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NURS 307 INTEGRATED MENTAL HEALTH AND
ADDICTION INTO NURSING EXAM AND STUDY
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What are the two individual variation in drug effects? - ANSWER - Age and Ethnicity (genetic makeup)
How does age influence drug effects? - ANSWER - - there is an alteration in gastric absorption
- renal function is altered in very young and old
- liver metabolism decreases with age
What are the 4 phases of drug treatment? - ANSWER - 1) initiation - long-acting IM?2) stabilization - max amount of improvement with little side effect 3) maintenance - importance to maintain therapeutic effect 4) discontinuation
What are the 5 psychotropic medication classes? - ANSWER - - Antipsychotic medications
- Mood stabilizer 1 / 4
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- Antidepressant
- Anti-anxiety and sedative-hypnotics
- Stimulants
What are the target symptoms and types of antipsychotic medications? -
ANSWER - Target: psychotic symptoms
Types: typical (1st gen) and atypical (second gen)
What are the four preparations for antipsychotic medications? - ANSWER - Oral IM Depot Long-acting injectable
What are the two depot medications for antipsychotics? - ANSWER - Haloperidol and fluphenazine (typical) two weeks
What is the medication for long-acting injectables for antipsychotics? - ANSWER - Risperdal Consta (atypical) for four weeks (after four weeks, they go to injection clinic)
What are the side effects of antipsychotic medications? - ANSWER - -
Cardiovascular: orthostatic hypotension
- Weight gain: blocking histamine receptor 2 / 4
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- Endocrine and sexual: block dopamine; sexual dysfunction is side
effect sometimes when discontinued med.
- Blood dyscrasias: agranulocytosis - clozapine (usually titrate clozapine
dose slowly) lack of neutrophil WBC
- EPS
- NMS - neuroleptic malignant syndrome (rare, but life threatening)
What do we do if patients are responding poorly to antipsychotic medications? - ANSWER - obtain antipsychotic plasma levels in patients who have had poor response despite a trial with an adequate dose/duration
Why is obtaining antipsychotic plasma levels helpful? - ANSWER - 1) Rule out poor adherence 2) Identify rapid elimination 3) Confirm true treatment resistance 4) Although not all antipsychotics have well-established therapeutic plasma levels, olanzapine is among those agents that do
What are the four typical antipsychotics? - ANSWER - 1) Phenothiazines - Thorazine, prolix in 2) Thioxanthene’s - Navan 3) Dibenzoxapines - oxetane 4) Haloperidol - Haldol
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pg. 4 What are the 6 atypical antipsychotics? - ANSWER - Clozapine (Clozaril) Risperidone (Risperdal) Olanzapine (Zyprexa) Quetiapine (Seroquel) Ziprasidone (Geodon) Aripiprazole (Abilify)
What are some acute syndromes (medication-related movement disorders) - ANSWER - This only occurs in some patients.
- Dystonia
- Parkinsonism
- Akathisia
What is dystonia? - ANSWER - Involuntary muscle spasms, abnormal postures
What is parkinsonism? - ANSWER - Rigidity, akinesia (slow movement), tremor, mask-like face, loss of spontaneous movements
What is akathisia? - ANSWER - Inability to sit still, restlessness
What is the etiology of acute movement disorders? - ANSWER - It is related to dopamine in the nigrostriatal pathway that increases cholinergic activity
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