Extrapyramidal side effects: p. 789- A variety of signs and symptoms that are often side effects of the use of certain psychotropic drugs, particularly the phenothiazines. Three reversible extrapyramidal side effects are: acute dystonia, akathisia, and pseudoparkinsonism. A fourth, tarditive dyskinesia, is the most serious and is not reversible Akinisia: p. 784- regular rhythmic movements, usually of lower limbs; constant pacing may also be seen; often noticed in people taking antipsychotic medication. Tardive dyskinesia: p. 796- A serious and irreversible side effect of the phenothiazines and related drugs that consists of involuntary tonic muscle spasms typically involving the tongue, fingers, toes, neck, trunk or pelvis Acute Dystonia:p. 789- Abnormal muscle tonicity resulting in impaired voluntary movement. May occur as an acute side effect of neuroleptic (antipsychotic) medication, in which it manifests as muscle spasms of the face, head, neck, and back
27. Know the symptoms of each type of schizophrenia for a scenario question p.413 1. Paranoid (positive): hallucinations & delusions(PP: persecutory, grandiose), aggressive. No disorganized speech/behavior, catatonia, or inappropriate affect present. 2.Disorganized (hebephrenic): Dominant: disorganized speech/behavior, inappropriate affect. Delusions & hallucinations if present are not prominent or fragmented. Associated features include grimacing, mannerisms, & other oddities of behavior. PP: Flat, odd, regressive, extreme social withdrawal 3. Catatonic: Motor inability (waxy flexibility, or stupor). Excessive purposeless motor activity (agitation). Extreme negativism or mutism. Peculiar voluntary movements (posturing, stereotyped movements, prominent mannerisms, prominent grimaces). Echollalia or echopraxis PP: stupor, mutism, negativism, shown by resistance of movement, waxy flexability, excitement 4. Undifferentiated: PP: Mixed type
5. Residual: PP: no longer active- phase symptoms
28. What is the mechanism of action and side effects of Zyprexa? Olanzapine (Zyprexa)52, 405, 406 – Route: PO, ODT (orally disintegrating tablet), IM (short acting) Maintenance dose: 5-20 mg/day, EPS: Low, Ach: moderate, OH: moderate, Sed: Low, Adverse effects: significant weight gain, drowsiness, insomnia, agitation and restlessness, possibly akathisia or parkinsonism
29. What are the positive and negative symptoms for schizophrenia? Positive: p. 391- Hallucinations, Delusions, illusions, disorganized speech patterns, paranoia, Bizarre behavior, Positive formal thought disorder and speech patterns (things added to a person) Alterations in thinking: (thought broadcasting, thought insertion, thought withdrawal, delusion of being controlled, concrete thinking) Alterations in speech: (associative looseness, neologisms (words a person makes up that have special meaning for that person), echolalia (pathological repeating of another’s word by imitation), clang association (meaningless rhyming of words), word salad( a jumble of words that is meaningless to the listener and perhaps the speaker as well), Alterations in perception: hallucination, illusions, personal boundary difficulties (depersonalization( a nonspecific feeling that a person has lost his/her identity, that the self is different or unreal), derealization ( the false perception by a person that the environment has changed) Alterations in Behavior: extreme motor agitation, stereotyped behaviors (motor patterns that originally had meaning to the person but are now mechanical or lack purpose), automatic obedience (the performance by a catatonic client of all simple commands in a robotlike fashion), Waxy flexibility (excessive maintenance of posture), Stupor (catatonic client is motionless for long periods and may even appear to be in a coma), negativism (equivalent to resistance), agitated behaviors Negative : p. 391- Affective flattening (flat, blunted, inappropriate, bizarre affect), alogia (poverty of...
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