Antipsychotic Drugs Quiz: Medications and Side Effects

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Questions and Answers

What is the mechanism of action of dantrolene, a muscle relaxant?

Enhancing acetylcholine transmission at the neuromuscular junction

Blocking postsynaptic dopamine in the brain

Increasing GABAergic activity in the spinal cord

Inhibiting calcium release from the sarcoplasmic reticulum of skeletal muscle (correct)

Which of the following is NOT an extrapyramidal effect associated with antipsychotic drugs?

Ataxia (correct)

Dystonia

Tardive Dyskinesia

Drug-induced Parkinsonism

What is the nursing implication related to elderly patients with dementia-related psychosis who are treated with antipsychotics?

Be cautious with use of sedatives concurrently

Monitor renal function regularly

Notify healthcare provider if Tardive Dyskinesia occurs (correct)

Adjust dose based on body weight changes

What is a common adverse effect associated with phenothiazines like chlorpromazine?

Orthostatic hypotension (D) Signup and view all the answers

What should nurses do in terms of dosing when caring for patients on antipsychotic therapy?

Check the dose carefully as dosages often change during therapy (A) Signup and view all the answers

Which symptom is clozapine most effective against?

Extrapyramidal effects (B) Signup and view all the answers

What adverse effect has a higher risk with second-generation antipsychotics like quetiapine and risperidone?

Hyperlipidemia (B) Signup and view all the answers

How long may it take for the therapeutic effects of second-generation antipsychotics to be fully seen?

6 weeks (C) Signup and view all the answers

What should be monitored before starting specific drugs like clozapine?

Blood glucose levels (C) Signup and view all the answers

Which muscle should IM injections be given into for acute psychotic episodes?

Ventrogluteal muscle (A) Signup and view all the answers

What should a patient do after receiving an IM injection of second-generation antipsychotics to prevent orthostatic hypotension?

"Lie die" for 30-60 minutes (C) Signup and view all the answers

What are the symptoms associated with Neuroleptic Malignant Syndrome?

Fever, altered mental status, rigid muscles (D) Signup and view all the answers

What is the recommended treatment for Neuroleptic Malignant Syndrome?

Quickly taper off the antipsychotic and provide supportive care (C) Signup and view all the answers

Which medication can be used for muscle relaxation in the treatment of Neuroleptic Malignant Syndrome?

Benzodiazepines (C) Signup and view all the answers

What is a potential cardiovascular effect associated with Neuroleptic Malignant Syndrome?

Tachycardia (D) Signup and view all the answers

What is the role of Haloperidol in the management of schizophrenia according to the text?

First line therapy for schizophrenia (C) Signup and view all the answers

Which adverse effect is a Black Box Warning for clozapine?

Fatal agranulocytosis (C) Signup and view all the answers

What should be monitored in a patient prescribed clozapine to assess for extrapyramidal side effects?

White blood cell count (B) Signup and view all the answers

Which is NOT a potential anticholinergic effect to assess for while a patient is taking clozapine?

Diarrhea (D) Signup and view all the answers

What should be done if a patient on clozapine develops decreased white blood cell count?

Initiate close monitoring and consider discontinuing the medication (C) Signup and view all the answers

Which potential effect of clozapine requires monitoring to prevent falls in patients?

Central nervous system depression (C) Signup and view all the answers

What is the mechanism of action of flumazenil?

Inhibits BZD activity at receptor sites (D) Signup and view all the answers

Which medication is used for the maintenance of alcohol sobriety?

Disulfiram (B) Signup and view all the answers

What is the major adverse effect of disulfiram if alcohol is consumed?

Seizures (A) Signup and view all the answers

Which medication works slower than other opioids and produces less euphoria?

Methadone (B) Signup and view all the answers

What is the main use of buprenorphine-naloxone in opioid abuse treatment?

Reduces urges by blocking opiate receptors (D) Signup and view all the answers

What is the Black Box Warning associated with disulfiram?

Must know they are taking this med (D) Signup and view all the answers

Study Notes

Neuroleptic Malignant Syndrome (NMS)

Caused by depletion of dopamine
Symptoms: Fever, Altered mental status, Tachycardia, Hypertension, Rigid muscles, and Decreased reflexes
Treatment: Quickly taper off antipsychotic, Provide supportive care, Benzodiazepines or Dantrolene for muscle relaxation

Antipsychotics

Nonphenothiazine: Haloperidol (Haldol)
Uses: First-line therapy for schizophrenia and depression
Adverse Effects: Cardiovascular (EKG changes), Antiadrenergic (Hypotension, Dizziness, Fatigue), Hematologic (Agranulocytosis, Pancytopenia), Photosensitivity
Nursing Implications: Administer with food, avoid contact with skin, give 1-2 hours before bedtime

Benzodiazepine Reversal Agent

Prototype: Flumazenil
Mechanism of Action: Inhibits BZD activity at receptor sites
Use: Reverse effects of benzodiazepines
Adverse Effects: Risk of seizures
Contraindications: Not for use with benzodiazepine-dependent patients
Nursing Implications: Monitor for seizures

Enzyme Inhibitors for Maintenance of Alcohol Sobriety

Prototype: Disulfiram
Mechanism of Action: Prevents normal metabolism of alcohol, resulting in unpleasant reaction when consumed with alcohol
Use: Maintain state of sobriety
Adverse Effects: Headache, Chest pain, Seizures, N/V, Heart failure, MI, Death
Contraindications: Not for patients who consumed alcohol in past 12 hours, or patients with heart conditions
Nursing Implications: Patient must know they are taking this medication, monitor for side effects

Opioid Agonists for Treatment of Opioid Abuse

Prototype: Methadone
Mechanism of Action: Same as other opioids, but works slower and produces less euphoria
Use: Detoxification/maintenance therapy for opioid addiction
Adverse Effects: QT prolongation
Contraindications: Not for use without approved opioid addiction treatment program
Nursing Implications: Monitor for QT prolongation

Opioid Antagonist/Agonist for Treatment of Opioid Abuse

Prototype: Buprenorphine-Naloxone
Mechanism of Action: Buprenorphine blocks opiate receptors, Naloxone reverses effects of opioids
Use: Maintenance therapy for short-acting opioid dependence
Adverse Effects: Risk of addiction, abuse, and misuse leading to respiratory depression
Contraindications: Not for use with buccal and transdermal routes
Nursing Implications: Monitor for respiratory depression

Extrapyramidal Effects

Dystonia
Drug-induced Parkinsonism
Akathisia
Tardive Dyskinesia
Nursing Implications: Assess for EPSE, monitor for adverse effects

First-Generation Antipsychotics

Phenothiazines: Chlorpromazine
Mechanism of Action: Blocks postsynaptic dopamine in the brain
Use: Effective against positive and negative symptoms
Adverse Effects: Extrapyramidal effects, weight gain, hyperglycemia, diabetes, hyperlipidemia
Nursing Implications: Obtain baseline EKG, monitor for idiopathic edema and muscle necrosis

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Test your knowledge on antipsychotic medications including drug names, classes, mechanisms of action, uses, adverse effects, contraindications, and nursing implications. Focus on first generation antipsychotics like phenothiazines such as Chlorpromazine.

Antipsychotic Medications Quiz

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