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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)?
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
Severe twisting of the neck and back
Severe arching of back
Oculogyric Crisis
Severe rolling back of the eyes into the head
Spasm of the throat in which breathing and swallowing become severely impaired and emergency tracheotomy maybe required
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.
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)
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
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
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
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)?
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
memory impairments
What is Cogentin (benztropine) commonly used to treat?
dystonia EPS
What is the classification of Artane (trihexyphenidyl); is the med available in IM?
No IM available
What is the classification and indication for Benadryl (diphenydramine)?; is it available in IM?
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