lOMoARcPSD|44532475
NUR2474 Pharmacology Module 3 Quiz Review
Test tips:
Be cautious of negatively worded questions! They are easy, but often misinterpreted due to not
paying attention to them.
Topics review:
1. General features of schizophrenia and Chlorpromazine (class, mechanism of action,
adverse effects, administration/withdrawal teaching, and review early and late EPS
specifically).
a. Chlorpromazine .
i. Class: Antipsychotic (low-potency)
ii. Mechanism of action: blocks dopamine. Many cause serious movement
disorders known as (Extrapyramidal symptoms EPS). None if the
Schizophrenia medications are addictive. Suppress symptoms during acute
psychotic episodes.
iii. Adverse effects (First Generation Antipsychotics)
1. EPS
2. Neuroleptic malignant syndrome: Risk of death without treatment
due to cardiovascular collapse & dysrhythmias.
a. “Lead pipe” rigidity, sudden high fever, sweating,
autonomic instability, dysrhythmias, fluctuations in blood
pressure, altered level of consciousness, and seizures or
coma may develop.
3. Parkinsonism: Bradykinesia, mask-like facies, drooling, tremor,
rigidity, shuffling gait, cogwheeling, and stooped posture.
4. Akathisia: Pacing and squirming brought on by an uncontrollable
need to be in motion.
5. Tardive Dyskinesia: Choreoathetoid movements of the tongue and
face; lip-smacking movements; tongue flicks out in a “fly-
catching” motion; slow, worm-like movement of the tongue; and
involuntary movements of the limbs, toes, fingers, and trunk
iv. Administration/withdrawal teaching
1. Contraindications
a. Parkinson’s Disease because it further reduces dopamine.
Levodopa counteracts antipsychotic effects.
v. Early and late EPS
1. What causes it
a. Taking first or second generation antipsychotic drugs that
antagonize dopamine receptors.
2. Symptoms (first generation drugs)
a. Acute dystonia: involuntary muscle contractions that may
cause repetitive twisting movements.
Downloaded by madiba South Africa stuvia ()
, lOMoARcPSD|44532475
b. Oculogyric crisis: prolonged upward deviation of the eyes.
c. Opisthotonos: Muscle spasm causing a backward arching
of the head, neck, and spine.
d. Joint dislocation
e. Impaired respiration
f. Anticholinergic medications (benztropine and
diphenhydramine): May further complicate by causing dry
mouth, blurred vision, photophobia, urinary hesitancy,
constipation, and tachycardia.
b. Haloperidol (High-Potency)
i. Indications
1. Schizophrenia
2. Acute Psychosis
3. Preferred agent for Tourette’s Syndrome
ii. Adverse Effects
1. EPS
2. Neuroendocrine effects
3. Can prolong QT interval and cause dysrhythmias
2. Review strategies and treatments for EPS.
a. Strategies
i. Stop the causing agent immediately.
b. Treatments
i. Benzodiazepines
ii. Beta blockers
iii. Anticholinergic drugs
3. Review general teaching topics for patients on antipsychotics (adherence).
a. Teaching topdiaics
i. A few days to kick in, a few weeks to take full therapeutic effect
ii. Adherence
1. Withdrawal syndrome
4. General features of depression and Fluoxetine (Prozac) (class, mechanism of action,
adverse effects, teaching, administration/withdrawal, and review serotonin syndrome).
a. Class: antidepressant
b. Mechanism of action: selective inhibition of serotonin reuptake (SSRI), makes
more serotonin available at synapse.
c. Adverse effects
i. Serotonin syndrome
ii. Insomnia
iii. Withdrawal syndrome (don’t stop abruptly, taper off slowly)
iv. Teratogenesis (only drug safe for breast feeding is sertraline/Zoloft)
v. EPS
vi. Bruxism (clenching/grinding teeth)
vii. Bleeding disorders
Downloaded by madiba South Africa stuvia ()
NUR2474 Pharmacology Module 3 Quiz Review
Test tips:
Be cautious of negatively worded questions! They are easy, but often misinterpreted due to not
paying attention to them.
