Schizophrenia Flashcards
what does atypical antipsychotics act on
- serotonin, norepinephrine, histamine neurotransmitters
- lower risk of extrapyramidal side effects and tardive dyskinesia
where do typical antipsychotics act
- dopamine system
where do auditory hallucinations occur
- wernickes area
when is the onset of schizophrenia
late adolescence or early adulthood
what is the suicide risk percentage
10%
what is the dopamine hypothesis
- hyperactice transmission in mesolimbic pathways
- hypoactive transmission in prefrontal cortex
what is schizophrenia
spectrum of conditions that involve psychosis
what is high levels of dopamine in the brain related to
positive symptoms
what generation is typical antipsychotic meds
first generation
what generation are atypical antipsychotic medications
second
what do drugs do for schizophrenia
reduce dopamine activity
what causes parkinsonism
- low levels of dopamine in the brain due to antipsychotic medictaions
what causes NMS and what treats it
- dopmaine antagonist (antiphyschotics)
- bromocriptine
typical is helpful for:
- positve symtpoms
treatment for dystonia, parkinsonism, tardive dyskinesia
- anticholinergic agents
treatment for akathisia
- beta blockers or benzodiazepines
tardive dyskinesia
- sucking and smacking movements of lips
- chewing motion
- involuntary muscles used
structural brain differecnes in schizophrenia
- reduced brain volume
- reduced grey and white matter
- enlarged lateral and thrid ventricles
- increased CSF
somatic
- something is wrong with physical body (dont have own head)
serotinin syndrome onset
- 24 hours
serotinin syndrome cause and symptoms
- serotonin agonist
- hyperreactivity (tremours, reflexes)
SE of antipsychotics (6)
- orthostaic hypotension
- sedation
- anticholingergic side effects
- weight gain
- blood disorders (clozapine)
- movement disorders
safety concerns
- stabilizing actue phase
- suicide risk
- isolation
referential (delusions)
- think everything happening around you is about you (people talking)
psychosocial treatments
- increwasing social skills
- enchancing insight
- imporve problem solving
- independence and QOL
psychosis
- disconnection from reality
- can happen with other mental healt disorders or drug induced
Psychophramacology antipsychotics MOA
- block dopamine receptors (D2) in brain
prodrome
- time bewteen onset and treatment
- vague early signs
- not noticable
positive symptoms
- reflect an excess or distorition of normal function
phases of schizophrenia
- prodrome
- acute
- recovery
persecutory
- being watched, plotted against, fearful of others, paranoid
Nursing assesment
- delusions
- hallucinations
- disorganized speech
- personal hygeine
- negative symptoms
- level of fucntioning
neuropleptic malignant syndrome diagnostics
- hyperthermia
- exposure in 72 hours
- onset usually 10 days
- mental staus alteration
- BP irregularities
neuroleptic malignant syndrome (NMS) onset and symptoms
- days-weeks
- bradyreflexia, severe muscular rigidity
negative sympotms charatersitics
- blunted affect, alogia, avolition, anhedonia
Negative sympotms
- reduced affective expresion
- reduced social intercations
- blunted mood
how does schizophrenia affect a person?
affects how you think, feel, and behave
how do you treat serotonin syndrome
- benzodiazepine, cyproheptadine
- resolves in 24 hours
How do indivudals experience schizophrenia
each symptom is different in everyone.
each episode in someone is different
hallucinations
- perception experiences that occur without external stimuli
- auditory is most common
grandiose (delusion)
- has powers, influence, great importance
glutamine abnormalities may explain:
negative symptoms
genetic risk for schizophrenia
- close family has it
- genes
examples of positiove symptoms
- hallucinations
- delusions
- disorganized speech
- bizare behvaior
environmental risk for schizophrenia
- child birth complications
- inflammation or increased autoimmune system activation
- cannabis use during adolescence
- stress
DSM-5 criteria for schizophrenia
must have 2 or more symptoms for 1 month and impairs daily functioning
delusions
- fixed beliefs that dont change
- persicutory, somatic, religous, grandiose
caring for acute phases
- establish relationship
- promote trust
- dont agree or disagree wiht delusions or hallucinations
- adminster medications
atypical antipshychotics are helpful for
- positve and negative symptoms as it acts on more neurotransmitters
antipsychotic induced movement disorders
- psuedoparkinsonism
- acute dystonia
- akathisia
- Tardive dyskonesia
anhednoia
- lack of interest in lifes daily activities
akathisia
- restless
- constant movement
acute phase
- clear psychotic symptoms
- hallucinations, dleusion, confused thinking
acute dystonia
- facial grimacing
- involuntary eye movements (upward)
- muscle spasms
- laryngeal spasm
