Antipsychotics and anti anxiety drugs

What is psychosis?

Loss of contact with reality characterized by delusions, hallucinations, disorganized thoughts, and impaired information processing.

What neurotransmitter imbalance is most commonly associated with psychosis?

Dopamine imbalance.

What are the three major symptom categories of schizophrenia?

Cognitive, positive, and negative symptoms.

Examples of cognitive symptoms of schizophrenia?

Disorganized thinking, memory difficulties, decreased attention and concentration.

Examples of positive symptoms of schizophrenia?

Delusions, hallucinations, paranoia, and incoherent speech.

Examples of negative symptoms of schizophrenia?

Blunted affect, poverty of speech, social withdrawal, poor self-care, and lack of motivation.

What is the primary mechanism of action of antipsychotic drugs?

Block dopamine receptors in the brain.

What symptoms do typical (1st generation) antipsychotics primarily treat?

Positive symptoms.

What symptoms do atypical (2nd generation) antipsychotics treat?

Both positive and negative symptoms.

Which receptors are blocked by atypical antipsychotics?

Dopamine and serotonin receptors

What is extrapyramidal syndrome (EPS)?

A group of movement disorders caused by dopamine blockade.

What is acute dystonia?

Sudden painful muscle spasms of the face, neck, back, or eyes.

What is akathisia?

Extreme restlessness and inability to sit still.

What is tardive dyskinesia?

Involuntary movements such as tongue protrusion, lip smacking, and facial grimacing.

Which EPS symptom is often irreversible?

dive dyskinesia.

What is Neuroleptic Malignant Syndrome (NMS)?

A life-threatening reaction to antipsychotics characterized by fever, tachycardia, seizures, and rhabdomyolysis.

What drug is used to treat Neuroleptic Malignant Syndrome?

Dantrolene

Which phenothiazine antipsychotic is associated with strong sedation and orthostatic hypotension?

Chlorpromazine

Which phenothiazines are associated with severe EPS?

Fluphenazine and Perphenazine.

What unusual urine color may occur with chlorpromazine?

Red-brown or pink urine.

What is the mechanism of action of fluphenazine?

Blocks dopamine receptors in the brain.

Major adverse effect of fluphenazine that nurses monitor closely for?

EPS

What is haloperidol commonly used to treat besides schizophrenia?

Tourette syndrome.

Important contraindications/cautions with haloperidol?

Narrow-angle glaucoma, CNS depression, dehydration, cardiovascular disease, hepatic disease, blood dyscrasias.

How long may antipsychotics take to achieve full therapeutic effect?

6 weeks or longer

What must patients avoid while taking antipsychotics?

Alcohol and other CNS depressants.

Main advantage of atypical antipsychotics over typical antipsychotics?

Lower risk of EPS and tardive dyskinesia.

Major metabolic side effects of atypical antipsychotics?

Weight gain, dyslipidemia, and diabetes mellitus.

Which atypical antipsychotic is reserved for severe schizophrenia unresponsive to other drugs?

Clozapine

What life-threatening adverse effect is associated with clozapine?

Agranulocytosis (severe leukopenia).

Which atypical antipsychotic is converted to paliperidone?

Risperidone

What disorders can aripiprazole treat?

Schizophrenia, bipolar disorder, autism, depression, and Tourette syndrome.

How does lorazepam work?

Enhances GABA activity by binding to benzodiazepine receptors.

What is the antidote for benzodiazepine overdose?

Flumazenil

Why should benzodiazepines never be stopped abruptly?

Withdrawal can cause anxiety, tremors, hypertension, seizures, and status epilepticus.