Pharm for MH exam 1

What is Thorazine (Chlorpromazine) used for?

Controls positive symptoms of Schizophrenia. It is an antipsychotic medication that helps reduce hallucinations, delusions, and agitation in patients.

The main mechanism for Thorazine

Block dopamine receptors in the brain.

Adverse reactions to Thorazine

EPS- Extrapyramidal Symptoms
TD- Tardive Dyskinesia
NMS- Neuroleptic Malignant Syndrome
Seizures
Orthostatic hypotension

What are Extrapyramidal Symptoms

Uncontrolled extra movements linked to dopamine blockade.

What is Tardive Dyskinesia

Involuntarily, repetitive movements caused by long-term exposure to antipsychotics, which may be irreversible.

What is Neuroleptic Malignant Syndrome

BIG emergency related to antipsychotics. Patients spike a high fever, with muscle rigidity and confusion.

What should a nurse monitor for with Thorazine?

Monitor for adverse effects and orthostatic hypotension.

Patient education for Thorazine

Avoid alcohol.

DO NOT stop taking medication abruptly.

What is Haldol used for?

Haldol is used for schizophrenia, psychosis, and psychiatric emergencies/ acute agitations. Can be given IV to HALT agitation.

The main mechanism for Haldol (Haloperidol)

HALDOL = HARDCORE DOPAMINE BLOCKER

Adverse reactions for Haldol

EPS- Extrapyramidal Symptoms
TD- Tardive Dyskinesia
NMS- Neuroleptic Malignant Syndrome
Seizures
Orthostatic hypotension

What should a nurse monitor for Haldol

Any listed adverse reactions

EKG monitoring: prolonged QT interval at high doses.

What is GEODON (Ziprasidone) used for?

Schizophrenia

Bipolar disorder

Acute agitation

Main mechanism for GEODON (Ziprasidone)

Inhibits dopamine AND serotonin inhibitors

Adverse reactions for GEODON (Ziprasidone)

EPS (lower risk than typical antipsychotics)

Confusion

Orthostatic hypotension

Akathisia = "I CANNOT SIT STILL."

Suicidal thoughts

What should a nurse monitor for with GEODON (Ziprasidone)

Monitor for adverse reactions and suicidal ideations

Periodic ECG readings (due to possible prolonged QT intervals)

AVOID use in patients with heart problems

Patient teaching for GEODON (Ziprasidone)

May take 4-6 weeks to work

Report any suicidal thoughts or ideation.

What is Risperdal (risperidone) used for?

Schizophrenia (positive and negative symptoms)
Autism-associated irritability/aggression
Bipolar mania

Main mechanism of Risperdal (risperidone)

Blocks dopamine receptors

Adverse reactions of Risperdal (risperidone)

EPS

NMS

Worsening hallucinations

Tachycardia

Orthostatic hypotension

Metabolic symptoms

What should a nurse monitor for with Risperdal (risperidone)

BP- take baseline BP BEFORE treatment

Monitor for metabolic changes

Patient is a fall risk on this medication

What is Clozaril (Clozapine) used for?

reserved for treatment-resistant schizophrenia

Main mechanism for reserved for Clozaril (Clozapine)

Blocks dopamine receptors

Adverse reactions of Clozaril (Clozapine)

AGRANULOCYTOSIS- severe neutropenia

seizures

tachycardia and orthostatic hypotension

metabolic changes (hyperglycemia)

What should a nurse monitor for with Clozaril (Clozapine)

Blood levels (neutropenia) draws done WEEKLY

Signs of infection: fever, sore throat, chills, ulcers

Metabolic changes

Contradictions of Clozaril (Clozapine)

DO NOT USE in patients with bone marrow depression (neutropenia)

What is Romazicon (Flumazenil) used for?

benzodiazepine antagonist, a reversal agent for benzo sedation.

(flips off the benzo)

What is the main mechanism of Romazicon (Flumazenil)

Antagonizes the benzodiazepine binding site on GABA-A receptors.

Adverse reactions of Romazicon (Flumazenil)

SEIZURES (especially with benzo dependence and seizure disorders)

REsedation- drug may wear off before the benzo.

What should the nurse monitor for with Romazicon (Flumazenil)

Seizure activity

Re-sedation

Respiratory depression

What is Cogentin (Benztropine) used for?

An anticholinergic that is used to treat EPS (movement-related disorder associated with antipsychotic medications)

Used for acute dystonia and parkinsonism- not typically used for TD

Patient education for Cogentin (Benztropine)

DO NOT stop abruptly

Fiber and fluids to help with constipation

What is Diazepam (Valium) used for?

It is a benzo, so it calms the brain and slows things down.

Adverse reactions to Diazepam (Valium)

Sedation

Possibility of abuse

Respiratory depression

What is Benadryl (diphenhydramine) used for

Antihistamine that treats EPS (specifically acute dystonia)

What is Dantrium used for?

Neuroleptic Malignant Syndrome