Pharmacology Quiz on Antipsychotics and Benzodiazepines

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Questions and Answers

Which condition is characterized by a drop in blood pressure when changing positions rapidly?

Orthostatic hypotension (correct)

Tachycardia

Bradycardia

Hypertension

Which of the following is NOT a common symptom of anticholinergic agents?

Denture caries

Urinary retention

Excessive salivation (correct)

Blurred vision

What is a notable ocular effect of thioridazine at doses greater than 800 mg/day?

Macular degeneration

Color blindness

Pigmentation disturbance and photosensitivity (correct)

Increased intraocular pressure

Which medication class is considered for treating depressive disorders linked to identifiable causes?

Selective serotonin reuptake inhibitors (SSRIs) Signup and view all the answers

Abnormalities in the 5-HT function can lead to which of the following issues?

Mood disturbances and anxiety Signup and view all the answers

Which of the following benzodiazepines is also known as Klonopin?

Clonazepam Signup and view all the answers

What is a common side effect of using benzodiazepines?

Drowsiness Signup and view all the answers

Which of the following conditions would contraindicate the use of buspirone?

Acute post-myocardial infarction Signup and view all the answers

What is the primary neurotransmitter that stimulants release to enhance alertness?

Norepinephrine Signup and view all the answers

Which of the following is not a potential side effect of benzodiazepines?

Increased heart rate Signup and view all the answers

What is the usual daily dose range for Chlorpromazine in adults?

200-1,000 mg Signup and view all the answers

Which of the following side effects is primarily associated with high-potency conventional antipsychotics?

Extrapyramidal side effects Signup and view all the answers

Which atypical antipsychotic has the narrowest usual dose range?

Risperidone Signup and view all the answers

A contraindication for the use of antipsychotics includes which of the following conditions?

Bone marrow depression Signup and view all the answers

What is the maximum usual daily dose for Fluphenazine?

40 mg Signup and view all the answers

Which drug is associated with a potential risk of agranulocytosis?

Clozapine Signup and view all the answers

What is the daily dose range for Olanzapine in adults?

5-20 mg Signup and view all the answers

Which of the following antipsychotics has the widest range of typical daily doses?

Quetiapine Signup and view all the answers

What is a key pre-treatment step for a client undergoing an EKG?

Ensure the client is NPO and has an empty bladder Signup and view all the answers

Which medication is commonly administered to produce muscle relaxation during treatment?

Anectine (Succinylcholine) Signup and view all the answers

What post-treatment observation is crucial when the client is recovering?

Oxygen saturation and vital signs Signup and view all the answers

What should be done to prevent airway obstruction during the procedure?

Apply a bite block or plastic airway Signup and view all the answers

Which condition is NOT a common complication from the treatment?

Hyperglycemia Signup and view all the answers

Which assessment is essential for elderly patients aged over 45 years before certain procedures?

EKG Signup and view all the answers

What type of drug is Roninul, and what is its purpose?

An atropine-like drug to dry secretions Signup and view all the answers

What immediate effect can be expected after the administration of a quick-acting anesthetic?

Drowsiness and confusion Signup and view all the answers

What is the usual daily dose range for Bupropion in adults?

200-450 mg Signup and view all the answers

Which condition is NOT a contraindication for atypical antidepressants?

Asthma Signup and view all the answers

What is the primary function of mood stabilizers like Lithium?

To prevent manic behavior Signup and view all the answers

Which of the following is NOT listed as a side effect of atypical antidepressants?

Orthostatic hypotension Signup and view all the answers

What is the usual daily dose range for Phenelzine in adults?

15-90 mg Signup and view all the answers

Which condition is a contraindication for MAOIs?

Cardiac arrhythmias Signup and view all the answers

What is the typical daily dose range for Trazodone?

25-600 mg Signup and view all the answers

Which of the following statements about Lithium is accurate?

Sodium intake should remain stable during Lithium treatment. Signup and view all the answers

What is the normal lithium level range for a Thai client?

0.8-1.2 mEq/L Signup and view all the answers

Which side effect is NOT associated with lithium usage?

Skin rash Signup and view all the answers

At what serum lithium level will a client begin to exhibit vomiting and diarrhea?

Above 1.5 mEq/L Signup and view all the answers

What is the recommended treatment if a client shows a sodium level of 130-133 mmol/L?

Seclusion for 1 day, limit fluid intake < 3 L/day Signup and view all the answers

Which condition is a contraindication for lithium treatment?

Pregnancy Signup and view all the answers

Which of the following is a potential symptom of intermittent hyponatremia due to polydipsia?

Tonic-clonic convulsion Signup and view all the answers

What immediate action should a nurse take if a client's lithium level exceeds 2.5 mEq/L?

Notify the physician and withhold lithium Signup and view all the answers

Which antianxiety medication group works selectively on the limbic system?

Benzodiazepines Signup and view all the answers

If a patient's sodium level is 114 mmol/L, what is the critical treatment recommended?

Provide 3-5% NaCl drip or Lasix IV slowly Signup and view all the answers

What side effect might suggest lithium toxicity at levels above 1.5 mEq/L?

Stagger and slurred speech Signup and view all the answers

Study Notes

Medication Therapy and Electroconvulsive Therapy

Objectives: Students will be able to explain neurological anatomy and its function related to mental illness, identify medication treatment for mental health and psychiatric clients, identify nursing intervention related to action and side effects of medication and rational drug use, describe the action of electroconvulsive therapy (ECT), and identify nursing intervention for clients with ECT.

