1st Gen Antipsychotics Flashcards
Chlorpromazine (Thorazine)
Potency: low
Half-life: 24hr
Comments: sedation and orthostatic hypotension very common
Mechanism: block central dopamine receptors - better for reducing positive symptoms
Side effects: extrapyramidal symptoms (parkinsonian syndrome, acute dystonias, akathisia); tardive dyskinesias (late onset choreiform and athetoid movements of trunk, extremities, mouth); sedation; neuroleptic malignant syndrome (NMS) - muscle rigidity, dystonia, fever, sweating, tachycardia, HTN –>medicate with dantrolene and/or bromocriptine; anticholinergic effects; alpha-adrenergic blockade - orthostatic hypotension; prolonged QT; increased prolactin (gynecomastia and galactorrhea, sexual dysfunction); weight gain
Haloperidol (Haldol)
Potency: high
Half-life: 24hr
Comments: EPS very common, available in long-acting intramuscular depot
Mechanism: block central dopamine receptors - better for reducing positive symptoms
Side effects: extrapyramidal symptoms (parkinsonian syndrome, acute dystonias, akathisia); tardive dyskinesias (late onset choreiform and athetoid movements of trunk, extremities, mouth); sedation; neuroleptic malignant syndrome (NMS) - muscle rigidity, dystonia, fever, sweating, tachycardia, HTN –>medicate with dantrolene and/or bromocriptine; anticholinergic effects; alpha-adrenergic blockade - orthostatic hypotension; prolonged QT; increased prolactin (gynecomastia and galactorrhea, sexual dysfunction); weight gain
Thioridazine (Mellaril)
Potency: low
Half-life: 24hr
Comments: higher incidence of cardiac disturbances, retinitis pigmentosa
Mechanism: block central dopamine receptors - better for reducing positive symptoms
Side effects: extrapyramidal symptoms (parkinsonian syndrome, acute dystonias, akathisia); tardive dyskinesias (late onset choreiform and athetoid movements of trunk, extremities, mouth); sedation; neuroleptic malignant syndrome (NMS) - muscle rigidity, dystonia, fever, sweating, tachycardia, HTN –>medicate with dantrolene and/or bromocriptine; anticholinergic effects; alpha-adrenergic blockade - orthostatic hypotension; prolonged QT; increased prolactin (gynecomastia and galactorrhea, sexual dysfunction); weight gain
Mesoridazine (Serentil)
Potency: low
Half-life: 30hr
Comments: cardiac arrhythmias (torsades de pointes)
Mechanism: block central dopamine receptors - better for reducing positive symptoms
Side effects: extrapyramidal symptoms (parkinsonian syndrome, acute dystonias, akathisia); tardive dyskinesias (late onset choreiform and athetoid movements of trunk, extremities, mouth); sedation; neuroleptic malignant syndrome (NMS) - muscle rigidity, dystonia, fever, sweating, tachycardia, HTN –>medicate with dantrolene and/or bromocriptine; anticholinergic effects; alpha-adrenergic blockade - orthostatic hypotension; prolonged QT; increased prolactin (gynecomastia and galactorrhea, sexual dysfunction); weight gain
Molindone (Lidone, Moban)
Potency: medium
Half-life: 12hr
Mechanism: block central dopamine receptors - better for reducing positive symptoms
Side effects: extrapyramidal symptoms (parkinsonian syndrome, acute dystonias, akathisia); tardive dyskinesias (late onset choreiform and athetoid movements of trunk, extremities, mouth); sedation; neuroleptic malignant syndrome (NMS) - muscle rigidity, dystonia, fever, sweating, tachycardia, HTN –>medicate with dantrolene and/or bromocriptine; anticholinergic effects; alpha-adrenergic blockade - orthostatic hypotension; prolonged QT; increased prolactin (gynecomastia and galactorrhea, sexual dysfunction); weight gain
Fluphenazine (Prolixin)
Potency: high
Half-life: 18hr
Comments: available in long-acting intramuscular depot
Mechanism: block central dopamine receptors - better for reducing positive symptoms
