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40 Cards in this Set
- Front
- Back
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Low Potency Typical Antipsychotics
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Chloropromazine (thorazine). Thioridazine (mellaril)
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Side Effects of Low Potency Typical Antipsychotics
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Low potency, less dopamine receptor affinity, typically are more anti-cholinergic and anti-histamine. Therefore, there is less incidence of Extra Pyramidal symptoms and neuroleptic malignant syndrome, however, more sedative.
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High Potency Typical Antispychotics
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Halaperidol (haldol). Fluphenazine (prolixin).
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Side Effects of High Potency Antispychotics
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High potency antipsychotics have high affinity to dopamine receptors, therefore, higher incidence of EPS and NMS. Lower anti histamine and cholinergic so less weight gain.
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Treatment of Symtoms Typical vs Atypical
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Typical and Atypical same efficacy for positive symptoms. Atypical better at treating negative symptoms of schizophrenia.
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Side Effect of Typical Antipsychotics
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Anti-dopmenergic (EPS and Hyperprolactenemia). Anti-H.A.M. Elevated liver enzymes. Seziures (more likely low potency
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Thoridazine Side Effects
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Retinal pigmentation
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Chloropromazine Side Effects
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Pigmentation of the skin blue gray color. Rashes and photosensativity.
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EPS Symtoms
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Include dystonia. Akathesia. Tardive dyskenesia.
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Treatment for Dystonia
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Benztropine. Trihexyphenidyl. Diphenhyramine
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Treatment for Tardive Dyskinesia
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Switch to atypical antipsychotic.
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Neuroepileptic Malignant Syndrome
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Fever. Autnomic instability (tachycardia, hypertension, diaphoriesis). Leukocytosis. Tremor. Elevated creatinine phosphokinase. Rigidity.
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Treatment of NMS
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Treated by removal of antipsychotic meds. Supportive care. Can give dantrolene, bromocriptine, and amantadine.
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Atypical Antipsychotics
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Quetpen (seroquel). Aripiprozole (abilfy). Risperadone. Olanzopine (zyprexa). Ziprasidone (geodon).
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Clozapine side effects
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Clozaril has seizures and agranulocytosis associated.
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Olazapine Side Effects
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Greatest risk of weight gain, hyperlipidemia, glucose intolerance and liver toxicity
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Ziprasidone Side Effects
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Pronlongation of QT interval
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Mechanism of Action for Atypical Antipsychotics
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Block both dopamine and serotonin receptors in the CNS.
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Indications of Mood Stabilizers
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For anti-mania treatment. Less regularly for potentiation of antidepressents, antipsychotics, abstinence in alcohlism, and decrease impulsivity and aggrestion in dementia, MR, personality disorders.
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Types of Mood Stablizers
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Lithium. Carbazepine. Valproic acid.
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Lithium Indications
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Anti-manic. Stablize both depressive and manic states in bipolar
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Onset of Action and Plasma Lithium Levels
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Takes 5 to 7 days for onset of action. Theraputic plasma levels are 0.7 to 1.2. Above 1.5 is toxic and about 2.0 is lethal.
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Side Effects of Lithium
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Ataxia. Tremor. Hypothyroidism. Nephrogenic DI. Benign leukocytosis. Altered mental status, convulsions, and death seen in toxic levels.
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What to Monitor in Lithium Us
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TSH. GFR. Li blood levels.
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Indications of Carbamazepine
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Stops rapid cycling in Bipolar disorder. Anti-convulsant. Trigeminal Neuralgia. Blocks Na+ channels. Takes 5 to 7 days for onset.
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Indications of Valproic Acid
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Depakene is an anti-convulsant that is used to stop rapid cycling in mania. Works by incrasing GABA in cns.
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Side Effects of Valproic Acid
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Dapakene side effects include Alopecia, hemorrhagic pancratitis. Hepatotoxicity. Thrombocytopenia. Terogen.
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What to Monitor for Valoproic Acid
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LFTs. CBC.
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Diagnostic Criteria for Bipolar Disorder I
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5 of the following symptoms not secondary to substance abuse lasting longer than a week: Distractiblity, impulsivity, grandiosity, flight of idease, a, speech pressured, tremors.
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Diagnostic Criteria for Bipolar Disorder II
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Hypomanic state, with or with out depression. Hypomanic state is less than one week and does not require hospitalization.
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Lamotrigine
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Is an anticonvolsant that is used to treat bipolar depression.
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Atypical Antispychotics and Mania
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If severe symptoms of Mania thatn consider atypical antipsychotics due to shorter onset of action.
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Dysthmia
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Is the presence of depressive symptoms that do not meet MDD episode that last for 2 years.
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Cyclothymia
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Is the presence of depressive symptoms and manic symptoms for 2 years.
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Atypical Depression
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Is the increase in vegetative symptoms of increased weight, appetite, and sleep. Treated with MAOI.
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Postpartum Blues
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Is immediately after bith up to 2 weeks. Mother feels sadness and emotional lability. No negative feelings toward baby. Supportive treatment
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Pospartum Depression
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Within 1 to 3 months after birth. Mother shows signs of depression and anxiety. May have negative feelings towards baby. Antidepressants is treatment
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Postpartum Psychosis
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2 to 3 three weeks with in birth. Depression and delusions with thoughts to harm. May have thoughts of harming baby. Antipyschotics, lithium, and possibly antidepressants.
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Bereavement and MDD
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May not be normal bearvement if patient wants to die, excessivly feels worthlessness, marked psychomotor retardation, psychosis. Meets MDD after 2 months of symptoms and is adversly affected
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Treatment of Serotonin Syndrome
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Discontinue medications. Cycloheptadine.
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