antipsychotic medications
Prescription drugs that are used to reduce psychotic symptoms; frequently used in the treatment of schizophrenia; also called neuroleptics.
Block dopamine, acetylcholine, histamine, and norepinephrine receptors in the brain and periphery. Acute and chronic psychosis, sch...
Adv. Pharmacology Final 6521
antipsychotic medications - Answer Prescription drugs that are used to reduce psychotic
symptoms; frequently used in the treatment of schizophrenia; also called neuroleptics.
Block dopamine, acetylcholine, histamine, and norepinephrine receptors in the brain
and periphery. Acute and chronic psychosis, schizophrenia, manic phase of bipolar
disorders, Tourette's syndrome, delusional and schizoaffective disorders, dementia.
Conventional (typical) or atypical.
Patient education: s/s of orthostatic hypotension - move slowly when standing up.
Sedation - avoid hazardous activities such as driving until sedation wears off.
Impaires libido and erection / ejaculation
*avoid anticholinergic drugs, barbiturates, benzos and alcohol.
first generation antipsychotics - Answer a group of medications originally developed to
combat psychotic symptoms by reducing dopamine levels in the brain; also called
conventional or typical antipsychotics
block receptors for dopamine, acetylcholine, histamine, and norepinephrine
Ex.
(low potency): Chlorpromazine, Thioridazine
s/e orthostatic hyposension, long Q-T syndrome, high sedation
(medium potency): loxapine, perhenazine,
s/e moderate sedation
(high potency):fluphenazine, haloperidol, pimozide, thiothoxene, frifluoperizine
s/e movement problems
second generation antipsychotics - Answer drugs that alleviate schizophrenia with less
likelihood of movement problems
S/E: are associated with metabolic adverse effects (eg. weight gain, dyslipidemia,
hyperglycemia, and increased risk of diabetes). As such they should be monitored for
changes. Olanzapine and clozapine carry the greatest risk.
Ex. apripiprazole, asenapine, brexpiprazole, cariprazine, clozapine, iloperidone,
lurasidone, olanzapine (Zyprexa), Quetiapine (Seroquel), Risperidone,
Potency - Answer the size of the dose needed to elicit a given response
Neuroleptic Malignant Syndrome (NMS) - Answer A rare and sometimes fatal reaction
to high-potency neuroleptic drugs. Symptoms include muscle rigidity, fever, and
elevated white blood cell count. It is thought to result from dopamine blockage at the
basal ganglia and hypothalamus.
Treatment: support body through withdrawal.
Chlorpromazine (Thorazine) - Answer - Chlorpromazine is used to treat psychotic
disorders such as schizophrenia or manic-depression, and severe behavioral problems
in children ages 1 through 12. Chlorpromazine is also used to treat nausea and
vomiting, anxiety before surgery, chronic hiccups, acute intermittent porphyria, and
symptoms of tetanus.
S/E:
, Adv. Pharmacology Final 6521
- This medication can cause photophobic skin reactions and damage to the retina of the
eye if exposed to direct sunlight. PTs taking this should be reminded to wear protective
clothing, apply sunscreen and wear sunglasses when they are outside.
sedation, orthostatic hypotension, anticholinergic effects.
Clozapine (Clozaril) - Answer Second Generation (Atypical) Antipsychotic
low affinity to D2 dopamine receptors
treats schizophrenia and suicidal behavior. Not many EPSs.
S/E weight gain, orthostatic hypotension, sedation, cholinergic, urinary retention,
constipation, tachycardia.
extrapyramidal symptoms - Answer side effects of antipsychotic medications that affect
a person's gait, movement, or posture
Usually caused by high potency first gen. antipsychotics
Also referred to as EPS
Acute Dystonia: occurs within first few days of therapy. Severe spasm of the muscles of
tongue, face, neck and back.
Parkinsonism: bradykinesia, mask-like facies, drooling, tremor, rigidity, shuffling gait,
stooped posture.
Akathisia: pacing and squirming, need to move uncontrollably. develops in first 2
months of treatment.
Tardive Dyskinesia: occurs with long-term therapy. Involuntary choreoathetoid
movements of the tongue and face.
Haloperidol (Haldol) - Answer An antipsychotic drug thought to block receptor sites for
dopamine, making it effective in treating the delusional thinking, hallucinations and
agitation commonly associated with schizophrenia.
-Preferred treatment for Tourette syndrome.
-Hepatic metabolism, excreted in urine.
-early extrapyramidal reactions occur frequently. Long Q-T .
Risperidone (Risperdal) - Answer Antipsychotic (Atypical)
rapid-acting used for schizophrenia and acute bipolar mania.
Absorbed rapidly, not effected by food, peaks 1 hour after dosing. Excreted through
urine.
S/E: increases prolactin levels but symptoms uncommon. Metabolic effects. Sedation in
large doses.
Olanzapine (Zyprexa) - Answer antipsychotic (atypical), mood stabilizer,
thienobenzodiazepine
antagonizes dopamine and seratonin type 2 in the CNSalso has antocholinergic,
antihistiminic, and anti alpha1 adernergic effects
decreases manifestations of psychoses
Metabolized by the liver.
Peaks in 6 hours
21-54 hour half-life
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