COLUMBAN COLLEGE

College of Nursing
Rizal Ext., Bo. Barretto, Olongapo City
Tel. No. (047) 222-9360 loc. 105

V. PSYCHOPATHOLOGY

PRECIPITATING PREDISPOSING
FACTOR FACTOR
Genetics Environmental
Unknown Stress

PSYCHOSIOAL NON-MODIFIABLE
STRESS FACTORS:
MODIFIABLE  Age
FACTORS:  Gender
 Lifestyle Stimulated by different o Male (15-25)
 Alcohol factors o Female (25-35)
 Smoking
 Substance Abuse
Failure in
development/Subsequent Enlarged ventricles and
loss of brain tissue cortical atrophy

Diminished glucose
metabolism and
diminished oxygen in the
frontal cortical

Decrease brain volume

and abnormal brain
function in frontal and
temporal lobe
 COLUMBAN COLLEGE
College of Nursing
Rizal Ext., Bo. Barretto, Olongapo City
Tel. No. (047) 222-9360 loc. 105

Malfunctioning
of transmission
of electrical impulses

Increases dopaminergic
system activity

Induced psychotic
symptoms

Positive symptoms Negative symptoms

 Delusion Cognitive symptoms
 Alogia
 Hallucination  Memory relapses
 Flat Affect
 Disorganized
Behavior

Drug of Choice:
 Biperiden
 Chlorpromazine
 Fluphenizine Decanoate
 Haloperidol
DRUGS STUDY
 COLUMBAN COLLEGE
College of Nursing
Rizal Ext., Bo. Barretto, Olongapo City
Tel. No. (047) 222-9360 loc. 105

NOMENCLATURE ACTION INDICATION CONTRADICITON ADVERSE NURSING

EFFECT RESPONSIBILITY
GENERIC NAME: Classification: Parkinsonian Untreated narrow angle CNS and peripheral effects: *Assess
Biperiden Anticholinergic drug syndrome especially to glaucoma, intestinal stenosis  skin rashes for Parkinsonism,
counteract or obstruction, mega colon,  dyskinesia EPS.
Action: muscular rigidity and prostatic hypertrophy, life  ataxia *Assess for mental
BRAND NAME: Synthetic tremor; extrapyramidal threatening tachycardia  twitching status.
Akineton anticholinergic drug, symptoms  impaired speech *Assess patient
blocks cholinergic  micturition response
responses in the difficulties. if anticholinergics are
Dosage CNS given.
&Frequency:  Fatigue
*Assess for tolerance
Initially 1 mg bid  dizziness
over long term
,increased by 2mg/day.  restlessness therapy, dosage may
Route  agitation have to be increased
of Administration:  anxiety or changed.
PO  confusion *Avoid activities that
require alertness,
may cause dizziness,
drowsiness and
blurring of vision
 COLUMBAN COLLEGE
College of Nursing
Rizal Ext., Bo. Barretto, Olongapo City
Tel. No. (047) 222-9360 loc. 105

NOMENCLATURE ACTION INDICATION CONTRAIDICTION ADVERSE NURSING

EFFECT RESPONSIBILITY

Generic: Alters effects SchizophreniaPHypersensitivity; 1. Assess mental status prior to and

Chlorpromazine of dopamine (D2) in and hypersensitivity to CNS: periodically during therapy.
CNS. Has significant psychoses. sulfites (injectable) NEUROLEPTIC
BRAND: anticholinergic/alpha- Hyper or benzyl alcohol MALIGNANTS 2. Monitor BP and pulse prior to and
Thorazine adrenergic blocking excitable, (SR capsules); cross- YNDROME, frequently during the period of dosage
activity combative, sensitivity with other sedation, extra adjustment. May cause QT interval changes
CLASSIFICATION: explosive phenothiazines may pyramidal on ECG.
Antiemetics,Antipsychotics behavior in occur; angle-closure reactions, TD.
children. glaucoma; bone- EENT: 3. The drug may be taken with or without
Hyperactive marrow depression; Blurred vision, food.
child with severe liver/CV dry eyes, lens
conduct disease; concurrent opacities. 4. Observe patient carefully when
disorder. pimozide use CV: administering medication.
Acute mania. Hypotension (↑
Nausea and with IM, IV), 5. Monitor I&O ratios and daily weight.
vomiting. tachycardia.
Intractable GI: 6. Monitor for development of neuroleptic
hiccups. Constipation, dry malignant syndrome (fever, respiratory
Preoperative mouth, anorexia, distress, tachycardia, seizures, diaphoresis
apprehension. hepatitis, ileus, ,hypertension or hypotension, pallor,
Acute priapism. tiredness, severe muscles tiffness, loss of
intermittent GU: bladder control. Report symptoms
porphyria. Urinary immediately. May also cause leukocytosis,
retention. elevated liver function tests, elevated CPK
Off-Label Derm:
Use: Photo sensitivity, 7. Advise patient to take medication as
Vascular pigment directed. Take missed doses as soon as
 COLUMBAN COLLEGE
College of Nursing
Rizal Ext., Bo. Barretto, Olongapo City
Tel. No. (047) 222-9360 loc. 105

headache. changes, rashes. remembered, with remaining doses evenly

Bipolar Endo: spaced throughout the day.
disorder Galactorrhea,
amenorrhea. 8. Do not increase dose or discontinue
Hemat: medication without consulting healthcare
AGRANULOC professional.
YTOSIS,
leukopenia. 9. Instruct patient to report significant
Metab: changes in neurological status, such as
Hyperthermia. seizures, extreme lethargy, slurred speech,
Misc: disorientation or ataxia.
Allergic
reactions 10. Monitor kidney and liver function of the
patient.

