Treatment modalities for schizophrenia

20問 • 2年前

問題一覧

Select the 1st generation/typical/tradition antipsychotics:

Flephenzine (Prolixin, also deaconate form), Haloperidol (Haldol, also deaconate form), Chlorpromazine (Thorazine), Thiothixene (Navane), Trifluoperazine (stelzine), Perphenazine (Trilafon)

Select the 2nd generation/atypical antipsychotics:

risperidone (Risperdal), Olanzapine (Zyprexa), Quetiapine (Seroquel, XR), Lurasidone (Latuda), Clozaril, Ziprasidone (Geodon)

Select the types of antipsychotic medications

First gen, Second gen, Third gen, Injectable short and long acting First gen: haloperidol, fluephenazine decanoate Second-generation: olanzapine, pamoate, paliperidone palmitate

Abilify (aripiprazole)is?

A third generation antipsychotic

Select statements true to antipsychotics:

Effective for relapses, 2-6 weeks for full effect, Increase mortality in demented elderly (especially atypical/second generation), Nonaddictive, Not lethal in overdose by themselves, Impaired swallowing

Select statements true to first gen/typical/traditional antipsychotics:

Dopamine antagonists (D2 receptor antagonists), Target positive symptoms of schizophrenia, Advantage less expensive that second generation, Disadvantages: EPS, anticholinergic side effects, tardive dyskinesia, weight gain, sexual dysfunction, endocrine disturbances

For first gen/traditional/typical antipsychotics Low potency/high dose is?

High sedation, High Ach side effects, Low EPS, Thorazine, “wine coolers”

For first gen/traditional/typical antipsychotics high potency/low dose:

Low sedation, Low Ach side effects, High EPS, Haldol, “tequila, whiskey”

Long- acting antipsychotics (LAIs) Deopt injections:

First gen: Fluphenazine deaconate (Prolixin D) Haloperidol decanoate (Haldol D), Second gen: Risperdone (Risperdal Consta) Aripiprazole (Abilify Maintena) Paliperidone palmitate (Invega Sustenna) Olanzapine (Zyprexa Relprevv), Can last several weeks, Typically for noncompliant patients

Select statements true to second generation atypical antipsychotics:

Serotonin and dopamine antagonists, i.e. clozapine (Clozaril), Treat both positive and negative symptoms, Minimal to no extrapyramidal side effects (EPS) or tardive dyskinesia, Disadvantage- tendency to cause significant weight gain (except Abilify), Metabolic Syndrome

Metabolic syndrome:

Weight gain (abdomen), Dyslipidemia, Increased blood glucose, Insulin resistance, ⬆️Risk of diabetes, certain cancers, hypertensions, and CV disease

Interventions for metabolic syndrome:

Monitor labs: glucose, cholesterol, triglycerides, lipid profile, CBC with diff, BMP, Monitor weight, vital signs & EKG, Teach patient how to minimize weight gain through proper nutrition and physical activity, Teach patient and family about the importance of regulare medical evaluation and care to identify and correct possible changes that could lead to this syndrome and increase the risk of premature illness and death.

Select statements true to third generation antipsychotics:

Really a subset of SGAs, Aripiprazole (Abilify), brexpiprazole (Rexulti), and cariprazine (Vraylar), Dopamine system stabilizers, May improve positive and negative symptoms and cognitive function little risk of EPS pr tardive dyskinesia

Anticholinergic side effects

Dry mouth, urinary retention, constipation, blurred vision, photosensitivity, dry eyes, sexual dysfunction

Anticholinergic toxicity

Dry mucous membranes, Mydrasis (dilated pupils), Nonreactive pupils, Hot dry skin hyperthermia, Tachycardia, Seizure, ⬇️or absent peristalsis can lead to obstructions, Urinary rentention, Unstable vital signs, Agitation, Disorientation, Hallucinations, Reduced responsiveness, worsening of psychotic symptoms, Repetitive motor movements

Interventions for anticholinergic toxicity

Hold all meds and consult prescriber immediately, Implement emergency cooling measure as orders (cooling blanket, alcohol, or ice bath), Urinary catheterization as needed, Administer benzo or other sedative as ordered, Physostigmine (Eserine) may reverse the anticholinergic toxicity

Seclect statements true to neuroleptic malignant syndrome (NMS)

Severe muscle rigidity, dysphasia, Flexor-extensor posturing, Reduced or absent speech and movement, Decreased responsiveness, Hyperpyrexia temp over 103, HTN, tachycardia, diaphoresis, incontinence, Delirium, stupor, coma

Select FEVER in order for NMS

F= fever, E= encephalopathy (confusion disorientation), V= vital sign insability, E= enzyme elevations (CPK), R= rigidity

Select interventions for NMS:

Early detection ⬆️pts chance of survival, If suspected hold all antipsychotics and contact prescriber stat, Transfer to ICU, Bromocriptine (Parlodel) and dnatrolene (Dantrium ryanodex) can relieve rigidity and ⬇️fever, Cooling blankets, alcohol bath or cool or ice bath as ordered), Maintain hydration with oral or IV fluids correct electrolyte imbalance, Treat dysrhythmias, Small doses of heparin may decrease possibility of pulmonary emboli

Neutropenia

Reduced neutrophil counts and increased frequency and severity of infections, Any symptoms suggesting infection (sore, throat, fever, malaise, body aches) should be carefully evaluated, Hold drug and consult prescriber, Moderate neutropenia (ANC 500-999) and severe (ANC<500) should result in interruption

Health assessment questions

ユーザ名非公開 · 15問 · 2年前

Health assessment questions