Health Care > STUDY GUIDE > NURS 5334 EXAM 2 NOTES. COMPLETE STUDY GUIDE. LATEST 2022. (All)
NURS 5334 EXAM 2 NOTES. COMPLETE STUDY GUIDE. LATEST 2022.Psychiatric Drugs Two Groups: o First Generation Conventional Anti-psychotics Block the receptors for dopamine in central nerv... ous system (CNS) Cause serious movement disorders (extra pyramidal symptoms, EPS) Classified by potency Low, Medium, High Low Potency Chlorpromazine o Indications Schizophrenia Schizoaffective disorder in the manic phase of bipolar disorder Anti-nausea Relief of hiccups Control of severe behavioral problems in children o Adverse effects: Sedation Orthostatic hypotension Anticholinergic effects o Drug interactions Intensifies responses to CNS depressant Antihistamines Benzodiazepines Barbiturates Anticholinergic drugs Antihistamines Tricyclic antidepressants Atropine-like drugs Thioridazine o Adverse effects: Prolonged QT interval Cause fatal cardiac dysrhythmias Sedation Orthostatic hypotension Anticholinergic effects Weight gain o Black Box Warning: Dysrhythmias o Treats Schizophrenia only when patients have not responded to anything else High Potency Haloperidol o Butyrophenone family 1 o Indications: Schizophrenia Acute psychosis Preferred agent for Tourette Syndrome o Adverse effects: EPS Neuroendocrine effects Can prolong QT interval and cause dysrhythmias Fluphenazine o Phenothiazines subclass o Indications Schizophrenia Other psych disorders o Adverse effects: EPS Acute dystonia Parkinsonism Akathisia Sedations Orthostatic hypotension Anticholinergic effects Gynecomastia Galactorrhea Menstrual irregularities Mechanism of Action (MOA) Block a variety of receptors within and outside the central nervous system Suppress symptoms of psychosis by blocking dopamine 2 receptors in the mesolimbic area of the brain Adverse Effects Result of walking receptors for dopamine, acetylcholine, histamine, and norepinephrine Acute dystonia Oculogyric crisis Opisthotonos Joint dislocation Impaired respiration Some anticholinergic meds can help o Benztropine and diphenhydramine Some are irreversible, so crucial to monitor Can produce Parkinson-like symptoms o Bradykinesia o Mask-like faces o Drooling o Tremor o Rigidity 2 o Shuffling gait o Cogwheeling o Stopped posture o Possible due to blockade of D2 receptors Other EPS symptoms: akathisia o Pacing and squirming brought on by uncontrollable need to be in motion Tardive dyskinesia and choreoathetoid movements of tongue and face o Lip smacking o Tongue flicks in and out o A slow worm like movement of tongue o Involuntary movements of limbs, toes, fingers, trunk Neuroleptic Malignant Syndrome o Rare but serious (risk of death if not treated) o Lead pipe rigidity o Sudden high fever o Sweating o Autonomic instability o Dysrhythmic o Fluctuations of blood pressure o Altered level of consciousness o Seizures or coma can develop o Death is results of respiratory failure, cardiovascular collapse, dysrhythmias Anticholinergic effects o Dry mouth, poor vision, photophobia, urinary hesitancy, constipation, tachycardia Can cause orthostatic hypotension o due to blocking of alpha 1 adrenergic receptor at blood vessels Other effects: o Sedation, neuro endocrine affects seizures, sexual dysfunction, dermatologic effects agranulocytosis and severe dysrhythmias BLACK BOX WARNING: Severe dysrhythmias Do NOT abruptly withdraw Can precipitate a mild abstinence syndrome Schizophrenia is primary indication Suppress symptoms during psychotic episodes Continued use does reduce risk of relapse Medication Interactions Anticholinergic o Can intensify anticholinergic effects CNS depressants o Can intensify the depressant effect 3 Levodopa o Indirect/direct dopamine receptor agonists can counteract the antipsychotic effects of neuroleptics Overall safe and deaths from overdose rare Overdose can cause: o Hypertension o CNS depression, EPS Treatment of Overdose: o Fluids o Alpha adrengergic agonists o Gastric lavage o Emetics aren’t effective due to neuroleptics blocking antiemetic action [Show More]
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