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Antipsychotics. How they work C. Matthews MSN, RN, CNE Fall 2013. Understanding theory on cause of schizophrenia helps understand meds that work for management of psychoses. Symptoms. “positive” +++++. Negative -------. Normal with normal behaviors/thoughts SUBTRACTED
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Antipsychotics How they work C. Matthews MSN, RN, CNE Fall 2013
Understanding theory on cause of schizophrenia helps understand meds that work for management of psychoses
Symptoms “positive” +++++ Negative ------- Normal with normal behaviors/thoughts SUBTRACTED MINUS includes lack of interest, motivation, responsiveness, or pleasure in everyday activities • Normal PLUS abnormal symptoms • PLUS hallucinations, delusions, disorganized thoughts or speech patter
Positive & Negative symptoms come from different areas of the brain • Video explaining how antipsychotics work • http://www.ask.com/youtube?q=how%20antipsychotic%20drugs%20work • The screen goes blank – right click to end power point and the you tube site will show up on your computer, go to you tube video with this picture……. • I’d stop at 11min 8 sec.
Things the RN should know about Antipsychotics • Autonomic effects (see anticholinergic poster in classroom – “can’t see, can’t pee, can’t spit, can’t poop”): • blurred vision; urinary retention; Dry mouth; Constipation • These can be minimalized by intervention: • Laxatives, mouth care, candies or meds for dry mouth • May disappear with long-term continued therapy.
Things the RN should know about Antipsychotics • Extrapyramidal symptoms: • Dystonias • Tardive dyskinesia: • “rhythmic involuntary movements of facial muscles” EPS
EPS • http://www.bing.com/videos/search?q=youtube+tardive+dyskinesia+symptoms&FORM=VIRE7#view=detail&mid=1D9F56AFEF0C824CC9341D9F56AFEF0C824CC934 • Not everyone has such extreme movements. • These are same movements seen in Parkinson’s disease (you’ve seen Michael J. Fox). They are caused by same thing – a disturbance in the balance of the neurotransmitters dopamine and acetylcholine in the basal ganglia.
References • Adams, M. , Holland, N. & Urban, C. (2014). Pharmacology for nurses, a pathophysiologic approach. (4th Ed.) Pearson, Boston. • Adams, M. P. & Urban, C.Q. (2013). Pharmacology connections to nursing practice. (2nd ed.) Pearson, Boston.