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92 Cards in this Set
- Front
- Back
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Agranulocytosis
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Extremely low levels of WBC. Sx include sore throat, fever & malaise. This may be a s/e of long-term therapy with some antipsychotic medications
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Akinesia
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Muscular weakness; or a loss or partial loss of muscle movement; a type of extrapyramidal side effect associated with some antipsychotic medications
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Gynecomastia
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Enlargement of the breasts in men; may be a s/e of some antipsychotic medications
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Hypnosis
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A tx from disorders brought on by repressed anxiety. The individual is directed into a state of subconsciousness and assisted, through suggestions, to recall certain events that he or she cannot recall while conscious
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Neuroleptic Malignant Syndrome (NMS)
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A rare but potentially fatal complication of treatment with neuroleptic drugs. Symptoms include severe muscle rigidity, high fever, tachycardia, fluctuations in blood pressure, diaphoresis, and rapid deteroriation of mental status to stupor and coma
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Oculogyric crisis
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An attack of involuntary deviation and fixation of the eyeballs, usually in the upward position. It may last for several minutes or hours and may occur as an extrapyramidal side effect of some antipsychotic medications
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Retrograde Ejaculation
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Ejaculation of the seminal fluid backwards into the bladder; may occur as a s/e of antipsychotic medications
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Tardive Dyskinesia
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Syndrome of symptoms characterized by bizarre facial and tongue movements, a stiff neck, and difficulty swallowing. It may occur as an adverse effect of long-term therapy with some antipsychotic medications
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Dextroamphetamine/amphetamine mixture (Adderall)
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CNS Stimulants
Onset: PO - tablet: 0.5-1 hr |
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Adderall - side effects
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hyperactivity, insomnia, irritability, restlessness, tremor, dizziness, headache, palpitations, tachycardia, HTN, anorexia, constipation, cramps, diarrhea, dry mouth, metallic taste, N/V, erectile dysfunction, increased libido, urticaria, psychological dependence
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Adderall - patient & family teaching
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Take med at least 6 hr before HS; drug-induced dry mouth can be minimized by rinsing frequently with water or chewing sugarless gum or candies; limit caffeine intake; may impair judgment - use caution when dirving; notify physician if nervousness, restlessness, insomnia become severe
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dystonia
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bizarre uncoordinated movements of neck, face, eyes, tongue, body, arms, legs
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what is intervention for ocular gyration?
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benadryl
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what are 2 early signs of tardive dyskinesia
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fine movement of tongue and excessive blinking
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pseudoparkinson symptoms
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symptoms of Parkinson's; tremor, rigidity, akinesia
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psychotropic or psychoactive
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drugs that change or alter mood and thoughts of the person having difficulty responding to reality.
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What do psychotropic drugs affect?
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CNS
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Neurotransmitter
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highly specialized chemical substances that are involved in the transport of information across the synaptic gap
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prototype
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the first type or form of a drug that is typical of later medications or the drug that is most characteristic of the classification
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physiological effect
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usual or expected effect of the drug. how the drug exerts its effect at the tissue or cellular level
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side effect
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a consequence other than that for which a drug or other agent is used. can be an adverse effect. some drugs are used just for their side effects
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extra pyramidal
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outside the pyramidal tracts. The pyramidal tract is a motor nerve tract that extends from the brain down the spinal cord. This tract controls and coordinates one's posture, stature, supporting and locomotion mechanisms
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catecholamines
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sympathomimetic amines that play an important part in the body's physiological response to stress. Catecholamines activate the adrenergic system.
The catecholamines are epinephrine, norepinephrine and dopamine |
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epinephrine
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also called adrenaline. An excitatory neurotransmitter of the sympathetic branch of the ANS. When we are stressed extra epinephrine is released by the medulla of the adrenal glands into the blood stream which gives strength and cardiac output
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norepinephrine
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released in response to sympathetic stimulation
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dopamine
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Involved in regulating motor function. The dopamine theory is the leading theory for the biological basis of schizophrenia. Excess dopamine = psychosis behavior. Must be balanced w/ acetylcholine.
