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NURSING NR 546 ADV MIDTERM STUDY GUIDE WEEK 1-4 (100% GUARANTEED PASS)
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NURSING NR 546 ADV MIDTERM STUDY GUIDE WEEK 1-4 (100% GUARANTEED PASS)
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NURSIING NR 546 ADV MIDTERM STUDY GUIDE WEEK 1 -4 (100% GUARANTEED PASS) Typical antipsychotics (conventional) (FGA) • Treats positive (+) symptoms only appropriate for the acute and chronic management of schizophrenia and psychosis. • Non-selectively blocks dopamine D2 receptors, specifically in mesolimbic pathway; also blocks Ach (Muscarinic), histamine, NE Five main SE of FGAs • Sedation • Postural Hypotension • Lower seizure threshold • Anticholinergic side effects • Photosensitive Haloperidol -High -Appropriate for acute, severe agitation and aggression -Butyrophen ones • Initial oral dose 1-15mg/day (can give once daily or divide; • Usual dose 1-40mg/day (orally); • Max dose 100mg/day • Tablets 0.5, 1, 2, 5, 10, 20mg; Concentrate 2mg/ml; Injection 5mg/ml • Half-life 13-38 • Higher risk for EPS and TD • Avoid in older adults due to increased risk of cerebrovascular accident (CVA), cognitive decline, and death in persons with dementia and with dementia -related psychosis. Fluphenazine -Medium -Psychotic D/Os • Initial oral dose 0.5-10mg/day divided doses; • Usual dose 1-20mg day; • Max dose40mg/day • Tablet 1, 2.5, 5, 10mg; Elixer 2.5mg/ml; Concentrate 5mg/ml • Half-life 15 hours Thiothixene -Medium • Initial dose 5-10mg/day; • Usual dose 15-30mg/day; • Max dose 60mg/day divided • Capsules 2, 5, 10mg • Half-life 3.4-34 hours Thioridazine -Low-2nd line due to QTc issues • Initial dose 50-100mg/3xday/increase gradually; • Usual dose 200-800mg divided; • Max dose 800mg/day • Tablets 10, 15, 25, 50, 100mg • Metabolized by CYP450 2D6 Chlorpromazine -Low-2nd line due to QTc issues -schizophrenia -DA 2 antagonist • Usual dose 200-800mg divided; maximum 800mg/day • Psychosis -increase dose until symptoms are controlled; after 2 weeks reduce to lowest effective dose • Can improve in one week but may take several weeks for full effect on behavior • Tablet 10, 25, 50, 100, 200mg • Half-Life 8-33 hours • Phenothyazine • SXS-Dry mouth, pupil dilation, blurred vision, cog impair, constipation, urinary retention, tachycardia Mesoridazine -Low-off market due to dangerous side effects, including irregular heartbeat and QT prolongati on. *Low potency meds require higher doses to achieve efficacy *Low potency meds have more anticholinergic, antihistaminic, and α 1 properties resulting in more sedation than higher potency meds. *High risk for developing hyperprolactinemia and EPS (negative symptoms aren’t affected by FGAs only positive symptoms) Neurolepsis is a term to describe antipsychotic medication effects on psychotic clients, with respect to cognition and behavior . Newer medications (SGA) do not necessarily have these same effects. Neurolepsis syndrome has three major features. Examine the image below to learn more about the PEA acronym. • Psychomotor slowing - extreme form of slowness or absence of motor movement (nigrostriatal pathway) • Emotional quieting - worsening of negative and cognitive symptoms (mesocortical pathways) • Affective indifference - worsening of affective symptoms (mesocortical pathway) Atypical antipsychotics (SGA) Developed to treat both positive (+) and (-) negative symptoms • SGAs are considered serotonin -dopamine antagonists, as they maintain D2 antagonism but also have simultaneous serotonin 5HT2A antagonism • Lower affinity for D2 and higher affinity for 5HT • Effective for treatment -resistant clients • Does not increase prolactin levels • Treats positive and negative symptoms • Lower risk of EPSThe benefits of buying summaries with Stuvia:
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