Side effects: extrapyramidal symptoms (parkinsonian syndrome, acute dystonias, akathisia); tardive dyskinesias (late onset choreiform and athetoid movements of trunk, extremities, mouth); sedation; neuroleptic malignant syndrome (NMS) - muscle rigidity, dystonia, fever, sweating, tachycardia, HTN –>medicate with dantrolene and/or bromocriptine; anticholinergic effects; alpha-adrenergic blockade - orthostatic hypotension; prolonged QT; increased prolactin (gynecomastia and galactorrhea, sexual dysfunction); weight gain
Trifluoperazine (Stelazine)
Potency: high
Half-life: 18hr
Mechanism: block central dopamine receptors - better for reducing positive symptoms
Side effects: extrapyramidal symptoms (parkinsonian syndrome, acute dystonias, akathisia); tardive dyskinesias (late onset choreiform and athetoid movements of trunk, extremities, mouth); sedation; neuroleptic malignant syndrome (NMS) - muscle rigidity, dystonia, fever, sweating, tachycardia, HTN –>medicate with dantrolene and/or bromocriptine; anticholinergic effects; alpha-adrenergic blockade - orthostatic hypotension; prolonged QT; increased prolactin (gynecomastia and galactorrhea, sexual dysfunction); weight gain
Thiothixene (Navane)
Potency: high
Half-life: 34hr
Mechanism: block central dopamine receptors - better for reducing positive symptoms
Side effects: extrapyramidal symptoms (parkinsonian syndrome, acute dystonias, akathisia); tardive dyskinesias (late onset choreiform and athetoid movements of trunk, extremities, mouth); sedation; neuroleptic malignant syndrome (NMS) - muscle rigidity, dystonia, fever, sweating, tachycardia, HTN –>medicate with dantrolene and/or bromocriptine; anticholinergic effects; alpha-adrenergic blockade - orthostatic hypotension; prolonged QT; increased prolactin (gynecomastia and galactorrhea, sexual dysfunction); weight gain
Perphenazine (Etrafon, Trilafon)
Potency: high
Half-life: 12hr
Mechanism: block central dopamine receptors - better for reducing positive symptoms
Side effects: extrapyramidal symptoms (parkinsonian syndrome, acute dystonias, akathisia); tardive dyskinesias (late onset choreiform and athetoid movements of trunk, extremities, mouth); sedation; neuroleptic malignant syndrome (NMS) - muscle rigidity, dystonia, fever, sweating, tachycardia, HTN –>medicate with dantrolene and/or bromocriptine; anticholinergic effects; alpha-adrenergic blockade - orthostatic hypotension; prolonged QT; increased prolactin (gynecomastia and galactorrhea, sexual dysfunction); weight gain
Loxapine (Loxitane)
Potency: medium
Half-life: 8hr
Mechanism: block central dopamine receptors - better for reducing positive symptoms
Side effects: extrapyramidal symptoms (parkinsonian syndrome, acute dystonias, akathisia); tardive dyskinesias (late onset choreiform and athetoid movements of trunk, extremities, mouth); sedation; neuroleptic malignant syndrome (NMS) - muscle rigidity, dystonia, fever, sweating, tachycardia, HTN –>medicate with dantrolene and/or bromocriptine; anticholinergic effects; alpha-adrenergic blockade - orthostatic hypotension; prolonged QT; increased prolactin (gynecomastia and galactorrhea, sexual dysfunction); weight gain
Pimozide (Orap)
Potency: high
Half-life: 55hr
Mechanism: block central dopamine receptors - better for reducing positive symptoms
Side effects: extrapyramidal symptoms (parkinsonian syndrome, acute dystonias, akathisia); tardive dyskinesias (late onset choreiform and athetoid movements of trunk, extremities, mouth); sedation; neuroleptic malignant syndrome (NMS) - muscle rigidity, dystonia, fever, sweating, tachycardia, HTN –>medicate with dantrolene and/or bromocriptine; anticholinergic effects; alpha-adrenergic blockade - orthostatic hypotension; prolonged QT; increased prolactin (gynecomastia and galactorrhea, sexual dysfunction); weight gain
