Final Exam Flashcards
FIRST GENERATION DRUGS
FIRST GENERATION DRUGS
Chlorpromazine (Thorazine)
Haloperidol (Haldol) For take-downs the dose is 5mg
Perphenazine (generic only)
Fluphenazine (generic only)
Prolixin
ANTIPSYCHOTIC MEDS
used to treat
- schizophrenia and
- schizophrenia-related disorders
FIRST GENERATION DRUG
SIDE EFFECTS
- Extrapyramidal symptoms (EPS) such as: rigidity, persistent muscle spasms, tremors, restlessness . (This can also happen with second generation anti-psychotics).
- Tardive dyskinesia (TD). TD causes muscle movements a person can’t control . The movements commonly happen around the mouth. TD can range from mild to severe, and in some people the problem cannot be cured . Sometimes people with TD recover partially or fully after they stop taking the medication .
SECOND GENERATION DRUGS
SIDE EFFECTS
- cause “metabolic syndrome”: major weight gain and changes in a person’s metabolism . This may increase a person’s risk of getting diabetes and high cholesterol. A person’s weight, glucose levels, prolactin levels and lipid levels should be monitored regularly.
Clozapine (Clozaril)
300-450 mg Daily
- can cause agranulocytosis.
- must get their white blood cell counts (ANC in particular) checked every week or two.
- must be in a Clozapine Registry in order to receive the medication.
- potentially helpful for people who do not respond to other antipsychotic medications, esp. young men with suicidal ideation
- MEDICATION OF LAST RESORT FOR ANTIPSYCHOTIC
- Atypical antipsychotic medications are sometimes used to treat symptoms of bipolar disorder. Often, antipsychotics are used as adjuncts to mood stabilizers .
SECOND GENERATION DRUGS
- Clozapine (Clozaril) 300-450mg daily
- Risperidone (Risperidone) 1-4mg daily (up to 8mg max daily dose)
- Olanzapine (Zyprexa) 10-20mg daily
- Quetiapine (Seroquel) 100-800mg daily
- Ziprasidone (Geodon) 40-200mg daily
- Aripiprazole (Abilify) 10-15mg daily
FDA issued a Public Health Advisory for all antipsychotic medications
The FDA determined that death rates are higher for elderly people with dementia when taking this medication.
Tips on Drugs
If you get an order that DOES NOT MAKE SENSE, challenge the order!
You have to know:
- What you are doing
- Why you are doing this
- The right dose
“Positive symptoms” of schizophrenia
Positive is too much of something
- a feeling of agitation and having hallucinations or delusions
- usually diminish within 1-3 weeks.
“Negative symptoms”
of schizophrenia
Negative is too little of something
- example: doesn’t want to shower
- withdrawal and lack of self-care should also improve on SGAs
- Hard to treat
“Take down” meds or “B-52’s”
combination of :
- Haldol 5mg
- Ativan 2 mg
- benztropine 1mg, (sometimes Benadryl is used instead of benztropine).
ANTIDEPRESSANTS TREAT
DEPRESSION
- depression commonly treated with antidepressant medications.
- Antidepressants work to increase circulation of one or more of these monoamine neurotransmitters the brains:
- serotonin
- norepinephrine
- dopamine
- takes three or four weeks until the medicine takes effect
- Some people (6-18 months),
- some people (possibly lifetime)
- DON’T STOP antidepressants suddenly! Can cause flu-like symptoms called discontinuation syndrome. Decrease slowly the dose . People don’t get addicted, or “hooked,” on the medications, but stopping them abruptly can cause withdrawal symptoms .
SSRI (antidepressant)
SELECTIVE SEROTONIN
REUPTAKE INHIBITORS
Fluoxetine (Prozac) 20-60mg daily
Citalopram (Celexa) 20-40mg daily
Sertraline (Zoloft) 25-150mg daily
Paroxetine CR (Paxil CR) 25-50mg daily
Escitalopram (Lexapro) 10-20mg daily
SNRI (antidepressant)
SEROTONIN AND NOREPINEPHRINE
REUPTAKE INHIBITOR
Venlafaxine XR (Effexor XR) 75-300mg/day
Duloxetine (Cymbalta) 30-60mg daily
Desvenlafaxine (Pristiq) 50-100mg daily
NDRI (antidepressant)
NOREPINEPHRINE AND DOPAMINE
REUPTAKE INHIBITOR
Bupropion XL (Wellbutrin XL) 150-300mg/day