Final Exam: MH701 / MH 701
(Latest Update )
Psychopharmacologic / Neuroscience
Foundations of Mental Health Care
| Review Questions and Answers |
100% Correct - Frontier
Question:
Which of the atypical antipsychotics has less sedating side effects?
Answer:
Lurasidone is the least sedating of all of the atypical antipsychotics.
Generally speaking the "pines" are more sedating than the drones. Potent
antihistamine actions: clozapine, quetiapine, olanzapine and iloperidone.
Question:
Which of the atypical antipsychotics has less metabolic side effects?
Answer:
Low metabolic risk - Ziprasidone, aripiprazole, lurasidone, iloperidone (low
for dyslipidemia) & anasapine.
,Question:
Neuroleptic Malignant syndrome—Symptoms & Treatment
Answer:
*A life threatening emergency and is fatal in 10% of cases.
* Symptoms - reduced consciousness; increased muscle tone; autonomic
dysfunction (hyperpyrexia, hypertension, tachycardia, tachypnea, diaphoresis
& drooling). Can have cogwheeling (upper limbs with rigidity &*
superimposed rhythmic contractions on passive ROM).
* Treatment - early detection, discontinuation of the antipsychotic,
management of temperature, and monitoring for complications.
Question:
Extrapyramidal side effects-interventions for treating:
Answer:
Most common EPS sx are: akathisia (trouble standing still, paces floor, feet in
constant motion), parkinsonism and dystonic reactions.
If it develops, give benztropine (Cogentin) trihexyphenidyl, or
diphenhydramine.
Question:
Interventions for treating dystonia:
Answer:
Benztropine or anticholinergic
,Question:
Interventions for treating Akathisia:
Answer:
Propranolol is more effective for akathisia.
Question:
What to do for TD:
Answer:
* Switch to a atypical or clozapine.
* Taper off at first sign.
* VMAT2 inhibitor: Valbenzapine (Ingreeza) or Deutetrabazine (Austedo) can
be given.
* This is permanent.
* Benztropine can worsen TD.
Question:
Clozaril-What is important to know about his medication?
Answer:
Clozapine is the only antipsychotic that does not cause TD. (has low levels of
D2 occupancy).
, Question:
what patient education will you provide regarding Clozaril?
Answer:
Clozapine can cause weight gain, sedation. Can cause agranulocytosis, needs
to be placed in registry.
Question:
-What labwork will be required to be monitored while taking Clozaril?
Interventions if patient complains of illness?
Answer:
* Baseline ANC must be greater than1500 before initiating med. Draw weekly
for first 6 months, then every 2 weeks for the next 6 months, then every
month.
* Mild neutropenia: (100-1499), redraw lab within 24 hours and monitor 3x
week until >1500.
* Moderate neutropenia: (500-999): interrupt treatment and confirm ANC.
Monitor daily until ANC is >1000, then 3x week until >1500.
* Severe neutropenia: (<500): stop tx, hematology consult, do not restart
unless absolutely required.
(Latest Update )
Psychopharmacologic / Neuroscience
Foundations of Mental Health Care
| Review Questions and Answers |
100% Correct - Frontier
Question:
Which of the atypical antipsychotics has less sedating side effects?
Answer:
Lurasidone is the least sedating of all of the atypical antipsychotics.
Generally speaking the "pines" are more sedating than the drones. Potent
antihistamine actions: clozapine, quetiapine, olanzapine and iloperidone.
Question:
Which of the atypical antipsychotics has less metabolic side effects?
Answer:
Low metabolic risk - Ziprasidone, aripiprazole, lurasidone, iloperidone (low
for dyslipidemia) & anasapine.
,Question:
Neuroleptic Malignant syndrome—Symptoms & Treatment
Answer:
*A life threatening emergency and is fatal in 10% of cases.
* Symptoms - reduced consciousness; increased muscle tone; autonomic
dysfunction (hyperpyrexia, hypertension, tachycardia, tachypnea, diaphoresis
& drooling). Can have cogwheeling (upper limbs with rigidity &*
superimposed rhythmic contractions on passive ROM).
* Treatment - early detection, discontinuation of the antipsychotic,
management of temperature, and monitoring for complications.
Question:
Extrapyramidal side effects-interventions for treating:
Answer:
Most common EPS sx are: akathisia (trouble standing still, paces floor, feet in
constant motion), parkinsonism and dystonic reactions.
If it develops, give benztropine (Cogentin) trihexyphenidyl, or
diphenhydramine.
Question:
Interventions for treating dystonia:
Answer:
Benztropine or anticholinergic
,Question:
Interventions for treating Akathisia:
Answer:
Propranolol is more effective for akathisia.
Question:
What to do for TD:
Answer:
* Switch to a atypical or clozapine.
* Taper off at first sign.
* VMAT2 inhibitor: Valbenzapine (Ingreeza) or Deutetrabazine (Austedo) can
be given.
* This is permanent.
* Benztropine can worsen TD.
Question:
Clozaril-What is important to know about his medication?
Answer:
Clozapine is the only antipsychotic that does not cause TD. (has low levels of
D2 occupancy).
, Question:
what patient education will you provide regarding Clozaril?
Answer:
Clozapine can cause weight gain, sedation. Can cause agranulocytosis, needs
to be placed in registry.
Question:
-What labwork will be required to be monitored while taking Clozaril?
Interventions if patient complains of illness?
Answer:
* Baseline ANC must be greater than1500 before initiating med. Draw weekly
for first 6 months, then every 2 weeks for the next 6 months, then every
month.
* Mild neutropenia: (100-1499), redraw lab within 24 hours and monitor 3x
week until >1500.
* Moderate neutropenia: (500-999): interrupt treatment and confirm ANC.
Monitor daily until ANC is >1000, then 3x week until >1500.
* Severe neutropenia: (<500): stop tx, hematology consult, do not restart
unless absolutely required.
