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Pharm Brainscapes by Cheryl and Phil > Test 2: Antipsychotics > Flashcards

Test 2: Antipsychotics Flashcards

1
Q

What are anti-psychotics indicated for?

A

Schizophrenia, delusional disorders, bipolar disorder, depressive psychoses, and drug-induced psychoses.

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2
Q

Outside of their normal uses antipsychotics are also used to treat:

A

Emesis

Tourette’s syndrome Huntington’s chorea

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3
Q

Should antipsychotics be used to treat dementia related psychosis in older adults?

A

No

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4
Q

What are the 2 groups of antipsychotic drugs?

A

FGA (First Generation Antipsychotics_

SGA (Second generation antipsychotics)

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5
Q

What type of movement disorders can antipsychotics cause?

A

extrapyramidal movement

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6
Q

It is crucial for the RN to monitor patients treated with antipsychotic medications for symptoms of ___, and to report them immediately if present.

A

EPS

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7
Q

Which type of Antipsychotics cause EPS?

A

FGA

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8
Q

What receptors do FCA’s block?

A

Dopamine

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9
Q

What receptors do SGA’s block?

A

Dopamine, serotonin (much stronger)

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10
Q

In which type of antipsychotics is the risk of EPS less?

A

SGA’s

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11
Q

Why is the risk of EPS less in SGA’s?

A

Only moderate blockage of dopamine unlike FGA’s

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12
Q

Chronic illness characterized by disordered thinking and reduced comprehension of reality:

A

Schizophrenia

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13
Q

When do symptoms of schizophrenia usually emerge?

A

Adolescence or early adulthood

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14
Q

Schizophrenia symptoms can be divided into 3 groups what are they?

A

Positive
Negative
Cognitive

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15
Q

Which type of antipsychotics have an increased risk of: metabolic effects but not EPS
EX: (weight gain, diabetes, and dyslipidemia- causes cardiovascular events and early death. )

A

SGA’s

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16
Q

Schizophrenia symptoms that: exaggeration or distortion of normal function

A

Positive

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17
Q

Examples of positive symptoms:

A

(1) Hallucinations
(2) Delusions (fixed false beliefs)
(3) Agitation
(4) Tension
(5) Paranoia

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18
Q

Schitzophrenia symptoms that include: loss or diminution of normal function.

A

Negative symptoms

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19
Q

Examples of negative schizophrenia symptoms:

A

(1) lack of motivation
(2) poverty of speech
(3) blunted affect
(4) poor self-care
(5) social withdrawal

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20
Q

Schotzophrenia symptoms that include: Disordered thinking, Reduced ability to focus attention and Prominent learning and memory difficulties would fall into which category?

A

Cognitive

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21
Q

All FGA’s have the ability to relieve psychosis, but how do they differ? In terms of _______

A

Potency

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22
Q

The term potency refers only to the _____ of the dose needed to elicit a given response; potency implies nothing about the maximal effect a drug can produce.

A

size

23
Q

How do FGA’s differ the most? In terms of their ____________

A

Side Effects

24
Q

How long do antipsychotics take to have full effects?

A

2-4 weeks for substantial effects, possible months for full

25
Q

What is the worst side effect FGA’s can produce?

A

Tardive Dyskinesia

26
Q

Why can parkinson’s-like symptoms occur in patients taking antipsychotics?

A

Because antipsychotics affect the extrapyramidal motor system which is the same neuronal network that parkinsons symptoms come from.

27
Q

How would parkinsons-like symptoms present in a patient taking an antipsychotic?

A
  • Bradykinesia (slow movement)
  • masklike facies (staring eyes and slightly open mouth)
  • drooling
  • tremor
  • rigidity
  • shuffling gait
  • cogwheeling (muscles move with slight hesitations)
  • stooped posture.
28
Q

Slow involuntary facial movements (lip smacking, tongue flickin) are a side effect experienced by 15-20% of patients taking long term FGAs. What is this disorder called?

