Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
schizo drugs and tm
Schizophrenia drugs and treatments
| Question | Answer |
|---|---|
| another word for antipsychotics | neuroleptics major tranquilizers |
| how neuroleptics work | 1) block dopamine receptors 2) block dopamine and serotonin receptors |
| time frame for neuroleptic results | full effect in 3-6 weeks |
| problem with neuroleptics | 10% of pts don't respond |
| paradigm of thirds | 1) 1/3 achieve significant and lasting improvement 2) 1/3 achieve some improvement with intermittent relapses and residual disability 3) 1/3 experiences severe and permanent incapacity and do not respond to meds |
| sex that responds better to antipsychotics | women |
| overall effects of neuroleptics | 1) decrease hallucinations 2) decrease delusions 3) improve cognitive state |
| imperative education for pts and their families when neuroleptics are started | they need to know that results are not immediate and improvement may not happen until over a month after the drug therapy is started |
| classes of neuroleptics | 1) typical 2) atypical |
| typical neuroleptics | 1) older class 2) work on positive signs and symptoms 3) more side effects |
| atypical neuroleptics | 1) newer generation 2) work on positive and negative symptoms |
| Forms of neuroleptics | 1) oral (tabs, liquids) 2) parenteral 3) long-acting 4) decanoate forms |
| contraindications: typical neuroleptics | 1) known hypersensitivity 2) comatose state 3) CNS depression evident 4) parkinson's or narrow angle glaucoma 5) liver, renal or cardiac insufficiency 6) controlled seizure disorders |
| typical neuroleptics that are not compatible and why | prolong the QT interval 1) thioridazine 2) pimozide 3) haloperidol 4) molindone |
| contraindications: atypical neuroleptics | 1) hypersensitivity 2) comatose 3) severe depression 4) dementia-related psychosis 5) lactation |
| atypical neuroleptics that are not compatible and why | prolong QT interval 1) ziprasidone 2) risperidone 3) paliperidone 4) iloperidone |
| interactions: typical | 1) additive hypotensive effects (anti-HTN) 2) additive CNS effects (CNS depressants) 3) additive anticholingeric effects (anticholinergics) |
| side effects: DA blockage | 1) extrapyramidal symptoms (EPS) 2) prolactin elevation |
| side effects: cholinergic blockage | 1) dry mouth 2) blurred vision 3) constipation 4) urinary retention 5) tachycardia |
| side effects: alpha1 adrenergic blockage | 1) dizziness 2) orthostatic hypotension 3) tremors 4) reflex tachycardia |
| side effects: histamine blockage | 1) weight gain 2) sedation |
| other side effects | 1) photosensitivity 2) seizures 3) agranulocytosis 4) diabetes 5) skin rash 6) ECG changes |
| treatment: dry mouth | 1) give sugarless candy, gum, ice, frequent sips of water 2) strict oral hygiene |
| treatment: blurred vision | 1) explain that it will subside after a few weeks 2) don't drive car until vision clears 3) clear small items from pathways to prevent falls |
| hormonal side effects in men | 1) decreased libido 2) retrograde ejaculation 3) gynecomastia |
| hormonal side effects in women | reversible amenhorrhea. continue on contraceptives. |
| agranulocytosis: what, which drug, when | 1) low WBC 2) typical, clozapine 3) usually occurs during first 3m of treatment |
| agranulocytosis: symptoms, reaction | 1) sore throat, fever, malaise 2) get a count |
| special precautions for clozaril | 1) baseline WBC and absolute neutrophil count before 2) weekly counts for the first 6m of treatment 3) only 1w supply dispensed at a time |
| hypersalivation: what drug, treatment | 1) clozaril 2) sugar free gum to increase swallowing rate 3) anticholingeric meds like scopolamine patch or clonidine |
