Term
| Antipsychotics (typical) are used to inhibit which neuro trans mitter? |
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Definition
| Dopamine also called dopamine antagonists because they block D2 dopamine receptors in the brain reducing psychotic symptoms. |
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Term
| True or False some antipsychotics can act as antiemetic drugs |
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Definition
| True; may glock the chemorecrptor trigger zine and vomiting center in the brain. |
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Term
| Antipsychotics treat which symtoms (choose all that apply) |
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Definition
incoherent speech
hallucinations
delusions
paranoia
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Term
| Antipsychotics (atypical) block? |
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Definition
| serotonin; receptors D4 and have less EPS (extrapyramidal symtoms) |
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Term
| Pseudoparkinsonism (AKA Extrapyramidal symptoms [EPS]) is a major side effect of typical antipsychotic drugs. What are the s/s? |
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Definition
stooped posture
mask like facies
rigidity
remors at rest
shuffling gait
pill-rolling motion of the mand
bradykinesia |
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Term
| True or False patients who take lower strength antipsychotics (like Thorazine) are less likely to have pseudoparkinsonism? |
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Definition
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Term
| An adverse extrapuramidal reaction that may occur is dystonia. What are the s/s? |
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Definition
muscle spasm of the face, tounge, neck, and back
facial grimacing
abnormal or involuntary upward eye movement
laryngeal spasms that can impair respiration
(these are treated with anticholinergic/antiparkinsonism drugs:Cogentin) |
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Term
akathisia also an adverse reaction to antipsychotics. What are the s/s?
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Definition
trouble standing still
restless
paces the floor
in constant motion (rocks back and forth)
best treated with lorazepam or propranolol
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Term
| serous advers reaction that occurs in clients taking antipsychotic drugs for more than a year strait can develop tardive dyskinesia. What are the s/s? |
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Definition
protrusion and rolling of the tongue
sucking and smacking movement of the lips
chewing motion
facial dyskinesia
involuntary movement of the body and extremites
(antipsychotic drugs should be stopped in all who experience this reaction) |
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Term
| Antipsychotics are highly protein bound >90% what is this patient at risk for if they are taking Asprin, warfarin, digioxin? |
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Definition
| Toxicity all of these are fighting for protein binding sites which could result in toxicity |
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Term
| Antipsychotics are broken up into two major categories: typical and atypical. Typical antipsychotics are further broken down into two catagories what are they? |
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Definition
| phenothiazines and nonphenothiazines |
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Term
| urine that is pinkish or red brown when a patient is taking Phenothiazine is (expected, not expected) side effect? |
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Definition
| expected but the patient should be informed of this ahead of time and that it is harmless. |
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Term
| Phenothaiazines are broken into three sub groups differenciated by there side effects. What are the three groups? (select all that apply) |
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Definition
aliphatic phenothiazines (Ex:Thorazine)
piperazine(Ex: Proxlin, Trilafon)
piperidine (Ex: Mellaril) |
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Term
| Adverse reactions (remeber these are the worst of the worst reactions that can happen not the side effects) of phenothiazines are? |
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Definition
hypertension
hypotension
tachycardia
extrapyramidal symptoms (tardive dyskinesia)
impaired thermoregulation
convulsions
life-threatening: agranulocytosis |
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Term
| Antacids and should be given how many hours before or after antipsychotics to aid absorbtion? |
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Definition
| 1 hour before or 2 hours after |
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Term
| Nonphenothiazines groups include? |
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Definition
butyrophenone (Ex: Haldol)
dibenzoxazepine (Ex: Loxitane)
dihydroindolone (Ex: Moban)
thioxanthenes (Ex: Navane) |
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Term
| Most common side effects of antipsychotics are? |
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Definition
Drowsiness
anticholinergic effects (dry mouth, increased heart rate, urinary retnetion, constipation) |
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Term
| Adverse reactions of nonphenothiazines are? |
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Definition
dystonia
tardive dyskinesia
blood dyscrasias (blood cell disorder such as agranulocytiosis /watch and report low WBC's)
marked photosensitivity (wear the sunscreen) |
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Term
| Phenothiazine lowers the seizure threshold what does this mean for someone on anticonvulsants? |
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Definition
| They may need to increase the dosage of the anticonvulsant to maintain the same level of theraputic effect of preventing seizure. |
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Term
| Antipsychotics interact with alcohol, hypnotics, sedatives, narcotics, and benodiazepines by? |
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Definition
| potentiating the sedative effect so watch the respiration rate with people on these other drugs and no alcohol please. |
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Term
| Since antipsychotics are metabolised through the liver how would the dosage compair from a younger person to a older person? |
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Definition
| the dosage in an older person or a person with liver damage is lower because in both cases there is reduced liver function. |
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Term
| Atypical antipsychotics include which drugs? Select all that apply) |
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Definition
closapine (Clozaril) watch WBC's and seizures
risperidone (Risperdal)
olanzapine (Zyprexa)
quentiapine (Seroquel)
paliperidone (Invega) ER swallow hole
siprasidone (Geodon) watch ECG's
aripiprazole (Abilify)
all patients taking these should be monitored for hyperglycemia and other symptoms of diebetes millitus |
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Term
| Assessment for pt. on phenothiazine or nonphenothiazine would include? |
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Definition
baseline vitals
health history of drug therapy
mental status, cardiac, eye and repiratory disorders |
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Term
| liquid concentrait phenothiazine and nonphenothiazine should be diluted with and protected from? |
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Definition
| Fruit (avoid apple though), light |
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Term
| Phenothiazine and nonphenothiazine can cause hypotension what vital sign should we monitor? |
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Definition
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Term
| While giving an oral dose phenothiazine and nonphenothiazine what can we do to prevent gastric irritation? |
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Definition
