Antipsychotics PDF

Antipsychotics Schizophrenia Disordered thinking and a loss of reality Positive Symptoms Negative Symptoms Hallucinations Delusions Agitation Paranoia Withdrawal ↓ motivation ↓ speech Blunt Affect Poor Judgment/Care Antipsychotic Drugs 1st Generation = Conventional (+ symptoms) (Chlorpromazine & Hal...

Antipsychotics Schizophrenia Disordered thinking and a loss of reality Positive Symptoms Negative Symptoms Hallucinations Delusions Agitation Paranoia Withdrawal ↓ motivation ↓ speech Blunt Affect Poor Judgment/Care Antipsychotic Drugs 1st Generation = Conventional (+ symptoms) (Chlorpromazine & Haloperidol) 2nd Generation = Atypical (+/- symptoms) (Aripiprazole, Clozapine, Olanzapine, Risperidone) ***Both utilize PO/IM routes Movement Disorders (Extrapyramidal Symptoms) Both generations have a risk for movement disorders, but 1st Gen is especially problematic… Acute dystonia Head/back muscle spasms Parkinsonism Parkinson symptoms Akathisia Restless movement (suicide risk) Tardive Dyskinesia Facial dyskinesia (lip smacking, tongue thrusting) Use Valbenazine to block storage of dopamine If these occur, stop the drug, or reduce the dose/switch to a low potency benzodiazepine. 1st Generation (Chlorpromazine & Haloperidol) MOA Use Adverse Blockade of D2 dopamine receptors Positive symptom treatment (acute and preventative) → rapid, but takes months for full effect Movement disorders Sedation & Ortho hypo Antimuscarinic effects (dry mouth, blurred vision, retention) Arrhythmias Endocrine problems BLACK BOX WARNING (elderly mortality) 2nd Generation (Aripiprazole, Clozapine, Olanzapine, Risperidone) MOA: Use Adverse Other Blockade D2 & serotonin receptors Symptom treatment and Bipolar Disorder Metabolic Effects (weight gain, dyslipidemia, diabetes, CVD) Variable sedation Ortho hypo Arrhythmias Endocrine Problems Less extrapyramidal effects. Clozapine is more effective, but has a risk of agranulocytosis