Drug Therapy for Psychotic Disorders

Comprehensive flashcards covering the pharmacology of psychotic disorders, including first and second generation antipsychotics, their side effects, and nursing responsibilities.

Dopamine

The neurotransmitter thought to be most likely related to schizophrenia when it exhibits an increased level of activity.

First-generation antipsychotics

Also known as "typical" antipsychotics, this class includes phenothiazines such as chlorpromazine and non-phenothiazines such as haloperidol.

Second-generation antipsychotics

Also known as "atypical" antipsychotics, these block dopamine receptors, serotonin and glutamate receptors, and have anticholinergic, antihistamine, and alpha-adrenergic blocking abilities.

Chlorpromazine (Thorazine)

A first-generation phenothiazine that blocks postsynaptic dopamine receptors in the brain; administered IM or PO.

Black Box Warning (Antipsychotics in older adults)

Antipsychotic drug treatment in older adults with dementia-related psychosis is associated with an increased risk of death.

Extrapyramidal Effects (EPS)

Adverse CNS effects including Tardive Dyskinesia, Akathisia, Dystonia, and Drug-Induced Parkinsonism.

Tardive Dyskinesia

An EPS adverse effect characterized by repetitive, involuntary movements such as lip smacking and continual chewing.

Neuroleptic Malignant Syndrome (NMS)

A severe adverse reaction to antipsychotic drugs summarized by the acronym FEVER: Fever (hyperthermia), Encephalopathy, Vitals unstable, Elevated creatine kinase, and Rigidity of muscles.

Haloperidol (Haldol)

A first-generation non-phenothiazine antipsychotic that blocks postsynaptic dopamine receptors and necessitates monitoring for NMS and EPS.

Clozapine (Clozaril)

A second-generation (atypical) antipsychotic that requires regular complete blood counts and monitoring of neutrophil counts due to the risk of agranulocytosis.

Agranulocytosis

A severe hematologic adverse effect involving a dangerous reduction in the number of white blood cells, requiring careful monitoring in patients taking antipsychotics.

Orthostatic Hypotension

A cardiovascular adverse effect common with second-generation antipsychotics, requiring patients to make slow position changes.

Ventrogluteal

The recommended site for IM administration of chlorpromazine and haloperidol.

$$60\,mL$$

The amount of fruit juice required to be mixed with chlorpromazine liquid for oral administration.

Drug Tapering

The nursing process of gradually reducing the dose of 1st generation non-phenothiazines or atypical antipsychotics to prevent extrapyramidal effects or withdrawal symptoms.

Therapeutic effect of Haloperidol

The initial assessment goal following administration for an acute psychotic episode is observing decreased agitation and combativeness.