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Term
| Why do we have to administer phenothiazine and nonphenothiazine deep IM? |
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Definition
| because they are irritating to fatty tissue. DO NOT ADMINISTER INTRAVENOUSLY! |
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Term
| Listed under Risperdal there is a life threatening adverse reaction called? |
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Definition
| Neuroleptic malignant syndrome (NMS): s/s = increased fever, pulse, and blood pressure; muscle rigidity; increased creatine phosphokinase and WBC count; altered mental status; acute renal failure; varing levels of consciousness; pallor; diaphoresis; tachycardia and dysrhythmias (even though this is only listed under the one drug I beleive it may be possible in all the drugs listed as antipsychotics) |
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Term
| Since some of the antipsychotics have anticolinergic properties we should not give them to people with ( ) and we should monitor ( & 's). |
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Definition
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Term
| With any patient on atypical antipsychotics you must monitor their ( ) level. |
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Definition
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Term
| A client on antipsychotics (clozapine) comes into the hospital complaining of malaise, fever, and sore throat what tests might you expect the doctor to order? |
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Definition
| WBC's; all these could point to agranulocytosis a blood dyscrasia associated with antipsychotics |
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Term
| A client calls the health care clinic and says he feels stable and has decided to stop taking his antipsychotics. What would you tell him? |
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Definition
| You should talk to your health care provider before reducing you antipsychotics it is not recomended to stop them abruptly |
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Term
| A client comes in hysterical, and says he thinks he's pissing blood. On admission you discover that the client is on and antipsychotic. You obtain a specimen of urine from him that is red-brown in color and a dip stick test indicates that there is no protein in the urine. What teaching opertunity with this client was over looked. |
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Definition
| Informing the client that pink or redish - brown urine is a harmless side effect of antipsychotics. |
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Term
| Anxiolytics are used to treat? |
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Definition
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Term
| A major group of antiolytics are Benzodiazepines they enhance the action of ( ) an inhibitory neurotransmitter within the CNS. |
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Definition
| GABA(gamma-aminobutyric acid) |
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Term
| prolonged use of benzodiazepines is not recomended because? |
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Definition
| tolorence developes within weeks or months in less than 2-3 months in clients taking meprobamate or phenobarbital |
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Term
| Benzodiazepines primarily work as an anxiolytic but are also used for? |
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Definition
anticonvulsant
sedative-hypnotic
preoperative |
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Term
| Benzodiazepines are metabalized in the ( ) and secreated by the ( )? |
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Definition
| liver; kidneys; are highly protein bound 80-98% (be careful with ppl who have decreased renal or hepatic function) |
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Term
| Most frequently perscribed benzodiazapine is? |
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Definition
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Term
| Ativan side effects/adverse reactions are? |
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Definition
| drowsiness, dizziness, weakness, confusion, blurred vision, nausea, vomiting, anorexia, sleep disturbance, restlessness, hallucinations/hypertension, hypotension |
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Term
| Benzodiazepine Antagonists (antidote) is? |
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Definition
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Term
| Bensodiazepines used for anxiety are? |
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Definition
alprazolam (Xanax)
chlordiazepoxide (Librium)
chlorazepate (Tranxene)
diazepam (Valium)
ketazolam (Loftan)
lrazepam (Ativan) |
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Term
| Benzodiazepines used for aniety associated with depression |
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Definition
alprzolam (Xanax)
clonazepam (Klonopin)
lorazepam (Ativan) |
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Term
| benzodiazepines used as treatment for insonia (short term)? |
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Definition
estazolam (Prosom)
flurazepam (Dalmane)
quazepam (Doral)
temazepam (Restoril)
triazolam (Halcion)
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Term
| benzpdiazepines use to treat seisures and epilepticus are? |
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Definition
clonazepam (Klonopin)
clorazepate (Tranxene)
diazepam (Valium) - status epilepticus
lorazepam (Ativan) - status epilepticus
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Term
| benzodiazepines used to treat alcohol withdrawl are? |
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Definition
clorazepate (Tranxene)
chlordiazepoxide (Librium)
diazepam (Valium)
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Term
| benzodiazepine used to treat skeletal muscel spasms are? |
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Definition
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Term
| benzodiazepines used in preoperative medications are? |
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Definition
chlordiazepoxide (Librium)
diazepam (Valium)
lorazepam (Ativan)
midazolam (Versed) |
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Term
| Ativan contraindications are? |
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Definition
| Hypersensitivity, CNS depression, shock, coma, narrow-angle glaucoma, pregnancy, lactation and use caution with anyone who has hepatic or renal dysfunction or suicidal thoughts |
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Term
| The Herbal OTC to watch for with any of the antipsychotics or anxiolytics (Benzodiazepines) is? |
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Definition
Kava Kava
in benzodiazepines it inhances sedation
in antipsychotics (phenothiazines - increase risk of dystonic reaction) (fluphenazine - risk of severity of dystonia when taken concurrently) |
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Term
| Warn clients not to drink ( ) while taking bensociazepines. |
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Definition
|
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Term
| psychological dependency can occure with most anxiolytics. (True or False) |
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Definition
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Term
| A patient comes into the ED he looks emasiated is sweating and you notice when he sign in at the desk that his hands are trembling; when you speak with him he seems agitated says he hasn't slept in days and that he stopped taking his medicine a week ago. What medicine do you think he means? |
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Definition
| Benzodiazepines; all of the aboved mentioned (anorexia, insomnia, remr, muuscular cramps, sweating, agitaion, and nervousness) are signs that this patient abruptly stopped taking benzodiazepines. These effects can last several weeks and take up to 2-10 days to develop. |
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