NURS 5359 EXAM 1 LATEST
Identify the different dopamine pathways and what role each
pathway plays in relation to schizophrenia/psychosis symptoms and
treatment.
Mesolimbic: Associated with the 'reward' system of the brain;
abnormalities in this pathway are linked to the positive symptoms of
schizophrenia.
Mesocortical: This pathway impacts the prefrontal cortex and is
associated with negative symptoms of schizophrenia like apathy and
social withdrawal.
Nigrostriatal: Primarily involved in motor control; disturbances here
may lead to EPS seen with some antipsychotics.
Tuberoinfudibular: Regulates prolactin secretion from the pituitary
gland. Antipsychotics that block dopamine in this pathway can cause
increased prolactin levels, leading to side effects such as galactorhhea
and gynecomastia.
Identify potential medical emergencies associated with antipsychotic
medications such as neuroleptic malignant syndrome, and how to
manage these emergencies.
Neuroleptic Malignant Syndrome (NMS): A life threatening reaction
to antipsychotic drugs characterized by muscle rigidity, fever, altered
mental status, and autonomic dysfunction. IMMEDIATE MEDICAL
INTERVENTION IS CIRITICAL.
Management of NMS: Discontinuation of the offending drug, intensive
monitoring, and treatment with medications such
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1
, NURS 5359 EXAM 1 LATEST
as dantrolene or bromocriptine. Supportive care in an ICU setting is
often required.
Know the following medications, including their most commonly
expected side effects, drug interactions, potentially serious adverse
events, FDA indications, and lab work that should be monitored
prior to starting and while on the medication: Aripiprazole
FDA indications: Approved for the treatment of schizophrenia, bipolar
disorder, major depressive disorder, and irritability associated with
autistic disorder.
Common side effects: Headache, anxiety, insomnia, nausea, dizziness,
and risk for EPS.
Serious adverse effects: Potential for stroke in elderly patients with
dementia-related psychosis; also associated with tardive dyskinesia and
NMS.
Drug interactions: May occur with other CNS active drus,
antihypertensives, and inhibitors or inducers of CYP3A4 and CYP2D6.
Monitoring: Regular monitoring includes assessing for worsening
psychiatric condition, TD, and metabolic changes like blood sugar and
cholesterol levels.
Know the following medications, including their most commonly
expected side effects, drug interactions, potentially serious adverse
events, FDA indications, and lab work that should be monitored
prior to starting and while on the medication: Brexpiprazole
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PAGE
2
, NURS 5359 EXAM 1 LATEST
FDA indications: primarily for the treatment of schizophrenia, and as an
add-on treatment to antidepressants for major depressive disorder.
Common side effects: possible, side effects include weight gain,
sedation, headache, and Gastro intestinal disturbances, such as
constipation and nausea.
Serious adverse events: risks include potential for metabolic changes,
like increased cholesterol, and glucose levels, and a slight increase in the
risk for stroke in elderly patients with dementia related psychosis.
Drug interactions: may interact with other CNS depressants, and the
metabolism can be affected by inhibitors or inducers of CYP3A4 AND
CYP2D6 ENZYMES.
Know the following medications, including their most commonly
expected side effects, drug interactions, potentially serious adverse
events, FDA indications, and lab work that should be monitored
prior to starting and while on the medication: Chlorpromazine
FDA indications: First generation antipsychotic used for the treatment
of schizophrenia, manic phases of bipolar disorder, and severe
behavioral problems.
Common side effects: Sedation, dry mouth, blurred vision, constipation,
and can lead to EPS such as tremors and rigidity.
Serious adverse events: Includes severe EPS, TD, and NMS. Risk of
cardiovascular effects like orthostatic hypotension.
END OF
PAGE
3
Identify the different dopamine pathways and what role each
pathway plays in relation to schizophrenia/psychosis symptoms and
treatment.
Mesolimbic: Associated with the 'reward' system of the brain;
abnormalities in this pathway are linked to the positive symptoms of
schizophrenia.
Mesocortical: This pathway impacts the prefrontal cortex and is
associated with negative symptoms of schizophrenia like apathy and
social withdrawal.
Nigrostriatal: Primarily involved in motor control; disturbances here
may lead to EPS seen with some antipsychotics.
Tuberoinfudibular: Regulates prolactin secretion from the pituitary
gland. Antipsychotics that block dopamine in this pathway can cause
increased prolactin levels, leading to side effects such as galactorhhea
and gynecomastia.
Identify potential medical emergencies associated with antipsychotic
medications such as neuroleptic malignant syndrome, and how to
manage these emergencies.
Neuroleptic Malignant Syndrome (NMS): A life threatening reaction
to antipsychotic drugs characterized by muscle rigidity, fever, altered
mental status, and autonomic dysfunction. IMMEDIATE MEDICAL
INTERVENTION IS CIRITICAL.
Management of NMS: Discontinuation of the offending drug, intensive
monitoring, and treatment with medications such
END OF
PAGE
1
, NURS 5359 EXAM 1 LATEST
as dantrolene or bromocriptine. Supportive care in an ICU setting is
often required.
Know the following medications, including their most commonly
expected side effects, drug interactions, potentially serious adverse
events, FDA indications, and lab work that should be monitored
prior to starting and while on the medication: Aripiprazole
FDA indications: Approved for the treatment of schizophrenia, bipolar
disorder, major depressive disorder, and irritability associated with
autistic disorder.
Common side effects: Headache, anxiety, insomnia, nausea, dizziness,
and risk for EPS.
Serious adverse effects: Potential for stroke in elderly patients with
dementia-related psychosis; also associated with tardive dyskinesia and
NMS.
Drug interactions: May occur with other CNS active drus,
antihypertensives, and inhibitors or inducers of CYP3A4 and CYP2D6.
Monitoring: Regular monitoring includes assessing for worsening
psychiatric condition, TD, and metabolic changes like blood sugar and
cholesterol levels.
Know the following medications, including their most commonly
expected side effects, drug interactions, potentially serious adverse
events, FDA indications, and lab work that should be monitored
prior to starting and while on the medication: Brexpiprazole
END OF
PAGE
2
, NURS 5359 EXAM 1 LATEST
FDA indications: primarily for the treatment of schizophrenia, and as an
add-on treatment to antidepressants for major depressive disorder.
Common side effects: possible, side effects include weight gain,
sedation, headache, and Gastro intestinal disturbances, such as
constipation and nausea.
Serious adverse events: risks include potential for metabolic changes,
like increased cholesterol, and glucose levels, and a slight increase in the
risk for stroke in elderly patients with dementia related psychosis.
Drug interactions: may interact with other CNS depressants, and the
metabolism can be affected by inhibitors or inducers of CYP3A4 AND
CYP2D6 ENZYMES.
Know the following medications, including their most commonly
expected side effects, drug interactions, potentially serious adverse
events, FDA indications, and lab work that should be monitored
prior to starting and while on the medication: Chlorpromazine
FDA indications: First generation antipsychotic used for the treatment
of schizophrenia, manic phases of bipolar disorder, and severe
behavioral problems.
Common side effects: Sedation, dry mouth, blurred vision, constipation,
and can lead to EPS such as tremors and rigidity.
Serious adverse events: Includes severe EPS, TD, and NMS. Risk of
cardiovascular effects like orthostatic hypotension.
END OF
PAGE
3
