ANTIPSYCHOTICS

TYPICAL/CONVENTIONAL ANTIPSYCHOTICS

ATYPICAL ANTIPSYCHOTICS .

CLASSIFICATION OF ANTIPSYCHOTICS .

50.64 Tab: 10.15.200 Oral conc:100/ml Inj : 25/ml Piperidines Thioridazine (Mellaril) Perphenazine (Trilafon) 150 – 800 12 .4.100.150.8.25.100.2.40 Tab: 1.5.CHEMICAL CLASS DAILY DOSAGE RANGE(MG) AVAILABLE FORMS (MG) Phenothiazines Aliphatic Chlorpromazine 75 – 400 Tab:10.100/ml Tab: 2.50.10 .25.200 Conc: 30/ml.16 Conc: 16/5ml Inj: 5/ml Piperazine Trifluoperazine 4 .

2.5.30 .10.100 Tab : 0.2.20 Conc : 5/ml DAILY DOSAGE RANGE(MG) AVAILABLE FORMS (MG) Thioxanthenes Thiothixene 6 .1.5.10.20 Conc : 2/ml Inj : 50/ml Caps : 1.CLASSIFICATION CHEMICAL CLASS Butyrophenones Haloperidol 1 .5.

30 Olanzapine (Zyprexa) Quetiapine (Seroquel) Aripiprazole 5 .37.100.5.300 Tab : 5.200.100 Tab : 0.160 Caps : 20.CHEMICAL CLASS DAILY DOSAGE RANGE(MG) AVAILABLE FORMS (MG) Atypical antipsychotics Clozapine (Clozaril) Risperidone (Risperdal) 300 – 900 1-6 Tab : 12.25.30 Ziprasidone 40 .5.50 Tab : 2.5.20 Powder for inj : 10 Tab : 25.7.20 150 – 750 10 .5.5.1.10.15.0.5.15.4 Conc : 1/ml Powder for inj : 25.40.25.3.10.2.60.80 Powder for inj : 20 .20.

SIDE EFFECTS AND NURSES ROLE .

Dry mouth Typical antipsychotics Chlorpromazine Thioridazine Trifluoperazine Ziprasidone Fluphenazine Perphenazine Haloperidol Thiothixene Atypical antipsychotics Quetiapine Aripiprazole .

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Explain that this will subside after few weeks Clear small items from pathway to pervent falls .

Blurred vision Typical antipsychotics Thioridazine Fluphenazine Haloperidol Typical antipsychotics Constipation Atypical antipsychotics Atypical antipsychotics Chlorpromazine Thioridazine Clozapine Aripiprazole Haloperidol Ziprasidone .

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• Monitor intake and output. .Urinary retention • Instruct client to report any difficulty in urination.

Urinary retention Typical antipsychotics Triflupromazine Thioridazine Fluphenazine Perphenazine Haloperidol Atypical antipsychotics .

Concentrates may be mixed with juice or other liquid just before adminisration Administer tablets or capsules with food. .

Nausea Typical antipsychotics Chlorpromazine Thioridazine Trifluoperazine Atypical antipsychotics Risperidone Ziprasidone .

Avoid driving or operating dangerous machines while experiencing sedation .

Sedation Typical antipsychotics Chlorpromazine Triflupromazine Atypical antipsychotics Risperidone Aripiprazole Thioridazine Trifluoperazine Perphenazine Fluphenazine .

Instruct client to rise slowly from a lying or sitting position .

Typical antipsychotics Orthostatic hypotension Trifluoperazine Perphenazine Photosensitivity Chlorpromazine Fluphenazine Thiothixine Atypical antipsychotics Clozapine .

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• • • • Decreased libido Galactorrhoea and Gynecomastia Amenorrhoea Sexual dysfunction Hormonal effects Nursing intervention • Provide explanation of the effects and reassurance of reversibility. • Discuss with physician possibility of ordering alternate medication. .

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Weight gain Typical antipsychotics Triflupromazine Thioridazine Atypical antipsychotics Clozapine Olanzapine Ziprasidone Quetiapine .

Neuroleptic malignant syndrome (NMS) • Teach client and family members to observe for NMS and report immediately. • Discontinue neuroleptic medication immediately. . • Monitor vital signs.degree of muscle rigidity.intake and output and level of consciousness.Extrapyramidal symptoms (EPS) Tardive dyskinesia • Teach client and family members to observe for EPS and report immediately.

Extrapyramidal symptoms (EPS) Typical antipsychotics Chlorpromazine Thioridazine Trifluoperazine Fluphenazine Atypical antipsychotics Olanzapine Risperidone Perphenazine Haloperidol Thiothixene .

syncope or weakness. • Monitor vital signs every shift. • Observe for symptoms of dizziness.Routine ECG should be taken before initiation and periodically during therapy. palpitations . .

Agranulocytosis • Teach client to observe and report immediately for symptoms of sore throat. malaise. fever. . • A complete blood count should be monitored weekly for first 6 months and every other week thereafter.

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QT interval prolongation Agranulocyto Hypersalivat Diabetes sis ion Hyperliped emia Clozapine Ziprasidone Clozapine Chlorpromazi ne Clozapine Risperidone Clozapine Olanzapine Clozapine Olanzapine Quetiapine .

+ = mild.Traditional Neuroleptics: Adverse Effects Class/agent Sedation ACH EPS Orthostasis  chlorpromazine thioridazine +++ ++ to +++ + to ++ +++   fluphenazine haloperidol trifluoperazine + to ++ 0 to + +++ +    perphenazine thiothixene  0 = none or not significant. ++ = moderate. +++ = marked ACH = anticholinergic effects. EPS = extrapyramidal effects .

EPS = extrapyramidal effects a Dose-related EPS above 6 mg/day . ACH = anticholinergic effects. + = mild.Atypical Neuroleptics: Adverse Effects Agent clozapine Sedation +++ +++ ACH 0-+ EPS Orthostasis +++ risperidone Olanzapine Quetiapine 0-+ + + 0-+ + + 0 . +++ = marked.++ (a) 0 0 + + + 0 = none or not significantly different from placebo. ++ = moderate.

Jaypee. Stamford. 304 – 306. 5th ed. Nurses Drug Guide. • available at http://www. 303.britannica.358.mentalhealth. Psychiatric Mental Health Nursing.• Tripathi KD. 424 .Shannon MT. p.html assessed on 11/4/12 • available at http://www. • Townsend MC. Essenials of Medical Pharmacology. Jaypee. p.433.com / EBchecked/topic/ 455623/ phenothiazine assessed on 13/4/12 Bibliography . • Wilson BA.3rd ed.com/drug /p30-c01. p.Stang CL.673. 6th ed.

nlm.co.gov/pmc / articles/PMC2327229/ assessed on 16/4/12 • available at http://www.wikipedia.asp assessed on 16/4/12 .nih.com / professional/total/ effects.uk/medicine / Perphenazine.htm assessed on 13/4/12 • available at http://en.reintegration.Bibliography • available at http://www.org/wiki/ Butyrophenone assessed on 15/4/12 • available at http://www.patient.ncbi.

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