NSG 552
Psychopharmacology
Exam 1 Study Guide
40-question exam- 1 hour to take the exam
Content Covered
Schizophrenia spectrum and other psychotic disorders
Bipolar disorder
Depressive disorder
Antipsychotics
Basic Terminology
Psychopharmacology: the use of psychotropic medications in the
treatment of psychiatric disorders
Pharmacokinetics: the study of what the body does to drugs, such as
absorption, distribution, metabolism, and excretion.
Pharmacodynamics: the study of what the drugs do to the body. For
example, target sites for drugs- receptors, ion channels, enzymes
(MAOIs), and carrier proteins/reuptake pumps.
Management of Acute Psychosis
Psychotic symptoms can increase patients’ risk for harming
themselves or others or being unable to meet their basic needs.
Psychosis may be seen in many psychiatric disorders
Psychosis is the core feature of schizophrenia and other conditions in
the schizophrenia spectrum
Acute psychosis may occur in bipolar disorder and major depression
with psychotic features
We consider agitation to be a psychiatric emergency
For agitated patients not willing or able to take oral medications, IM
medications such as olanzapine (Zyprexa) and haloperidol (Haldol)
can be used.
, IM haloperidol should be administered with benztropine (Cogentin) or
diphenhydramine (Benadryl) to reduce the risk of severe EPS
(Extrapyramidal symptoms) or dystonia
o EPS- tremors, stiffness, restlessness
o Dystonia- a chronic neurological movement disorder causing
involuntary, sustained, or repetitive muscle contractions,
resulting in painful twisting, spasms, and abnormal postures.
For severely agitated patients, it is suggested to use a benzodiazepine
in combination with the antipsychotic. For example, Haldol with
lorazepam and Cogentin.
Typical/ First Generation/ Neuroleptics/ Conventional Antipsychotics
Introduced in the 1950’s
Block D2 receptors (Dopamine 2 receptors)
Effective for positive symptoms
They can worsen negative symptoms secondary to the decrease of DA
(dopamine) in the mesocortical pathway
Long-acting forms available (Decanoate
Examples of first-generation antipsychotics include haloperidol
(Haldol), Chlorpromazine (Thorazine), Fluphenazine (Prolixin),
Loxapine (Adasuve), Perphenazine (Trilafon), and Thioridazine
Carry a higher risk of movement-related side effects like tardive
dyskinesia compared to newer meds
Atypical/Second-generation antipsychotics
First-line treatment
They have fewer neurological side effects
Effective for both positive and negative symptoms
They are serotonin-dopamine antagonist (D2/ 5HT2A)
They can cause EPS, but at a lower risk
They have a lower incidence of tardive dyskinesia
They do have metabolic side effects which include weight gain,
hyperlipidemia, hyperglycemia, diabetes, hypertension, cardiac and
respiratory side effects
They also have some antihistaminic, antiadrenergic, and
antimuscarinic effects
o Antihistaminic effects include drowsiness, dry mouth, dizziness,
and headache
Psychopharmacology
Exam 1 Study Guide
40-question exam- 1 hour to take the exam
Content Covered
Schizophrenia spectrum and other psychotic disorders
Bipolar disorder
Depressive disorder
Antipsychotics
Basic Terminology
Psychopharmacology: the use of psychotropic medications in the
treatment of psychiatric disorders
Pharmacokinetics: the study of what the body does to drugs, such as
absorption, distribution, metabolism, and excretion.
Pharmacodynamics: the study of what the drugs do to the body. For
example, target sites for drugs- receptors, ion channels, enzymes
(MAOIs), and carrier proteins/reuptake pumps.
Management of Acute Psychosis
Psychotic symptoms can increase patients’ risk for harming
themselves or others or being unable to meet their basic needs.
Psychosis may be seen in many psychiatric disorders
Psychosis is the core feature of schizophrenia and other conditions in
the schizophrenia spectrum
Acute psychosis may occur in bipolar disorder and major depression
with psychotic features
We consider agitation to be a psychiatric emergency
For agitated patients not willing or able to take oral medications, IM
medications such as olanzapine (Zyprexa) and haloperidol (Haldol)
can be used.
, IM haloperidol should be administered with benztropine (Cogentin) or
diphenhydramine (Benadryl) to reduce the risk of severe EPS
(Extrapyramidal symptoms) or dystonia
o EPS- tremors, stiffness, restlessness
o Dystonia- a chronic neurological movement disorder causing
involuntary, sustained, or repetitive muscle contractions,
resulting in painful twisting, spasms, and abnormal postures.
For severely agitated patients, it is suggested to use a benzodiazepine
in combination with the antipsychotic. For example, Haldol with
lorazepam and Cogentin.
Typical/ First Generation/ Neuroleptics/ Conventional Antipsychotics
Introduced in the 1950’s
Block D2 receptors (Dopamine 2 receptors)
Effective for positive symptoms
They can worsen negative symptoms secondary to the decrease of DA
(dopamine) in the mesocortical pathway
Long-acting forms available (Decanoate
Examples of first-generation antipsychotics include haloperidol
(Haldol), Chlorpromazine (Thorazine), Fluphenazine (Prolixin),
Loxapine (Adasuve), Perphenazine (Trilafon), and Thioridazine
Carry a higher risk of movement-related side effects like tardive
dyskinesia compared to newer meds
Atypical/Second-generation antipsychotics
First-line treatment
They have fewer neurological side effects
Effective for both positive and negative symptoms
They are serotonin-dopamine antagonist (D2/ 5HT2A)
They can cause EPS, but at a lower risk
They have a lower incidence of tardive dyskinesia
They do have metabolic side effects which include weight gain,
hyperlipidemia, hyperglycemia, diabetes, hypertension, cardiac and
respiratory side effects
They also have some antihistaminic, antiadrenergic, and
antimuscarinic effects
o Antihistaminic effects include drowsiness, dry mouth, dizziness,
and headache
