NURS660 Psychopharm 660 Exam 1 Questions With Correct
Answers
Acute dystonia - ANSWER-Sustained muscle contraction in the face, neck, trunk, or extremities, can
affect the larynx. Oculogyric crisis can be a dystonic reaction. Painful.
Onset- quickly, within hours.
Reversible with treatment of an anticholinergic, benadryl, benzotropine, or congentin.
Adrengeric receptors - ANSWER-Benefits unknown.
possible side effects:
a1- orthostatic hypotension, dizziness, reflex tachycardia
a2- drug interactions
Akathisia - ANSWER-Uncontrollable motor restlessness. Pace, fidget, rock back and forth. Often
misdiagnosed as anxiety, difficult to diagnose
Onset: typically occurs within days to weeks but within a month.
Reversible with beta blockers, benzos, can switch pt's medication.
First generation antipsychotics with high potency are highly likely to produce akathisia.
Aripiprazole (Abilify) - ANSWER-Atypical antipsychotic
"3rd generation". D2 partial agonism
Management of schizophrenia, and acute manic or mixed episodes in bipolar disorder.
Adjunct to treat depression or irritability associated with autism (ages 6-18)
SE: dizziness, insomnia, akasthisia, n/v, weight gain (less likely to cause), suppresses prolactin levels
Interactions- ketoconazole and other 3a4 inhibitors increase aripiprazole levels.
May increase effects of antihypertensives
Brexpiprazole (Rexulti) - ANSWER-Greater affinity for d2 blockade
Indications: schizophrenia and treatment resistant depression
, SE: dizziness, sedation, hypotension, restlessness. hyperglycemia and DKA.
Metabolic labs before, monitor BMI and lipids
Chlorpromazine (Thorazine) - ANSWER-Indications: schizophrenia, psychoses, manic-depression, and
severe behavioral problems in children ages 1-12. Chlorpromazine is also used to treat nausea and
vomiting, anxiety before surgery, chronic hiccups, acute intermittent porphyria, and symptoms of
tetanus.
SE: photophobia, lightheadedness, dizziness, drowsiness, blurred vision, weight gain, trouble sleeping
Interactions: Food, alcohol, and benztropine can reduce absorption. Antacids can slow absorption.
Lithium and barbituates can lead to increased clearance.
TCAs decrease clearance
Serious adverse effects: postural hypotension, EKG changes, respiratory depression
Clozapine - ANSWER-Atypical Antipsychotic
SE: AGRANULOCYTOSIS- ANC blood testing prior, during. Can be very sedating, excessive salivation,
Increased risk of myocarditis, Greatest degree of weight gain and possibly greatest cardiometabolic risk
Indications- treatment resistant schizophrenia, reducing suicidal behavior
Clozapine Monitoring - ANSWER-Regular ANC blood testing is necessary before and during clozapine
treatment to monitor for agranulocytosis.
Conventional Antipsychotics - ANSWER-First-Generation drug for Schizophrenia
-Pure D2 antagonism
-Treats pos. symptoms ONLY (dopamine receptors)
-Less expensive, more side effects
Disadvantages: Extrapyramidal side effects, Anticholinergic side effects, tardive dyskinesia, lower seizure
threshold*
-Chlorpromazine, Haloperidol, thiordazine, perphenazine
Dopamine and Schizophrenia - ANSWER-Major neurotransmitter in schizophrenia
Some atypical psychotics block dopamine receptors
