Topic 10: Psychotic Disorders

medications used to treat psychotic disorders

antipsychotics (first generation) & antipsychotics (second & third generation)

antipsychotics (first generation) example

haloperidol & chlorpromazine

haloperidol & chlorpromazine (1st generation antipsychotics) complications

• extrapyramidal symptoms

• neuroleptic malignant syndrome

• high grade fever

• muscle rigidity

• dysrhthmias

extrapyramidal symptoms

• acute dystonia

• parkinsonism

• akathisia

• tardive dyskinesia

acute dystonia

severe spasms of tongue, neck, face, or back

akathisia

inability to stand.sit still

tardive dyskinesia (TD)

involuntary movement of tongue & face (i.e., lip-smacking)

haloperidol & chlorpromazine (1st generation antipsychotics) nursing administration

• control EPS (anticholinergics, beta-blockers, benzos)

• take 2-4 weeks for significant improvement

antipsychotics (2nd & 3rd generatinon) examples

risperidone & clozapine

risperidone & clozapine (2nd & 3rd generation antipsychotics) therapeutic effect

controls positive & negative symptoms of psychotic disorders

risperidone & clozapine (2nd & 3rd generation antipsychotics) complication

• DM

• weight gain

• hypercholesterolemia

• orthostatic hypotension

• anticholinergic effects

risperidone (2nd & 3rd generation antipsychotics) nursing consideration

IM once every 2 weeks

first generation antipsychotics vs second/third generation anticholinergics

first generation antipsychotics are conventional drugs & second/third generation antipsychotics are atypical