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94 Cards in this Set
- Front
- Back
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Amisulpride use and side effects
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Use; Antipsychotic
Side effects; raised prolactin, anxiety, agitation, lowered BP, nausea, akathsia, constipation, drowsiness |
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HALF LIFE
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The amount of time it takes for the drug in the blood stream to be reduced by half
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PHARMOCODYNAMICS
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The effect of drugs on the body
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COMMON BENZO's
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Diazepam- valium
Lorazepam - laropam Alprazolam - xanax Clonazepam - rivotril |
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COMMON SIDE EFFECTS OF BENZO's
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Decrease CNS activity so cause sedation, loss of coordination, dizziness, headache, RISK of dependence
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SODIUM VALPROATE use and side effects
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Use; mood stabilizer
Side effects; GI irritation (take with food) increases appetite, hepatic damage (need liver functioning test prior to commencing) |
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LITHIUM use and side effects
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Use; Mood Stabilizer
Side effects; potential for toxicity due to narrow therapeutic range, nausea, trembling hands, increased thirst. |
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PHARMOKINETICS
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The effect of the body on the drugs
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COMMON MOOD STABILIZERS
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Lithium
Sodium Valproate Carbemazepine Lamotrogine |
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CARBAMAZEPINE (TEGRETOL) use and side effects
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Use; Mood stabilizer
Side effects; drowsiness, dry mouth, confusion, nausea, headaches |
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SOME PRINCIPLES OF RECOVERY ORIENTATED PRACTICE
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The service contends with more than the persons symptoms, it is holistic.
The service promotes individual decision making and taking responsibility It empowers people to move towards self management of their condition The system assists people to connect through mutual self help |
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KEY CONCEPTS OF THE WELLNESS RECOVERY ACTION PLAN
W.R.A.P. |
Hope
Personal responsibility Education Self advocacy Supports |
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SOME RECOVERY PRINCIPLES
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Born out of hope
Journey defined by individual Non-linear journey Skills can be learnt Based on the fact that people can recover from a mental illness Active and ongoing process |
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RISPERIDAL use and side effects
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Use; Antipyschotic
Side effects; Insomnia, postural hypotension, agitation, anxiety, headache, raised heart rate |
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Define DELUSION
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A false fixed belief that is inconsistent with one's social, cultural and religious beliefs which cannot be reasoned with the use of logic
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Name the 4 theories for the causes of SCHIZOPHRENIA
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1- Neuro-anatomical abnormalities
2- Genetic predisposition 3- Biochemical theories (ntx) 4- The stress diathesis model |
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SUBSTANCE ABUSE DSM criteria
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Due to use did not carry out obligations at work/home
Used substances even when knew it was dangerous to physical/mental health Repeated legal problems form use Continued to use despite knowing it has caused/worsened social, interpersonal problems |
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SUBSTANCE DEPENDENCE DSM criteria
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Maladaptive pattern leading to significant clinical impairment of three/more of the following in same 12 month period.
TOLERANCE WITHDRAWAL Larger amounts over longer period Persistent desire to cut down/stop Important activities reduced/stopped Continued use despite knowledge of consequence |
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Age of Onset SUBSTANCE USE
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LATE TEEN'S EARLY 20'S, 75% develop substance use disorder by 25
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WHAT IS CO-MORBIDITY?
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When 2 disorders or illnesses occur at the same time/person
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WHY DO DRUG DISORDERS OFTEN CO-OCCUR WITH OTHER MENTAL ILLNESSEs
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Genes may predispose individuals to develop both addiction and other mental illnesses
Mental illness can lead to drug abuse Drugs of abuse can cause symptoms of mental illness |
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Does exposure to traumatic events put people at higher risk of substance abuse use disorder?
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Yes, emotionally traumatized people are at a much higher risk of abusing drugs, there are strong associations between PTSD and substance abuse
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SIGNS AND SYMPTOMS OF ALCOHOL WITHDRAWAL
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Increased body temp
Increased pulse rate Increased respiration rate Increased BP Nausea and vomiting Tremor Sweating Agitation Disturbed sleep Tactile disturbances (pins and needle, numbness, crawling sensation) Auditory and visual hallucinations SEIZURE DELIRIUM DELIRIUM TREMENS |
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WHAT IS DELIRIUM TREMENS?
