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Pharmacology - Spring 2024 > Ch. 17 Drugs - Psychoses > Flashcards

Ch. 17 Drugs - Psychoses Flashcards

1
Q

Schizophrenia Positive Symptoms

A

ADD to normal behavior
Hallucinations, delusions, or paranoia
Strange and irrational behavior, actions
Rapid alternation between extreme hyperactivity and stupor

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2
Q

Schizophrenia Negative Symptoms

A

SUBTRACT from normal behavior
Lack of motivation; detachment
Deterioration of hygiene, job, academic performance
Withdrawal from social and interpersonal relationships

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3
Q

Conventional or “typical” antipsychotics

A

First Generation Psych Meds

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4
Q

Example of first generation psych med

A

chlorpromazine
(early 1950s, “first generation”)

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4
Q

Second generation psych meds

A

Atypical antipsychotics with fewer side effects

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4
Q

Third generation psych meds

A

also atypical; dopamine-serotonin system stabilizers

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5
Q

Example of third generation psych med

A

aripiprazole (Abilify)

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5
Q

chlorpromazine MOA

A

blocks positive symptoms

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6
Q

chlorpromazine pharmacologic class

A

D2 dopamine receptor antagonist; phenothiazine

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6
Q

Adverse Effects of First Generation Psych Meds

A

Acute dystonia
Akathisia
Anticholinergic effects
Disparity
Hypotension
Neuroleptic malignant syndrome
Secondary parkinsonism
Sedation
Sexual dysfunction
Tardive dyskinesia

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7
Q

Severe Adverse Effects of First Generation Psych Meds

A

Increased risk of suicide
Agranulocytosis
Pancytopenia
Sudden unexplained death

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8
Q

Body Systems to Monitor when taking First Generation Psych Meds

A

Decrease of psychotic symptoms, side effects
Anticholinergic side effects
Alcohol, illegal drug, caffeine, and nicotine use
Cardiovascular changes
Seizures and patient’s environment
Neuroleptic malignant syndrome (NMS)

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9
Q

haloperidol (Haldol) Pharmacologic class

A

D2 dopamine receptor antagonist; NONphenothiazine

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10
Q

haloperidol (Haldol) MOA

A

blocks positive symptoms

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11
Q

Adverse effects of nonphenothiazine (haloperidol [Haldol])

A

SAME AS PHENOTHIAZINES

Acute dystonia
Akathisia
Anticholinergic effects
Disparity
Hypotension
Neuroleptic malignant syndrome
Secondary parkinsonism
Sedation
Sexual dysfunction
Tardive dyskinesia

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12
Q

risperidone (Risperdal) - atypical antipsychotic treats what symptoms?

A

Both positive and negative symptoms

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13
Q

risperidone (Risperdal) MOA

A

block dopamine type 2 receptors, serotonin and alpha-adrenergic receptors

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14
Q

Atypical antipsychotic side effects

A

Less dramatic side effects than first generation, but still significant

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15
Q

Dopamine-serotonin system stabilizers

A

Third generation psych meds
Newest antipsychotic class
New drug class, approved in 2002

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16
Q

Example of third generation psych med

A

Aripiprazole (Abilify)

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17
Q

Aripiprazole (Abilify) controls what schizophrenia symptoms?

A

Positive and negative

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18
Q

Third generation psych med side effects

A

Low incidence of serious side effects compared to other antipsychotic drugs

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19
Q

Severe spasms, particularly the back muscles, tongue, and facial muscles; twitching movements

A

Acute dystonia

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20
Q

Constant packing with repetitive compulsive movements

A

Akathisia

21
Q

Dy mouth, tachycardia, blurred vision, orthostatic hypotension, and urinary retention

A

Anticholinergic effects

22
Q

High risk of suicide among patients receiving antipsychotic therapy

A

Disparity

23
Q

Particularly severe when the patient when the patient moves quickly from a recumbent to an upright position

