week 5 Flashcards
what do antipsychotic drugs not be used to treat?
older adults with dementia
when does schizophrenia typically emerge?
in adolescence or early adulthood
which symptoms of schizophrenia are treated with antipsychotics?
only positive symptoms
what type of drugs end in “azine”
antipsychotic drugs
adverse effects of the first generation antipsychotics
acute dystonia parkinsonism akathisia Anticholinergic effects orthostatic hypotension
Oldest and largest group of FGAs
Phenothiazines
why is clozapine in very limited use?
because of the adverse effects like agranulocytosis
what happens in patients with atypical depression
many symptoms are the opposite, they experience hypersomnia, weight gain
who tend to have more atypical forms of depression
women
what do depressed and suicidal clients have low levels in the CSF fluid
serotonin
Tricyclic Antidepressents most dangerous adverse effect
cardiac toxicity
antidote for Tricyclic Antidepressent overdose
Cholinesterase inhibitor (physostigmine)
what foods do you want to avoid with Monoamine Oxidase Inhibitors
tyramine-rich foods
what is given to treat bipolar disorders
lithiums
Antipsychotics
Antiepileptics
Anxiolytics
which is stronger sedatives or hypnotics?
hypnotics
how do amphetamines work
they are CNS stimulants
Non-amphetamine-modafanil (Provigil) use
Narcolepsy
what is akathisia?
restlessness
what is acute dystonia?
severe muscle spasm tongue, face neck, back
what is acute dystonia treated with?
anticholinergics
what is Tardive dyskinesia?
involuntary movements of the tongue, face, such as lip smacking, which causes speech and or eating disturbances
what is done to prevent tardive dyskinesia?
- using lowest effective dose
- for the shortest time period
- assessments done after 12months and a neuro eval is done every 3 months
what is neuroleptic malignment syndrome characterized by?
- sudden high temperature
- instability of ANS
what should the nurse do if a patient developes Neuroleptic malignant syndrome?
- stop medication
- monitor VS
- increase fluids
- antipyretics
what time of day should anti psychotics be given?
at night because of sedative effects
how can anti psychotics effect the skin? (2)
they can increase sensitivity and agranulocytosis
how can anti psychotics effect the cardiac system?
can cause severe dysrthythmias
how should anti psychotics be stopped?
Should be tapered if stopped because can cause a mild abstinence syndrome
what effect will combining anticholinergics with antipsychotics have?
Increased anticholinergic effect
what effect will combining CNS depressants with antipsychotics have?
Increased depressant effect
what is the drug interact between levodopa and antispychotics
May counteract the antipsychotic effects of neuroleptics
what is the prototype of phenothiazines?
chlorpromazine
what are phenothiazines used for?
Schizophrenia
Intractable hiccups
prototype of 2nd and 3rd generation of antipsychotics
Clozapine
why is Clozapine (2nd +3rd gen antipsychotics in limited use?
Limited use because of agranulocytosis
what needs to be monitored for patients on phenothiazines? (6)
BP (standing and at rest)
Pulse rates
Weight
Complete blood count (CBC) with differential
Electroencephalogram (EEG)
Ocular examination
“boring philosophers watched clever ethical outlaws”
what should be obtained for patients on 2-3 gen of anti psychotics?
Baseline vital signs Weight Serum glucose Triglyceride levels CBC
risks for olanzepine?
- low risk of EPS
- high risk for DM weight gain and dyslipidemia
risks for Quetiapine?
low risk of EPS but same high risk as olanzapine with the addition of cataracts, sedation and anticholinergic effects. Eye screenings every 6 months
the advantages of the second/third antipsychotics?
Fewer EPS
Fewer anticholinergic effects
Relief of positive and negative symptoms of disease
complications of second-third generation antipsychotics
DM Weight gain Hypercholesteremia Orthostatic hypotension Anticholinergic effects Dizziness/sedation Mild EPS Elevated prolactin levels Sexual dysfunction
how can nurses ensure that patients adhere to taking their medications
checking the cheeks social support systems injecting the medication educate written and verbal instructions
symptoms of depression
Mood alteration Lack of pleasure Apathy Anorexia Insomnia
how long do symptoms need to be present for it to be considered depression?
Needs to be present for most of day for every day for at least two weeks
gender specific differences of depression in women
Atypical symptoms
Seasonal effect
Coexisting anxiety and eating disorders
Suicide tries
gender specific differences of depression in men
Coexisting alcoholism
Coexisting substance abuse
Completed suicide
what levels of NE are found in depressed individuals?
Low NE metabolites found in urine and CSF of depressed individuals
types of drugs to treat depression
Tricyclic antidepressants (TCAs)
Selective serotonin reuptake inhibitors (SSRIs)
Serontonin/norepinephrine reuptake inhibitors (SNRIs)
Monoamine oxidase inhibitors (MAOIs)
Atypical antidepressants
what is a way of treating severe depression without the use of drugs
Electroconvulsive therapy (ECT)-
conditions other than depresssion that are treated with TCAS, SSRIS and Atypicals
OCD Panic Disorder Eating Disorders Social Anxiety GAS PMS PMDD ADD
what is the action of Tricyclic Antidepressants
Blocks the reuptake of NE and serotonin, allowing more effect to occur from these transmitters
what do tricyclic antidepressents end in?
- tyline
what screenings do you need every 6 months with olanzapine
eye screening
