Personality and Mood Disorders Q 21
Which of the following interventions is important for a client with paranoid personality disorder taking olanzapine (Zyprexa)?
A. Explain effects of serotonin syndrome.
B. Teach the client to watch for extrapyramidal adverse reactions.
C. Explain that the drug is less effective if the client smokes.
D. Discuss the need to report paradoxical effects such as euphoria.
Correct Answer: C. Explain that the drug is less effective if the client smokes.
Olanzapine (Zyprexa) is less effective for clients who smoke cigarettes. Olanzapine doesn’t cause euphoria (damn), and extrapyramidal side effects aren’t a problem. However, the client should be aware of adverse effects such as tardive dyskinesia.
Option A: Serotonin syndrome is a potentially life-threatening condition precipitated by the use of serotonergic drugs. It may be a consequence of therapeutic medication use, accidental interactions between medications or recreational drugs, or intentional overdose. Symptoms can range from mild to fatal and classically include altered mental status, autonomic dysfunction, and neuromuscular excitation. Multiple drugs may precipitate serotonin toxicity by a variety of mechanisms. SSRIs such as citalopram, escitalopram, fluoxetine, fluoxetine, paroxetine, and sertraline impair reuptake of serotonin from the synaptic cleft into the presynaptic neuron.
Option B: Extrapyramidal side effects (EPS), commonly referred to as drug-induced movement disorders are among the most common adverse drug effects patients experience from dopamine-receptor blocking agents. Centrally-acting, dopamine-receptor blocking agents, namely the first-generation antipsychotics haloperidol and phenothiazine neuroleptics, are the most common medications associated with EPS.
Option D: The amphetamine class of drugs is used for medical and recreational purposes. They carry a multitude of effects that include general and cognitive performance enhancement along with euphoric effects. They also induce aphrodisiac effects in many users. ADHD treatment commonly uses a combination of dextroamphetamine and levoamphetamine, as well as pure dextroamphetamine and lisdexamfetamine. Methamphetamine is a widely trafficked and illegal drug used for recreational purposes. Athletes use many drugs that are related to the amphetamine class of drugs for physical performance enhancement. These drugs fall under bans by the world anti-doping agency (WADA).