week 5

Question 1

what do antipsychotic drugs not be used to treat?

Answer 1

older adults with dementia

Question 2

when does schizophrenia typically emerge?

Answer 2

in adolescence or early adulthood

Question 3

which symptoms of schizophrenia are treated with antipsychotics?

Answer 3

only positive symptoms

Question 4

what type of drugs end in “azine”

Answer 4

antipsychotic drugs

Question 5

adverse effects of the first generation antipsychotics

Answer 5

acute dystonia
parkinsonism 
akathisia 
Anticholinergic effects 
orthostatic hypotension

Question 6

Oldest and largest group of FGAs

Answer 6

Phenothiazines

Question 7

why is clozapine in very limited use?

Answer 7

because of the adverse effects like agranulocytosis

Question 8

what happens in patients with atypical depression

Answer 8

many symptoms are the opposite, they experience hypersomnia, weight gain

Question 9

who tend to have more atypical forms of depression

Answer 9

women

Question 10

what do depressed and suicidal clients have low levels in the CSF fluid

Answer 10

serotonin

Question 11

Tricyclic Antidepressents most dangerous adverse effect

Answer 11

cardiac toxicity

Question 12

antidote for Tricyclic Antidepressent overdose

Answer 12

Cholinesterase inhibitor (physostigmine)

Question 13

what foods do you want to avoid with Monoamine Oxidase Inhibitors

Answer 13

tyramine-rich foods

Question 14

what is given to treat bipolar disorders

Answer 14

lithiums
Antipsychotics
Antiepileptics
Anxiolytics

Question 15

which is stronger sedatives or hypnotics?

Answer 15

hypnotics

Question 16

how do amphetamines work

Answer 16

they are CNS stimulants

Question 17

Non-amphetamine-modafanil (Provigil) use

Answer 17

Narcolepsy

Question 18

what is akathisia?

Answer 18

restlessness

Question 19

what is acute dystonia?

Answer 19

severe muscle spasm tongue, face neck, back

Question 20

what is acute dystonia treated with?

Answer 20

anticholinergics

Question 21

what is Tardive dyskinesia?

Answer 21

involuntary movements of the tongue, face, such as lip smacking, which causes speech and or eating disturbances

Question 22

what is done to prevent tardive dyskinesia?

Answer 22

• using lowest effective dose
• for the shortest time period
• assessments done after 12months and a neuro eval is done every 3 months

Question 23

what is neuroleptic malignment syndrome characterized by?

Answer 23

• sudden high temperature

- instability of ANS

Question 24

what should the nurse do if a patient developes Neuroleptic malignant syndrome?

Answer 24

• stop medication
• monitor VS
• increase fluids
• antipyretics

Question 25

what time of day should anti psychotics be given?

Answer 25

at night because of sedative effects

Question 26

how can anti psychotics effect the skin? (2)

Answer 26

they can increase sensitivity and agranulocytosis

Question 27

how can anti psychotics effect the cardiac system?

Answer 27

can cause severe dysrthythmias

Question 28

how should anti psychotics be stopped?

Answer 28

Should be tapered if stopped because can cause a mild abstinence syndrome

Question 29

what effect will combining anticholinergics with antipsychotics have?

Answer 29

Increased anticholinergic effect

Question 30

what effect will combining CNS depressants with antipsychotics have?

Answer 30

Increased depressant effect

Question 31

what is the drug interact between levodopa and antispychotics

Answer 31

May counteract the antipsychotic effects of neuroleptics

Question 32

what is the prototype of phenothiazines?

Answer 32

chlorpromazine

Question 33

what are phenothiazines used for?

Answer 33

Schizophrenia | Intractable hiccups

Question 34

prototype of 2nd and 3rd generation of antipsychotics

Answer 34

Clozapine

Question 35

why is Clozapine (2nd +3rd gen antipsychotics in limited use?

Answer 35

Limited use because of agranulocytosis

Question 36

what needs to be monitored for patients on phenothiazines? (6)

Answer 36

BP (standing and at rest) Pulse rates Weight Complete blood count (CBC) with differential Electroencephalogram (EEG) Ocular examination "boring philosophers watched clever ethical outlaws"

Question 37

what should be obtained for patients on 2-3 gen of anti psychotics?

Answer 37

``` Baseline vital signs Weight Serum glucose Triglyceride levels CBC ```

Question 38

risks for olanzepine?

Answer 38

- low risk of EPS | - high risk for DM weight gain and dyslipidemia

Question 39

risks for Quetiapine?

Answer 39

low risk of EPS but same high risk as olanzapine with the addition of cataracts, sedation and anticholinergic effects. Eye screenings every 6 months

Question 40

the advantages of the second/third antipsychotics?

Answer 40

Fewer EPS Fewer anticholinergic effects Relief of positive and negative symptoms of disease

Question 41

complications of second-third generation antipsychotics

Answer 41

``` DM Weight gain Hypercholesteremia Orthostatic hypotension Anticholinergic effects Dizziness/sedation Mild EPS Elevated prolactin levels Sexual dysfunction ```

Question 42

how can nurses ensure that patients adhere to taking their medications

Answer 42

``` checking the cheeks social support systems injecting the medication educate written and verbal instructions ```

Question 43

symptoms of depression

Answer 43

``` Mood alteration Lack of pleasure Apathy Anorexia Insomnia ```

Question 44

how long do symptoms need to be present for it to be considered depression?

Answer 44

Needs to be present for most of day for every day for at least two weeks

Question 45

gender specific differences of depression in women

Answer 45

Atypical symptoms Seasonal effect Coexisting anxiety and eating disorders Suicide tries

Question 46

gender specific differences of depression in men

Answer 46

Coexisting alcoholism Coexisting substance abuse Completed suicide

Question 47

what levels of NE are found in depressed individuals?

Answer 47

Low NE metabolites found in urine and CSF of depressed individuals

Question 48

types of drugs to treat depression

Answer 48

Tricyclic antidepressants (TCAs) Selective serotonin reuptake inhibitors (SSRIs) Serontonin/norepinephrine reuptake inhibitors (SNRIs) Monoamine oxidase inhibitors (MAOIs) Atypical antidepressants

Question 49

what is a way of treating severe depression without the use of drugs

Answer 49

Electroconvulsive therapy (ECT)-

Question 50

conditions other than depresssion that are treated with TCAS, SSRIS and Atypicals

Answer 50

``` OCD Panic Disorder Eating Disorders Social Anxiety GAS PMS PMDD ADD ```

Question 51

what is the action of Tricyclic Antidepressants

Answer 51

Blocks the reuptake of NE and serotonin, allowing more effect to occur from these transmitters

Question 52

what do tricyclic antidepressents end in?

Answer 52

- tyline

Question 53

what screenings do you need every 6 months with olanzapine

Answer 53

eye screening