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NSG 322 > Antipsych Meds > Flashcards

Antipsych Meds Flashcards

1
Q

Antipsychotic Medications alleviate the symptoms of schizophrenia BUT

thinkcompliance

A

-cannot cure the underlying psychotic processes
-Psychotic symptoms return with medication noncompliance
-Even with medication compliance, relapse of psychosis can occur

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2
Q

Antipsychotic drugs are effective for…

A

-Acute exacerbations of schizophrenia
-Reducing the number of relapses
-Lessening the effects of relapses

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3
Q

what are the two classes of antipsychotic drugs

A

*Neuroleptics (Typical antipsychotics) (FGAs)
*Atypical antipsychotics (SGAs & TGAs)

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4
Q

Neuroleptics (Typical antipsychotics) (FGAs) target…

A

positive symptoms

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5
Q

Atypical antipsychotics (SGAs & TGAs) target..

A

positive and negative symptoms
*Atypical agents also treat anxiety, depression, & decrease suicidal behavior

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6
Q

Extrapyramidal symptoms (EPS)

A

are involuntary, drug-induced movements that include acute and tardive (delayed) symptoms.
-akathisia
-dystonia
-Pseudoparkinsonism

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7
Q

EPS can develop into…

A

tardive dyskinesia (irregular, jerky movements), which is a permanent condition

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8
Q

Examples of typical antipsychotics (first generation)

A

-chlorpromazine
-fluphenazine
-haloperidol
-perphenazine

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9
Q

what are the advantages of First-generation antipsychotics

A

-Inexpensive
-Available in oral and IM injection forms - both immediate and long-acting injections (LAIs)

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10
Q

Neuroleptic Malignant Syndrome (NMS) can be caused by

A

The high potency 1st generation antipsychotics (like Haldol)

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11
Q

Neuroleptic Malignant Syndrome (NMS) S/S

A

-Sudden high fever
-Sweating
-Rigidity
-Dysrhythmias
-Fluctuations in BP
-Decreased LOC
-Respiratory failure

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12
Q

treatments for symptoms of Neuroleptic Malignant Syndrome (NMS)

A

bromocriptine (Parlodel) or dantrolene (Dantrium)

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13
Q

acute dystionia is treated with

A

IM (diphenhydramine) Benadryl or (benztropine) Cogentin

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14
Q

Acute dystonias

A

a series of uncontrollable cramping, muscle movements, and spasms of the tongue, face, neck, and back

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15
Q

acute dystonia: oculogyric crisis

A

uncontrolled rolling back of the eyes

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16
Q

acute dystonia: Torticollis

A

head tilt due to shortening or spasm of one sternomastoid muscle

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17
Q

acute dystonia: glossospasm

A

spasm of the tongue

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18
Q

acute dystonia: Opisthotonus

A

The back is rigid and arching, and the head is thrown backward.

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19
Q

Pseudoparkinsonism s/s

A

*Rigidity (lead pipe, cogwheeling)
*Bradykinesia
*Mask-like face
*Shuffling gait
*Tremor
*Postural deficits
*Chorea
*Hemiballismus
*Athetosis
*Certain dystonias
*Tics

20
Q

Pseudoparkinsonism is treated with

A

anticholinergics

21
Q

Akathisia

A

is an inner restlessness. The patient twitches and moves and wiggles. There is a constant urge to be moving, and while this is abnormal, it is still voluntary movement, the urge cannot be ignored.

22
Q

what must be stopped when Tardive Dyskinesia (TD) develops

A

*Offending med must be stopped
*Anticholinergics are stopped

23
Q

Tardive dyskinesia s/s

A

*consists of abnormal, involuntary movements usually involving the tongue, fingers, toes, trunk, and/or pelvis

24
Q

early symptoms of TD

A

*Tongue fasciculations
*Constant lip smacking

25
Q

Later (permanent) TD symptoms

A

*Oral movements (e.g., uncontrollable biting, chewing, or sucking motions; an open mouth; lateral movements of the jaw)
*Thrusting, serpentine, or choreic movements of the neck, trunk, or pelvis
*Torticollis
*Facial tics (including abnormal involuntary blinking or chewing)

