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Schizophrenia
| Question | Answer |
|---|---|
| what are examples of Atypical antipsychotics? | -Aripiprazole (Abilify) -olanzapine (Zyprexa) -quetianpine (Seroquel) -risperidone (Risperdal) -lurasidone (Latuda) -Cariprazine (Vraylar) |
| what are S/E of Atpyicals | same as typical but milder and less common -metabolic syndrome -sedation -nervousness -HYPERSALAVATION -headache/dizziness -priapism -Cardiovascular-dysthymias and synocope(also known as fainting) -NMS -Seizures |
| S/E of both typical and Atypical | -Anticholinergic -EPS -Sexual distrubances -priaism -Metabolic syndrome-Acute dystonic reactions -NMS |
| Atypical | first line medication used but second generation drug tx: positive and negative symptoms |
| typical | first generation medication but last to be used due to side effects tx: positive symptoms only |
| metabolic syndrome | increase in glucose, blood pressure, weight, and lipid levels -need to be treated immediately -increase the risk of getting: diabetes, cardiac disease/hypertension, and stroke |
| Neuroleptic Malignant syndrome (NMS) | rare but potentially fatal -Severe EPS -hyperpyrexia: temp >103 -autonomic dysfunction: hypertension, tachycardia, diaphoresis, incontinence |
| treatment for NMS | mild: bromocriptine (Parlodel) -> decrease muscle rigidity Severe: dantrolene (Dantrium) -> decrease muscle spasms |
| acute dystonic reaction | acute spasms of tongue, face, neck and back (tongue and jaw first); eyes are fixed up and neck |
| treatment of acute dystonia | benztropine (Cogentin) diphenhydramine HCL (Benadryl) |
| Priapism | erection that last longer than 4 hours --> painful |
| EPS | -akathisia -dystonia -parkinsonism -tardive dyskinesia |
| Anticholinergics | cant pee-urinary retention cant see- dry mucous membranes cant spit-dry mouth cant shit-constipation |
| projection | hallmark of blaming, scape goating, prejudicial thinking, stigmatization always feel like others are out to get them |
| Flight of ideas | rapid shifting of ideas with only superficial associative connection between them is expressed as a disconnected rambling from subject to subject and it occurs especially in manic phase of bipolar disorder |
| residual | when one or more episodes have occurred but occurrence of (+)symptoms and behavior become less prominent |
| reality testing | objective evaluation of sensory impressions, thus allowing individual to distinguish between internal and external world and between fantacy and reality |
| proprioception | your sense of where you are in relation to the environment |
| Neuroleptics | psychiatric medications -typical -Atypical |
| High potency medication | |
| ambivalence | hesitant between several feelings, attitudes, or desires towards a person or situation |
| mood symptoms of schizophrenia | -depression -anxiety -demoralization -suicidality -agitation |
| cognitive symptoms of schizophrenia | impairment in memory disruption in social learning inability to reason, solve problems, focus attention |
| (-) symptoms of schizophrenia | -apathy -lack of motivation -anhedonia -blunt or flat affect -poverty and speech-social withdrawal |
| (+) symptoms of schizophrenia | hallucination delusions bizarre behavior catatonia formal thought disorder |
| prodromal | |
| akathisia | internal restlessness and external restless pacing and fidgeting |
| psychosis | not DX but a symptom -total inability to recognize reality EX: delusions and hallucinations |
| anhedonia | inability to experience any pleasure in activities that usually produce pleasurable feelings |
| catatonia | bizarre behavior -extreme motor agitation -stereotyped behaviors -autonomic obedience -Waxy flexibility -Stupor -Negativism |
| avolition | lack of motivation; inability to initiate task such as social contacts, grooming, and other aspects of activities of daily living |
| command hallucinations | voices command the person to harm themselves or others -behavior: tilting or turning of the head-as if listening to someone- frequent blinking of eyes, grimacing, even verballing responding to "unseen others" |
| depersonalization | nonspecific feeling that a person has lost their identity |
| derealization | false perception by a person that the environment has changed |
| echolalia | pathological repeating of anothers words by imitation and oftern seen in people with catatonia |
| echopraxia | mimicking movements of another- also seen in catatonia |
| ideas of reference | when paranoid individual misinterprets messages of others or gives private meaning to communications of others |
| loose associations | thinking becomes haphazard, illogical and confused |
| negativism | equivalent to resistance Active: pt does opposite of what was told to do Passive: (catatonia) when pt doesn't perform activities that are normal expectations-getting out of bed, dressing, and eating |
| neologisms | made up words that have special meaning for the person -children ofterndo this but it is imaginative, constructive and adaptive |
| poverty of thought | restriction in amount of speech answers range from brief to monosyllabic one-word answers |
