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Mental Health Chapter 26 Exam 3
Terms in this set (25)
What are the Target Symptoms for Antipsychotics
Positive and Negative symptoms
Difficulty with socialization
What is the drug action of atypical antipsychotics?
Block at dopamine2 (D2) and serotonin2 (5-HT2) postsynaptic receptors
thus they are DA and 5-HT antagonists
advantages of atypical antipsychotics
Improve positive symptoms of schizophrenia, but unlike typical drugs, they also improve negative symptoms
mood symptoms, hostility, violence, suicidal behavior, difficulty with socialization, cognitive impairment seen in schizophrenia
Disadvantages of atypical antipsychotics?
- weight gain, diabetes, dyslipidemia
Higher cost compared with typical antipsychotics
What are the Side effects of atypical antipsychotics ?
Weight gain and metabolic disturbances
prolonged Q-T interval
agranulocytosis, seizures, myocarditis
Drug action of typical antipsychotic medications?
Dopamine (DA) antagonists: they block postsynaptic D2 receptors in several DA tracts in brain; decrease in positive symptoms of schizophrenia and EPS
Side effects of antipsychotics?
EPS - movement disorder
- Acute dystonic reactions
- Parkinson syndrome
Neuroleptic malignant syndrome (NMS)
Photosensitivity, anticholinergic effects, or metabolic syndrome
Side effects of antipsychotics - continued
Constipation, dry mouth, blurred vision, orthostatic hypotension, tachycardia, urinary retention, nasal congestion
Weight gain, diabetes, and dyslipidemia, often resulting in cardiovascular disease
What extrapyramidal symptoms?
Changes in muscle tone
- may resemble parkinson disease
What are acute dystonic reactions? (ADR)
Spasms of major muscle groups of neck, back, or eyes that occur suddenly
Frightening, painful, and need treatment with medication
(ADR) what is oculogyric crisis?
eyes involuntarily in fixed position, usually up and sideways, for minutes or several hours
- very scary!
(ADR) what is torticollis?
head inclined to one side involuntarily because of contraction of muscle on that side of neck
What is Akathisia ?
inability to remain still
- inner restlessness
- leg aches relieved by movement
What is parkinsonism?
- slow movement or rigidity
- impaired balance
Parkinson syndrome: What is Akinesia?
abnormal state of hypoactivity or muscle paralysis
Parkinson syndrome: What is Cogwheel rigidity?
abnormal rigor in muscle tissue, including jerky movements when muscle passively stretched
Parkinson syndrome: What is Fine Tremor ?
quick, rhythmic, quivering movements that sometimes disappear during purposeful movements
What is Tardive Dyskinesia?
Involuntary movements: tongue protrusion, lip smacking, chewing, blinking, grimacing, choreiform movements of limbs and trunk, foot tapping
What is Neuroleptic malignant syndrome?
Fever, tachycardia, sweating, muscle rigidity, tremor, incontinence, stupor
- rare but potentially fatal
What is the treatment for neuroleptic malignant syndrome?
stop triggering drug, initiate supportive care
What is the acronym for NMS
F - fever
E - encephalopathy
V - vitals unstable
E - elevated enzymes
R - Rigidity of muscles
What should you teach pts about antipsychotics ?
- Full benefits may take 4 or more weeks
- When switching from one antipsychotic to another, gradually decrease one drug while gradually increasing new drug (over 2-4 days)
- Taper slowly over days to weeks to avoid dyskinetic reactions and side effects
- Do not cause chemical dependency or tolerance to antipsychotic effects
- Low abuse potential; safe in overdose
Why do atypical antipsychotics improve negative symptoms as well as positive symptoms?
because they affect serotonin and dopamine and serotonin affects the negative symptoms
what are some typical antipsychotics ?
What are some atypical antipsychotics?
Aripiprazole (Abilify) - not effective on its own
Risperidone (Risperdal, Consta, M-Tabs) - used a lot in kids
Olanzapine (Zyprexa, Zydis)
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