,
, Typical Antipsychotics - 1st Generation
(targets positive symptoms: delusions, catatonia, bizarre behavior, hallucinations)
Drug Uses Actions/ Side Effects Therapeutic Effects
Contraindicatio
ns
haloperidol acute psychosis Action: akathisia (restlessness) sedation,
(Haldol) blocks dopamine decreased agitation,
chronic receptors in brain dystonia (uncontrollable decreased
useful for schizophrenia muscle contraction- results in combativeness,
outpatients in twisting of body) decreased psychomotor
long-acting mental activity, decreased
form Assess for: hallucinations, decreased
retardation with EPS, TD, parkinsonism delusions, decreased
hyperkinesia psychotic behavior
uncontrollable temper
tourettes in don't give if pt outburst stereotypic
children has: parkinson’s, behavior (banging head on
seizures, wall)
severe
autism
spectrum mental NMS - assess temp.
depression
disorder
alopecia
urinary retention
targets positive amenorrhea
symptoms breast
engorgement
conversion galactorrhea
disorder priapism
gynecomastia
seizures
hyperthermia
Assess for:
laryngospasm /
bronchospasm
hyperglycemia,
hypoglycemia,
hyponatremia
Thiothixene acute psychosis orthostatic hypotension
(Navane)
NMS = Neuroleptic Malignant Syndrome:escalates rapidly - usually starts w/ fever - life
threatening hyperpyrexia, severe HTN, diaphoresis,
(103 °, 116 bpm, 34 Resp, 100/50 BP) stop immediately; bring to ER
benztropine (Cogentin) anticonvulsant for EPS usually taken with 1st gen. antipsychotics,
also treats symptoms of Parkinson’s disease.
If antipsychotics are abruptly stopped, can get acute
psychosis. If taking antipsychotics watch glucose & TSH
Atypical Antipsychotics - 2nd Generation
Not typically used...too expensive
, (Targets positive and negative symptoms (-pine, -done)
Drug Uses Actions/ Side Effects Therapeutic Effects
Contraindicatio
ns
Clozapine schizophrenia, Actions: dizziness, do weekly blood test
(Clozaril) dopamine & decreased for safe dosing for 6 mos
serotonin alertness,
used in pts who receptor agranulocytosis - rare
respond poorly blocker also do WBC count with
to other blocks Notify Dr if: neutrophils weekly.
antipsychotics glutamate, increased HR, lethargy, Watch for sore throat
anticholinergic, weakness, flu-like symptoms because of infections.
alpha
adrenergic
blocker
EPS,
TD,
targets positive don't give to pt dystonia, monitor for
& negative with akathisia hyperglycemia-
symptoms agranulocytosis seizures potentially dangerous
hyperglycemia side effect of
weight gain agranulocytosis
don’t give to increased death in older
older pt with adults with dementia-
dementia orthostatic hypotension related psychosis
Olanzapine derivative of weight gain watch glucose; great for
(Zyprexa) clozapine anorexia
short acting anti- if used with metformin,
psychotic can counterbalance
weight changes.
give to anorexia
nervosa pts drug is sedating,
administer at bedtime
Aripiprazole schizophrenia, lowers dopamine akathisia [restlessness]
(Abilify) bipolar disorder,
depression,
anxiety
Asenapine
(Saphris)
Iloperidone D2, D3, 5-HT2a orthostatic hypotension -
(Fanapt) receptors goes away with time
Lurasidone major D2, 5HT2a avoid grapefruit and
(Latuda) depression, receptors grapefruit juice
, Typical Antipsychotics - 1st Generation
(targets positive symptoms: delusions, catatonia, bizarre behavior, hallucinations)
Drug Uses Actions/ Side Effects Therapeutic Effects
Contraindicatio
ns
haloperidol acute psychosis Action: akathisia (restlessness) sedation,
(Haldol) blocks dopamine decreased agitation,
chronic receptors in brain dystonia (uncontrollable decreased
useful for schizophrenia muscle contraction- results in combativeness,
outpatients in twisting of body) decreased psychomotor
long-acting mental activity, decreased
form Assess for: hallucinations, decreased
retardation with EPS, TD, parkinsonism delusions, decreased
hyperkinesia psychotic behavior
uncontrollable temper
tourettes in don't give if pt outburst stereotypic
children has: parkinson’s, behavior (banging head on
seizures, wall)
severe
autism
spectrum mental NMS - assess temp.
depression
disorder
alopecia
urinary retention
targets positive amenorrhea
symptoms breast
engorgement
conversion galactorrhea
disorder priapism
gynecomastia
seizures
hyperthermia
Assess for:
laryngospasm /
bronchospasm
hyperglycemia,
hypoglycemia,
hyponatremia
Thiothixene acute psychosis orthostatic hypotension
(Navane)
NMS = Neuroleptic Malignant Syndrome:escalates rapidly - usually starts w/ fever - life
threatening hyperpyrexia, severe HTN, diaphoresis,
(103 °, 116 bpm, 34 Resp, 100/50 BP) stop immediately; bring to ER
benztropine (Cogentin) anticonvulsant for EPS usually taken with 1st gen. antipsychotics,
also treats symptoms of Parkinson’s disease.
If antipsychotics are abruptly stopped, can get acute
psychosis. If taking antipsychotics watch glucose & TSH
Atypical Antipsychotics - 2nd Generation
Not typically used...too expensive
, (Targets positive and negative symptoms (-pine, -done)
Drug Uses Actions/ Side Effects Therapeutic Effects
Contraindicatio
ns
Clozapine schizophrenia, Actions: dizziness, do weekly blood test
(Clozaril) dopamine & decreased for safe dosing for 6 mos
serotonin alertness,
used in pts who receptor agranulocytosis - rare
respond poorly blocker also do WBC count with
to other blocks Notify Dr if: neutrophils weekly.
antipsychotics glutamate, increased HR, lethargy, Watch for sore throat
anticholinergic, weakness, flu-like symptoms because of infections.
alpha
adrenergic
blocker
EPS,
TD,
targets positive don't give to pt dystonia, monitor for
& negative with akathisia hyperglycemia-
symptoms agranulocytosis seizures potentially dangerous
hyperglycemia side effect of
weight gain agranulocytosis
don’t give to increased death in older
older pt with adults with dementia-
dementia orthostatic hypotension related psychosis
Olanzapine derivative of weight gain watch glucose; great for
(Zyprexa) clozapine anorexia
short acting anti- if used with metformin,
psychotic can counterbalance
weight changes.
give to anorexia
nervosa pts drug is sedating,
administer at bedtime
Aripiprazole schizophrenia, lowers dopamine akathisia [restlessness]
(Abilify) bipolar disorder,
depression,
anxiety
Asenapine
(Saphris)
Iloperidone D2, D3, 5-HT2a orthostatic hypotension -
(Fanapt) receptors goes away with time
Lurasidone major D2, 5HT2a avoid grapefruit and
(Latuda) depression, receptors grapefruit juice
