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29 Cards in this Set
- Front
- Back
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Which meds are better for positive symptoms of Schizophrenia?
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Traditional Conventional Antipsychotics: act on dopamine receptors
Haloperidal (Haldol), Trifluoperazine (Stelazine), Chlorpromazine (Thorazine), Deconoate (Haloperidol deconoate and Fluphenaziine deconoate). |
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What are the positive symptoms of Schizophrenia?
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delusions, ideas of reference, persecution, grandiosity, somatic sensations, jealousy, control, thought broadcasting, thought insertion, thought withdrawal, delusion of being controlled, alterations in speech: associative looseness, neoglisms, echolalia, clan association, word salad.
Alterations in perception: (hallucinations: sensory perception for which no external stimulus exists) Personal Boundary difficulties Alterations in behavior: extreme motor agitation, stereotyped behaviors, automatic disobedience, waxy flexibility, stupor, negativism. |
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What are the negative symptoms of Schizophrenia?
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affective blunting, anergia (lack of energy), anhedonia (no pleasure), avolition (lack of motivation), poverty of content of speech, thought blocking (lost ability to think), flat affect/inappropriate affect
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What are the side effects to watch for with typical conventional antipsychotics?
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EPS, Anticholinergic effects, lower seizure threshold
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what are the EPS symptoms?
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akathisia (inner restlessness), dystonia (sustained muscles contractions, twitching), parkisoniasm, tardive dyskinesia (twitching of face, tongue rolling, lip smacking, limbs- rapid, purposeless, slow, complex movements), rocking, twisting pelvic thrust.
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what are delusions?
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false, fixed beliefs that cannot be corrected by reasoning
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what meds are best for negative symptoms of Schizophrenia
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Atypical Or Novel Antipsychotics
Serotonin, dopamine ,(5HT4) Antagonists diminishes negative and positive s/s Clozapine (Clozaril), Quetiapine (Seroquil), Risperidone (Risperdal), Zipreasidone (Geodon), Olanzapine (Zyprexa), Aripoprazole (Abilify) |
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What meds are typical?
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Haloperidal (Haldol), Trifluoperazine (Stelazine), Chlorpromazine (Thorazine), Halperidol deconoate (haldol), Fluphenazine deconoate (prolixin)
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What meds are Atypical
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Clozapine (Clozaril), Quetiapine (Seroquil), Risperidone (Risperdal), Zipreasidone (Geodon), Olanzapine (Zyprexa), Aripoprazole (Abilify)
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If patient has EPS what prn med would be ordered?
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Dantrium (dantrolene) - tx to reduce muscle spasms
antiparkinsonian meds (use of this may make ACH effects go up) anticholinergic drugs: (Benadryl) Diphenhydramine HCL - first choice, (Artane) trihexyphenidyl, benztropine (cogentin), (Symmetryl) amantadine HCL, (Akineton) Biperidon, Procyclidine HCL (Kemadrin), Bromocriptine mesylate (Parlodel) |
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What side effects to watch for with atypical antipsychotics meds?
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less side effects: wt gain and metabolic abnormalities (glucose dysregulation and hypercholesterolemia) which increase cardiac adn diabetes issues, ACH s/e, less eps s/e
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what are the anticholinergic side effects?
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blurred vision, dry mouth, constipation, urinary retention and hesistancy, photosensitivity, dry eyes, inhibition of ejaculation or impotence in men
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What are some of the rare yet toxic effects of typical antipsychotics?
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ACH s/e and EPS s/e, Hypotension, postural hypotension, tachycardia
Rare: Agranulocytosis, Cholestatic jaundice, NMS (neuroleptic malignant syndrome) |
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Severe EPS, Hyperpyrexia, Autonomic dysfunction (decreased LOC, hyperprexia,
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neuroleptic malignant syndrome
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Clozapine (Clozaril) side effects? what type of drug?
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atypical antipsychotic
agranulocytosis high seizure rate excessive salivation tachycardia |
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Risperidal (Risperidone) side effects and what type of drug?
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atypical antipsychotic
Hypotension insomnia sedation sexual dysfunction |
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Olanzapine (Zyprexa)
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atypical antipsychotic
34% wt gain drowsiness insomnia possible akathisia and parkinsonism |
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Quetiapine (Seroquel)
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atypical antipsychotic
orthostasis HA |
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Ziprasidone (Geodon)
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atypical antipsychotic
ECG changes Low wt gain Target depressive episodes |
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Aripiprazole (Abilify)
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atypical antipsychotic
New class little or no wt gain increase in glucose, HDL, LDL, or triglyceride levels |
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Haloperidal (haldol)
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Typical Antipsychotic
low sedative large doses for assaultive behaviors also same in elderly (avoid s/e of hypotension) Less falls and dizziness High EPS |
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Trifluoperazine (Stelazine)
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Typical Antipsychotic
low sedative use for paranoia and withdrawal High EPS NMS |
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Chlorpromazine (Thorazine)
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Typical Antipsychotic
Increase sensitivity to sun Highest sedative and hypotensive Retinitis Pigmentosa (800 mg/day) |
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Haloperidol deconoate (Haldol)
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Typical Antipsychotic
long lasting z track IM given q3-4 wks |
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Fluphenazine deconoate (Prolixin)
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Typical antipsychotic
long acting Z track IM given q2-4 wks |
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How often do you need to get blood work for agranulocytosis?
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q wk for 6 months
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How do u treat a patient with Cholestatic Jaundice?
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stop meds, give high protein and high carb diet. LFT q 6 months
S/e of typical antipsychotic |
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TX of NMS?
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dantrium (reduce muscle spasms) and Bromocriptine (Parlodel) relieve muscle rigidity, cool body temp, stop neuroleptic, fluids, electrolytes, tx arrythmias, heparin for emboli, early detection
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Autonomic dysfunction?
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tachycardia, hypertension, diaphoresis, incontinence
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