Antipsychotics, Antidepressants - PowerPoint PPT Presentation

1 / 28
About This Presentation
Title:

Antipsychotics, Antidepressants

Description:

Anticholenergic, adrenergic blocking effect. EPS, pseudoparkinsonism ... of norepinephrine into peripheral adrenergic nerves: see increased sympathetic tone ... – PowerPoint PPT presentation

Number of Views:130
Avg rating:3.0/5.0
Slides: 29
Provided by: wwcc4
Category:

less

Transcript and Presenter's Notes

Title: Antipsychotics, Antidepressants


1
Antipsychotics, Antidepressants
  • Barbara S. Hays, RN
  • Winter, 2006

2
Psychosis
  • Thought disturbances
  • Out of touch with reality

3
SCHIZOPHRENIA
  • GROUP of mental disorder
  • Disordered thought processes
  • Psychotic features
  • Disrupted interpersonal relationships
  • DISTURBANCES in
  • Thought processes
  • Affect, mood
  • Behavior

4
Affective disorder of schizophrenia
  • Flattened, blank
  • Blunted
  • Inappropriate, incongruous

5
Affective disorder of schizophrenia
  • Flattened, blank
  • Blunted
  • Inappropriate, incongruous

6
Autism of schizophrenia
  • Retreats into self
  • Stereotypical behaviors like hair twirling
  • May forget to feed, bathe, dress body
  • Own language (neologisms)

7
  • Illusions
  • Delusions
  • Hallucinations

8
Atypical antipsychotics to treat schizophrenia
(Easy p 459, 60)
  • Block dopamine receptors (less than the
    typicals do) and seratonin receptors
  • Clozapine (Clozaril)
  • Resperidone
  • Fewer extrapyramidal tract side effects

9
Typical Antipsychotics(Easy p 462)
  • Thorazine (chlorpromazine)
  • Prolixin (Fluphenazine)
  • Mellaril (Thioridazine)
  • Stelazine (Trifluoperazine)

10
Typical antipsychotics
  • THORAZINE especially
  • After dopamine in CNS
  • Anticholenergic, adrenergic blocking effect
  • EPS, pseudoparkinsonism
  • Tardive dyskinesias (can become permanent)
  • Orthostatic hypotension
  • Photosensitivity
  • Agranulocytosis (report sore throat/fever STAT!)

11
THORAZINE
  • Extrapyramidal tract side effects (EPSs)
  • Acute dystonias
  • Torticolis
  • Occulaogyral crisis
  • Ajastgesua (restless legs, etc)

12
THORAZINE
  • pseudoParkinsonism from decreased dopamine
  • Artane
  • Cogentin
  • Tardive dyskinesias (long term, hi doses)
  • PERMANENT
  • Facial grimaces
  • Tongue movements

13
Other ANTIPSYCHOTICS
  • PROLIXIN (fluphenazine)
  • HALDOL (haloperidol) anticholinergic effects
    dry mouth, orthostatic hypotension, etc.
  • give with Cogentin to reduce s/es

14
(No Transcript)
15
Affect MEDICATIONS
  • Antidepressants (Easy p 441 459)
  • SSRIs
  • MAO inhibitors
  • Tricyclics
  • Atypicals
  • Mood stabilizers (Easy p 456)

16
DEPRESSION
  • Theories
  • Freud
  • Biologic

17
S/S DEPRESSIONSilvestri p 947 (box 61-2)
  • Sense of inadequacy and helplessness
  • Maybe unresolved grief
  • Psychomotor retardation
  • Vegetative signs
  • Weight loss
  • Constipation
  • Early morning awakening

18
Care of DEPRESSED client
  • Simple, structured activities
  • One-on-one (maybe with nurse)
  • Watch for suicide when energy level on the rise
  • Assess degree of risk
  • Find out if has lethal plan

19
Selective Seratonin Reuptake Inhibitors (Easy p
441)
  • PROZAC (fluoxetine)
  • PAXIL (paroxetine)
  • ZOLOFT (sertraline)
  • EFFOXOR (seratonin norepinephrine)
  • ELAVIL (seratonin norepinephrine)
  • DONT GIVE WITH MAOIS

20
MonoAmineOxidase Inhibitors
  • PARNATE is prototype
  • Parnate-cheese reaction -- increased
    catecholamines HTN, CVA
  • Aged, fermented things
  • Blue cheese
  • Chianti wine
  • DC at least 2-5 weeks prior to beginning SSRIs

21
TRICYCLIC antidepressants (Easy p 448)
  • Block reuptake of norepinephrine into peripheral
    adrenergic nerves see increased sympathetic tone
  • Takes 2-4 weeks to see results
  • Uses
  • Depression
  • Phobic attacks
  • bedwetting

22
TOFANIL (imipramine)Prototype Pro p 450
  • Potentiates effects of seratonin and
    norepinephrine
  • Arrhythmias
  • Constipation
  • Avoid concurrent use with MAOIs (stop MAOI 2
    weeks before starting Tofranil)

23
Elavil (amipriptyline)
  • Take daily at bedtime
  • Anti-cholinergic effect
  • Dry mouth (hard candy, sugarless gum)
  • constipation

24
Other Antidepressants/Anxiolytics
  • BARBITURATES (ital) (Easy p 430)
  • CNS depressants
  • Dont withdraw suddenly
  • BENZODIAZEPINES (pam, plam ) (Easy p 437)
  • Valium
  • Xanax
  • Ativan
  • Avoid ETOH combination effect

25
BIPOLAR (old term manic depressive)

26
BIPOLARsilvestri p 947
  • Psychotic at both extremes

27
MOOD STABILIZERS(Easy p 456 459)
  • LITHIUM CARBONATE
  • Therapeutic blood level 0.8 1.2 mEq/l
  • Toxic level 1.5 - 2

28
MOOD STABILIZERS
  • LITHIUM CARBONATE (a natural salt)
  • Chops off both ends of bipolar
  • Hard on kidneys over time
  • Take with food, milk, to decrease GI upset
Write a Comment
User Comments (0)
About PowerShow.com