| EPS: states, causes | 1) 75% of ppl get them 2) caused by low DA |
| EPS | 1) pseudoparkinsonism 2) akinesia 3) akathisia 4) acute dystonia |
| pseudoparkinsonism | 1) tremor 2) shuffling gait 3) drooling 4) rigidity 5) lack of arm swing 6) masked fascies |
| pseudoparkinsonism: when, who | 1) 1-5d after initiation of meds 2) women, elderly, dehydrated pts |
| masked fascies | face not animated bc muscles aren't moving |
| treatment of pseudoparkinsonism | 1) anticholinergics 2) reduce dose |
| pseudoparkinsonism: drugs | 1) artane 2) cogentin |
| akinesia | 1) muscle weakness 2) fatigue 3) slow movement 4) painful muscles |
| akinesia: treatment | anticholinergics (same as pseudoparkinsonism) |
| akinesia: drugs | same as pseudoparkinsonism 1) artane 2) cogentin |
| akathisia | 1) continuous restlessness and fidgeting 2) restless legs/can't sit still 3) anxiety |
| akathisia: stats, dangers, who, when | 1) 20-50% pts affected 2) most linked w non-compliance and suicide 3) can be misinterpreted as exacerbation of symptoms 4) women 5) 50-60d after start of therapy |
| akathisia: treatment | 1) change antipsychotic 2) anti-anxiety drugs 3) anticholinergics |
| akathisia: anti-anxiety drugs | 1) inderal 2) ativan 3) valium |
| akathisia: anticholinergics | 1) artane 2) cogentin 3) benadryl 4) symmetrel |
| acute dystonia | 1) involuntary spasms 2) abnormal postures 3) rigidity in face, arms, legs, neck |
| types of dystonia | 1) oculogyric crisis 2) torticollis 3) laryngeal/pharyngeal constriction |
| oculogyric crisis | contracted positioning of the eyes. Eyes pulled in one direction or rolled back |
| torticollis | contracted positioning of neck muscles. Pull neck to one side |
| laryngeal/pharyndeal constriction | 1) gagging 2) cyanosis 3) respiratory distress |
| acute dystonia: treatment | 1) IV cogentin 2) IV benadryl |
| tardive dyskinesia | abnormal muscle movement, especially of face, tongue, mouth, fingers or toes |
| tardive dyskinesia: treatment | 1) no effective treatment 2) often irreversible 3) withdraw drugs at first sign |
| tardive dyskinesia: first sign | vermiform movements of the tongue |
| neuroleptic malignant syndrome (NMS) | hyperactivity of sympathetic nervous system 1) muscle rigidity 2) tachypnea 3) hyperpyrexia 4) tachycardia 5) fluctuations in BP 6) incontinence 7) confusion/delirium |
| NMS: cardinal sign | hyperpyrexia: 101-107 degree fever |
| NMS: stats, when | 1) rare. 1-2% of pts 2) 14-30% mortality rate 3) onset can happen at any point in treatment form hours to years, but progression is rapid |
| NMS: treatment | 1) d/c antipsychotics immediately 2) place on medical unit 3) drugs to counteract 4) cool pt 5) hydration 6) cardiac monitoring |
| NMS: meds and what they do | 1) parlodel: relieve muscle rigidity/DA blockage decreased 2) dantrium: relax muscles |
| NMS: caution w geodon | have baseline EKG before it bc it causes electrical abnormalities in the heart |
| education for meds | 1) review side effects 2) caution about OTC meds 3) don't d/c meds without talking to dr 4) use sunscreen and protective clothing 5) report sore throat, fever, bleeding 6) WBC every week for clozaril |
| OTC meds that may interact | 1) cold meds 2) diet pills |
| general principles when around schizophrenic patients | 1) be calm around pt 2) keep promises 3) be consistent in care 4) set limits 5) don't touch without warning in paranoid pts 6) avoid laughing/whispering |
| how to treat the schizophrenic pt | 1) don't reinforce hallucinations or delusions 2) reality orientation 3) encourage verbalization 4) if withdrawn, spend one on one time |
| effects of smoking on neuroleptics | increases metabolism |
Created by:
rkasiejka27
Popular Nursing sets