11. Monitor cardiovascular status of the

patient
 COLUMBAN COLLEGE
College of Nursing
Rizal Ext., Bo. Barretto, Olongapo City
Tel. No. (047) 222-9360 loc. 105

NOMENCLATURE ACTION INDICATION CONTRAIDICTION ADVERSE NURSING

EFFECT RESPONSIBILITY
Alters the effects Acute psychotic  Seizure  extrapyramidal  Assess mental status
Generic Name: of dopamine in symptoms Disorder symptom such as prior to and periodically
Haloperidol the CNS  Relieve muscle rigidity or during therapy.
(Haldol)  Also has hallucinatio  Glaucoma spasm  Monitor BP and pulse
Class: anticholinergic ns, prior to and frequently
Anti-psychotic and delusions,  elderly clients  posture leaning during the period of
alpha-adrenergic disorganize forward dosage adjustment. may
blocking activity. d cause QT interval
thinking  masklike facial changes on ECG.
 Diminished  severe appearance Observe patient
signs anxiety carefully when
and symptoms of  seizures  blurred vision administering
psychoses medication, to ensure
 urinary frequency that medication is
actually taken and not
 anemia hoarded.
 Monitor I&O ratios and
daily eight. Assess
 photosensitivity
patient for signs and
symptoms of
 dry mouth
dehydration.
 Monitor for
 nausea-vomiting development of
neuroleptic malignant
 anorexia syndrome (fever,
respiratory distress,
 COLUMBAN COLLEGE
College of Nursing
Rizal Ext., Bo. Barretto, Olongapo City
Tel. No. (047) 222-9360 loc. 105

tachycardia, seizures,
diaphoresis,
hypertension
or hypotension, pallor,
tiredness, severe muscle
stiffness, loss of bladder
control. Report
symptoms
immediately. May also
cause leukocytosis,
elevated liver function
tests, elevated CPK.
vomiting, GI upset,
trembling, or
uncontrolled
movements
of mouth, tongue or jaw

NOMENCLATURE ACTION INDICATION CONTRAIDICTION ADVERSE NURSING

EFFECT RESPONSIBILIT
 COLUMBAN COLLEGE
College of Nursing
Rizal Ext., Bo. Barretto, Olongapo City
Tel. No. (047) 222-9360 loc. 105

Hypersensitivity; cross- CNS:  Assess patient’s men

Generic: Alters the effects Acute and sensitivity with other NEURO LEPTIC (orientation, mood, b
Fluphenazine of dopamine in chronic phenothiazines may MALIGNANT before and periodica
CNS. psychoses. exist; subcortical brain SYNDROME, extra throughout therapy.
BRAND: Anticholinergic damage; severe pyramidal reactions,
Prolixin, and alpha- CNS depression; coma; sedation,  Monitor blood press
Fluphenazine adrenergic bone marrow tardive dyskinesia. standing, lying),ECG
Decanoate blocking activity. depression; liver EENT: respiratory rate befo
disease; Blurred vision, dry eyes. frequently during the
CLASSIFICATION: hypersensitivity to CV: dosage adjustment. M
Antipsychotics sesame oil (decanoate Hypertension, Q-wave and T-wave
salt); some products hypotension, tachycardia. ECG. Observe patien
contain alcohol or GI: when administering
tartrazine and should be Anorexia, constipation, medication to ensure
avoided in clients with drug-induced hepatitis, medication is actuall
known in tolerance; dry mouth, ileus, nausea, not hoarded.
concurrent use of drugs weight gain.
that prolong QT GU:  Assess fluid intake a
interval. Urinary retention. function. Increased b
Derm: fluids in the diet help
Photo sensitivity, minimize constipatio
pigment changes, rashes.
Endo:
Galactorrhea.  Monitor patient for o
Hemat: of akathisia (restless
AGRANULOCYTOSIS, desire to keep movin
leukopenia, extrapyramidal side
thrombocytopenia. parkinsonian)
Misc:
Allergic reactions
COLUMBAN COLLEGE
College of Nursing
Rizal Ext., Bo. Barretto, Olongapo City
Tel. No. (047) 222-9360 loc. 105

 Difficulty speaking or
swallowing, loss of balance
control, pill rolling, mask-like
face, shuffling gait, rigidity,
tremors; dystonic

 Muscle spasms, twisting

motions, twitching, inability to
move eyes, weakness of arms
or legs) every 2 mos. during
therapy and 8-12 wk after
therapy has been discontinued.
Reduction in dosage or
discontinuation of medication
may be necessary.
Trihexyphenidylor
diphenhydramine may be used
to control these symptoms.

 Monitor for tardive dyskinesia

(uncontrolled rhythmic
movement of mouth, face, and
extremities; lip smacking or
puckering; puffing of cheeks;
uncontrolled chewing; rapid or
worm-like movements of
tongue). Report immediately;
COLUMBAN COLLEGE
College of Nursing
Rizal Ext., Bo. Barretto, Olongapo City
Tel. No. (047) 222-9360 loc. 105

may be irreversible

 Monitor for development

of neuroleptic malignant
syndrome (fever, respiratory
distress, tachycardia, seizures,
diaphoresis, hypertension or
hypotension, pallor, tiredness,
severe muscles tiffness, loss of
bladder control). Report
immediately.