Antipsychotics
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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

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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.


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