NU664C Study Guide for Midterm Exam Latest Update

NU664C Study Guide for Midterm Exam Latest Update - Correct Answers Guaranteed A+

Be able to describe baseline labs you would want to have prior to ordering antipsychotics. - CORRECT

ANSWER: · CBC, CMP, LFTs, Lipid Panel, HgbA1c, U/A, Urine Drug Screen

Be able to describe three positive symptoms and three negative symptoms of schizophrenia. - CORRECT ANSWER: Positive symptoms-Delusions, Hallucinations, Ideas of reference, Catatonic, Disorganized speech, thinking or behavior Negative symptoms-Flat affect, Asocial, Monotone, Anhedonia, Avolition, Isolation, Poverty of Speech, Decreased self-care

Compare and contrast Neuroleptic Malignant Syndrome (NMS) to Serotonin Syndrome. Know the key symptoms of each syndrome. What lab values may be elevated with NMS? What medications are associated with the development of each syndrome? How is each syndrome treated? - CORRECT

ANSWER: >Neuroleptic Malignant Syndrome (NMS)

· Stiffness, rigidity · Elevated CK · Elevated WBC · Fever · Develops over days or weeks

· Meds: Haldol, Thorazine, Prolixin, Stelazine.

· Resolution of NMS = Average of 9 days.· Txmt: Hold all antipsychotics & notify MD.; Administer Dopamine agonist drugs (Bromocriptine) and muscle relaxants (Dantrolene and Benzos); Hydration, Safety >Serotonin Syndrome · High body temperature · Dilated pupils · Agitation · Diarrhea 1 / 2

· Increase reflexes · Myoclonus · Tremors · Ataxia · Sweating · Nausea and vomiting · Occurs/Onset within 24 hours · Typically caused by use of 2 or more serotonergic drugs, SSRI, MAOI, TCA, Amphetamines

· Labs: None

· Resolution of Serotonin Syndrome <24 hours · Treatment: Supportive Care, increase Oxygen to >94% sat, I.V. crystalloid to treat volume depletion; Use benzos to sedate; Need ICU care.

Describe 2-3 common side effects of atypical antipsychotics. - CORRECT ANSWER: · Weight gain · Sedation · Metabolic Syndrome

· EPS

(unlikely to cause ? QTc Prolongation)

Describe 2-3 common side effects of typical (first-generation) Antipsychotics. - CORRECT ANSWER: · Antipsychotics can be categorized into two main groups: the older conventional antipsychotics, which have also been call first-generation antipsychotics or dopamine receptor antagonists, and the newer drugs, which have been called second-generation antipsychotics or serotonin dopamine antagonists (SDAs).· Clinicians have a number of alternatives for treating extra-pyramidal side effects. These include reducing the dose of the antipsychotic (which is most commonly a DRA), adding an anti-Parkinson medication, and changing the patient to an SDA that is less likely to cause extrapyramidal side effects.· First-generation antipsychotics have a high rate of extrapyramidal side effects, including rigidity, bradykinesia, dystonias, tremor, and akathisia. Tardive dyskinesia (TD)—that is, involuntary movements in the face and extremities—is another adverse effect that can occur with first-generation antipsychotics.· The risk in elderly pts. Is much higher. Although seriously disabling dyskinesia is uncommon, it can affect walking, breathing, eating, and talking when it occurs. Individuals who are more sensitive to acute extrapyramidal side effects appear to be more vulnerable to developing tardive dyskinesia.

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