Tiêu đề COMPRE - HANDOUTS - PSYCH (Mr. Arzadon) SC ✅

2 TOPRANK REVIEW ACADEMY - Prof. Kenneth Arzadon, RN DECANOATE NEUROLEPTICS / ANTIPSYCHOTICS 1 st generation 2 nd generation 3 rd generation Typical / Conventional MOA: ↓ DOPAMINE Indication: + signs chlorpromazine haloperiDOL thioridazine loxapine fluphenazine molindone Atypical MOA: ↓ DOPAMINE / SEROTONIN Indication: + / - signs olanzapine risperidone quetiapine ziprasidone clozapine lurasidone Dopamine System Stabilizers MOA: regulates receptors Indication: + signs aripiprazole brexpiprazole Not recommended for elderly patients SAFE for elderly (>65 y/o) Less side effects Depot Treatment / Long Term Injection (LTI) Indication: non-compliance Common cause: side effects, memory problem SIDE EFFECTS OF ANTIPSYCHOTICS Constipation – increase fluid, fiber in the diet Agranulocytosis – Monitor ____________, report any signs of infection (fever, sore throat) Tooth decay – sugarless hard candy or gum Dry mouth – sugarless hard candy or gum to stimulation salivation Orthostatic hypotension – change position gradually Galactorrhea – use cotton underwear Photosensitivity – avoid direct sunlight, use umbrella and sunglasses, apply SPF 25 lotion Arrhythmias – immediately report abnormal heart beat Weight gain – lessen intake of sugary food and beverages Sedation – avoid driving and operating machineries EXTRA PYRAMIDAL SYNDROME Cause: ↓dopamine (1st and 2nd generation neuroleptics) Nursing Action: Notify the physician, DO NOT discontinue to prevent relapse! Intervention: Decrease the dose, shift to another generation NEUROLEPTIC MALIGNANT SYNDROME TARDIVE DYSKINESIA Muscle spasms laryngeal spasms → airway obstruction → DEATH Hyperthermia Hypertension Nursing Action: Discontinue the Medication Treatment: dantrolene, baclofen (muscle relaxants) Prevention: Hydrate the patient Delayed involuntary movements (after 6 months) Tongue protrusion Tongue twisting Teeth grinding Lip Smacking Nursing Action: Notify the physician Treatment: Ingrezza (valbenazine) Prevention: Start with the lowest dose Treatment: Akineton (biperidine) Benadryl (diphenhydramine) Cogentin (benztropine) ARTANE (Trihexyphenidyl) Dysphagia Oculogyric crisis Torticollis Dystonia – uncontrollable muscle spasms Akathisia – agitation, intense need to move Pseudoparkinsonism – tremors and unstable gait