ANTIPSYCHOTIC AGENTS/NEUROLEPTICS Flashcards
A mental health condition characterized by delusions, hallucinations, illusions, disorganized behavior, and a difficulty relating to others
psychosis
Psychosis is A condition that affects the way your brain process information. It causes you to _______
lose touch with reality
You might see, hear, or believe things that are not real
Psychosis
Psychosis is a ____, not an illness
symptoms
What causes pyschosis?
mental or physical illness
brain damage
substance abuse or drug addiction
extreme stress
depression or trauma
chronic alcoholism
overdoses of certain medication
Seeing, hearing or feeling something that is not there
Hallucinations
Firm ideas and belief not founded in reality
Delusions
Distorted perceptions of actual sensory stimuli
Illusions
An extreme suspicion and delusion that they are being followed, and that others are trying to harm them. Some psychotic clients may exhibit this.
Paranoia
Give at least 3 s/sx of psychosis
Hallucinations, delusions or paranoia
Strange behavior such as communicating in rambling statements or made-up words
Attitude of indifference or detachment toward the activity’s
Rapid alteration between extreme hyperactivity and stupor
Strange or irrational actions
Deterioration of personal hygiene, and job or academic performance Marked withdrawal from social interactions and interpersonal relationship
A class of medication primarily used to manage psychosis (including delusions, hallucinations, paranoia or disordered thought), principally in schizophrenia but also a range of other psychotic disorder.
ANTIPSYCHOTIC DRUGS/NEUROLEPTICS
What are the Basic Categories of Antipsychotic Agents
- Conventional antipsychotics/First generation or Typical antipsychotics
- Atypical antipsychotics
What are the conventional antipsychotics/First generation or Typical antipsychotics agents?
Phenothiazine and phenothiazine like drugs
Phenothiazines are the most effective at treating positive signs of ______, such as hallucinations and delusions
schizophrenia
Treatment of choice for psychoses for 50 years
Phenothiazines
Phenothiazines act by preventing ____ and ____ from occupying their receptor site in certain regions of the brain
dopamine and serotonin
PHENOTHIAZINES Example Drugs
Chlorpromazine (Thorazine)
Fluphenazine HCL (Permitil, Prolixin)
Promazine HCL (Prozine, Sparine)
Mesoridazine besylate (Serentil)
Thioridazine HI (Mellaril)
First effective drug used to treat schizophrenia, was approved by the FDA in 1954
Chlorpromazine (Thorazine)
Low potency phenothiazine
Chlorpromazine (Thorazine)
Sedation, drowsiness, dizziness, constipation
Photosensitivity, extrapyramidal syndrome
Orthostatic hypotension, ejaculation disorder
Anticholinergic effects such as dry mouth, postural hypotension and urinary retention are common
Phenothiazines Side effects/adverse effects
Pancytopenia, agranulocytosis
Anaphylactoid reaction, tardive dyskinesia
Neuroleptic malignant syndrome, hypothermia
Adynamic ileus, sudden unexplained death
Phenothiazines Serious Side Effects
A serious set of adverse reaction to antipsychotic drugs.
EXTRAPYRAMIDAL SIDE EFFECTS
It occurs early in the course of pharmacotherapy and involve severe muscle spasms, particularly of the back, neck, tongue and facial muscles, twitching movements
Acute dystonia
the most common EPS, an inability to rest or relax.
Akathisia
The client paces, has trouble sitting or remaining still, and has difficulty sleepin
Akathisia
includes tremor, muscle rigidity, stooped posture, and a shuffling gait.
Parkinsonism
characterized by unusual tongue and face movements such as lip smacking and wormlike motions of the tongue, puffing of cheeks, uncontrolled chewing movements.
Tardive dyskinesia
Tardive dyskinesia is the effect of long-term use of phenothiazines ______
Akathisia
A toxic reaction to therapeutic doses of antipsychotic drug
Neurologic malignant syndrome (NS)
A rare, though potentially life-threatening adverse effect of antipsychotic agent
NS
The onset is varying from early in treatment to alter several months of therapy
NS
The clients exhibit elevated body Temperature, unstable blood pressure, profuse sweating, dyspnea, muscle rigidity, and incontinence
NS
Contraindication to the use of phenothiazine and phenothiazine like drugs include _____,______,______,_______,_______,_____ (children under age ____ months) and presence of _______
CNS depression, bone marrow suppression, coma, alcohol withdrawal syndrome, lactation, age(children under age 6 months) and presence of Reye’s syndrome
used phenothiazines with caution in clients with
asthma, emphysema, respiratory infections, pregnancy (use only when benefits outweigh risks) and elderly person or children
Assess a child for hyperexcitability, dehydration or gastroenteritis as well as chicken pox or measles, because such conditions increase the potential for ______
EPS
If possible, phenothiazines should not be given to children under ___ years of age.
12
If the patient is elderly, determine whether a lower dose maybe indicated owing to the __________ in older adults.
slower metabolism
Consists of drugs whose chemical structures are dissimilar to the phenothiazines.
Nonphenothiazines
Nonphenothiazines block the postsynaptic ______
D2 dopamine receptor
Nonphenothiazines have equal efficacy as the ______
phenothiazines
Nonphenothiazine causes less sedation and fewer anticholinergic side effects than________ (Thorazine) but exhibits an equal or even greater incidence of extrapyramidal signs especially in the elderly.
chlorpromazine
Nonphenothiazines Example drugs
Haloperidol (Haldol)
Chlorprothixene(taractan)
Loxapine succinate (Loxitane)
Molindone HCL (Moban)
Most common drug of non-phenothiazines and used for the management of the acute and chronic psychotic disorders.
Pimozide (Orap), Thiothixene HCL (Navane) Haloperidol (Haldol)
Pimozide (Orap), Thiothixene HCL (Navane) Haloperidol (Haldol) has long-acting preparations that last for approximately ______through IM or SQ
3 weeks
Non-phenothiazines contraindications include Parkinson’s disease, CNS depression, alcoholism, seizure disorders, and age younger than______
3 years old
sedation is a less severe side effect than with phenothiazines, but there is a greater incidence of ____ with non-phenothiazines antipsychotics. A possible life-threatening adverse effect of the antipsychotic drug is NMS.
EPS
Caution client that any form of _____ used with non-phenothiazines will likely increase anxiety
caffeine
Assessing older clients, check for unusual reaction to _____
Haloperidol
There is an increase of _____ in elderly woman
tardive dyskinesia
This category of drug is not safe for use with children younger than ____-.
2 years old
