cns (1) - Central Nervous System Agents Reading Assignment:...

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Central Nervous System Agents Reading Assignment: Kee Unit 6 Chapters 20, 21, 22, 23; Lilley: Part 2, Chapters 12, 13, 14, 15 Topic Objectives On completion of this topic, the student will: 1. Identify the key drugs, mechanism of action, therapeutic effects, side effects and patient care implications of: a. Phenothiazine antipsychotics b. Other neuroleptic agents c. Anti-Parkinson’s agents d. Antidepressant classes, including tricyclics, MAOI’s, SSRI’s and second generation agents e. Mood stabilizers f. Anti-convulsants g. Benzodiazepines 2. Describe patient care implications of the agents discussed. Neurotransmitters Acetylcholine (Ach)-pathology, treatment of Alzheimer’s and parkinsonism Dopamine(DA)-pathology and treatment of schizophrenia, parkinsonism GABA-pathology and treatment of anxiety Serotonin (5HT)-pathology and treatment of mania and depression Mental Disorder Neurotransmitter Alteration Schizophrenia, other psychoses Increased dopamine Parkinson’s Decreased dopamine, increased acetylcholine, GABA Anxiety Decreased GABA Depression Decreased norepinephrine, serotinin Nurse’s Role Assessment Physical assessment, lab, drug history, social/family history, Mental Status Exam Side effects, prevent noncompliance, non-medical interventions Maintain times/dosages, monitoring, teaching, ensuring safety, documenting Evaluation Observe symptoms/side effects, desired effects, pt. knowledge Advanced Practice-Prescriptive Authority Central Nervous System Agents 239
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Treatment Phases and Patient Education Initiation period ID learning needs, problems, diagnoses, level of understanding, SE, attitudes, family/s.o. Stabilization period Concerns, target behaviors, symptoms, drug name, admin schedule, route, SE, plan Maintenance period Missed doses, monitor SE, drug levels, interactions, dietary limits, long-term effects Patient Compliance Increased risk factors Lack of alliance Inadequate patient/family education Poorly controlled side effects Polypharmacy History noncompliance Recidivism Interventions Explore feelings re: meds Monitor compliance Notify MD Issues to promote Understanding of treatment Medication myths=addicted Self-med trial while in hospital Psychotropics and the Elderly Higher serum levels Deteriorating hepatic and renal function Decreased albumin, lean muscle, body water Increased body fat More common side effects Orthostatic hypotension Anticholinergic effects Sedation Extrapyramidal effects Cardiac complications 240 Central Nervous System Agents
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Ethical Issues Research drugs--clinical trials Informed consent Right to refuse medications Least restrictive measures Chemical restraints Treatment guardians Homelessness Antipsychotic Drugs/Neuroleptics
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cns (1) - Central Nervous System Agents Reading Assignment:...

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