PSYCHOSES

Drugs for Psychoses Conventional (Typical) Antipsychotics Phenothiazines Chlorpromazine Non-phenothiazines Haloperidol (Haldol) Atypical Antipsychotics Risperidone (Risperdal)

Psychosis Severe mental and behavioral disorders characterized by: Delusions Hallucinations Illusions Paranoia

Etiology of Schizophrenia Acute episode – occur over hours or days Chronic episode – develop over months or years Genetic Neurological Environmental

Schizophrenia Abnormal thoughts and thought processes Disordered communication Withdrawal from other people and outside environment Severe depression

Schizophrenia POSITIVE NEGATIVE Normal behavior, but include: Hallucinations Delusions Disorganized thought or speech pattern Subtract from normal behavior, and include lack of: Interest Motivation Responsiveness Pleasure

Importance of Drug Compliance Goal is to reduce psychotic symptoms so patients have ability to self-care and interact with people Drugs do not cure mental illness Patients must continue drug regimen to remain in remission

Extrapyramidal Effects Lip smacking Spasm of face, tongue, back muscles Facial grimacing Involuntary upward eye movements Jerking motions Extreme restlessness Stooped posture Shuffling gait Tremors at rest

Nurse’s Role Obtain health history (long-term physical problems) Obtain drug history (use of illegal drugs, alcohol, etc.) Give client drug education

Nurse’s Role Obtain health history (long-term physical problems) Obtain drug history (use of illegal drugs, alcohol, etc.) Give client drug education

Pharmacologic Management of Psychosis Conventional antipsychotics (1st generation) Phenothiazines (Thorazine) Conventional nonphenothiazine antipsychotics Nonphenothiazines (Haldol) Atypical antipsychotics (2nd generation) Risperdal

Protoytpe Drugs Chlorpromazine Hydrochloride (Thorazine) Haloperidol (Haldol) Risperidone (Risperdal)