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Mental Health Nursing > Week 8: Psychopharmacology, Psychoeducation in Treatment Concordance, the Nurse & Physical Health Promotion > Flashcards

Week 8: Psychopharmacology, Psychoeducation in Treatment Concordance, the Nurse & Physical Health Promotion Flashcards

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1
Q

What are the common neurochemical actions of psychotropic medications?

A

Modify reuptake of neurotransmitters into presynaptic neuron
Activate or inhibit postsynaptic receptors
Inhibit enzyme activity in synaptic cleft

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2
Q

What are the common indications for anti-psychotic medications?

A

Psychotic disorders: schizophrenia, delusional disorder, schizoaffective disorders, schizophreniform disorder, bipolar 1 disorder, major depressive disorder with psychotic features
Tourettes syndrome: adjunct for involuntary movements
Aggressive/disruptive behaviour: sedative, particularly when illicit drugs involved

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3
Q

What are examples of typical anti-psychotic medications?

A

Haloperidol (PO or IMI)

Fluphenazine (IMI)

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4
Q

What are examples of atypical anti-psychotic medications?

A

Olanzapine

Clozapine

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5
Q

How do anti-psychotic medications work?

A

Medications target neurotransmitters related to dopamine to produce and increase function to improve negative symptoms
Two pathways implicated: mesocortical and mesolimbic tracts
Antagonists at dopamine receptor inhibit overproduction and over absorption at receptor site (presynactic and post-synactic)

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6
Q

What are the extra-pyramidal side effects related to anti-psychotic medications?

A 
Dystonia
Akathisia
Parkinsonian-like symptoms
Tardive dyskinesia
Neuroleptic malignant syndrome
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7
Q

When is the onset of dystonia after administration of anti-psychotic medication?

A

24 hours, especially in the case of high doses and IMI

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8
Q

What are the forms of dystonia?

A

Oculogyric crisis: involuntary upward deviation of the eyes
Torticollis or retrocollis: neck spasms, respectively tilted or twisted sideways or backwards
Laryngeal spasm: compromises airway

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9
Q

What is the treatment for dystonia?

A

Anti-cholinergic (benzotropine) IMI then low PO doses
Review anti-psychotic dose
Lower dose

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10
Q

What is akathisia?

A

Intense feeling of inner restlessness (mentally) or experienced as restlessness of the lower limbs

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11
Q

What is the treatment for akathisia?

A

Lower dose of anti-psychotic
Assess and manage suicidal ideation
Short term Propanolol/Diazepam

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12
Q

What are Parkinsonian-like symptoms?

A

Reduced movement
Cogwheel rigidity of peripheries
Drooling
Tremors

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13
Q

When is the onset of parkinsonian-like symptoms after administration of anti-psychotic medication?

A

Within 1-2 weeks

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14
Q

What is tardive dyskinesia?

A

Syndrome of abnormal involuntary movements of face, eyes, mouth, tongue, trunk and peripheries
Irreversible

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15
Q

When is the onset of tardive kinesia after administration of anti-psychotic medication?

A

Within 1-2 weeks, gradual

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16
Q

What is the treatment for tardive dyskinesia?

A

Cease or reduce anti-psychotic medicatino dose

17
Q

What is neuroleptic malignant syndrome?

A

blank

18
Q

What are the features of neuroleptic malignant syndrome?

A

Fever
Muscular rigidity
Autonomic instability

19
Q

When is the onset of neuroleptic malignant syndrome after administration of anti-psychotic medication?

A

Rapid, after large or rapidly titrated increase in anti-psychotic medication dose

20
Q

What is the treatment for neuroleptic malignant syndrome?

A

Cease anti-psychotic medications
Consider hospitalisation for rehydration and monitoring
ECT

21
Q

What are non-EPSE side effects of anti-psychotic medications?

A 
Metabolic syndrome:
Central obesity
High BP
High triglycerides
Low HDL cholesterol
Insulin resistance

Cardiovascular related problems:
Tachycardia
Arrhythmia
Cardiomyopathy

22
Q

What are the benefits of using an atypical anti-psychotic medication over typical?

A 
Same efficacy
Lower potential for EPSEs
Improved tolerability
Improvement in negative symptoms
Improvement in cognitive functioning
Reduction in relapse
23
Q

What is the indication for Clozapine?

A

Treatment resistant schizophrenia

Mental Health Nursing (3 decks)

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