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inhibits the isoenzyme which metabolize some antidepressants, antianxiety meds and anticonvulsants, raises plasma level of drug
drug induced parkinsonism
cogwheeling, tremor, pill rolling of fingers, mask like facies, shuffling gait...can grab arm to see if it is shaking
late onset, irreversible abnormal movements, lip smacking, tongue protrusion, foot tapping
EPS meds side effects
Raise blood sugar and prolactin(milk discharge), dry mouth, blurred vision, constipation, urinary retention, paralytic ileus, orthostatic hypotension
Neuroleptic Malignant Syndrome
kills patients, high b/p and temp, diaphoresiss, muscle rigidity, increased CPK (late sign)
1st generations antipsychotics
treat positive symptoms of schizophrenia, more likely to have EPS and cause orthostatic hypotension, avoid in elderly
long acting oily form givenlong acting deep IM and last 2-4weeks, must stay 3 hours after injection, use oral first, 1st gen
2nd generation antipsychotics
treat positive and negative symptoms (lack of energy, interest,no talking) decrease dopamine and increase serotonin
3rd generation antipsychotic
blocks dopamine where it is to high and moderates dopamine in other areas
block reuptake of serotonin and norepinephrine, can be used to easily overdose, EKG must be done prior, alcohol is cardiotoxic
increase dopamine and tyramine. long acting metabolics, wait 2 weeks before starting another antidepressant, low tyramine diet, no demerol (serotonin syndrome)
restlessness, unstable vitals, increased B/P seizures, hyperthermia collapse of cardiovascular systems
bipolar patient presents as depressive and is given an antidepressants, agitation, loss of inhibitions, delusional thinking
need salt and water, may cause problems with thyroid or kidney, narrow therapeutic window check blood, 2-3 weeks for therapeutic level 1-1.5
vomiting, diarrhea, ataxia or loss of coordination, tremor or muscle weakness, drowsiness and seizures
increase Gaba,decrease anxiety, cause respiratory depression, temporary relief, not good for addicts, don't stop abruptly due to convulsion
potentiate GABA, Reticular activating system is responsible for arousal and sleep regulation, side effects are lapses in memory
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