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NUR 2474 Pharm Quiz 3
Terms in this set (33)
What are the EPS symptoms?
acute dystonia, oculogyric crisis, opisthotonus, joint dislocation, impaired respiration, anticholinergic effects, Parkinsonism, akathisia, TD.
What class of drugs are most likely to produce EPS effects?
1st generation antipsychotics- chloropromazine/ haloperidol
High potency antipsychotic prototype
How does a high potency antipsychotic work?
it has a more severe action and is able to be administered IM and stop psychosis immediately and at a more severe level.
define what acute dystonia is
slow movement that is with EPS
define what oculogyric crisis is
abnormal upward eye deviations with EPS
define what opisthotonus is
muscle spasm with backwards arching of the back, with EPS
define the parts of Parkinsonism
bradykinesia, slow movements, mask like face, drooling, tremor, rigidity, shuffling gait, cog wheeling, stooped posture.
pacing and squirming brought on by an uncontrollable need to be in motion.
define parts of tardive dyskinesia
movements of the tongue and face, lip smacking, fly catching tongue movement, slow worm like tongue movement, involuntary limb/ trunk movement.
what medications can we use to treat EPS?
benzo's, beta blocker, anticholinergics
What is important about adherence with any psychiatric medication?
the patient must be educated on how to take the med, what side effects are present and how to reduce them, what to report, taking the drug exactly as prescribed and to not stop the drug cold turkey, they must call provider.
what are the side effects of SSRI use?
serotonin syndrome, withdrawal effects, neonatal abstinence syndrome, teratogenesis, EPS, bleeding disorders, sexual dysfunction and weight gain.
define what serotonin syndrome is
a. a toxic level of serotonin is in the body. It starts 2-72 hrs. after treatment.
i. S/S: AMS, anxiety, hallucinations, confusion, incoordination, hyperreflexia, sweating, tremor, fever.
ii. Will resolve spontaneously after D/C the medication.
iii. Increased risk with use of MAOIs, can have a peripheral effect.
why do young adults often choose to stop an SSRI medication suddenly?
it causes them to gain weight and have sex dysfunction- will have to taper the medication
How does the SSRI fluoxetine work in the body?
it works to prevent serotonin uptake at the synapse, making more available in the body for use and for longer time.
What are two assessments we should do before giving a antidepressant?
mood and suicide- the medications can change ones mood and cause suicidal thoughts.
what is neuroleptic malignant syndrome
a rare but serious reaction causing lead pipe muscle rigidity, high fever, sweating, instability, HR and BP fluctuations, altered LOC, seizures and coma.
how do we treat bipolar disorder's fluctuations?
use a mood stabilizer to control mood, antidepressant can be used for when depression occurs, and antipsychotic can be used for mania
what is an example of a mood stabilizer used to treat bipolar disorder?
what are side effects of lithium
GI effects, tremors, polyuria, renal toxicity, goiter and hypothyroidism, teratogenesis.
when are side effects of lithium seen in drug therapy?
when drug levels are at a therapeutic range.
therapeutic level of lithium
toxic level of lithium
1.5 or greater
what happens to the side effects of lithium use when they are at the toxic level?
the normal side effects will worsen and become more apparent
what is the process of monitoring the blood levels with lithium
we should monitor blood levels early in use every 2-3 days to find appropriate dosing, once dosing is therapeutic, we will monitor levels every 3 to 6 months
when should we see the effects of lithium
initial effects will be apparent 5-7 days after starting, with full effects taking place in about 3 weeks long term
What is the best way to know how to treat insomnia?
do a thorough assessment to figure out what the cause of the sleep issues are.
how will we treat short term diagnosed insomnia
7 to 10 days of a Benzo/ trazadone, etc to help short term until the cause of the sleep disturbance is identified.
how will we treat long term insomnia?
either we will treat the cause of the disturbance, or if there is not a specific cause, we will give Benzo/ tazadone/ dose-in/antihistimanes
what other methods can we use to treat insomnia?
nonpharm methods like relaxation
what does paroxetine do and what is it used for?
it treats anxiety and is an SSRI and will cause more serotonin to be at the synapse available.
what should we do to determine if one has an anxiety disorder?
have a full assessment done to determinate exact cause of the disorder.
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