| stereotyped behavior | motor pattern that originally had meaning to the person but are now mechanical and lack purpose EX: sweeping the floor, washing windows |
| thought blocking | may be signaled when a pt stops talking in the middle of sentence and remains silent |
| thought broadcasting | belief that ones thoughts an be heard by others |
| thought insertion | belief that thoughts of others are being inserted into ones mind EX: they made me think bad thoughts |
| waxy flexibility | seen in catatonic evident by excessive maintenance of posture and pt hold unusual postures for long periods of time |
| word salad | identify a jumble of words that is meaningless and perhaps to the speaker as well. may include string of neologisms |
| Last resort Atypical 2nd generation drug | clozapine( Clozaril) |
| S/E of clozapine | AGRANULOCYTOSIS, increase seizures |
| teaching for clozapine | report signs of infection, fever, illness of any kind |
| long lasting 2nd generation drugs (atypicals) | haloperidol(Haldol) fluphenazine decanoate(Prolixin) paliperidone(Invega Sustenna) aripiprazole(Aristada) risperidone(Resperidol Consta) |
| what is required prior to using long acting injection for a medication? | PO treatments in order to verify that they are not allergic or show adverse effects |
| what is the range for long acting injections? and how are they administered? | 2-4 weeks -deep IM |
| 1st generation (typical) drugs | haloperidol(Haldol) ttifluerizone(stelazine) fluphenazine(prolixin) lozapine(loxitane) perphenazine thioridazine(Mellaril) chlorpromazine or CPZ (Thorazine) |
| S/E of typicals | -EPS( akinesia,akathisia, pseudo-parkinsonism, acute dystonia, tardive dyskinesia) anticholinergic NMS Orthostatic hypotension decreased seizure threshold priapism neuroleptic syndrome |
| common indicator for pseudo-parkinsonism | -pill rolling trimmers -cogwheeling |
| which side effect can be irreversible | tardive dyskinesia |
| what do you do when you see acute dystonia | take to emergency room and IM benadryl |
| Benztropine (Cogentin) | dosage: 1-2 mg PO or IM PRN used to treat the symptoms of Parkinson's disease. |
| Benztropine (Cogentin) | S/E: drowsiness, dizziness, headache, loss of appetite, nausea, stomach upset, vision changes, sleeplessness, trembling of the hands, numbness in your fingers, depression, memory problems, nervousness |
| diphenhydramine HCL (Benadryl) | dose: 50-100 PO or IM PRN is an antihistamine. It is used to treat the symptoms of an allergic reaction. It is also used to treat Parkinson's disease. |
| trihexyphenidyl( Artane) | DOSE: 6 mg PO PRN is an antiparkinsonian agent of the antimuscarinic class. |
| Amantidine(Symmetrel) | DOSE: 100 mg PO PRN approval for use both as an antiviral and an antiparkinsonian medication. |
| medications to treat EPS | benztropine diphenhydramine HCL trihexyphenidyl HCLamantidine |
| what S/E can occur when taking thses meds with antipsychotics? | anticholinergic tardive dyskinesia |
| acute phase | periods of lorid (+) symptoms(EX: hallucination, delusions) as well as (-) symptoms and cognitive symptoms |
| stabilization phase | period in which acute symptoms particularly (+) symptoms decrease in severity |
| maintenance phase | period in which symptoms are in remission, although there might be milder persistent symptoms(residual symptoms) |
| grandeur | false belief that one is very powerful and important person, having special abilities, possessing great wealth or beauty |
| erotomania | false belief that another person, usually a stranger, high class or famous person, is in love with them |
| auditory | hearing voices that do not exist |
| visual | seeing a person, object or animal that is not in present environment |
| olfactory | smelling odors that are not present |
| gustatory | tasting sensations that have no stimulus in reality |
| tactile | feeling strange sensations where no external objects stimulate such feelings EX: believing bugs are crawling on you when they are not |
| catatonia specifiers | extreme abnormal motor behavior bizarre posturing waxy flexibility stereotyped behavior echolalia echopraxia |
| paranoia specifier | intense and strongly defended irrational suspicion projection defense mechanism ideas of reference |
| helpful guidelines when working with an individual who is paranoid | speak indirectly identify with, rather than fight, the patient don't rationalize. share mistrust |
| black box warning for both typical and atypical drugs | fatality in older adults with dementia related psychosis |
| acute phase intervention | acute psychopharmacological treatment supportive and directive communication limit setting psychiatric, medical, and neurological evaluation |
| stabilization and maintenance phase interventions | |
| how do you treat pseudoparkinsonism? | anticholinergic EX: trihexyphenidryl or benztropine |
| what is the AIMS test | -abnormal involuntary movement scale -assess for EPS and early detection of tardive dyskinesia |
| what do you use for violent behavior? | FGA: Haloperidol and benzo (lorazepam) SGA: olanzapine risperidone |
Created by:
sydneyblair
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