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Unit 3: The Nervous System

Psychosis. mental health condition characterized by:DelusionsHallucinationsIllusionsparanoia. May be acute or chronicCauses:PathologyGeneticsUnidentifiable causeIndividual cannot function normally in society. Schizophrenia. Most common psychiatric disorderGenerally symptoms appear in ea

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Unit 3: The Nervous System

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    1. Unit 3: The Nervous System Chapter 17: Drugs for Psychoses

    2. Psychosis “mental health condition characterized by: Delusions Hallucinations Illusions paranoia May be acute or chronic Causes: Pathology Genetics Unidentifiable cause Individual cannot function normally in society

    3. Schizophrenia Most common psychiatric disorder Generally symptoms appear in early adulthood Symptoms may occur suddenly or may take months or years to develop Apparent genetic component May also be r/t NT imbalances Symptoms include: Hallucinations, delusions, paranoia Rambling statements, made-up words Rapid alteration between hyperactivity and stupor Indifferent/detached Strange or irrational action Deterioration in hygiene, work or academic performance Withdrawal from social interaction or interpersonal relationships

    4. Schizoaffective Disorder “condition in which client exhibits symptoms of both schizophrenia and mood disorders” Deep depression follows acute symptoms In time, both positive and negative symptoms will manifest Must rule out other conditions causing bizarre behavior Chronic amphetamine or cocaine use Certain complex partial seizures Brain neoplasms, infections, or hemorrhage

    5. Pharmacologic Management of Psychoses Mechanism of action of all antipsychotics: Act by entering dopaminergic synapsesand competing for dopamine, thus blocking the majority of dopamine receptors. Compliance decreases when undesirable side effects are produced Primary goal: Reduce psychotic symptoms to level that allows client to function as a normal member of society.

    6. Phenothiazines Most effective for treating positive symptoms Treatment of choice Believed to block dopamine and serotonin from occupying receptor sites in certain brain regions Prototype: chlorpromazine (Thorazine) p. 213 Examples: Table 17.1 Adverse effects: acute dystonia, akathisia, anticholinergic effects, hypotension, parkinsonism, sedation, sexual dysfunction, tardive dyskinesia Malignant neuroleptic syndrome

    7. Phenothiazines What are the nursing considerations for phenothiazine therapy? What teaching should be included?

    8. Nonphenothiazines Equal efficacy as phenothiazines Spectrum of side effects same, but cause less sedation and fewer anticholinergic side effects Extrapyramidal side effects are equal or greater than phenothiazines Believed to have same mechanism of action– blockage of postsynaptic D2 receptors Prototype: haloperidol (Haldol) p. 215

    9. Nursing Considerations What are the nursing considerations for nonphenothiazine therapy? What teaching should be included?

    10. Atypical Antipsychotics Second generation– broader spectrum, control both positive and negative symptoms Produce effect without causing extrapyramidal symptoms Mechanism of action: unknown; thought to block several different receptor sites in the brain

    11. Atypical Antipsychotics Prototype: clozapine (Clozaril) p. 219 Others: Olanzapine (Zyprexa) Risperidone (Risperdal) Adverse effects: Tachycardia, transient fever, sedation, dizziness, headache, somnolence, anxiety, nervousness, hostility, insomnia, n/v, constipation, parkinsonism, akathisia Serious: neurolepic malignant syndrome, agranulocytosis

    12. Nursing Considerations for Atypical Antipsychotics What are the nursing considerations for atypical antipsychotic therapy? What teaching should be included?

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