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It is an acute brain syndrome that manifests as a clouded state of consciousness, confusion, poor sleep, hallucinations, autonomic nervous system hyperactivity.
DEATH RATE AROUND 20% IF UNTREATED |
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HOW LONG DOES IT TAKE FOR DELIRIUM TREMENS TO OCCUR, after last drink???
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48-96 HOURS
MAY TAKE UP TO 7 DAYS TO APPEAR (MONITOR 1/2 TO 1 HRLY) |
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PHARMA INTERVENTION FOR ALCOHOL WITHDRAWAL?
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DIAZEPAM (first line treatment)
ANTIPSYCHOTICS maybe used THIAMINE should be used b-vit MULTIVITAMINS |
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IF ALCOHOL WITHDRAWAL PATIENT CANNOT TOLERATE DIAZEPAM (due to alcohol hepatistis or other liver condition) WHAT SHOULD BE GIVEN?
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OXAZEPAM
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WERNICKE KORSAKOFFS's
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PRESENTATION; confusion, reduced eye movement, peripheral neuropathy (damage to) and ataxia
CAN lead to permanent brain damage Due to thiamine deficiency |
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what would you expect to find on physical examination of an alcohol dependent person?
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General appearance; agitation, premature aging, malnutrition
signs of intoxication Spider naevi, bruising Tremor Sweating Pulse and BP raised Cardiac enlargement Nystagmus Ataxia Signs of peripheral neuropathy |
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The Element of a BRIEF drug dependence Assessment
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TYPE OF DRUG
ROUTE OF ADMINISTRATION FREQUENCY DOSE DURATION TIME AND AMOUNT OF LAST DOSE |
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METHYLPHENDIATE (RITALIN) side effect and use
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Use; psychostimulant, ADHD
Side effects; Abdo pain, apetite loss, cardiac arrthymia, dizziness headaches, and more |
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Describe HARM REDUCTION
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Harm reduction is used to identify a range of strategies that target the consequences of drug use rather than focusing on the drug itself.
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TWO MAIN MED'S GIVEN FOR ALCOHOL WITHDRAWAL
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VALIUM (diazepam)
THIAMINE |
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Define substance dependence
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A maladaptive pattern of substance abuse leading to significant impairment or distressed, tolerance, withdrawal and increasing consumption
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TWO most important questions to ask for gathering tobacco use history
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How many cigarettes do you smoke a day
How long after you wake up do you have your first cigarette? |
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TWO important questions to ask for gathering alcohol use history
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Quantity and frequency of consumption and The beverage type
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What is an ID?
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Significant sub average intellectual functioning in any two areas
-communication -selfcare -home living -social interpersonal skills, use of community resources -self direction -functional academic skills -work -leisure -health and safety BEFORE THE AGE OF 18 |
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define DUAL DISABILITY
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The presence of mental health problems in a person with an intellectual disability
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What is Forensic psychiatry?
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A branch of psychiatry that has to do with the issues of patients and problems at the interface between the legal and psychiatric systems
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What is an anticholinergic??
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Anticholinergic's are used to treat the side effects of antipsychotic's, (such as parkinsonism and akathsia) they act by blocking the ntx acetylcholine in the CNS and peripheral NS.
EX; Benzotropine, Atropine |
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What is the difference between Blunted and Flat affect??
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Blunted affect involves a limited range of expression and intensity of emotion. few physical gestures of emotion, client may speak in a monotonous tone.
A Flat affect is a more severe form of blunted affect with essentially no affective expression. |
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Describe Extrapyramidal symptoms
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EPS's are a set of side effects that are common with antipyschotic medications, they affect the extrapyramidal system a neural network that is part of the motor system involved in coordination and movement.
EX; dystonias (muscle tension disorders Dyskinesias (movement disoders) |
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Define DEPERSONALISATION
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A sense of personal reality being lost or altered, being estranged from oneself.
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Define SOMATISATION
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A psychological process whereby anxiety or psychological conflict is translated into physical complaints
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Describe Motivation interviewing
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MI is an adaptation of the socratic style of interviewing, based on the assumption that change is produced collaboratively and cannot be imposed from the outside.
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CIRCUMSTANTIALITY
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Before getting to the point or answering a question the person gets caught up in countless details and explanations.
