Schizo Medicaitons Flashcards
(41 cards)
what are Typical Antisychotics and what do they target
Dopamine antagonists (D2 recepto Antagonists)
target positive symptoms
adv of typical antipsychotics
less expensive
disadv of typical antipsychotics
Extrapyramidal side effects (EPS)
Anticholinergic (ACh) side effects
Tardive dyskinesia
Weight gain, sexual dysfunction, endocrine disturbances
2-6 wks for effect
2 Typical antipsychotics
chlorpromazine (Thorazine)*
haloperidol (Haldol)*
side effects of typical antipsychotics
anticholinergic, sedation, EPS, hypotension,
seizure, photosensitivity, skin rash, GI upset,
EKG changes, hormonal/endocrine,
Agranulocytosis, Neuromalignant Syndrome,
Tardive Dyskinesia
S/E of antipsychotic meds
Anticholinergic (Ach) Side Effects
Dry mouth, urinary retention/hesitancy, constipation, blurred vision, dry eyes, sexual dysfunction
Hypotension & orthostatic hypotension
Extrapyramidal Side Effects (EPS)
–Acute Dystonia
–Akathisia
–Pseudoparkinsonism
–Tardive Dyskinesia (TD)
Agranulocytosis
Neuroleptic Malignant Syndrome (NMS)
Metabolic Syndrome
Prolongation of QT Interval
Liver Impairment
what is pseudoparkinsonism
simulates Parkinson’s
disease and is a reversible syndrome that
includes the following symptoms:
tremulousness in the hands and arms
rigidity in the arms and shoulders
Bradykinesia
Akinesia
Hypersalivation
masked facies
shuffling gait
Tx of pseudoparkinsonism
dosage reduction or the addition of oral anticholinergic agents
what is akathisia
feeling of inner restlessness that can be manifested as excessive pacing or inability to remain still for any length of time.
Tx of akathisia
dosage reduction when possible, or the addition of a low-dose beta blocker, such as propranolol (Inderal)
dystonia’s extrapyramidal S/E
Torticollis - spasmodic and painful spasm of muscles ( head pulled to one side)
Oculogyric Crisis: eyes roll back toward the head. Emergency Situation
Opisthotonus –A type of spasm in which the head and heels arch backward in extreme hyperextension and the body forms a reverse bow;
Laryngospasm- spasm of throat impairing breathing and swallowing
Oral-facial maxillary spasms- treat emergently as they may progress
T/F Dystonia extrapyramidal S/E are emergent
True
Tx for mild S/E
reduce dosage
d/c med (taper)
switch to another class med
add anticholinergic ageny:
benztropine
diphenhydramine
trihexphenidyl
add beta blocker = propranolol
what is tardive dyskinesia
involuntary movement disorder that can occur with long-term antipsychotic treatment and may not be reversible even if the medication is discontinued.
usually involves the orofacial region, but all parts of the body can be involved. Abnormal movements can include myoclonic jerks, tics, chorea, and dystonia. They become most evident when patients are aroused, but ease during relaxation and disappear during sleep.
Attempts to treat tardive dyskinesia usually begin by discontinuing the offending agent or switching to one with a lower risk, but evidence is insufficient to show that this or any other treatment markedly reduces symptoms after onset
Risk factors for tardive dyskinesia
long-term therapy with FGAs at higher dosages, older age, female sex, and concurrent affective disorders
TX of tardive dyskinesia
D/C med or reduce dosage
Clozapine (Clozaril) shown some efficiancy
New med for tardive dyskinesia
avobenzone
S/S of neuroleptic malignant syndrome
fever 103- 105 degrees Fahrenheit or greater
diaphoresis
muscle rigidity: arm/abdomen board like-with corresponding increased CPK levels
labile BP: hypotension or hypertension
tachycardia: > 130 bpm
Tachypnea: >25 rpm
agitation: r/t respiratory distress
mental status changes; stupor /coma
predisposing factor to neuroleptic malignant syndrome
dehydration
usually associated with antipsychotics
Interventions with neuroleptic maligant syndrome
stop all antipsychotics
Dantrolene
Bromocriptine
Levodopa
lorazepam
What are Atypical antipsychotics and what do they treat
serotonin and dopamine antagonists
treat positive and neg symptoms
benefits to atypical antipsychotics
minimal to no EPS or tardive dyskinesia
Disadv to atypical antipsychotics
weight gain
metabolic syndrome
Atypical Antipsychotic meds
clozapine (Clozaril)
olanzapine (Zyprexa)
quentiapine (Seroquel)
respiridone (Respiradol)
Respiradol Consta
ziprasidone (Geodon)
