presented by Elizabeth Galik
Antipsychotic medications are used among older adults to treat chronic psychiatric disorders such as schizophrenia and bipolar disorder and are also used off-label to treat symptoms of hyperactive delirium and behavioral symptoms in the context of dementia. Antipsychotic use requires ongoing monitoring for potential side effects such as sedation, elevated blood sugar, weight gain, and anticholinergic side effects, such as blurry vision, constipation, and orthostasis. Additionally, antipsychotics may also cause drug-induced movement disorders, some of which may be non-reversible. This session will describe the Food and Drug Administration (FDA)- approved and off-label uses of antipsychotics among older adults and will improve your skills in monitoring for potential side effects of these medications. Assessment of drug-induced movement disorders, such as Parkinsonism, dystonia, akathisia, and dyskinesias, will be emphasized through clinical examples and the use of standardized rating instruments.
Elizabeth Galik is a Professor at the University of Maryland School of Nursing. She received a BSN from the University of Pennsylvania, an MSN from Villanova University, a post-master's Adult Nurse Practitioner Certificate from Johns Hopkins University, and a PhD from the University of Maryland. Her research interest is in developing and testing interventions to improve functional performance, physical activity, and quality of life among older adults with dementia. Dr. Galik practices clinically as a nurse practitioner in community and long-term care settings and focuses on the medical and neuropsychiatric care of individuals with dementia. In addition to her research, she also teaches in the adult and geriatric nurse practitioner program. Dr. Galik was awarded a John A. Hartford Foundation pre-doctoral fellowship, and has received extramural research funding from the Alzheimer's Association, Foundation of the American Medical Directors’ Association, and the American Academy of Nurse Practitioners. She is a Board Member of the Maryland Gerontological Association, and the President Elect for the Gerontological Advanced Practice Nurses Association. Her memberships include Sigma Theta Tau International, Phi Kappa Phi, Southern Nursing Research Society, Gerontological Association of America, and the American Academy of Nurse Practitioners.
This chapter will describe both the approved and “off-label” uses of antipsychotic medications and will review their effectiveness for different psychiatric disorders and conditions, such as schizophrenia, bipolar disorder, delirium, and behavioral and psychological symptoms of dementia. This is important, as antipsychotic dose ranges, length of treatment, and potential side effects may vary based on different conditions.
This chapter will discuss how antipsychotics impact neurotransmitters in the brain, such as dopamine and serotonin. There are numerous potential side effects associated with antipsychotics that may negatively impact the health and function of older adults. Common side effects include sedation, elevated blood sugar, weight gain, and anticholinergic side effects, such as blurry vision, constipation, and orthostasis. Additionally, antipsychotics have also been associated with an increased risk of death among older adults with dementia.
This chapter will describe drug-induced movement disorders such as Parkinsonism, dystonia, akathisia, and dyskinesias through clinical descriptions and demonstrations. This is important because drug-induced movement disorders negatively impact function, comfort, and quality of life, and in some instances may be non-reversible.
This chapter will familiarize you with the accurate assessment of drug-induced movement disorders through the use of standardized rating instruments. You will have the opportunity to practice the use of one of these instruments based on the assessment of a symptomatic patient.