Antipsychotics Flashcards
(28 cards)
Antipsychotic Agents
Used for diverse spectrum of psychotic disorders
What population of people should antipsychotics NOT be used in?
Elderly w/ dementia
Increases risk of death substantially
-Cardiac and infection causes
MOA of first generation antipsychotics (FGA’s)
Block receptors for dopamine (DA) in CNS
DA antagonists
Serious side effects of FGA’s
Extrapyramidal symptoms ( acute dystonia, akathisia, parkinsonism, and tardive dyskinesia) Malignant Neuroleptic Syndrome
Serious side effects of SGA’s
Metabolic effects (dyslipidemia, diabetes, weight gain)
Symptoms of schizophrenia
Disordered thinking
Difficulty comprehending reality
Hallucinations (auditory & visual)
What type of hallucinations are more common in schizophrenia?
Auditory is more common
Positive symptoms of schizophrenia
Hostility
Suspicion
Violence
Persecutory hallucinations
Negative symptoms of schizophrenia
Withdrawn Hermit quiet stop caring for self (hygiene, employment etc) Blunted affect talk slowly Monotone
Treatment for EPS reactions
Anticholinergics like diphenhydramine & benztropine
Restore balance of Ach and Dopamine in brain
How quickly does acute dystonia occur
5 hours- couple days of starting therapy
Akathisia
Incredible need for motion
Pacing back and forth
Acute dystonia
Back spasm
Laryngospasm–emergency!
Facial spasm
Oculogyric crisis
Parkinsonism
Shuffling feet
rigid movements
mask like face
Tardive dyskinesia
First generation antipsychotics
Occurs months to years after therapy
Worm like movements of face and lounge
Permanent
Depot preps
Long-acting injectable form available for antipsychotic medications
Last for 1-2 weeks
Slow release
Drug therapy purpose
Suppression of acute episodes
Prevention of acute exacerbations
Maintenance of highest level of functioning as possible
Dosing of antipsychotics
Start at smallest dose
Highly individualized
Older adults need less
Haloperidol MOA
Blocks DA, NE, Ach, and histamine
Haloperidol classification
High potency FGA
Haloperidol adverse effects
EPS
Higher frequency of NMS
Cardiovascular (prolong QT)
Neuroendocrine effects are seen on occasion
Neuroendocrine effects of some antipsychotics
Galactorrhea
Menstrual irregularities
Gynecomastia
Chlorpromazine classification
Low potency FGA
Chlorpromazine MOA
Blocks DA, alpha 1 & 2 adrenergic receptors, NE, Ach, and histamine
AKA antagonists of these receptors