Mental Health Nursing- Questions and Answers
- Financial well-being, socio-economic status and educational status
- Trauma
- Sex and gender
Determinants of Mental Health - Age
- Genetics
- Physical health, lifestyle, diet, exercise, smoking, use of substances
- Personality
The theory that a genetic or biological predisposition to certain mental disorders
stress-vulnerability model (e.g., schizophrenia, mood disorders) exists and that psychological and social factors
can increase the likelihood of symptomatic episodes.
- Antipsychotics (neuroleptics)
- Antidepressants
Mental Health Drug Classes
- Mood stabilisers
- Anxiolytics
- Pharmacokinetics (how they are absorbed and metabolised).
Factors that determine response to drug - Environmental influences (diet, smoking, other drugs involved).
- Pharmacogenomics (genetic factors influencing drug effects).
, Treat psychotic symptoms (not its underlying causes): predominately the positive
symptoms (delusions, hallucinations, thought disorder).
Antipsychotic medications
Work by blocking dopamine receptors in the brain. Dopamine antagonists.
Typical antipsychotic medications are the older, first-generation drugs. They
antagonise dopamine receptors and can help manage the positive symptoms of
psychosis, but not the negative. Atypical antipsychotic medications are newer and
can help manage both the positive and negative symptoms associated with
psychosis.
Typical antipsychotics
Older ‘first generation’ antipsychotic drugs.
They have an affinity with D1 and D2 receptors.
Typical antipsychotics vs atypical Helps reduce positive symptoms of psychosis but has lots of neurological side
antipsychotics effects.
Side effects are mostly extrapyramidal
Atypical antipsychotics
More recently developed antipsychotic drugs.
High affinity with D2 & 5-HT receptors
Similar efficacy to typical antipsychotics but with better side effect profile.
Side effects are mostly anticholinergic or metabolic
- Tablets
- Syrups
Administration of antipsychotics
- IMI fast-acting
- IMI slow-release
- Extrapyramidal Side Effects (EPSEs)
Antipsychotic side effects - Neuroleptic Malignant Syndrome
- Metabolic syndrome
The extrapyramidal system is involved in motor
coordination and movement. Symptoms arise
when there are disturbances to this symptom.
- More common with typical antipsychotics
Extrapyramidal Side Effects (EPSEs) - Primarily consist of four primary dimensions:
1.Parkinsonian symptoms
2. Akathisia
3. Acute dystonia
4. Tardive dyskinesia
Rigidity, mask like face, shuffling gait, tremor at rest, difficulty speaking or
swallowing.
EPSE: parkinsonism
Resolved with anticholinergic or
antiparkinsonian drugs or possibly a change in medication.
Restlessness, leg aches, person can not stay still, subjective sense of restlessness -
both motor and cognitive restlessness. Need to crawl out of skin.
EPSE: akathisia
Resolved by reducing the dose, changing medication, low dose of propranolol (beta
blocker)
- Financial well-being, socio-economic status and educational status
- Trauma
- Sex and gender
Determinants of Mental Health - Age
- Genetics
- Physical health, lifestyle, diet, exercise, smoking, use of substances
- Personality
The theory that a genetic or biological predisposition to certain mental disorders
stress-vulnerability model (e.g., schizophrenia, mood disorders) exists and that psychological and social factors
can increase the likelihood of symptomatic episodes.
- Antipsychotics (neuroleptics)
- Antidepressants
Mental Health Drug Classes
- Mood stabilisers
- Anxiolytics
- Pharmacokinetics (how they are absorbed and metabolised).
Factors that determine response to drug - Environmental influences (diet, smoking, other drugs involved).
- Pharmacogenomics (genetic factors influencing drug effects).
, Treat psychotic symptoms (not its underlying causes): predominately the positive
symptoms (delusions, hallucinations, thought disorder).
Antipsychotic medications
Work by blocking dopamine receptors in the brain. Dopamine antagonists.
Typical antipsychotic medications are the older, first-generation drugs. They
antagonise dopamine receptors and can help manage the positive symptoms of
psychosis, but not the negative. Atypical antipsychotic medications are newer and
can help manage both the positive and negative symptoms associated with
psychosis.
Typical antipsychotics
Older ‘first generation’ antipsychotic drugs.
They have an affinity with D1 and D2 receptors.
Typical antipsychotics vs atypical Helps reduce positive symptoms of psychosis but has lots of neurological side
antipsychotics effects.
Side effects are mostly extrapyramidal
Atypical antipsychotics
More recently developed antipsychotic drugs.
High affinity with D2 & 5-HT receptors
Similar efficacy to typical antipsychotics but with better side effect profile.
Side effects are mostly anticholinergic or metabolic
- Tablets
- Syrups
Administration of antipsychotics
- IMI fast-acting
- IMI slow-release
- Extrapyramidal Side Effects (EPSEs)
Antipsychotic side effects - Neuroleptic Malignant Syndrome
- Metabolic syndrome
The extrapyramidal system is involved in motor
coordination and movement. Symptoms arise
when there are disturbances to this symptom.
- More common with typical antipsychotics
Extrapyramidal Side Effects (EPSEs) - Primarily consist of four primary dimensions:
1.Parkinsonian symptoms
2. Akathisia
3. Acute dystonia
4. Tardive dyskinesia
Rigidity, mask like face, shuffling gait, tremor at rest, difficulty speaking or
swallowing.
EPSE: parkinsonism
Resolved with anticholinergic or
antiparkinsonian drugs or possibly a change in medication.
Restlessness, leg aches, person can not stay still, subjective sense of restlessness -
both motor and cognitive restlessness. Need to crawl out of skin.
EPSE: akathisia
Resolved by reducing the dose, changing medication, low dose of propranolol (beta
blocker)