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serotonin
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Is found in many tissues including blood platelet. Produces vasoconstriction and stimulation of the smooth muscle. It has an inhibitory action on behavior of calming
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Benzodiazepines
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Xanax
Librium Klonopin Valium Ativan Buspar |
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What is the antidote for the Benzodiazepines?
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Flumazenil (Romazicon) - inhibits the effect of the benzos a the GABA receptors.
Available for IV use only |
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Four subtypes of antidepressants are ?
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Tricyclics
MAO Inhibitors SSRIs SSNRIs |
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Impact of invention of Thorazine for psychiatry?
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Have many individuals a chance to function; has provided researchers w/ info to study origins & etiologies of mental illness. Knowledge gained from learning how these drugs work has promoted advancement in understanding how behavioral disorders develop.
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SSRIs - action on neurotransmitters
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Inhibit reuptake of serotonin
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Tricyclics - action on neurotransmitters
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Inhibit reuptake of serotonin and norepinephrine
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MAO Inhibitors - action on neurotransmitters
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Increase NE and serotonin by inhibiting the enzyme that degrades them
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SSNRIs - action on neurotransmitters
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Inhibits serotonin and NE reuptake
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Indications for Anxiolytics
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Anxiety disorders
anxiety symptoms acute alcohol withdrawal skeletal muscle spasms convulsive disorders status epilepticus preoperative sedation |
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2 major subtypes of anxiolytics
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Minor tranquilizers
Sedatives/Hypnotics |
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Anxiolytics (minor tranquilizers) used for?
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to treat anxiety by depressing the CNS
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Sedatives/hypnotics
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Sedatives block the awareness of and reaction to environmental stimuli resulting in associated CNS depression
Hypnotics further depress the CNS to inhibit neuronal arousal and induce sleep |
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What is a significant side effect that is specific to Buspar?
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Persistent headache
Involuntary movements of the head or neck muscles |
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What is Buspar?
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A newer anxiolytic drugs
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How is Buspar differ from the benzodiazepines?
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Does not cause sedation or muscle relaxation. Has no CNS effects
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Family teaching with Ritalin (methylphenidate) should include?
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May cause insomnia, weight loss and GI upset
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What drugs could cause serious adverse effects when given with lithium?
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Ibuprofen
Haloperidol Thiazide diuretics Antacids |
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Side effects that commonly occur with tricyclics?
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blurred vision, constipation, urinary retention, orthostatic hypotension, reduction in seizure threshold, tachycardia, arrhythmias, photosensitivity, weight gain
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Side effects that commonly occur with SSRIs?
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insomnia, agitation, headache, weight loss, sexual dysfunction, serotonin syndrome
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Side effects that commonly occur with MAOIs?
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Hypertensive crisis
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Once lithium therapy is begun, physican may also order antipsychotic. Why?
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Lithium has a lag time of 1-3 weeks. Antipsychotics prescribed to decrease hyperactivity until lithium can take effect
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Symptoms of hypertensive crisis include ?
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severe occipital HA, palpitations, N/V, nuchal rigidity, fever, sweating, marked increase in BP,chest pain, coma
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How can a pt on MAOIs prevent hypertensive crisis from occurring ?
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Must avoid foods high in TYRAMINE such as aged cheeses, pickled herring, preserved meats, beer, wine, chocolate, sour cream, yogurt, OTC cold meds and diet pills
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What is therapeutic range for lithium carbonate?
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0.6 to 1.5 mEq/L
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Initial S/S of lithium toxicity ?
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Blurred vision, ataxia, tinnitus, persistent N/V, severe diarrhea
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Nursing implications for client on lithium therapy ?
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Give with food to minimize GI upset. Ensure client gets adequate sodium in diet and drinks 2500 to 3000 cc fluid per day. Check for lithium levels before administering dose. Monitor client's I&O.
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Most commonly used group of anxiolytics and 2 examples
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Benzodiapines
chlordiazepoxide (Librium) diazepam (Valium) |
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Common s/e of anxiolytics ?
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Drowsiness, sedation, confusion, orthostatic hypotension
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Client on long-term anxiolytic therapy must be instructed ...?
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Not to stop taking the drugs abruptly in order to prevent a potentially life-threatening situation
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Mechanism of action that produces the desired effect with antipsychotic meds?
