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Mental Health
Chapter 17: Antiparkinsonian Drugs
67
Psychology
Undergraduate 2
06/04/2013

Additional Psychology Flashcards

 


 

Cards

Term

 

 

What does the EPS in the brain do?

Definition

 

 

Regulates involuntary movements

Term

 

 

What must the EPS have in balance to function properly?

(2)

Definition

 

1. Acetylcholine

 

2. Dopamine

Term

 



In PD, cells in the ___  ___ lose their pigmentation, indicating a decline in ___ production, which then results in an imbalance of ___ .

 

Definition

 

Substantia nigra

 

DA

 

ACh

Term

 

 

What are the four cardinal symptoms of PD?

Definition

 

1. Tremor

2. Bradykinesia

3. Rigidity

4. Postural instability

 

Term

 

 

How does the imblance on DA and ACh differ in EPSEs from PD

Definition

 

EPSEs are caused by DA receptors being blocked at the end of the DA tracts and in PD DA receptors are blocked at the beginning of the DA tracts

Term

 

 

What is the only drug class that is given to treat EPSEs and why?

Definition

 

 

Anticholinergic because dopaminergics can cause too much DA to be in the brain, causing psychosis

Term

 

 

___ drugs cause EPSEs

Definition

 

 

Antipsychotics

Term

What EPSE?

 

Subjective feeling of restlessness

Definition

 

 

 

Akathesia

Term

What EPSE?

 

Characterized by restless legs, jittery feelings, and nervous energy

Definition

 

 

Akathesia

Term

What EPSE?

 

Responds poorly to treatment and is a major source of noncompliance with medication.

Definition

 

 

Akathesia

Term

What EPSE?

 

This is the absence of moving or slowed movement

Definition

 

 

Akinesia or Bradykinesia

Term

What EPSE?

 

Responds to anticholinergics and is characterized by weakness, fatigue, painful mjuscles, and anergia

Definition

 

 

Akinesia or Bradkinesia

Term

What EPSE?

 

Abnormal postures (freezing) caused by involuntary muscle spasms

Definition

 

 

Dystonia

Term

What EPSE?

 

Characterized by sustained, twisted, and contracted positioning of the legs, trunk, neck, or mouth

Definition

 

 

Dystonia

Term

What EPSE?

 

Appears early in treatment, usually within the first 3 days.

Definition

 

 

Dystonia

Term

What EPSE?

 

Responds to anticholinergics, but may need to be giver parenterally.

Definition

 

 

Dystonia

Term

What EPSE?

 

Has types including torticollis, oculogyric crisis, and laryngeal-pharyngeal constrictions

Definition

 

 

Dystonia

Term

 

 

What is torticollis?

Definition

 

 

Contracted positioning of the neck

Term

 

 

What is oculogyric crisis?

Definition

 

 

Contracted positioning of the eyes upward

Term

 

 

If a severe dystonic reaction occurs, what do you do first?

Definition

 

 

Administer antiparkinsonian drug IM

(Cogentin or Benadryl)

Term

What EPSE?

 

Characterized by tremor, bradykinesia, and postural instability

Definition

 

 

Parkinsonism

Term

What EPSE?


Tongue writhing, tongue protrusion, teeth grinding, and lip smacking (stop when sleeping)

Definition

 

 

Tardive Dykinesia

Term

What EPSE?

 

Generally apears after 6 months

Definition

 

 

TD

Term

What EPSE?

 

Anticholinergics are not used to treat, in fact they make this EPSE worse.

Definition

 

 

TD

Term

What EPSE?

 

Often irreversible unless caught in time

Definition

 

 

TD

Term

What EPSE?

 

You measure this with AIMS.

Definition

 

 

TD

Term

What EPSE?


Characterized by hyperthermia (101.1 – 103, but can be as high as 108), rigidity, and autonomic dysfunction

Definition

 

 

NMS

Term

What EPSE?

 

Treated with muscle relaxants (Dantrium) and central acting dopaminergics (Parlodel)

Definition

 

 

NMS

Term

 

What major routine assessment should you do to predict NMS?

 

Definition

 

 

Temperature

Term

What EPSE?

 

Characterized by leaning to one side and adults are more vulnerable.

Definition

 

 

Pisa Syndrome

Term

 

 

What do antipsychotics do to dopamine?

Definition

 

 

Block it

Term

 

 

Schizophrenia is linked to excessive amounts of ___ .

Definition

 

 

DA

Term

 

 

What antiparkinsonian drug can cause psychosis in schizophrenic patients and why?

