Antipsychotic Medications Flashcards
conditions managed with antipsychotics
- Schizophrenia
- Bipolar Disorder
- Severe Depression
- Substance Abuse (maybe symptom of above)\
Manage severe agitation
Lesser uses: nausea, vomiting, hiccups
Sometimes used to treat dementia but must use caution - Very seldome
three types of symptoms for schizophrenia
positive
negative
cognitive
Positive
Exaggeration or distortion of normal function Hallucinations Delusions Agitation Tension Paranoia
Negative
Loss or diminution of normal function Lack of motivation Poverty of speech Blunted affect Poor self-care Social withdrawal
Cognitive
Disordered thinking Reduced ability to focus attention Prominent learning and memory difficulties Subtle changes* Florid changes: Thinking and speech may be completely incomprehensible to others
Primary neurotransmitter at work when we talk about schizophrenia
dopamine
Underactivity of D1 receptor
negative symtpoms
Overactivity of D2 receptors
positive symptoms
Three major objectives of treatment for shizophrenia
- Suppression of acute episodes
- Prevention of acute exacerbations
- Maintenance of the highest possible level of functioning
Strategic and therapeutic considerations for treatment of schizophernia
- Drug selection
- Dosing
- Route
- Oral (tablets, capsules, and liquids)
- Intramuscular
- Inhaled
First Gen Examples
Chlorpromazine (Thorazine) Fluphenazine(Prolixin) Perphenazine (Trilafon) Trifluoperazine (Stelazine) Thioridizine (Mellaril) Thiothixene (Navane) Haloperidol (Haldol)
2nd Gen
Olanzapine (Zyprexa) Clozapine (Clozaril) Risperidone (Risperdal) Quetiapine (Seroquel) Ziprasidone (Geodon) Aripiprazole (Abilify) Paliperidone (Invega)
Typical action
Blocks post-synaptic D2 receptors in basal
ganglia, hypothalamus, limbic system and
medulla; lipid soluble
Atypical action
Less D2 blockade than the typicals. Hypothesis:
blocks serotonin receptors in cortex which
decreases inhibition of dopamine; thus more effect
on negative symptoms of schizophrenia
Typical intended effects
Reduces positive symptoms of Schizophrenia (hallucinations, tics) Treatment of nausea, vomiting, hiccups Reduces aggressive behaviors Not much effect on negative symptoms
Atypical intended effects
Reduces positive symptoms of schizophrenia but
less than typicals
Reduces negative effects of schizophrenia
Also used to augment treatment of bipolar disorder, depression, delusional disorders
Typical side effects
Extrapyramidal effects (EPS); tardive dyskinesia Anticholinergic effects Adrenergic effects Prolonged QT Sedation Hyperprolactinemia
A typical side effects
Less risk of EPS, tardive dyskinesia
Metabolic syndrome: insulin resistance, weight
gain*, hyperprolactinemia
Seizures, tachycardia,dizziness, sleep problems,
constipation, rhinitis
Prolonged QT
Sedation
Typical contraidincatiosn precaustions
Narrow angle glaucoma, severe liver or CVD,
bone marrow depression.
Caution: epilepsy, BPH, DM, CNS tumors.
mortality psychosis of dementia in elderly