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Decreases levels or activity of dopamine
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Phenothiazines are an example of a ?
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"typical" antipsychotic group
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2 examples of phenothiazines
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chlorpromazine (Thorazine)
fluphenazine (Prolixin) |
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What are the newer "atypical" antipsychotics?
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clozapine (Clozaril
olanzapine (Zyprexa) ziprasidone (Geodon) |
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Potential adverse hormonal effects assoc w/ antipsychotic therapy?
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Decreased libido
retrograde ejaculation gynecomastia amenorrhea weight gain |
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Symptoms of agranulocytosis ? (a very serious s/e of antipsychotics therapy)
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sore throat
fever malaise |
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Symptoms of extrapyramidal side effects assoc w/ antipsychotic therapy ?
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Pseudoparkinsonism (tremor, shuffling gait, drooling rigidity), akinesia (muscular weakness), akathisia (continuous restlessness and fidgeting, dystonia (spasms of face, arms, legs, neck), oculogyric crisis (uncontrolled rolling back of the eyes), sometimes tardive dyskinesia is considered as an extrapyramidal symptom (bizarre facial and tongue movements, stiff neck and difficulty swallowing)
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Potentially life-threatening situation that could occur in a client who abruptly withdraws from long-term CNS stimulants ?
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Depression
Suicidal ideation |
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Classification of medication that is commonly prescribed for drug-induced extrapyramidal reactions ?
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Antiparkinsonian agents: benztropine (Cogentin) and trihexyphenidyl (Artane)
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Benzodiazepines facilitate the transmission of ?
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GABA
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Psychostimulants increase release of ?
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biogenic amines
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Before 1950, what were the only significant psychotropic drugs available?
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sedatives & amphetamines
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Since the 1950's, psychopharmocology has expanded to includle ?
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antipsychotic, antidepressant and antianxiety drugs
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Psychotropic drugs are intended to be used as an adjunct to ?
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individual or group therapy
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Nurse's role in medication administration and evaluation ?
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monitors for s/e & adverse rx
evaluates the therapeutic effectiveness of the medication |
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Neurotransmitters are chemicals that are ?
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stored in the axon terminals of the presynaptic neuron
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Receptors are ?
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molecules situated on the cell membrane that are binding sites for neurotransmitters
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Reuptake is ?
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the process of neurotransmitter inactivation by which the neurotransmitter is reabsorbed into the presynaptic neuron from which it had been released (It blocks it and the body absorbs it)
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Antidepressants block ?
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reuptake of biogenic amines (catalyst or enzyme)
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Antipsychotics block ?
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dopamine and other receptors
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Antianxiety drugs have increased effects when taken with ?
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alcohol, barbiturates, narcotics, antipsychotics, antidepressants, antihistamines, neuromuscular blocking agents, cimetidine, disulfiram, kava kava or valerian root
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Therapeutic range for lithium for ACUTE MANIA ?
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1.0-1.5 mEq/L
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Therapeutic range for lithium for MAINTENANCE ?
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0.6-1.2 mEq/L
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Antipsychotics can also be used in the treatment of ?
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bipolar mania and as antiemetics
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Antiparkinsonian Agents are contraindicated in ?
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angle-closure glaucoma, pyloric, duodenal or bladder neck obstructions, prostatic hypertrophy or myasthenia gravis & those exposed to high environmental temps
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Sedatives/Hypnotics
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Phenobarbital
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MAO Inhibitors
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isocarboxazid (Marplan)_
phenelzine (Nardil) tranylcypromine (Parnate) |
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Neuroleptics - Prototype?
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Thorazine
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Antiparkinsonians - Prototype?
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Cogentin
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Anxiolytics - Prototype?
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Valium
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Tricyclic Antidepressants - Prototype?
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Elavil
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MAOI Antidepressants - Prototype?
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Nardil
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SSRI Antidepressants - Prototype?
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Prozac
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Anti-Manic Agents - Prototype?
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Lithium Carbonate
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Anti-Manic Agents - Mood Stabilizer - Prototype?
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Tegretol, Depakote
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Stimulants - Prototype?
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Adderall
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