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CLONAZEPAM use and side effects
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USE; Benzo, mania
Side effects; drowsiness, poor muscle control, irritability |
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CHLORPROMAZINE use and side effects
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Use; anti-psychotic
Side effects; drowsiness, BP up or down, abnormal HR, faintness, dizziness |
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VALPROIC ACID use and side effects
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USE; mood stabiliser
Side effects; nausea, vomiting, diarrhea, abdo pain, dizziness, indigestion, sedation, weight gain |
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CLOZAPINE use and side effects
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USE; antipsychotic
Side effects; Constipation, Agranulocytosis, hypersalivation, weightgain |
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OLANZAPINE use and side effects
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USE; antipsychotic
Side effects; constipation, weight gain, drowsiness, |
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CITALOPRAM use and side effects
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USE; antidepressant
Side effects; drowsiness, insomnia, nausea, weight changes, headaches |
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define Anhedonia
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A psychological condition characterized by an inability to experience pleasure
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Describe Agranulocytosis
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A blood disorder characterized by severe depletion of white blood cells, rending the body almost defenseless against infection.
CLOZAPINE |
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SYMPTOMS OF CONCERN FOR THOSE ON CLOZAPINE
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fever, rigors (shakes/shivers), sore throat, any signs of infection, cognitive changes.
Action; Treat infection and stop clozapine |
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Signs and symptoms of NEUROLEPTIC MALIGNANT SYNDROME
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Fever
Encephalopathy (disease that effects the functioning of the brain) (en cef pha lop pathy) Vitals unstable Elevated enzymes Rigidity of muscles Treatment; stop neuroleptic drugs, treat hyperthermia, hydrate and use benzodiazepines to relax muscles. |
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Target of SNRI antidepressants
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Serotonin and norepinephrine (noradrenalin)
Examples; Velanfaxine, duloxatine |
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TRICYCLIC antidepressants and side effects
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Side effects can occur before the antidepressant action, which can increase suicide risk
Narrow therapeutic range (risk of overdose) Anticholinergic side effects; dry mouth, blurred vision, constipation, dizziness |
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MAOI's and side effects
MONO AMINE OXIDASE INHIBITOR antidepressant |
Restrict diet; unable to eat high tyramine food cheese, alcohol, chocolate, banana's miso soup.
excess norepinephrine (due to high amounts of tyramine in above foods) CAN cause hypertensive crisis |
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FIRST LINE CHOICE FOR ANTIDEPRESSANTS
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SSRI's
Examples; prozac, sertraline, citalopram |
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How antipsychotics work
3 theories |
1- DOPAMINE HYPOTHESIS
2- SEROTONIN HYPOTHESIS 3- NMDA GLUTAMATE HYPOTHESIS |
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Symptoms of DEMENTIA
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High risks (falls, nutrition)
Neuro symptoms (gait, balance, vision) Psychiatric symptoms (depressed mood, affect instability) Behavioural symptoms (apathy, restless, wandering) Cognitive symptoms (language ability, insight, memory) ADL's (continence, hygiene) |
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What is SCHIZOPHRENIA?
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A major disturbance in thought, perception, cognition, and psychosocial functioning.
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DYSTONIA
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prolonged, often painful muscle contractions that often occur in the eye, tongue, neck and back.
TX; anticholinergics |
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AKATHISIA
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Motor restlessness, sense of anxiety inability to lie down or sit still.
TX; benzodiazepines |
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PSEUDOPARKINSONIAN SYMPTOMS
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Decreased motor movements, muscle rigidity, drooling, mask like face, shuffling gait.
TX; anticholinergics |
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Tardive dyskinesia
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significant adverse effect usually irreversible and late onset complication, abnormal stereotyped, rhythmic movements of the limbs and torso, tongue protrusion and chewing movements.
TX; anticholinergics antihistaminergics |
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Negative symptoms of schizophrenia
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Anhedonia; loss of enjoyment
Avolition; lack of goals Affect flattening Alogia; poverty of speech |
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Mania symptoms
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Inflated self esteem or grandiosity
Decreased need for sleep More talkative, pressure of speech Flight of ideas Dis-tractability Increase in goal directed activity Excessive involvement in pleasure seeking activities |
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Nursing Considerations for MANIA
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Risk management
Lower the mood Reduce physical activity Physical health needs (sleep,fluids, food) Education (symptom management) Education and support of family members. |
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Nursing Considerations for DEPRESSION
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Risk management
Establishing the therapeutic relationship Physical health needs Structuring the day Cognitive restructuring Education on signs and symptoms, medication Education and support of family members |
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MAJOR DEPRESSIVE DISORDER
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A condition involving seriously depressed mood and other symptoms which affect all body systems and interfere significantly with a persons ability to carry out their daily living activities.
