Antipsychotics- First generation (typical)

Question 1

What are they indicated for?

Answer 1

Rapid tranquilisation in severe psychomotor agitation causing dangerous or violent behaviour

Schizophrenia, particularly when the metabolic side effects of second-generation antipsychotics are problematic

Bipolar disorder

Nausea and vomiting

Question 2

How do they work?

Answer 2

They block post-synaptic dopamine D2 receptors

Question 3

What are the side effects of these drugs in the class?

Answer 3

Drowsiness
QT interval prolongation

Erectile dysfunction

Hypotension

hyperprolactinaemia- Increase in prolactin hormone

Involuntary movements or muscle spasms

inner restlessness

Neuroleptic malignant syndrome- rare life-threatening side effect causing rigidity, confusion, autonomic dysregulaton and pyrexia

Tardive dyskinesia is a late effect occurring months or years after treatment comprising of pointless movements, involuntary and repetitive like lip smacking

Question 4

What are the warnings of this drug?

Answer 4

Older people are more sensitive to antipsychotics

Should ideally be avoided in dementia

Avoided in Parkinson’s disease

Question 5

What interactions occur with this drug class?

Answer 5

Drugs that prolong the QT interval