Schizo meds Flashcards
Mgt of Schizo
*Brief hospitalization of psych unit
*Adm of neuroleptics
*Milieu mgt
*Supportive therapy
*Psycho ed for fam
*Discharge planning
Antipsychotics
Typical AP
Atypical AP
Dopamine system stabilizer
It blocks selected dopamine receptors in the STRIATAL and LIMBIC areas in the brain, an action believed to reduce psychotic symptoms.
Typical AP agents
Typical AP affects
Histamine, serotonin, nor epi and acetylcholine
Does tolerance develops in typical ap?
NO
When should we give Typical AP agent
2 hrs po. Not taken with antacids of H2 blocking agents (Cimetidine)
Long acting prep for typical AP
Haloperidol and Fluphenazine (Prolixin). IM via depot inj, lasts 2-4 weeks
Contraindications for Typical AP
Known allergic response to any antipsychotic
CNS depression
Parkinson’s disease
Blood dyscrasias
Hepatic disease
Acute narrow-angle glaucoma
Benign prostatic hypertrophy
Examples of Typical AP
Fluphenazine (Prolixin)
Haloperidol (Haldol)
Chlorpromazine (Thorazine)
*ZINE, DOL, FON, MRIL
It blocks the dopamine receptors in the LIMBIC system and affect SEROTONIN receptors in the CORTICAL brain areas
Atypical AP agents
More advantages than Typical AP
Atypical AP
Reduces positive symptoms only
Typical, more side effects
Reduces both Positive and negative symptoms
Atypical AP
Decreases EPS or no EPS
Atypical
Does not affect dopamine in the striatal areas
Atypical
Atypical rapid dissolving prep:
Olanzapine (Zyprexa), Risperidone (Risperdal)
Atypical AP examples
Clozapine (Clozaril)
Olanzapine (Zyprexa)
Risperidone (Risperdal)
*PINE, DONE, CRIL, PREXA, QUEL, DAL, DON
RESTORES DOPAMINE activity in the CORTICAL levels of the brain and REDUCE dopamine in the LIMBIC areas, thus decreasing psychotic symptoms
Dopamine System stabilizer
Has common side effects
DSS
Drug under DSS
Aripiprazole- Abilify
Common side effects of Psychotropic drugs
*Anticholinergic effects
*Cardiovascular effects
*CNS
*GI
*Endocrine
Anticholinergic effects
*Dry mouth: sugar less bbg, rinse mouth freq.
*Blurred vision: eye pain=narrow angle glaucoma
*urinary retention
*constipation
Cardiovascular effects
*Postural Hypotension: change position slowly
*Arrythmias: report sensation of racing pulse
CNS
*Headache
*Drowsiness, dec mental alert
*TAKEN HS OD
GI
*Nausea, dec appetite: take with full stomach
*Wt. gain, inc app: take enough cal
Endocrine effects
*Amenorrhea
*Gynecomastia
*Sexual dysfunction: Anorgasmia in W and Erectile dys in men
Extra Pyramidal Effects of Psychotropic drugs
*Pseudo parkinsonism
*Acute dystonic reaction
*Akathisia
*Tardive Dyskinesia
Pseudo parkinsonism
*Drooling
*Motor retardation (akinesia)
*Lack of facial expression
*shuffling gait
*fine tremors (pill-rolling)
Treatment for pseudo p
Antipsychotics + anticholi, congentin, artane
Acute dystonic reaction
*muscle spasm of jaw, tongue, neck, or eyes
*laryngeal spasm
*Oculogyric crisis- backward rolling of eyes
Treatment for Acute dystonic reaction
*Stop drug, adm antidote (congentin, benadryl)
Akathisia
*motor restlessness
*state of moving
*diff. of sitting still
*strong urge to move
treatment for akathisa
*Adm antiparkinsonian drug
*Reduce antipsychotic dose
Tardive Dyskinesia
*Serious, irreversible
*involuntary movements, mouth, tongue, and face
*grinding teeth, lip smacking
Serious side effects of Psychotic drugs
*Agranulocytosis
*Seizures
*Hepato toxicity
*Neuroleptic malignant syndrome
decrease white blood cells characterized by sore throat, low grade fever, malaise, mouth sores
Agranulocytosis
treatment for agranulocytosis
*Stop the drug
*reverse isolation
*monitor cbc
Kind of seizure in serious effects
tonic cloning seizures: give anticonvulsants
abnormal liver function series (elevated enzymes), fever, nausea, jaundice and abdominal pain
Hepato toxicity: bed rest, good nutrition, adeq fluids
Neuroleptic malignant syndrome
*Altered consciousness
*severe hyperthermia (38.9)
*Diaphoresis
*Tachycardia, Massive dopamine blockage in brain
Treatment for neuroleptic malignant syndrome
*Stop drug
*check vs
*adm dopamine receptors stimulator: Bromocriptine (Parlodel)
*Adm, iv fluids, hypothermia measures
