FGA and SGA: Adverse Effects and Nursing Considerations (Nursing)

00:01 Now, we made a chart for you here just so you can see, kinda comparison of those things.

00:05 You have first generation in the top row, second generation on the bottom row, EPS.

00:11 Well, first generation antipsychotics have a higher risk than second generation anti-psychotics for EPS.

00:18 Second generations have a lower risk than first generation but they have equal risk for tardive dyskinesias.

00:25 Now, the metabolic risk just come with the second-generation antipsychotics.

00:30 Both the first and the second generation have an increased risk of death with the elderly if you use it to treat dementia.

00:38 Maximum response will develop over months is appropriate for both first and second generation.

00:43 The risk for neuroleptic malignant syndrome is much higher with first generation antipsychotics.

00:50 Now in a summarized potential adverse effect again, remember the early reactions -- dystonia, parkinsonism, and akathisia--the late reactions are tardive dyskinesias.

01:01 The anticholinergic effects of these medications when you have dry eye, dry mouth, urinary tension, constipation, tachycardia, and suppression of sweating.

01:12 Remember, anticholinergic is against those cholinergic responses which are much more often like a parasympathetic response.

01:21 This will block those parasympathetic responses that's why your eyes are dry, your mouth is dry, you're hanging on the urine, you're constipated because it's really dry and stuck, you have tachycardia, and you don't sweat.

01:34 You also have a risk for neuroleptic malignant syndrome, orthostatic hypotension, these medications might make them feel sedated or kinda sleepy, and it reduces the seizure threshold.

01:47 Now this doesn't mean that someone taking antipsychotic will necessarily have a seizure but if you already have a seizure disorder, this could make you more likely to have a seizure so your other medication may need to be adjusted.

02:00 Also it has some sexual dysfunction side effects which are usually not acceptable to most patients.

02:06 Now these are some of the things that are unique nursing considerations in the care of someone who's about to start taking an antipsychotic or who's continuing to take an antipsychotic.

02:18 Medication adherence and compliance is really difficult.

02:21 Because of the disease process itself, because of the way the medications make someone feel.

02:27 It's difficult for them to keep taking the medication.

02:30 They can just become really frustrated.

02:32 Nurses have to be skilled at the development of a genuine therapeutic relationship with the patient and family.

02:40 So, it's gonna involve a lot of conversation, being very patient, listening, being an excellent listener, and letting them talk and vent when they need to because consistent dosing is critically important to the effectiveness of treatment.

02:55 Patients need to stay on these medications for the rest of their life or at least through periods of crisis in order to really see an effective treatment plan.

03:04 Patients are often hesitant to continue those medications.

03:07 They also might be concerned about addiction, you know, they might have some paranoias, it's just very complicated to get them to continue to take the medication.

03:15 So, support the family members and other caregivers can be beneficial so they understand the importance and they also have a safe place to vent to someone who understands the challenges of the disease process.