A

hypotension

24
Q

High fever, tachycardia, incontinence, confusion, muscle rigidity, and high serum creatine kinase; can be fatal

A

Neuroleptic malignant syndrome

25
Q

Tremor, muscle rigidity, stooped posture and shuffling gait

A

Secondary parkinsonism

26
Q

Usually diminishes with continued therapy

A

Sedation

27
Q

Impotence and diminished libido

A

Sexual dysfunction

28
Q

Bizarre tongue and face movements, such as lip smacking and wormlike motions of the tongue; puffing of cheeks, uncontrolled chewing movements

A

Tardive dyskinesia

29
Q

Acute dystonia
Akathisia
Secondary Parkinsonism
Tardive Dyskinesia

A

Extrapyramidal Symptoms

30
Q

Most common EPS

A

Akathisia - inability to rest or relax.
Patient paces, has trouble sitting or remaining still, and has difficulty sleeping

31
Q

Drugs that cause anticholinergic side effects

A

phenothiazine drugs -chlorpromazine

32
Q

haloperidol (Haldol) may be given with what other drugs?

A

Short-acting benzodiazepines - Lorazepam

33
Q

Normal side effects of haloperidol (Haldol)

A

Dystonic Behavior in EPS

34
Q

Killer Side Effect of haloperidol (Haldol)

A

Neuroleptic Malignant Syndrome

35
Q

Potential life-threatening reaction most often seen with typical antipsychotics

A

Neuroleptic Melignant Syndrome (NMS)

36
Q

High fever and diaphoresis
Change in mental status
Muscle Rigidity
Tremors

A

Signs & Symptoms of NMS

37
Q

Chlorpromazine and haloperidol (Haldol) treat what symptoms of schizophrenia?

A

Positive symptoms

38
Q

Risperidone (Risperdal) treat what symptoms of schizophrenia

A

Positive and negative symptoms

39
Q

Priority nursing actions for NMS

A

Hold haloperidol (Haldol)
Assess the patient
Notify HCP IMMEDIATELY

40
Q

Risperidone (Risperdal) indication for use

A

Schizoprenia, schizoaffective disorder & patient’s not responding to other antipsychotics

41
Q

Common side effects of risperidone (Risperdal)

A

Weight gain, hypersalivation (drooling), & sedation

42
Q

Major Adverse effects of risperidone (Risperdal)

A

Agranularocytosis
Leukopenia - low WBCs & low immunity - decreased neutrophils
High risk for infections
Sore throat, fever, flu like symptoms

43
Q

Priority action for adverse effects of risperidone (Risperdal)

A

IMMEDIATELY report to HCP

44
Q

risperidone (Risperdal) contraindications

A

Patients with dementia - increased mortality

45
Q

Can occur early in treatment or with an increased dose of medication

A

Acute Dystonia

46
Q

Severe form of restlessness associated with a compulsion to move. Usually the legs or torso, not the head

A

Akathisia

47
Q

Drug-induced movement disorder which mimics (or reveals) the S&S of idiopathic Parkinson’s Disease

A

Parkinsonism
(Secondary Parkinson’s)

48
Q

Collective term for a set of late-onset and sometimes irreversible movement disorders which can include cborea, dysphonia, dystonia, tics, and myoclonus

A

Tardive Dyskinesia

49
Q

Increase in dose or addition of medication that increases the levels of serotonin above the threshold that induces toxicity

A

Serotonin Syndrome

50
Q

Acute onset of symptoms

A

Serotonin Syndrome

51
Q

Signs of Serotonin Syndrome

A

Tremors & hyperreflexia

52
Q

NMS symptoms arise when?

A

Days, weeks, or months

53
Q

NMS is thought to be mediated by what?

A

Dopamine antagonism

54
Q

Signs of NMS

A

Slowed movements and lead pipe rigidity

Pharmacology - Spring 2024 (8 decks)

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