Test 2 Meds. Flashcards
olanzapine
Use: Anorexia Nervosa
second-generation antipsychotic medication
affects weight gain and improves cognition and body image.
fluoxetine
Use: Bulimia nervosa
selective serotonin reuptake inhibitor (SSRI)=antidepressant
has shown mixed results in maintaining weight and preventing relapse.
Helps relieve depression
Anxiolytics
Benzodiazepines
Lorazepam, Diazepam, Alprazolam
sleep aids for Dementia pts
topiramate
Use: Bulimia nervosa, Binge eating disorder
Anticonvulsant; mood stabilizer
Reduces binge purge/binge episodes, assist in weight loss
ondansetron
Use: Bulimia nervosa
Antiemetic; 5 HT antagonists
Reduce binge-purge episodes, increase frequency of normal meals
orlistat
Use: Binge eating disorder
Lipase inhibitor
Prohibit fat from storing; extreme diarrhea if consuming fatty foods
Adjunctive therapy to assist in weight loss
traditional
3-6 weeks effect
older antipsychotics
target POSITIVE symptoms
atypical
can have DM or weight gain issues, increase in cholesterol
newer antipsychotic; first chosen
3-6 weeks effect
diminishes NEGATIVE as well as POSITIVE symptoms
less side effects=higher compliance
Clozapine
antipsychotic: atypical
agranulocytosis (low WBC) need to be 3.5 to start
high seizure rate, increased DM risk, weight gain, orthostatic hypotension, high sedative effect
Quetiapine
antipsychotic: atypical
strong anticholinergic effects (give at bedtime)
SE: cardiac dysrhythmias, syncope, seizures
Risperidone
antipsychotic: atypical
insomnia, high extrapyramidal effects (tremors, slurred speech, anxiety) (dose related), 6-8 mg, low anticholinergic effect Can be given at bedtime to enhance sleep. Assess fall risk
Ziprasidone
antipsychotic: atypical
take with food to improve absorption
Olanzapine
antipsychotic: atypical
Sedating, give at bedtime. Requires monitoring for metabolic syndrome
**Aripiprazole
antipsychotic: atypical
Good for pts with auditory hallucinations and poor social functioning
Can be given during daytime hours; DOES NOT CAUSE WEIGHT GAIN,
Stabilizes DA receptors. Mildly sedative
**Haloperidol
high P=low S
antipsychotic: traditional HIGH potency=low sedation
tx for aggressive behavior
can prolong QT interval, lower ACH effects
Triflupoerazine
high P=low S
antipsychotic: traditional HIGH potency=low sedation
tx for aggressive behavior
low sedative effect, high incidence of EPS and TD effects
Fluphenazine
high P=low S
antipsychotic: traditional HIGH potency=low sedation
tx for aggressive behavior
available in tab, oral concentration, or IM injection; psychosis, agitation, orthostatic hypotension
2-4 week effects
Loxapine
Moderate
antipsychotic: traditional Medium potency
moderate sedative, Low ACH
reduces assaultive behavior
tabs, cap, oral concentrate, IM injection, schizophrenia only
Perphenazine
moderate
antipsychotic: traditional Medium potency
moderate sedative, Low ACH
reduces assaultive behavior
tabs, cap, oral concentrate, IM injection; schizophrenia only
Chlorpromazine
low P=high S
antipsychotic: traditional Low potency=high sedation
moderate sedative, Low ACH, N/v can occur, hiccups
ZOOMBIE MAKER!!!
tabs, solution, IM injection
mania
Thioridazine
low P=high S
antipsychotic: traditional Low potency=high sedation
moderate sedative, Low ACH, N/v can occur, hiccups
ZOOMBIE MAKER!!!
tabs, solution, IM injection
mania
Aphasia
language
Apraxia
loss of purposeful movement w/o loss of muscle power or coordination in general
Agnosia
does not recognize everyday objects
Anomia
words
Agraphia
inability to understand written language
Cholinesterase Inhibitors
increase acetylcholine to slow progression
mild-moderate alzheimer’s (6-12 months)
SE: N/V, headache
donepezil
rivastigmine
galantamine
NMDA receptor antagonist
decrease effects of glutamate, CNS excitation
SE: dizziness, constipation, headache
moderate-severe alzheimer’s (6-12 months) “buying time”
Memantine
Positive symptoms: alteration in thinking
delusions, persecution, grandiosity (king/queen), somatic sensation, thoughts broadcasting
need concrete thinking!
Positive symptoms: alteration in speech
associative looseness, neologism (making up words), echolalia (echo what you say), clang association, word salad
Positive symptoms: alteration in perception
hallucinations, illusions, auditory, visual, olfactory, tactile
personal boundary difficulties
postitive symptoms: alteration in behavior
extreme motor agitation, stereotyped, automatic obedience, waxy flexibility, stupor, negativism
Paranoid schizophrenia
unable to trust others around them, they are usually guarded, tense, and reserved “ideas of reference”
later in age (20s-30s)
catatonic schizophrenia
running around or mute no in between
extreme abnormal behavior, agitation, will not eat or move
disorganized schizophrenia
looseness of association, incoherent speech, poorly organized delusions and hallucinations, bizarre mannerisms, social withdrawal, severe cognitive impairment
early onset (early to middle teens)
donepezil
rivastigmine
galantamine
Cholinesterase Inhibitors
slows progression of alzheimers
mild-moderate
Memantine
NMDA receptor antagonist
slows progression of alzheimers
moderate to severe
immediate release/extended release
Paroxetine
SSRI antidepressant SE: sexual problems good for anxiety can cause weight gain SES; CAUTION WITH ELDERLY; black box warning
Sertraline
SSRI
antidepressant
SE: agitation, jittery/nervousness, SI, low sedation
SES; CAUTION WITH ELDERLY; black box warning
sensory intervention
music therapy
light therapy
hearing aids
active therapy/structured therapy
dancing, exercise, social interaction, outdoor walking
Psychological therapy
reality orientation, reminiscence therapy, relaxation training, structured support groups
Dementia characteristics
chronic
slow but even/months to years
clear awareness, orientation impairment, impaired judgement, normal psychomotor behavior, fragmented sleep/wake cycle, frequent naps
Delirium characterisitics
acute
abrupt progression, often in the evening
duration can be hours to less than a month, reduced awareness, alertness fluctuates, lethargic-hypervigilant, disorganized and incoherent speech, may have illusions or delusions, variable psychomotor behavior, sleep/wake cycle is disturbed may have days/nights reversed
Tardive Dyskinsia (TD) AIMS test
abnormal involuntary movement
Facial (spasms of tongue)
Limbs (spasms of fingers, toes, neck)
Trunk (spasms of trunk/pelvis)
NO KNOWN TX; very serious
Neuroleptic Malignant Syndrome (NMS)
“too many antipsychotics”
occur after longterm use give benzotripine (anticholinergic agent) muscle rigidity, dysphasia, temp 103 or higher, tachy, incontinence, diaphoresis
Psudoparkinsonism
masklike face with stiff drooping posture, shuffling gait, drooling
if pill rolling present give triexyphenidyl (anti-parkinson) or benzotripine (anticholinergic agent)
Acute Dystonic Reaction
opisthotonos-spasms of face tongue and neck
oculogyric crisis-eyed locked up (white of eyes)
give diphenhydramine (Benadryl)
Akathisia
inner motor restless (foot tappings, rocking, weight shifting)
decrease dose or change to lower potency meds
give triexyphenidyl (anti-parkinson), benzos, and beta-blocker