Topics review:
1. General features of schizophrenia and Chlorpromazine (class, mechanism of action,
adverse effects, administration/withdrawal teaching, and review early and late EPS
specifically).
a. Chlorpromazine .
i. Class: Antipsychotic (low-potency)
ii. Mechanism of action: blocks dopamine. Many cause serious movement
disorders known as (Extrapyramidal symptoms EPS). None if the
Schizophrenia medications are addictive. Suppress symptoms during acute
psychotic episodes.
iii. Adverse effects (First Generation Antipsychotics)
1. EPS
2. Neuroleptic malignant syndrome: Risk of death without treatment
due to cardiovascular collapse & dysrhythmias.
a. “Lead pipe” rigidity, sudden high fever, sweating,
autonomic instability, dysrhythmias, fluctuations in blood
pressure, altered level of consciousness, and seizures or
coma may develop.
3. Parkinsonism: Bradykinesia, mask-like facies, drooling, tremor,
rigidity, shuffling gait, cogwheeling, and stooped posture.
4. Akathisia: Pacing and squirming brought on by an uncontrollable
need to be in motion.
5. Tardive Dyskinesia: Choreoathetoid movements of the tongue and
face; lip-smacking movements; tongue flicks out in a “fly-
catching” motion; slow, worm-like movement of the tongue; and
involuntary movements of the limbs, toes, fingers, and trunk
iv. Administration/withdrawal teaching
1. Contraindications
a. Parkinson’s Disease because it further reduces dopamine.
Levodopa counteracts antipsychotic effects.
v. Early and late EPS
1. What causes it
a. Taking first or second generation antipsychotic drugs that
antagonize dopamine receptors.
2. Symptoms (first generation drugs)
a. Acute dystonia: involuntary muscle contractions that may
cause repetitive twisting movements.
Downloaded by madiba South Africa stuvia ()
, lOMoARcPSD|44532475
b. Oculogyric crisis: prolonged upward deviation of the eyes.
c. Opisthotonos: Muscle spasm causing a backward arching
of the head, neck, and spine.
d. Joint dislocation
e. Impaired respiration
f. Anticholinergic medications (benztropine and
diphenhydramine): May further complicate by causing dry
mouth, blurred vision, photophobia, urinary hesitancy,
constipation, and tachycardia.
b. Haloperidol (High-Potency)
i. Indications
1. Schizophrenia
2. Acute Psychosis
3. Preferred agent for Tourette’s Syndrome
ii. Adverse Effects
1. EPS
2. Neuroendocrine effects
3. Can prolong QT interval and cause dysrhythmias
2. Review strategies and treatments for EPS.
a. Strategies
i. Stop the causing agent immediately.
b. Treatments
i. Benzodiazepines
ii. Beta blockers
iii. Anticholinergic drugs
3. Review general teaching topics for patients on antipsychotics (adherence).
a. Teaching topdiaics
i. A few days to kick in, a few weeks to take full therapeutic effect
ii. Adherence
1. Withdrawal syndrome
4. General features of depression and Fluoxetine (Prozac) (class, mechanism of action,
adverse effects, teaching, administration/withdrawal, and review serotonin syndrome).
a. Class: antidepressant
b. Mechanism of action: selective inhibition of serotonin reuptake (SSRI), makes
more serotonin available at synapse.
c. Adverse effects
i. Serotonin syndrome
ii. Insomnia
iii. Withdrawal syndrome (don’t stop abruptly, taper off slowly)
iv. Teratogenesis (only drug safe for breast feeding is sertraline/Zoloft)
v. EPS
vi. Bruxism (clenching/grinding teeth)
vii. Bleeding disorders
Downloaded by madiba South Africa stuvia ()