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DYSTHYMIC DISORDER
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Chronically depressed mood for most of the day, more days than not, for at least two years
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BIPOLAR DISORDER
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Bipolar 1; marked symptoms of mania with at least 1 episode of depression.
Bipolar 2; recurrent bouts of major depression with episodic occurrence of hypomania |
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ANXIETY NTX
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Norepinephrine increases
Serotonin increases GABA decreases TX; benzo's act by stimulation GABA (inhibitory ntx) which decreased the effects of excitatory ntx. |
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Delusion of reference
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The belief that events or other peoples actions/words refer specifically to the individual and have special meaning for them.
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Grandiose delusions
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Exaggerated belief of one's importance, power, knowledge or identity.
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the impact of Self regulation of babies and children
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Helps
Regulating emotions, attention (ability to sustain concentration at age level), develop social relationships and communication, including cognition. |
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Mental ill-health in children is defined as
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A change in the child's usual behaviours, emotions, or thoughts
Persistent for more than 2 weeks Issue interferes with the child's usual routine Disability to child and caregiver |
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What triggers type 1 diabetes?
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Most cases are due to the autoimmune destruction of the pancreatic beta cells, which result in the inability to produce insulin.
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What is diabetes?
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The inability to produce or use insulin, when there is a lack of insulin glucose cannot be taken out of the blood by body cells.
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Metabolic syndrome risk factors
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Central obesity (belly fat)
High BP High triglycerides Low HDL-Cholesterol Insulin resistance |
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What areas would you inquire about to assess a persons level of anxiety?
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The effect it has on ADL's
Restlessness, sleep Difficultly concentrating Muscle tension Irritability Fatigue |
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THERAPIES/INTERVENTIONS TO ASSIST PEOPLE WITH ANXIETY
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Life style changes
Cognitive behavioural therapy Exposure based tasks Relaxation techniques/breathing Problem solving skills |
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WHAT are the two major groups of drugs used for ANXIETY
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Antidepressants
Benzo's |
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CHILD BEHAVIOUR CHECKLIST (ACHENBACH, 1991) Benefits of
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Helps to view young people as having issues related to predominant personality traits, developmental factors, or incidents and influences within their family and wider social environment.
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A Nursing intervention for adolescent psychosis. example.........
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Use active listening skills.
encourage to verbalize confusion and distress. This assists to diffuse agitation and calm patient, reducing the risk of aggression. |
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Define INTOXICATION
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Intoxication occurs when a person's intake exceeds their tolerance and produces behavioural and/or physical changes.
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define HAZARDOUS USE
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A repetitive pattern of use that poses a risk of harmful physical and psychological consequences.
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Define DELIRIUM
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An acute brain syndrome evident by agitation, hyperactivity, tremor, confusion and disorientation.
Delirium usually lasts for a short time, occurring around 24-48 hours without progressing to delirium tremens. |
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Withdrawal symptoms for BENZO Withdrawal
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Anxiety
panic attacks depression insomnia tremor nausea loss of appetite loss of weight muscle cramps distortion of hearing feelings of depersonalization distorted vision stiffness and muscle spasm paranoid thoughts and feelings flu like symptoms confusion |
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OPIOID DEPENDENCE IMPLICATIONS FOR NURSES
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Pain management
Damaged venous system, Infections, hepatitis risk of venous and arterial thrombosis general poor health status risk of multiple drug toxicity |
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INTERVENTIONS FOR SUBSTANCE RELATED DISORDERS
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Non-residential rehab, self help groups (AA, NA), community drug and alcohol services, individual/group counselling, pharmacotherapy - methodone, CBT, Motivational interviewing, residential treatment.
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PURPOSE of the alcohol and drug act 1966?
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It provides people who are diagnosed as alcoholics and drug addicts to undergo compulsory treatment under a court order at specially certified institutions
EX; SALVATION ARMY, NOVA RUST |
