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Identify the antipsychotics medication. Know the classifications types of this medication. Identify first generation antipsychotic (Mechanism of action , Indications, side effects) Identify second generation antipsychotic (Mechanism of action , Indications, side effects)
effects)
Definition
Psychiatric disorders.
These are severe psychiatric illness with serious
Types:
Antipsychotic drug are also known as Neuroleptics,
Classification:
Typical Antipsychotics (first generation):
1)
Phenothiazines:
2) 3)
Thioxanthenes:
Thiothixene
Dihydroindolones: Dibenzepines:
Molindone, Ziprasidone.
Benzisoxazole: Quinolinones:
Aripiprazole.
Third generation:
apiprazadole
Mechanism of action
Antipsychotic work by blocking
postsynaptic dopamine
receptors in the brains Dopaminergic pathway (basal
Indications
Bipolar mania
Schizophrenia
pediatric behavioral disorder Psychotic disorder. Tourettes disorder.
Side effects
Extra pyramidal symptom
Pseudoparkinsonism (tremor, shuffling gait, drooling, rigidity)
*Symptoms may appear 1 to 5 days following initiation of antipsychotic medication; occurs most often in women, the elderly. Akinesia (muscular weakness) Akathisia (continuous restlessness and fidgeting) *This occurs most frequently in women; symptoms may occur 50 to 60 days following initiation of therapy. Dystonia (involuntary muscular movements [spasms] of face, arms, legs, and neck) *This occurs most often in men and in people younger than 25 years of age. Oculogyric crisis (uncontrolled rolling back of the eyes) *This may appear as part of the syndrome described as dystonia. It may be mistaken for seizure activity. Dystonia and oculogyric crisis should be treated as an emergency situation.
Tardive dyskinesia
(bizarre facial and tongue movements, stiff neck, and difficulty swallowing) All clients receiving long-term (months or years) antipsychotic therapy are at risk. The symptoms are potentially irreversible. The drug should be withdrawn at the first sign, which is usually vermiform movements of the tongue; prompt action may prevent irreversibility.
include severe parkinsonian muscle rigidity, tachycardia, tachypnea, fluctuations in blood pressure, diaphoresis, and rapid deterioration of mental status to stupor and coma. This is a rare, but potentially fatal, complication of treatment with neuroleptic drugs. Routine assessments should include temperature and observation for parkinsonian symptoms. Onset can occur within hours or even years after drug initiation, and progression is rapid over the following 24 to 72 hours. Discontinue neuroleptic medication immediately. Monitor vital signs, degree of muscle rigidity, in- take and output, level of consciousness.
Newer.
symptoms.
Target the negative as well as the positive
symptoms of schizophrenia.
Mechanism of action:
reducing dopamine activity in the mesolimbic pathway.10,11 Antagonism of serotonin type 2 (5-HT2) receptors increases the release of endogenous dopamine.
This increase in dopamine decreases the likelihood of
extrapyramidal motor symptoms and elevated prolactin levels without significantly reducing the beneficial effects against positive symptoms of psychosis.
Indications
schizophrenia.
Side effects
Drowsiness, dizziness, sedation Nausea and vomiting Dry mouth, blurred vision. Seizure. Salivation Tachycardia Constipation Orthostatic hypotension
Third generation
Third generation
Mechanism of action:
The single third-generation drug works through a significantly different mechanism: partial agonism at D2 receptors. when levels of dopamine are high, aripiprazole blocks dopamine receptors, reducing dopaminergic activity. When levels of dopamine are low, the drug boosts the sensitivity of the receptors to the dopamine that is available. The same relationship is true for aripiprazoles interaction with specific types of serotonin receptors.
Drug interactions
Citalopram >> elevation of clozapine levels. Benzodiazepines >>respiratory arrest. lithium >> implicated in several cases of neuroleptic malignant syndrome. Antacids and antidiarrheal >> decrease absorption of antipsychotics. Barbiturates >> increase metabolism and decrease the effectiveness of antipsychotics. beta-adrenergic blocking agents >> Additive hypotensive effects
Nursing care
Patient education
Do not stop taking the drug abruptly. Protect himself from sunlight. Report weekly blood test. Report occurrence of any symptoms to the physician. Rise slowly from a sitting to prevent.. take frequent sips of water. Consult the physician regarding smoking.
temperature.
Do not drink alcohol. Do not consume others medication.
antipsychotics are taken concurrently with other drugs that produce these results (e.g., antihistamines, antidepressants, antiparkinsonian agents).
Side effects
Dry mouth
Blurred vision Constipation
Urinary retention
S S S S S
Foundations of psychiatric mental health nursing Nursing diagnosis in psychiatric nursing. http://www.ashp.org/DocLibrary/BestPractices/TPS_Antipsychotic.aspx. http://www.acnp.org/g4/gn401000123/ch121.html http://www.psych.org/MainMenu/PsychiatricPractice/ManagingYourPractic e/QuickPracticeInfo/microsoft%20word%20%20access%20to%20meds_schizophrenia.aspx?FT=.pdf www.psych.ufl.edu