Antipsychotic Meds (10) Flashcards
Identify the clinical use, side effects, adverse reactions and patient teaching for each generation of antipsychotics (10)
Antipsychotics 1st Gen
Name? 2
Indicated for?
Black Box Warning?
Haloperidol
Chlorpromazine
Indicated for acute and maintenance
Not approved for dementia related psychosis.
1st gen
Haloperidol and Chlorpromazine
Side effects?
GESWN
Gynecomastia, menstrual irregularities
Extrapyramidal Symptoms (EPS)
Sedation
Weight gain
Neuroleptic Malignant Syndrome (NMS)
Neuroleptic Malignant Syndrome
3 side effects?
Risk factors for NMS?
HOT, STIFF, OUT OF IT!!
Genetic Predisposition
Dehydration
Increasing dose or multiple antipsychotics
First month of treatment
Symptoms of NMS? 4
Treat with?
HOT, STIFF, OUT OF IT
Severe Muscle Rigidity “Lead Pipe”
Elevated Temperature
Altered Mental Status
Autonomic Instability
(HTN, tachycardia, diaphoresis, tachypnea)
Benzodiazapene OR Dantrolene
Extrapyramidal Symptoms
What happens? 3
Treatment for Acute?
Long term?
Acute onset that can become chronic encompassing the following:
Akathisia: inability to sit still
Dystonia: involuntary muscle spasms, stiffness
Pseudoparkinsonism: rigidity, tremor, slowed movement
Acute: Benztropine (Cogentin) or Diphenhydramine (Benadryl) IM or IV
Long term: daily oral anticholinergic therapy
Antipsychotics 2nd Gen (Atypicals)
Clozapine, Risperidone
Side effects?
Anticholinergic effects*
Hyperprolactinemia
Weight gain/metabolic syndrome
Agitation, insomnia
Weakness, fatigue, sedation
Cardiac Implications
Sexual dysfunction
EPS/NMS (but less likely)
Antipsychotics 2nd Gen Cholinergic Side effects
Can’t see: Blurred vision due to pupil dilation (mydriasis).
Can’t pee: Urinary retention.
Can’t spit: Dry mouth (xerostomia).
Can’t poop: Constipation
Clozapine (2nd gen)
Risk?
Risk: Severe Neutropenia
CBC when starting
Weekly ANC for the first 6 months
Biweekly for another 6 months
Then monthly
