Antipsychotic Drugs

Question 1

Antipsychotic Drugs - Non-Phenothiazines

FGAs

Answer 1

• haloperidol (Haldol)
• chlorprothixene (Taractan)
• thiothixine HCL (Navan)

Question 2

Antipsychotic Drugs - Non-Phenothiazines - Indications

Answer 2

• To control psychotic
behavior
• Less sedative than
phenothizines

Question 3

Antipsychotic Drugs - Non-Phenothiazines - ADRs

Answer 3

• Severe extrapyramidal 
  effects
• Leukocytosis
• Blurred vision
• Dry mouth
• Urinary retention

Question 4

Antipsychotic Drugs - Non-Phenothiazines - Nursing implications

Answer 4

• Teach client to avoid alcohol

Question 5

Antipsychotic Drugs/Phenothiazines

Answer 5

• chlorpromazine HCL
   (Thorazine)
• trifluoperazine HCL
   (Stelazine)
• thioridazine HCL
   (Mellaril)
• perphenazine
   (Trilafon)
• triflupromazine
   (Vesprin)

Question 6

Antipsychotic Drugs/Phenothiazines - indications

Answer 6

• To control psychotic
behavior; hallucinations,
delusions, and bizarre
behavior

Question 7

Antipsychotic Drugs/Phenothiazines - ADRs

Answer 7

• Drowsiness
• Orthostatic hypotension
• Weight gain
• Anticholinergic effects
• Extrapyramidal effects
  - pseudo-parkinsonism
  - akathasia
  - dystonia
  - tardive dyskinesia
• Photosensitivity
• Blood dyscrasias: 
  granulocytosis, leukopenia
• Neuroleptic malignant 
  syndrome

Question 8

Antipsychotic Drugs/Phenothiazines - Nursing implications

Answer 8

• Extrapyramidal effects are 
  MAJOR concern
-----------------------------------------
• Monitor elderly clients 
  closely
• Takes 2-3 weeks to achieve 
  therapeutic effect
• Keep client supine for 1 hour 
  after administration and 
  advise to change positions  
  slowly because of effects of 
  orthostatic hypotension
• Teach client to avoid:
  - alcohol
  - sedatives (potentiate effect 
    of CNS depressants
- antacids (reduce 
    absorption of drug)

Question 9

Atypical Antipsychotic Drugs

SGAs

Answer 9

• risperidone (Risperdal)
• olanzapine (Zyprexa)
• quetiapine (Seroquel)
• aripaprazole (Abilify)
• ziprasidone (Geodon)
• clozapine (Clozaril)

Question 10

Atypical Antipsychotic Drugs - indications

Answer 10

• Clozapine has superior
efficacy in clients who have
been treatment resistent

• Treat positive and
  negative symptoms of
  schizophrenia without 
  significant extrapyramidal
  symptoms (EPS)
• Clients who have not 
  responded well to typical 
  antipsychotics or have side 
  effects from typical 
  antipsychotics
• Fewer side effects

Question 11

Atypical Antipsychotic Drugs - ADRs

SGAs

Answer 11

• Risperdal: nueroleptic 
  malignant syndrome (NMS), 
  EPS, dizziness, GI 
  symptoms, (nausea, 
  constipation), anxiety
• Zyprexa: drowsiness, 
  dizziness, weight gain, EPS, 
  agitation
• Seroquel: drowsiness, 
  dizziness, headache, EPS, 
  anticholinergic effects
• Clozaril: agranulcytosis, 
  drowsiness, dizziness, GI 
  symptoms, NMS

Question 12

Atypical Antipsychotic Drugs - Nursing Implications

SGAs

Answer 12

• Monitor WBC weekly for first 
  6 months, then biweekly
• Baseline vital signs (VS) and 
  ECG; report abnormal VS
• Monitor for symptoms of 
  NMS and EPS
• Change positions slowly