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25 Cards in this Set
- Front
- Back
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What are positive psychotic symptoms? Name 3.
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Things that you can SEE.
Delusions, auditory hallucinations, racing thoughts. |
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What are negative psychotic symptoms? Name 4.
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Things you OBSERVE. Anhedonia, apathy, amotivation, ambivalence.
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What is anhedonia?
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Unable to enjoy pleasure.
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Are these all positive or negative symptoms of psychosis? If not, which is the exception?
A. Delusions B. Racing thoughts C. Anhedonia D. Auditory Hallucinations |
All are positive except C. Anhedonia.
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What is the name of the "older" group of anti-psychotics?
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Phenothiazines.
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What is the MOA for Phenothiazines?
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Block DA in CNS.
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Name 2 other Phenothiazines.
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1. Chlorpromazine
2. Mesoridazine -azine |
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What are the newer and more frequently used class of anti-psychotics? Name 6 drugs in this class. (2 most important to know)
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Atypical group.
Risperdal, Zyprexa Clozaril Geodon Seroquel Ziprasidone |
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How are Atypical group anti-psychotics different than Phenothiazines?
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They block 5-HT, SEROTONIN, IN ADDITION, to DA.
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What anti-psychotic is used in acute situations and in hospitals?
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HALDOL
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What is Neuroleptic Malignant Syndrome? (NMS)
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A rare, life-threatening/fatal, rxn to antipsychotic meds. Exact cause is unknown, yet it may be secondary to decreased dopamine activity in CNS.
Occurs when anti-psychotics are combined with anti-depressants or when 2 anti-depressants are used together. |
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How is NMS caused?
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It is an extrapyramidal motor symptom SE. It is induced by excessive cholinergic influence triggered by blocking the inhibitory effect of DA on cholinergic neurons. This CREATES AN IMBALANCE BTWN CHOLINERGIC AND DOPAMINERGIC, secondary to neuroleptic meds.
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What are some Sx of NMS?
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Catatonia (stupor, rigidity, excitement and tremors), high fever and severe elevation in BP. Could stroke or seizure.
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How do you treat NMS?
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Considered an emergency situation. Withdraw the medication and provide supportive care. Control the fever and get rid of the medication.
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What is akathesia?
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Sensations of motor restlessness, excessive voluntary mvmts, inability to sit still or lie still. Pts will appear agitated, will pace the floor or experience insomina.
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What causes akathesia?
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Imbalance between dopamine and AcH. Decreased DA levels. Secondary to neuroleptics.
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How is akathesia managed?
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Alterting the dosage and/or type of medication.
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What is tardive dyskinesia?
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Involuntary and fragmented mvmts. Rhythmic mvmts of mouth, tongue and jaw. Pts will often make sucking and smacking noises. Present w/ Parkinson like Sx.
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How is tardive dyskinesia caused?
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Imbalance between dopamine and AcH. Decreased DA levels.
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How is tardive dyskinesia treated?
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Holiday from neuroleptics may cause Sx to diminish or disappear within 3 months.
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What makes tardive dyskinesia SE different from all the others associated with anti-psychotics?
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Usually these SE are IRREVERSIBLE if chronically treated w/ neuroleptic drugs.
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In addition to treating psychosis, neuroleptics also have a strong .....effect?
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Antiemetic effect. Particularly useful in chemotherapy patients.
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What is the first-line of therapy drugs currently used for psychosis?
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Atypicals: Risperidone, Ziprasidone, Olanzapine.
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Why are Atypicals used over older anti-psychotics?
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Lower potential for Extrapyramidal motor symptoms. Lower risk fro tradive dyskinesia.
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What are some SE of Atypicals?
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Anxiety, orthostatic hypotension, sedation, EPS but to a lesser extent, GI distress, wt. gain, increased dream activity, decreased sexual function.
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