Term
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Definition
Drug of choice to medicate psychotic symptoms
Decrease psychotic symptoms
Prophylactic management of disease
*Prototype is Thorazine*
Others:
Prolixin, Haldol, Mellaril, Navane, Stelazine
Atypicals:
Clozaril, Zyprexa, Seroquil, Risperdol, Geodon |
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Term
Antipsychotics:
Desired Effects |
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Definition
Can see effects as early as 30 min > PO med; 15-30 min with IM admin
Causes decreased agitation, sedation, somnolence
Improvement in symptoms 1-3 weeks;
major improvement in 5-6 weeks for psychotic symptoms/schitzophrenia
Can treat anxiety in very low doses
(Haldol and Seraquil)
Thorazine is DOC for intractable hiccups
Haldol and Risperdal can
treat Tourette's symptoms |
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Term
Antipsychotics:
Important Considerations |
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Definition
Excretion is slow - 3 to 6 weeks. Patient may feel fine going off meds for a while.
Drugs should be given 6-12 weeks
trial to work before changing med.
Mellaril is the only drug with ceiling dose -
800 mg/24 hrs
(may cause retinopathy)
Older drugs have higher symptom profile, and higher incidence of extrapyrimidial effects and cardiac involvement, anti cholinergic effects and somnolence
Risperdal & Haldol also treat Tourettes
Seroquel and Haldol also treat anxiety
(in very low doses)
Thorazine used to treat nausea & vomiting
(in low dose)
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Term
Antipsychotics:
Long Acting Injectables |
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Definition
L/A injectables good for pt's with oral med compliance issues. Injections last 1-3 weeks.
Only available as:
Prolixin Deconate
Haldol Deconate
Riperdal Consta |
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Term
Antipsychotics:
To treat negative symptoms |
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Definition
Newer AP meds:
*Clozaril, Zyprexa, Seroquel, Risperdal, Geodeon
All have lower incidence of S/E
*Have to have a CBC to get Clozaril -
may cause agranulocytosis.
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Term
Antipsychotics:
To treat positive symptoms |
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Definition
Older AP drugs:
Thorazine, Prolixin, Haldol |
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Term
Antipsychotic Meds:
Side Effects |
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Definition
Weight gain with all - contribute heavily to comorbidities such as Type II DM, join problems, etc. due to weight gain/obesity.
Some meds cause somnolence.
Pseudoparkinsonism
Tartive Dyskinesia
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Term
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Definition
Side effect of antipsychotic med - stooped posture, shuffling gait, drooling, mask face
Treated with Levadopa |
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Term
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Definition
Caused by long term use of antipsychotics, however, s/s may be masked by same drugs. All AP drugs should be used in lowest dose possible to reduce incidence over time.
Common symptoms: Lip smacking, sucking, bon-bon sign, movements of tongue and chewing; Rocking movements from hips;
Pill rolling and frantic movements of fingertips; Swallowing difficulties.
Newer antipsychotics may be used in place of older APs because they don't cause TD
(according to current data). |
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Term
Neuroleptic Malignent Syndrome
(NMS) |
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Definition
Rare s/e, but higher in pts taking Haldol. As many as 1/3 of pts die from syndrome.
S/S: severe muscle rigidity with elevated temp (typically between 101 - 103 with no apparent cause), and rapid acceleration of symptoms that occurs over following 48 - 72 hours.
Early detection saves lives!! Hold AP drugs, or anything else that inhibit dopamine.
Includes at least 2 of the following s/s within 48 to 72 hours following onset of muscle rigitity:
Hypertension
Tachycardia
Tachypnea
Prominent diaphoresis
Incontinence
Mutism
Leukocytosis
Lab evidence: CPK
Treatment:
Admin dopamine agonist (bromocriptimine)
Admin muscle relaxants (benzo & dantraline)
Treat high temp
check labs for elevated liver enzymes, myoglobinuria, elevated WBC |
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Term
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Definition
Used to treat s/e of APs:
Cogentin (benztropin)
Artane (trihehyphenydil)
Akineton (Biperiden)
Should take for 6 mos +/-
NOT continuously |
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