26
Q

treatment for EPS

A

-IV/IM administration of anticholinergic meds
-Benztropine (Cogentin)
-Diphenhydramine (Benadryl)

27
Q

preventative assessment fro EPS

A

-Abnormal Involuntary Movement Scale (AIMS)
(Psychiatrist to test for EPS every 3 months)

28
Q

anticholinergics

A

*trihexyphenidyl (Artane)
*benztropine mesylate (Cogentin)
*diphenhydramine hydrochloride (Benadryl)
*amantadine hydrochloride (Symmetrel)

29
Q

Tardive Dyskinesia Treatment

A

-There is no cure for TD.
-The drug that caused the client’s TD must be stopped to prevent worsening of movements.

30
Q

as of 2019, what drugs are now used for TD

A

valbenazine and deutetrabenazine

31
Q

Atypical (2nd- & 3rd-Generation) Antipsychotics examples

A

clozapine
olanzapine
paliperidone
quetiapine
risperidone
ziprasidone
iloperidone
aripiprazole

32
Q

Atypical Antipsychotics: Side Effects

A

*CONSTIPATION - significant & very common side effect
*Lowered seizure threshold
*Metabolic side effects
*Weight gain, hyperglycemia, hyperlipidemia, cardiac myopathy
*Can lead to METABOLIC SYNDROME

33
Q

clozapine SE

A

Agranulocytosis

34
Q

clozapine interventions

A

*Strict monitoring protocols including weekly CBC
*Client education - immediately report any signs or symptoms of infection (e.g., sore throat, fever, flu-like symptoms, leukopenia)

35
Q

risperidone SE

A

*Gynecomastia & hyperprolactinemia

36
Q

ziprasidone SE

A

cardiac dysrhythmias
-QT prolongation

37
Q

Metabolic Syndrome

A

*Increased risk of diabetes, hypertension, heart disease
*Weight gain - need baseline weight & waist circumference and monitor during treatment for changes
*Dyslipidemia - monitor lipid levels (cholesterols & triglycerides)
*Altered glucose metabolism - monitor labs for blood sugar and Hgb A1C changes

38
Q

Overview: Typical (1st Generation) SE

A

*Extrapyramidal Symptoms (EPS)
*Dystonic reaction
*Akathisia
*Drug-induced parkinsonism
*Tardive dyskinesia (TD)
*Orthostatic hypotension
*Body temp alterations (hypothermia)
*Neuroleptic Malignant Syndrome (NMS)-fever

39
Q

Overview: Atypical (2nd & 3rd Generation)

monitor…

A

*EPS& TD possible, but less likely
*Risk for Metabolic Syndrome:
*Increased weight, blood glucose, triglyceride levels, insulin resistance
*Constipation
*QT prolongation
*Agranulocytosis (with clozapine)
*Gynecomastia (with risperidone)
*Cardiac dysrhythmias (with ziprasidone)

40
Q

3rd generation antipsychotic (aripiprazole) advantage

A

has even less side effects than 2nd generation

41
Q

Chorea

A

sudden, involuntary, irregular, and jerky movements that can affect any part of the body.

42
Q

Hemiballismus

A

violent, flinging movements of one side of the body

43
Q

Athetosis

A

Slow, writhing, continuous movements, especially in fingers and toes.

44
Q

Dystonia

A

involves involuntary muscle contractions that cause repetitive or twisting movements.

45
Q

Rigidity

A

Rigidity refers to stiffness and inflexibility of the muscles. In drug-induced pseudoparkinsonism, rigidity can be observed as a resistance to passive movement.
(lead pipe or cog wheel)

46
Q

Postural deficit

A

Difficulty maintaining an upright posture, stooped posture, and balance issues.

47
Q

Bradykinesia/Akinesia

A

Drug-Induced Pseudoparkinsonism: Both are hallmark features.
Bradykinesia: This term means slowness of movement. People with drug-induced pseudoparkinsonism may have difficulty initiating movements and once started, the movements are slow and difficult to carry out.

Akinesia: This is a more severe form of bradykinesia, referring to the inability to initiate movement.

NSG 322 (12 decks)

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