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Mental Health Medications (Olanzapine (Adverse side effects: (Dry mouth…

- - - - Management for people with severe schitzophrenia who dont respopnd to the normal druges, used to reduce the risk of recurrent suicidal behaviour in patients with schitzophrenia or schitzoaffective disorder.
        
        Pharmacokenetics: given orally, onset of the medication varies, peaks 1-6 hours, duration: typically lasts weeks.
        
        Indications: clozapine blocks the dopamine and serotonin receptors, depresses the functioning of the RAS, also has anticholinergic, antihistaminic and alpha-adrenergic blocking receptors
        
        Pharmacokenetics.
        
        Absorbtion takes place in the gastrointestinal tract
        
        Metabolised in the liver
        
        Excreted through bile and urine
  - - - Cafeine inhibits CYP1A2m patients should be encouraged to limit their intake and report substanital changes to their intake of cafeine to their doctor or nurse.
      - consumption of tabacco and alcohol are common amongst patients with schitzophrenia, when mental illness and substance use, impaired insight and motivation and the sedating effects of antipsychotics patients typically find it difficult to live a healthy lifestyle
- - - - a long-acting injectable formulation of olanzapine, given fortnightly
        
        shouldnt be administered intravenously or subcutaniouslly
        
        After administration patients are monitored for two hours every 30 minutes, this is due to the great risk of post injection sydrome.
        
        Post-injection syndrome includes a variety of signs and symptoms such as sedation and delirium that are associated with an olanzapine overdose
        
        Other symptoms include dizziness, weakness, aggression, ataxia, hypertension and seizures
        
        Nursing considerations: nurses must make sure that patients are alert, able to detect changes in patients state, vitals can be taken if patients express that they are feeling unwell, ask patients if they are experiencing any symtoms ie. dizziness, feeling week, agitated ect
      - used in conjunction with oral olanzapine
        
        patients beginning olanazapine are recommeded to take 10-20 mg/per day of immediate release tablets, to see if they are tolerable.
        
        when on 10 mg of oral, (IMI) 210mcg/2wks recommended starting dosage after 2 months, 150mcg/2wks (IMI)
        
        15mg/day orals, (IMI) 300mcg/2wks starting dosage. after 2 months 210 mcg/2wks,
        
        when on 20 mg of oral, (IMI) starting dosage and maintanience dose after 2 months is 300 mcg/weeks.
  - - - Excreted through urine and bile
- - - - Indications: since it is a typical antipsychotic their is blockage at the dopamine receptors, thus preventing stimulation of the dopamine postsynaptic neurons. there is also suppression of the RAS. this limits stimuli coming to the brain.
        
        Mechanism of action: It mainly acts by antagonism of D1 and D2 dopamine receptors
  - - - Absorption: Gastrointestinal tract
        
        Metabolised in the liver
        
        excreted through primary faces
  - - - Parkinson disease
      - severe hypotension
      - coronary disease
      - criculatory collapse
      - blood dyscrasias
    - - Weight gain: patients should be weighed regularly and encouraged to maintain a healthy diet and excerise regularly
      - constipation
      - Hypersalivation
      - Tachycardia
      - Dry mouth
      - agitation
- - - - Family dynamics: severe relationship issues with dad, sense of ambivalent attachment or sense of abandonment by main figure in his life and impaired self esteem as a result.
      - The patient has no contact with his biological father, the death of a maternal aunty was a significant loss in the patient life he described her as the only mother figure he had ever known.
    - - THE MEDICINES ACT 1981: This realtes to the manufacture sale, and supply of medicines medical devices and related products.
      - Mental Health Compulsory treatment Act 1992: this act looks at the circumstances in which the conditions under where individuals may be subject to compulsory psychiatric ssessment and treatment.
      - NZNO guidelines to medication administration 5.7 the registered nurse.: this outlines the scope of practice of nursing students in terms of medication administration. NZNO recommends that medication administration is always under the direct supervision of a registered nurse.
      - THE MEDICINES ACT 1981: this relates to the manufacture, sale, and supply of medicines, medical devices and related products.
      - HEALTH PRCATITIONERS COMPETENCE ASSURANCE ACT 2003; the primary principle of legislation is to protect the health and safety of the public through the provision of measures that make sure that health practitioners are fit and competent to practice within their respective professions.
      - The Misuse of Drugs Act 1975 and Misuse of Drugs regulations 1977: this act stipulates the classification of controlled drugs in determination of their risk to the public. the regulations provide for the prescribing and storage of controlled medications. Nurses need to be aware of the legislation in terms of the storage, recording and administration of medications and controlled drugs.