Pharmacology and the Nursing Process, 4th ed药理学与护理程序第四..pptVIP

Adverse Effects (cont’d) Body System Adverse Effects Metabolic/endocrine Galactorrhea, irregular menses,  increased appetite, polydipsia MANY OTHER ADVERSE EFFECTS Adverse Effects (cont’d) Neuroleptic malignant syndrome (NMS) Potentially life threatening High fever, unstable BP, myoglobinemia Extrapyramidal symptoms (EPS) Involuntary muscle symptoms similar to those of Parkinson’s disease Akathisia (distressing muscle restlessness) Acute dystonia (painful muscle spasms) Treated with benztropine (Cogentin) and trihexyphenidyl (Artane) Adverse Effects (cont’d) Tardive dyskinesia (TD) Involuntary contractions of oral and facial muscles Choreoathetosis (wavelike movements of extremities) Occurs with continuous long-term antipsychotic therapy Psychotherapeutic Drugs: Nursing Implications Before beginning therapy, assess both the physical and emotional status of patients Obtain baseline vital signs, including postural BP readings Obtain liver and renal function tests Psychotherapeutic Drugs: Nursing Implications (cont’d) Assess for possible contraindications to therapy, cautious use, and potential drug interactions Assess LOC, mental alertness, potential for injury to self and others Check the patient’s mouth to make sure oral doses are swallowed Psychotherapeutic Drugs: Nursing Implications (cont’d) Provide simple explanations about the drug, its effects, and the length of time before therapeutic effects can be expected Abrupt withdrawal should be avoided Advise patients to change positions slowly to avoid postural hypotension and possible injury Psychotherapeutic Drugs: Nursing Implications (cont’d) The combination of drug therapy and psychotherapy is emphasized because patients need to learn and acquire more effective coping skills Only small amounts of medications should be dispensed at a time to minimize the risk of suicide attempts Simultaneous use of these drugs with alcohol or other CNS depressants can be fatal Psychotherapeutic Dru