psychotropic agents Flashcards
(25 cards)
uses for antipsychotic agents
Schizophrenia
Antiemetics
Dementia
antipsychotic gets classifications
Phenothiazines
Nonphenothiazines
schizophrenia patho
Excessive activation of CNS receptors for dopamine. Insufficient activation of CNS receptors for glutamate.
positive schizophrenia symptoms
things in addition to normal thinking (hallucinations and delusions)
negative schizophrenia symptoms
a decrease or loss of normal function (stop talking, no motivation, no display of emotions, decrease in ability to think)
goals of schizophrenic therapy
Suppression of acute episodes
Prevention of acute exacerbations
Maintenance of the highest level of functioning
Done primarily through medications
Patients have a high noncompliance with pharmacologic therapy
antipsychotic meds info
Initial effects seen in 1-2 days.
Substantial improvement takes 2-4 weeks.
Full effects not seen for months.
Drugs are not curative; symptomatic relief.
antipsychotic meds SE
EPS-extrapyramidal symptoms Anticholinergic effects Orthostatic hypotension Sedation Seizures Sexual dysfunction Dermatologic effects- acne, rash Increased risk that patients will become diabetic
EPS side effects
acute dystonia
Parkinsonism
akathisia
tardive dyskinesia
acute dystonia
Severe spasm of muscles of tongue, face, neck or back
Oculogyric crisis: involuntary upward deviation of the eyes (medical emergency)
Treated with Benadryl
akathisia
restlessness
Characterized by pacing, squirming brought on by an uncontrolled need to be in motion
Treated with beta blockers
Develops within first two months of treatment
parkinsonism
Bradykinesia, drooling, tremor, rigidity Shuffling gait, stooped posture Cogwheeling or pill rolling Develops within first month of therapy Treated with Symmetrel, Cogentin-PRN No Levodopa
tardive dyskinesia
Twisting, writhing worm-like movements of tongue and face.
Lip smacking
Fly catching
Interferes with swallowing, chewing, speaking
Treatment: decrease dosage
Symptoms irreversible if left untreated
phenothiazines
Thorazine (chlorpromazine)
Associated with EPS side effects
antipsychotics and caffeine
negates the effects of the drug
tricyclic antidepressants
elavil (amitriptyline)
for major depression
Block reuptake of NE and serotonin (increase levels)
tricyclic antidepressants SE
orthostatic hypotension, sedation, anticholinergic effects, cardiac toxicity
tricyclic antidepressants nursing precautions
Take at Bedtime (drowsiness) Avoid alcohol Therapeutic effects 2-6 weeks Monitor for suicide Oral contraceptives decrease efficacy Contraindicated if cardiac history Used as adjunctive analgesics chronic pain
MAO inhibitors
rarely used
MAO in the brain inactivate NE and seratonin. MAO-B inactivates dopamine. In GI tract MAO inactivates tyramine. MOA inhibitors block these effects
marplan (isocarboxazid)
MAO inhibitors SE
Cause direct CNS stimulation: anxiety, mania, headache, insomnia
Orthostatic hypotension
Hypertension if eats foods high in tyramine
MAO inhibitors nursing precautions
No foods high in tyramine No combination with SSRIs 4-8 weeks for full effects No caffeine No phenylethylamine No Ginseng
SSRI side effects
CNS: headache, drowsiness, anxiety, tremors
GI: changes in taste, N/V, weight gain
GU: painful menstruation, cystitis, sexual dysfunction
SSRI nursing precautions
Can’t give with an MAO inhibitor Monitor LFTs- can be toxic to the liver Suicide precautions Takes 5 weeks to achieve full effects May cause weight gain Take once a day in the morning Can’t be taken during pregnancy
lithium salts
Mood Stabilizers- Antimanic Drugs
Need to closely monitor drug levels
Normal level: 0.6-1.6 mEq/L
As levels rise: lethargy, slurred speech, muscle weakness, polyuria
Toxic levels: Clonic movements, hyporeflexia, seizures, hypotension, renal toxicity, pulmonary toxicity
