antipsychotics Flashcards
first generation typical antipsychotics
Thorazine (chlorpromazine)—sedating
Prolixin (fluphenazine)
Prolixin Deconoate—long-acting injectable
Haldol (haloperidol)
Haldol Deconoate—long-acting injectable
Loxitane (loxapine)
Prolixin (fluphenazine)
Trilafon (perphenazine)
long acting injectable first gen typical antipsychotics
prolixin deconoate
haldol deconoate
uses for first gen typical antipsychotics
Improve positive symptoms of schizophrenia
Available in multiple preparations
Sedating
Strongly anti-cholinergic
Potentially debilitating side effects
early adverse effects of first gen typical antipsychotics
Neuroleptic Malignant Syndrome—generally within the first 3 days of treatment;
first sign is generally elevated temperature; unstable vital signs; dramatic change in sensorium; agitated or obtunded; high lethality; needs ICU care to support vital signs
midrange adverse effects of first gen typical antipsychotics
Extrapyramidal—dystonia; akathisia; pseudo-parkinsonism
late adverse effects of first gen typical antipsychotics
Tardive dyskinesia—repetitive, involuntary movements, such as grimacing and eye blinking; can be permanent; can detect with AIMS (Abnormal Involuntary Movement Scale)
Treatment of typical antipsychotic adverse effects:
Antihistamine—especially Benadryl (diphenhydramine)
Vistaril (hydroxyzine)
Antiparkinson’s drugs—Cogentin (benztropine); Artane (trihexyphenidyl)
second generation atypical antipsychotics
Clozaril (clozapine)—can cause agranulocytosis
Geodon (ziprasidone)—causes prolonged Q-T; available as injectable
Risperdal (risperidone)—available as long-acting injectable
Seroquel (quetiapine)—can be sedating
Abilify (aripiprazole)—also used for MDD and Bipolar
Zyprexa (olanzapine)—can cause metabolic syndrome and weight gain; available as long-acting injectable and quick-dissolving form
Invega (paliperidone)—available as long-acting injectable
Saphris (asenapine)—drowsiness
atypical - can cause agranulocytosis
Clozaril (clozapine)
atypical - causes prolonged Q-T; available as injectable
Geodon (ziprasidone)
atypical - available as long-acting injectable
Risperdal (risperidone)
atypical - can be sedating
Seroquel (quetiapine)
atypical—also used for MDD and Bipolar
Abilify (aripiprazole)
atypical—can cause metabolic syndrome and weight gain; available as long-acting injectable and quick-dissolving form
Zyprexa (olanzapine)
atypical —available as long-acting injectable
Invega (paliperidone)
atypical—drowsiness
Saphris (asenapine)
uses for atypical antipsychotics - second gen
EPS, TD, and anticholinergic side effects are less frequent
Possible agranulocytosis and prolonged QT interval
Risk for metabolic syndrome
Effective for positive and negative symptoms of schizophrenia
black box warning for atypical antipsychotics - second gen
Increased risk of mortality in geriatric clients with dementia
adverse effects of atypical antipsychotics - second gen
- Drowsiness, dizziness
- Dry mouth, constipation
- Increased appetite, weight gain
- ECG changes
- Extrapyramidal symptoms
- Hyperglycemia and diabetes
- Higher risk of metabolic effects compared to typical antipsychotics
what to report with atypical antipsychotics - second gen
sore throat, fever, malaise, unusual bleeding, easy bruising, persistent N/V, severe headache, rapid heart rate, difficulty urinating, muscle twitching, tremors, dark colored urine, excessive urine-thirst-or hunger, pale stools, yellow skin or eyes, muscular in-coordination, skin rash
