVA
  • avoid antacids
  • avoid CNS depressants
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15
Q

describe patient education for first generation antipsychotics (haloperidol)

A
  • take only as prescribed
  • take with a glass of water and food if GI upset occurs
  • do not stop abruptly
  • avoid alcohol
  • wear protective sunscreen outdoors
  • use caution when changing positions
  • report yellowing of the eyes and skin to healthcare provider
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16
Q

an elderly woman with dementia is receiving Haloperidol, what adverse effect is this patient at an increased risk of developing?

  1. muscle rigidity
  2. bradycardia
  3. increased temp
  4. tardive dyskinesia
A
  1. tardive dyskinesia

this is an adverse effect of haloperidol that can developany time after taking the medication

17
Q

give an example of a second generation antipsychotic

A

clozapine

18
Q

describe the action of second generation antipsychotic (clozapine)

A

blocks dopamine receptors in the brain

19
Q

what are second generation antipsychotics (clozapine) used for

A

schizophrenia
- psychotic symptoms
- recurrent suicidal behavior in patients with schizophrenia

20
Q

whats the PO onset of second generation antipsychotics (clozapine)

A

1-6hr

21
Q

what are the black box warnings for second generation antipsychotics (clozapine)

A
  • administration of clozapine of elderly patient with dementia, risk of death is increased
  • increased risk of seizure activity as clozapine dose increased
  • risk of fatal agranulocytosis
  • risk of hyperglycemia
22
Q

what are some contraindications of second generation antipsychotics (clozapine)

A
  • clozapine induced agranulocytosis
  • seizure disorder
  • CNS depression
23
Q

describe administration of second generation antipsychotics (clozapine)

A
  • need baseline WBC count and neutrophil count
  • monitor blood glucose level
  • taper dose if discontinued
  • pre/post mood assessment
24
Q

what are some nursing implications for second generation antipsychotics (clozapine)

A
  • do NOT give with herbals
  • avoid antacids
  • avoid CNS depressants
25
Q

describe patient education for second generation antipsychotics (clozapine)

A
  • take only as prescribed
  • take with a glass of water and food if GI upset occurs
  • do not stop abruptly
  • avoid alcohol
  • obtain weekly blood tests
  • report flu like symptoms
  • only one week of medication will be dispensed at a time

Pharm 2 (34 decks)

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