Antipsychotic Medications Quiz
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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?

<p>Orthostatic hypotension (D)</p> Signup and view all the answers

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

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

Which symptom is clozapine most effective against?

<p>Extrapyramidal effects (B)</p> Signup and view all the answers

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

<p>Hyperlipidemia (B)</p> Signup and view all the answers

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

<p>6 weeks (C)</p> Signup and view all the answers

What should be monitored before starting specific drugs like clozapine?

<p>Blood glucose levels (C)</p> Signup and view all the answers

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

<p>Ventrogluteal muscle (A)</p> Signup and view all the answers

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

<p>&quot;Lie die&quot; for 30-60 minutes (C)</p> Signup and view all the answers

What are the symptoms associated with Neuroleptic Malignant Syndrome?

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

What is the recommended treatment for Neuroleptic Malignant Syndrome?

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

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

<p>Benzodiazepines (C)</p> Signup and view all the answers

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

<p>Tachycardia (D)</p> Signup and view all the answers

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

<p>First line therapy for schizophrenia (C)</p> Signup and view all the answers

Which adverse effect is a Black Box Warning for clozapine?

<p>Fatal agranulocytosis (C)</p> Signup and view all the answers

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

<p>White blood cell count (B)</p> Signup and view all the answers

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

<p>Diarrhea (D)</p> Signup and view all the answers

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

<p>Initiate close monitoring and consider discontinuing the medication (C)</p> Signup and view all the answers

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

<p>Central nervous system depression (C)</p> Signup and view all the answers

What is the mechanism of action of flumazenil?

<p>Inhibits BZD activity at receptor sites (D)</p> Signup and view all the answers

Which medication is used for the maintenance of alcohol sobriety?

<p>Disulfiram (B)</p> Signup and view all the answers

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

<p>Seizures (A)</p> Signup and view all the answers

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

<p>Methadone (B)</p> Signup and view all the answers

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

<p>Reduces urges by blocking opiate receptors (D)</p> Signup and view all the answers

What is the Black Box Warning associated with disulfiram?

<p>Must know they are taking this med (D)</p> 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.

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