Chapter 3 pt 3 Flashcards
(32 cards)
what re the EPS seen from antipsychotics and how are they treated
dystonia (spasm) of face, next and tongue
parkinsonism (resting tremor, rigidity, bradykinesia)
akathisia (feeling of restlessness)
tx: anticholinergics (benztropine, diphenhydramine), benzos and beta blockers for akathisia
what are the 6 main side effects seen from antipsychotics
EPS anticholinergic metabolic syndrome tardive dyskinesia neuroleptic malignant syndrome prolonged QTc
what are the more weight neutral 2nd generation antipsychotics with less of a risk for metabolic side effects
apriprazole or ziprazidone
tardive dyskinesia is more commonly seen with what antipsychoitcs
1st generation
patients on second generation antipsychotics need to be monitored for what and how
metabolic syndorme
blood pressure, BMI, weight, fasting blood glucose, lipid panel
high-potency antipsychotics (haloperidol and fluphenazine) have higher risk of what side effects
EPS
low-potency antipsychotics (chlorpromazine) have primarily risk of what side effects
anticholinergic and antiadrenerigic
what is seen in neuroleptic malignant syndrome
change in mental status autonomic instability (high fever, labile blood pressure, tachycardia, tachypnea, diaphoresis) lead pipe rigidity elevated CPK leukocytosis metabolic acidosis
cumulative risk of developing tardive dyskinesia from antipsychotics (especially 1st generation) is what
5% per year
thioridazine may cause what side effect
irreversible RETINAL PIGMENTATION at high doses
chlorpromazine may cause what side effect
deposits in LENS and CORNEA
what is the prognosis of schizophreniform disorder
1/3 recover completely
2/3 either have schizoaffective or schizophrenia
what is treatment of schizophreniform disorder
hospital (if necessary)
6 months antipsychotics
supportive psychotherapy
what DSM-5 criteria schizoaffective disorder
meets criteria for tether major depressive or manic episode during which psychotic symptoms consistent with schizophrenia are also met
delusion or hallucinations for 2 weeks in the absence of mood disorder (differentiates from mood disorder w/ psychotic features)
mood symptoms present for a majority of psychotic illness
patients with what personality disorder may have transient, stress related psychotic experiences
BORDERLINE
these are considered part of their underlying personality disorder and not diagnosed as a brief psychotic disorder
brief psychotic disorder is fairly rare, but can be seen in reaction to what
major stressor: bereavement or sexual assault
what is the prognosis of brief psychotic disorder
high rates of relapse
almost all completely recover
what is treatment of brief psychotic disorder
brief hospitalization (usually for workup, safety, and stabilization)
supportive therapy
course of antipsychotics
benzos for agitation
what is the criteria for delusional disorder
one of more delusion for at least a month
does not meet criteria for schizophrenia
functioning in life not significantly impaired, and behavior not obviously bizarre
what are erotomania type of delusions
delusions that another person is in love with the individual
what are grandiose type delusions
delusions of having great talent
what are somatic type delusions
physical delusions
what are persecutory type delusions
delusions of being persecuted
what are jealous type delusions
delusions of unfaithfulness