A

Tardive Dyskinesia

29
Q

What are the early onset extra pyramidal side effects of antipsychotic drugs?

A

Acute Dystonia
Parkinsonism
Akathisia

30
Q

Spasms of muscles of tongue, face, neck, and back; opisthotonus (spasm of the muscles causing backward arching of the head, neck, and spine) is an extrapyramidal side effect of antipsychotics called:

A

Acute Dystonia

31
Q

Bradykinesia, mask-like facies, tremor, rigidity, shuffling gait, drooling, cogwheeling (rigidity in upper limb), stooped posture are an extrapyramidal side effect of antipsychotics called:

A

Parkinsonism

32
Q

Compulsive, restless movement;

Symptoms of anxiety, agitation are an extrapyramidal side effect called:

A

Akathisia

33
Q

What is the late onset extrapyramidal side effect that comes with antipsychotics

A

Tardive Dyskinesia

34
Q

Compare high and low potency FGA’s

A

Compared to low potency FGAs, high potency ones cause more early EPS, but less sedation, orthostatic hypotension, and anticholinergic effects. High potency are generally preferred for initial therapy

35
Q

Characterized by “lead pipe” rigidity, sudden high fever, and autonomic instability. Level of consciousness may rise and fall.

A

Neuroleptic Malignant Syndrome

36
Q

If a patient develops NMS what should the nurse do?

A
  1. Report Immediately
  2. Withdraw the drug
  3. Supportive measures
37
Q

What two drugs can help NMS?

A
  1. Dantrolene-( a direct-acting muscle relaxant that reduces rigidity and hyperthermia.)
  2. Bromocriptine-( a dopamine receptor agonist that may relieve CNS toxicity.)
38
Q

FGAs produce varying degrees of muscarinic cholinergic blockade, and can elicit the full spectrum of __________ responses.

A

anticholinergic

39
Q

Antipsychotic drugs promote orthostatic hypotension by blocking _______-adrenergic receptors on blood vessels.

A

alpha1

40
Q

Antipsychotic drugs can increase circulating levels of prolactin, a hormone that can cause:

A

gynecomastia and galactorrhea

41
Q

Can FGA’s cause sexual dysfunction?

A

Yes

42
Q

Three FGAs—(haloperidol, thioridazine, and pimozide)—pose a risk of fatal cardiac dysrhythmias. What is the mechanism of this?

A

Prolonged QT interval

43
Q

When used off-label to treat older adult patients with dementia-related psychosis, all antipsychotics (FGAs and SGAs) about _______ the rate of mortality.

A

double

44
Q

Which type of FGA’s produce more EPS?

A

High Potency

45
Q

Which type of FGA’s initially produce less side effects?

A

High Potency

46
Q

What is the common well known SGA that is the most affective against schitzophrenia?

A

Clozapine

47
Q

Why is clozapine more dangerous?

A

It can cause agranulocytosis

48
Q

Because of the risk of agranulocytosis with SGA’s what must be monitored?

A

White blood cell and neutrophil count

49
Q

Which type of antipsychotic can cause new onset diabetes?

A

SGA

50
Q

Drug therapy of schizophrenia has three major objectives:

A

(1) to suppress acute episodes,
(2) to prevent acute exacerbations,
(3) to maintain the highest possible level of functioning.

51
Q

A nurse assesses a patient receiving haloperidol. The nurse notices that the patient is shifting in the chair, rocking back and forth, and tapping both feet constantly. What is the most accurate term to document these findings.

A

Akathisia

52
Q

Antipsychotics should be avoided in what population due to an increased risk of mortailty?

A

Elderly patients with dementia

53
Q

A patient taking an antipsychotic who experiences sudden high fever is likely experiencing a symptom of:

A

Neuroleptic Malignant Syndrome

Pharm Brainscapes by Cheryl and Phil (6 decks)

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