Definition

 

 

Dopaminergics because they can cause too much DA to be released

Term

 

 

What do antipsychotics do that causes EPSEs?

Definition

 

 

Block DA recpetors

Term

 

 

What type of antipsychotic cause more EPSEs?

Definition

 

 

Typical

Term

 

 

Are anticholinergics a monotherapy or are they used adjuntively to treat EPSEs?

Definition

 

 

Monotherapy

Term

 

 

What 3 physiological systems are more effected by anticholinergics?

Definition

 

 

CV, GI, and Urinary

Term

 

 

What are some PNS S.E. of anticholinergics?

Definition

 

Dry mouth, urinary retention, constipation, blurred vision, nasal congestion, urinary hesitancy, photophobia, mydriasis, decreased sweating, fever, orthostatic hypotension, reduced breast milk, paralytic ileus

Term

Patient Teaching

 

Dry mouth

Definition

 

 

Sugar-less gum, sucking on ice chips, fluid rinses, take before meals

Term

Patient Teaching

 

Nasal congestion

Definition

 

 

OTC nasal decongestant if approved by the physician

Term

Patient Teaching

 

Urinary hesitancy

Definition

 

 

Run water in the sink, privacy, run water over the perineum

Term

Patient Teaching

 

Urinary retention

Definition

 

 

Encourage voiding, catheterization

Term

Patient Teaching

 

Blurred vision/photophobia

Definition

 

 

Normal sight should resume in a few weeks, wear sunglasses, eye drops, encourage caution when driving

Term

Patient Teaching

 

Constipation

Definition

 

 

Give laxatives, high fiber diet, encourage fluids, encourage walking,

Term

Patient Teaching

 

Mydriasis

Definition

 

 

Report to physician immediately if eye pain developes

Term

Patient Teaching

 

Decreased sweating

Definition

 

 

Can lead to fever, take temperature, reduce temperature with spong baths

Term

Patient Teaching

 

Fever

Definition

 

 

Limit strenuous activity, advise patient to wear protective clothing

Term

 

 

What are some CNS S.E. of anticholinergics?

Definition

 

 

Confusion, cognitive impoverishment, agitation, dizziness, drowsiness, disturbances in behavior

Term

 

 

What CN is effected if mydriasis, blurred vision, or impaired accomidation occurs?

Definition

 

 

III

Term

 

 

What CN is effected if dry mouth, decreased tearing, and dry nasal passages occurs?

Definition

 

VII

 

IX (minus decreased tearing)

Term

 

 

What CN is effected if tachycardia, constipation, or dilated bronchi occurs?

Definition

 

 

X

Term

 

 

What are the 3 main interactions with anticholinergics?

Definition

 

 

CNS depressants (alcohol), antacids, and antidiarrheals

Term

 

 

What do antacids and antidiarrheals do to anticholinergics?

Definition

 

 

Decrease the absorption

Term

 

 

What is considered the best drug to treat EPSEs?

Definition

 

 

Cogentin

Term

 

 

What anticholinergic can be administered in an IM form and how long does it take for it to take effect?

Definition

 

Cogentin

 

20-30 minutes

Term

T or F

 

It is prefered to have anticholinergics ordered PRN because some EPSEs are life threatening.

Definition

 

 

False, they are not ordered PRN because the doctor should know what the patient is experiencing before prescribing these drugs.

Term

 

 

What drug class is used to treat NMS specifically?

Definition

 

 

Dopaminergics

Term

 

 

How can Cogentin be given?

Definition

 

 

PO, IM, or IV

Term

 

 

What are the 2 most commonly used anticholinergics?

Definition

 

 

Cogentin and Benadryl

Term

 

 

Do dopaminergics increase or decrease DA in the brain?

Definition

 

 

Increase

Term

 

 

What are the three dopaminergic drugs?

Definition

 

1. Symmetrel

 

2. Parlodel

 

3. Dantrim

Term

 

 

What 2 vitamins are being debated on their usefulness for treatment of EPSEs?

Definition

 

 

Vitamins E and B6

Term

 

 

You should use antiparkinsonians cautiously in...

Definition

 

 

The elderly, pregnancy, seizure disorders, and hypertension

Term

 

What 2 drugs would a doctor prescribe together for a person with increased agitation and psychosis because it decreases anticholinergic S.E. and reduces anxiety?

Definition

 

 

Haldol and Ativan

Term

Patient Teaching

 

Orthostatic hypotension

Definition

 

 

Warm, not hot baths, limit exercis on hot days, no hot tubs

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