Psychopharmacology Nursing Midterm Exam 1 2025

Abnormalities in mood, behavior, and thinking are caused by - -alterations in neurotransmitters and their function in the brain Common neurotransmitters - -serotonin, dopamine, norepinephrine Fxn of neurotransmitters - -released when electrical impulses pass along the axon and transmit the impulse across the synapse Action of psychotropic drugs - -enhance, inhibit, or block the transmission of certain neurotransmitters Smoking *increases* the metabolism of - -antipsychotics and benzodiazepines Sodium in the diet influences the half-life of a what drug - -Lithium Slow metabolizers of atypical antipsychotics - -greater than 1/3 of blacks Slow metabolizers of benzos - -Asians Slow metabolizers are at risk for - -toxicity Discontinuation syndrome - -a condition that can occur following the interruption, dose reduction, or discontinuation of antidepressant drugs, including selective serotonin re uptake inhibitors (ssris) or serotonin-norepinephrine reuptake inhibitors (snris). Rebound or relapse of symptoms can occur with ________ syndrome - -discontinuation Guideline for TX of mental illness - -emotional responses beyond ordinary life Depression and psychosis generally need - -medical treatment Titration of medication - -starting dose low and increasing based on SE's and response If side effects occur... - -hold med or reduce dose Why should you only start one new med at a time? - -if SE's occur, you won't know what med caused it Psychosis defined - -hallucinations: sensory experience without stimulation Delusions: fixed false belief Psychopharmacology Psychopharmacology Psychopharmacology Why should delusions not be challenged? - -makes the person hold on to them tighter and makes them defensive Psychosis symptoms - -impaired communication, inability to relate to others, hallucinations, delusions, lack of response to external stimuli, loss of touch with reality Off label uses of antipsychotics - -hiccups, n/v, anxiety/tension, behavioral issues Convential antipsychotics action - -block *dopamine* receptors and lessens or stops development of strange thoughts and behaviors Dopamine regulates - -Fine muscle movement Emotions, thoughts, decisions, reward seeking Excess dopamine causes what - -nerve impulses in the brain stem to be transmitted *faster* resulting in abnormal thoughts Typical antipsychotic names - -*- zine* drugs Ex. Chlopromazine Exception: haloperidol Atypical antiphsychotics action - -block both *dopamine and serotonin* which treats both the positive and negative s/s of schizophrenia + symptoms of schizophrenia - -delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior - symptoms of schizophrenia - -emotional withdrawal, difficulty relating, flat affect, poor eye contact depression-like" Atypical antipsychotic names - -- pine, - done drugs Ex. Clozapine, risperidone Clozapine requires what labs - -CBC's to detect possible agranulocytosis Quetiapine should be dosed at night because it has what effect? - -antihistamine Olanazapine is known to cause what? - -weight gain Lurasadone should not be combined with what food? - -grapefruit juice Psychopharmacology Psychopharmacology Adverse effects or antipsychotics - -anticholinergic effects *(can't see, can't pee, can't spit, can't shit)* *steven johnson's syndrome* Photosensitivity Nausea Heartburn Orthostatic hypotension *(get up slowly)* Weight gain Seizures *(lowers the threshhold)* Alteration in sexual fxn Sinus tachycardia and EKG changes Agranulocytosis Are EPS reversible, irreversible, or fatal? - -reversible EPS: Pseudoparkinsonism - -stiff, stooped posture, mask-like face, cogwheel rigidity, shuffling gait, pill rolling, drooling, bradycardia EPS: Acute Dystonia - -involuntary muscle contractions of the neck, head, arms, legs, truck (torticollis), and oculogyric crisis (eyes roll back to reveal the whites of the eyes) EPS: Akathisia - -restlessness *always assess thoughout tx although the book says they occur early on* All 3 EPS are treated with - -anticholinergics Is tardive dyskinesia reversible, irreversible, or fatal? - -irreversible Tardive dyskinesia - -involuntary *rhythmic* movements of the facial muscles, tongue, and limbs like *lip smacking, tongue protrusion, cheek puffing*; a possible neurotoxic side effect of *long-term* use of antipsychotic drugs that target certain dopamine receptors Symptoms increase with anxiety and tension Compared with EPS, tardive dyskinesia is - -rhythmic Is NMS reversible, irreversible, or fatal? - -fatal NMS symptoms - -severe muscle rigidity, confusion, agitation, and increased temperature, pulse, and invariable blood pressure CPK (muscle) labs elevated Treatment for NMS - -fluids, stop med, dantrolene Psychopharmacology Psychopharmacology Metabolic syndrome characteristics - -hyperglycemia, dyslipidemia, abdominal obesity Metabolic syndrome can happen with what drugs? - -clozapine and olanzapine but can happen with *any antipsychotic* To prevent metabolic syndrome what should be done