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antipsychotics and anxiolytics
chapter 27 Antipsychotics and anxiolytics
35
Pharmacology
Undergraduate 4
04/10/2014

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Term
what is psychosis?
Definition
A mental and behavioral disorder
Causes gross distortion or disorganization of mental capacity, affective response, communication, ability to relate to others and recognize reality
Interferes with a person’s capacity to cope with ordinary demands of everyday life.
Term
what are symptoms of psychosis?
Definition
Delusions
Incoherence
Hallucinations
Personality disintegration
Reduced level of awareness
Aggressive or violent behaviors
Gross impairment in reality testing
Difficulty in processing information
Term
what is the theroy about psychosis?
Definition
results from dopamine imbalance in brain
Term
what is schizophrenia?
Definition
a chronic psychotic disorder that usually occurs in adolescence or early adulthood
Term
what is the affect of giving dopamine drugs?
Definition
the effect of pseudoparkinsonism
Term
when is schizophrenia diagnosed?
Definition
in adolescensce or early adulthood
Term
what are positive symptoms of schizophrenia?
Definition
Delusions
Paranoia
Hallucinations
Incoherent speech
Term
what are some negative symptoms of schizophrenia?
Definition

poor self-care

social withdrawl and a poverty of speech content

Term
what are the three groups of antipsychotics of phenothiazines?
Definition
aliphatic, piperazine and piperidine
Term
what is an aliphatic drug and its side effects?
Definition
chlorpromazind (thorazine) and the side effects are strong sedation, severe orthostatic hypotention and moderate EPS
Term
what is a piperazine  and its side effects?
Definition
Fluphenazine (Prolixin)
Side effects: low sedation, strong antiemetic
    effect, severe EPS
Term
 what is an example of a piperidine and its side effects?
Definition
Mesoridazine besylate (Serentil)
Side effects: strong sedation, hypotension, few EPS effects
Typical Antipsychotics (cont’d)
Fluphenazine (Prolixin)
Action: Block dopamine receptors in brain
Use: Manage symptoms of Schizophrenia
Interactions
Increase depression when taken with alcohol or
    other CNS depressants; Kava kava may increase EPS
Side effects
Sedation, dizziness, headache, seizures
Dry mouth, nasal congestion, blurred vision,
    photosensitivity, urinary retention
GI distress peripheral edema, tachycardia, EPS
Term
what is an example of a nonphenothiazine?
Definition
haloperidol (haldol)
Term
what is the action of Haldol?
Definition
Blocks dopamine receptors
Term
what is haldol used for?
Definition
Treat acute and chronic psychoses
Treat schizophrenia, Tourette’s syndrome, dementia
Term
what are the contraindications of haldol?
Definition
Narrow-angle glaucoma; severe liver, kidney and cardiovascular disease; blood dyscrasias, sedation
Term
what are side effects of haldol?
Definition
Sedation, EPS, headache, seizures
Dry mouth, blurred vision, photosensitivity, urinary retention
Tachycardia, orthostatic hypotension, dysrhythmias
Term
what are some interactions with haldol?
Definition
Increased sedation with alcohol, CNS depressants
Increased toxicity with anticholinergics
Decreased effects with phenobarbital, carbamazepine, caffeine
Term
what is EPS?
Definition

Pseudoparkinsonism symptoms

acute dystonia

akathisia and tardive dyskinesia

Term
what are symptoms of pseudoparkinsonism?
Definition
Stooped posture
Masklike features
Rigidity
Tremors at rest
Shuffling gait
Bradykinesia
Pill-rolling motion of the hand
Term
what are symptoms of acute dystonia?
Definition
Muscle spasms of face tongue, neck, and back
 Facial grimacing
 Involuntary upward eye movements
Laryngeal spasms
Term
what are symptoms of akathisia?
Definition
constant motion (pacing)
Term
what are symptoms of TD?
Definition
Protrusion and rolling of tongue, chewing action
Term
what is neuroleptic malignant syndrome?
Definition
Rare, potentially fatal condition
Term
what are the symptoms of neuroleptic malignant syndrome>?
Definition
Muscle rigidity, sudden high fever, altered mental status, BP fluctuations, tachycardia, dysrhythmias, seizures, rhabdomyolysis, acute renal failure, respiratory failure, coma
Term
what is treatment for neuroleptic malignant syndrome?
Definition
Immediate withdrawal of antipsychotics,
    hydration, hypothermic blankets, antipyretics,
    benzodiazepines, muscle relaxants
Term
what are some of example of an atypical antipsychotics?
Definition
lozapine (Clozaril, risperidone
    (Risperdal), ziprasidone (Geodon),
    aripiprazole (Abilify)
Term
what are the advantages of atypical antipsychotics?
Definition
Effective in treating both positive and negative
    symptoms of schizophrenia
Less likely to cause EPS or tardive dyskinesia
Term
what is the action  of atypical antipsychotics?
Definition
lock serotonin and dopaminergic D4 receptors
Term
with clozapine (clozaril) what are some adverse effects?
Definition
agranulocytosis
Term
what are some nursing interventions with antipsychotics and anxiolytics?
Definition
Monitor weekly WBC counts
Olanzapine (Zyprexa)
Does not cause agranulocytosis
Term
what is risperidon (risperdol) used for?
Definition
Manage symptoms of psychosis, schizophrenia
Side effects/adverse reactions
Sedation, weight gain, headaches, dry mouth,
    photosensitivity, urinary retention, EPS, seizures, sexual dysfunction, tachycardia, orthostatic
    hypotension, ECG changes
Term
what are some condtraindications with risperdol?
Definition
Dysrhythmias, blood dyscrasias, liver damage
Term
what are some interactions with risperdol?
Definition
Increased effects of antihypertensives
Decreased risperdol levels with concurrent use of
    carbamazepine
Concurrent use of cisapride may cause dysrhythmias
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