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EXAM 4 MENTAL HEALTH

Antipsychotic meds

QuestionAnswer
First Generation Antipsychotics (Conventional) Dopamine Antagonists - Target positive signs such as delusions, hallucinations, disturbed thinking, and other psychotic symptoms. No observable effect on negative symptoms. Can cause alterations in cardiac rhythm so EKG should be performed prior to administration.
First Generation Antipsychotics (Conventional) Drug Examples haloperidol (Haldol), chlorpromazine (Thorazine), fluphenazine (Prolixin), thioridazine (Mallaril), thiothixene (Navane), loxapine (Loxatine), perphenazine (Trilafon, Etrafon), mesoridazine (Serentil), molinidone (Moban)
Second Generation Antipsychotics (Atypical) Dopamine and serotonin antagonists. Diminish positive symptoms, and lessen negative symptoms. Can cause agranulocytosis. WBC and neutrophil counts need to be obtain before and during treatment. Blood glucose should also be monitored.
Second Generation Antipsychotics (Atypical) Drug Examples Clozapine (Clozaril), risperidone (Risperdal), olanzapine (Zyprexa), quetiapine (Seroquel), ziprasidone (Geodon), paliperidone (Invega), iloperidone (Fanapt), asenapine (Saphris), lurasidone (Latuda)
Psychopharmacology Medication Side Effect Considerations Side effects can be significant and range from mild discomfort to permanent movement disorders, which are upsetting and frightening to patients. THIS IS THE PRIMARY REASON FOR NONCOMPLIANCE
Non-neurological Side Effects of Antipsychotics Weight gain, sedation, photosensitivity, anticholinergic symptoms, orthostatic hypotension, agranulocytosis (bone marrow is not producing enough WBCs)
Extrapyramidal Symptoms (EPS) serious neurologic symptoms, are the major side effects of antipsychotic drugs. They include acute dystonia, pseudoparkinsonism, and akathisia.
Dystonia Acute muscular rigidity and cramping, a stiff or thick tongue with difficulty swallowing, and, in severe cases, laryngospasm and respiratory difficulties. Is most likely to occur in the first week of treatment.
Pseudoparkinsonism Stiff, stooped posture
Akathisia intense need to move about. The client appears restless or anxious and agitated, often with a rigid posture or gait and a lack of spontaneous gestures.
Neuroleptic malignant syndrome (NMS) is a potentially fatal idiosyncratic reaction to an antipsychotic. Includes rigidity, high fever, autonomic instability such as unstable blood pressure, diaphoresis, and pallor, delirium, and elevated levels of enzymes, particularly creatine phosphokinase. Most often occurs in first 2 weeks of treatment. Increased risk in those with dehydration, poor nutrition. TREATMENT SHOULD BE STOPPED
Tardive dyskinesia (TD) Abnormal and involuntary movements such as lip smacking, tongue protrusion, chewing, blinking, grimacing. Due to long-term use of conventional antipsychotics. It is irreversible
Anticholinergic side effects often occur with the use of antipsychotics and include orthostatic hypotension, dry mouth, constipation, urinary hesitance or retention, blurred near vision, dry eyes, photophobia, nasal congestion, and decreased memory. These side effects usually decrease within 3 to 4 weeks but do not entirely remit
Metabolic Syndrome cluster of conditions that increase the risk for heart disease, diabetes, and stroke. The syndrome is diagnosed when three or more of the following are present: obesity, increased BP, high blood sugar, high cholesterol,
Clozapine (Clozaril) Black Box Warning May cause agranulocytosis, a potentially life-threatening event. Obtain baseline WBC count and differential before initiation of treatment, and every week throughout treatment and for 4 weeks after it is discontinued
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