Topic 2.2 Medication Therapy or Psychopharmacology

Neuroscientists now view behavior and cognitive functions as a result of complex interactions within the central nervous system (CNS) and its ability to adapt and change in both structure and function.

Neuroanatomy

The cerebrum is the largest part of the human brain and can be divided into two hemispheres.
Each hemisphere is divided into four lobes: frontal, parietal, temporal, and occipital lobes.

Frontal Lobes

Control motor speech function, personality, and memory.
Often called the executive functions that govern one's ability to plan and initiate actions.

Parietal Lobes

Control sensory functions.

Temporal Lobes

Contain the primary auditory and olfactory areas.

Occipital Lobes

Controls visual integration of information.

Subcortical Structures

Beneath the cortex of the cerebrum, composed of six layers.
Basal ganglia: involved in motor functions, association in both learning and the programming of behavior or activities that are repetitive, over time and become automatic.

Limbic System

Includes hippocampus, thalamus, and hypothalamus.
Hippocampus: involves in storing information, particularly those with emotions attached.
Thalamus: acts as a regulatory structure to relay all sensory information except smell, prevents cortex from overload with sensory stimulus.

Hypothalamus

Regulates sleep-rest patterns, body temperature, and physical drives such as hunger and sex.

Neurons

Smallest cells of the brain that communicate with each other through synaptic transmission.

Psychopharmacology

Focuses on neurotransmission; the sending of impulses from one neuron to another across the synapse via specific substances called neurotransmitters.

Neurotransmitters

Small molecules control the opening/closing of ion channels.
Excite or inhibit responses at receptor sites and have been linked to mental disorders.

Function of Neurotransmitters

Acetylcholine: Important in learning and memory, wakefulness, and basic attention, peripherally affects muscles and major neurochemical in the autonomic nervous system.
Dopamine: Involved in involuntary motor movement, mood states, and pleasure components in reward systems; complex behaviors like judgment, reasoning, and insight.
Norepinephrine: Proposed role in learning and memory, attributing value in reward systems, fluctuates in sleep and wakefulness, major component of the sympathetic nervous system responses, including "fight or flight".
Serotonin: Proposed role in controlling appetite, sleep, mood states, hallucinations, pain perception, cognitive effects, sexual function; interacts with dopamine pathways and inhibits dopamine release.
Amino Acids (GABA): Fast inhibitory response post-synaptically inhibits excitability of neurons, contributing to seizure, agitation, and anxiety control.
Neuropeptides (Endorphins): Suppresses pain, modulates mood, and stress; likely involvement in reward systems and addiction.
Melatonin: Secreted in the dark and suppressed in light; helps regulate the sleep-wake cycle along with other biological rhythms.

Six Groups of Medication for Mental Health and Psychiatric Clients

Antipsychotic medication
Antidepressant medication
Mood stabilizers
Anti-anxiety medications
Stimulants
Anti-cholinergic or anti-parkinsonism medications

Antipsychotic medications (Major Tranquilizers)

Two types: typical (conventional) and atypical.
Conventional: Block D₂ receptors in the limbic region of the brain. Increasing dopamine causes strange thoughts, bizarre behavior, and hallucinations.
Atypical: Block serotonin postsynaptic receptors and other varieties of dopamine receptors (e.g., D₁ and D₅). Less side effects than typical but more expensive, usually for psychiatric patients in special wards.
Treat schizophrenia, schizoaffective disorder, delusional disorder, mood disorders with psychosis, and psychosis associated with delirium and dementia. Symptoms include impaired communication, delusions, behavior problems, and personality disorders.

Anti-anxiety medications and hypnotics (minor tranquilizers)

Relieve moderate to severe anxiety and tension associated with emotional disorders, physical disorders, excessive environmental stress, neurosis, and mild depression without excessive sedative or drowsiness.
Two groups: benzodiazepines and nonbenzodiazepines.

Benzodiazepine group

Works selectively on the limbic system of the brain, which is responsible for emotions like rage (anger) and anxiety.
Commonly used: chlordiazepoxide (librium), clonazepam (klonopin), diazepam (valium), oxazepam (serax), clorazepate (tranxene), lorazepam (ativan), prazepam (centrex), alprazolam (xanax), and triazolam (halcion).

Nonbenzodiazepine group

Meprobamate (Equanil): causes CNS depression.
Buspirone (BuSpar): blocks the release of serotonin and prevents the uptake of dopamine.

Stimulants

Acts as mood elevators used in treatment-resistant depression
Stimulants cause a release of norepinephrine and dopamine into the system from the presynaptic nerve cell, blocking their reuptake. This action stimulates the sympathetic nervous system, resulting in alertness, wakefulness, vasoconstriction, suppressed appetite, and hypothermia.

Electroconvulsive Therapy (ECT)

Introduced in 1937 by two Italian physicians.
Uses electric current to induce convulsive seizures in neurons throughout the brain, alleviating symptoms like major depression, acute manic episodes, or schizophrenia.
Different theories behind ECT actions (neurotransmitter, neuroendocrine, anticonvulsant, frontal lobe).
Two types: unmodified and modified (under anesthesia).
Preparation includes client education, videotapes, NPO/empty bladder, removal of prostheses, ECG electrodes placement and insertion of IV line, and a possible sedative.
Physical assessment and informed consent are crucial

Complications of ECT

Physical changes like hypertension, bradycardia.
Amnesia, apnea, fracture, or dislocation of joint, backache.

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Description

Test your knowledge on pharmacology with this quiz focused on antipsychotics and benzodiazepines. Answer questions about side effects, medication classes, and neurotransmitter functions. Perfect for students in pharmacology courses or professionals in the healthcare field.