Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
34 Cards in this Set
- Front
- Back
|
What are some common uses for antipsychotic meds?
|
Tx primary and secondary psychosis
Acute rage/agitation Vomiting and vertigo Intractable hiccoughs To augment analgesics in tx of pain Tourette's Syndrome |
|
|
What are the side effects of antipsychotics?
|
Sedation (chemical straight-jacket effect)
Orthostatic hypotension (fall precautions) Seizures (decreased threshold) Alterations in sexual functioning Anticholinergic effects Decreased tolerance to alcohol Photosensitivity (wear sunglasses) Cardiac Changes GI distress Other: increased appetite; false/positive pregnancy, amenorrhea, galactorrhea (breast milk production) |
|
|
What are the extrapyramidal side effects (EPS)?
|
Apathy
Akathisia Dyskinesia Dystonia Pseudo-parkinsonism TardiveDyskinesia |
|
|
What it acute dystonic reactions? (DEF & DESCRIPTION)
|
Severe muscle spasms that can be life-threatening if not treated immediately.
1. Torticollis- twisting of neck and back 2. Opisthotonus- arching of the back 3. Oculogyric Crisis- eye rolling to back of head 4. Laryngospasm- throat spasm affecting breathing 5. Oral/facial/maxillary spasms |
|
|
DEF
Torticollis |
Severe twisting of the neck and back
|
|
|
DEF
Opisthotonus |
Severe arching of back
|
|
|
DEF
Oculogyric Crisis |
Severe rolling back of the eyes into the head
|
|
|
DEF
Laryngospasm |
Spasm of the throat in which breathing and swallowing become severely impaired and emergency tracheotomy maybe required
|
|
|
DEF
Oral-facial-maxillary spasms |
Spasms of the face, lips, and tongue making it very difficult to talk, chew, and eat.
|
|
|
What is the treatment for acute dystonic reactions?
|
IM administration of diphenhydramine, 25mg or benzotropine, 0.5-1mg.
|
|
|
DEF & DESCRIPTION
Dyskinesias |
Abnormal muscle movements, not as severe as spasms
1. Facial tics/twitches 2. Chewing movements 3. Lip smacking 4. Blinking 5. Aimless movement of the tongue 6. Shoulder shrugging 7. Pedaling movements of legs 8. Flailing arms |
|
|
What is the treatment for dyskinesias?
|
Decrease dose
Some pt require prophylactic tx with anti-parkinsonian agents (ex:benztropine 1-2mg up to QID) |
|
|
DEF & DESCRIPTION
Tardive Dyskinesia |
Late onset of any dyskinesias. Usually does not occur until 4-6 months after tx with a neuroleptic has begun.
Can also occur with antidepressants that affect dopamineneurons |
|
|
What is the treatment for tardive dyskinesia?
|
1. Prevention (reg re-evaluation of drug dosages and assessments for beginning side effects
Must be tx after first symptom to prevent permanent damage 2. Maintenance on lowest dose of medication |
|
|
DESCRIPTION
Parkinsonian reactions |
1. Stiffness & slowness of voluntary movement
2. Masklike immobility of facial muscles 3. Stooped posture 4. Slow, monotonous speech 5. Shuffling gait speeds up on its own 6. Immobility |
|
|
What is the treatment for parkinsonian reactions?
|
IM or IV administration of diphenhydramine or benzpine
|
|
|
DEF & DESCRIPTION
Akathisia |
Nearly continuous muscle activity, less intense than dystonias or dyskinesias
1. Intolerance of inactivity 2. Continuous agitation and restlessness 3. Pacing 4. Constant leg and finger movements |
|
|
What is the treatment for akathisia?
|
Changing to a different neuroleptic or decreasing the dose
|
|
|
What is an Abnormal Involuntary Movement Scale (AIMS)?
|
An objectiv.e scale to assess for tardive dyskinesia
|
|
|
What are some metabolic syndromes that occur as a complication of antipsychotic meds.
|
1. Insulin resistance
2. Hypertension 3. High serum lipids 4. Obesity 5. Coagulation abnormalities 6. Associated with higher rates of diabetes |
|
|
What are some frequently used neuroleptics?
|
His Hadol
Majesty Mellaril Promises Prolixin Successful Stelazine and Novel Navane Treatment Thorazine |
|
|
What are nursing implications for Clozaril (Clozapine)
|
1. Adverse reaction: agranulocytosis (decreased WBC)
2. Blood must be monitored frequently and regularly when on maintenance |
|
|
What are the doses and uses for Risperidone (Risperdal)?
|
1. Start with 1mg BID and titrate up to 4-8mg/day
2. Other uses: behavioral problems, mental retardation, dementia, thought rumination * available in depot as Risperdal Consta |
|
|
What are the side effects and doses of Olanzapine (Zyprexa)?
|
1. Sedation is a major side effect
2. Titrate up to 20mg/day |
|
|
What are the doses, side effects nursing implications of Ziprasidone (Geodon)?
|
1. Sedation and headache are major side effects; not reported to cause weight gain
2. Average dose is 10-15mg/day *Available as an injection *Must be taken with 1g of fat to be efficient |
|
|
What are the doses and side effects of Aripiprazole (Abilify)?
|
1. Can be dosed daily
2. Side effects: headache, anxiety, insomnia; less sedating, weight change of 1kg over 1 year |
|
|
What drugs are used to treat EPS?
|
Cogentin (benztropine)
Artane (trihexyphenidyl) Benedryl (diphenydramine) Inderal (propranolol) |
|
|
What is the classification and actions of Cogentin (benztropine)?
|
Anticholinergic
Dopamine blocked= decreased ratio of actylcholine/dopamine: restores balance |
|
|
What is the dosage range for Cogentin (benztropine)?
|
1-3mg BID; available in IM
|
|
|
What are the side effects of Cogentin (benztropine)?
|
dry mouth
blurred vision urinary hesitancy constipation memory impairments |
|
|
What is Cogentin (benztropine) commonly used to treat?
|
pseudo-parkinsonian
dystonia EPS |
|
|
What is the classification of Artane (trihexyphenidyl); is the med available in IM?
|
Anticholinergic
No IM available |
|
|
What is the classification and indication for Benadryl (diphenydramine)?; is it available in IM?
|
Antihistamine
Available in IM Often given for acute episodes of dystonia |
|
|
What is the classification and indication for Inderal (propranolol)?
|
Beta blocker
May be given to treat akathsia |
