PSYCHOTHERAPEUTIC AGENTS restless, distructible, recless, and  Thioridazine (mellaril) is  Olanzapine (Zyprexia)

They are used to treat psychoses- distruptive. Treatment include therapeutic in children with  Quelopine (Seroqoun)
perceptual and behavioral disorders few simple rules,and Firm limits, severe behavioral problems  Ziprasidone (Geodon)
MENTAL DISORDER AND THEIR Avoid fatigue, Regular routine, marked by Combativeness. Classification/Atypical antipsychotics
CLASSIFICATION and structured invironment.  Fluphenazine deconeate  Inodtroduced in 1990
 They are thought to be cause ANTIPSYCHOTIC/NUEROLEPTIC (prolixin deconeate is the long  Reduced or no risk for EPSEs:
by some inherent dsyfunction of the DRUGS acting form (injectable) of  Blockade of 5-HT2 prevents D2
brain.  They are also called prolixin; last 2-3 weeks Blockage
 It leads to abnormal thought nueroleptics or major CLASSIFICATION OF TRADITIONAL  Increase effectiveness in
process and responses tranquilizers. ANTIPSYCHOTICS treating negative and cognitive
 Some theories attribute these  Most common side effects  Parenteral Haloperadol symtoms: dopamine is increase.
disorders to chemical imbalance in is dizziness alone or in combination with  Minimal risk of TD Tardive
the brain  They are indicated for benzodiazephine dyskinesia a streotyped involuntary
Kinds of Mental disoder schizophrenia, organic brain Lorazepam( ativan) is used to movements, lip smacking, tonque
• Schizoprenia-( Splitting of the syndrome with psychosis and help aggressive or psychiatric protrusion, chewing,blinking,
mood).it is mental illness delusional disorder (disorder of patients stay in control grimacing, Choeriform movements of
characterized by impairments in thinking)  Haloperedol is along limbs and tongue and foot tapping.
perception or expression of reality.  They are essentially acting form and can be given at Classification of Atypical antipsychotic
This include hallucination,paranoia, dopamine receptor blockers used 2-4 weeks intervals or longer. drug
delusions, speech disoder, and to treat disorders of thought This is used for individuals who  Absence of prolactin level
affective problems. process. struggle compliance elavations.
• Mania,it is associated bipolar CLASSIFICATION OF ACTION/Traditional antipsychotics  Clozapine is the first truly new
disorder ANTIPSYCHOTICS  Potent antagonist of antipsychotics
The two extreme mood states of • Traditional dopamine (D2, D3,D4 ) receptors  Respiridone is the most
mania (ranging from euporia or Antipsychotics  Extrapyramidal side frequently prescribe antipsychotics.
unpleasant mood) and High- potency effects are caused by the Available in injection form(long
depression(felling of sadness) Flephenanezine (prolixin) blocking of D2 receptors acting)
KINDS OF MENTAL DISORDER Haloperedol (Haldol) Side effects/ Traditional  Olanzapine is available in
3.NACROLEPSY- it is characterized by Thiothixene (Navane) antipsychotics injectable form and form and is
irrestable attacks of sleep (sleep Triflurperazine(Stelazine)  Low-potency drugs: more proven in treating acute mania and
attacks) occuring daily over at least 3 Moderate-Potency intense bipolar disorder
months with cratalepsy(breif episodes Perphenazine (trilafon)  High-potency drugs: more ACTION/Atypical Antipsychotic drugs
abrupt loss of muscle tone) and Loxapine( Loxitane) extrepyramidal effects  Blocks dopamine receptors but
hallucination or sleep paralysis at the Molidone(Moban)  Thioridazine (mellaril) has are weak blocker of D2= Low
beginning or end of sleep. LOW-POTENCY maximum upper limit of 800 incidence of extrapyramidal side
4. Attention-defecit disorder- it is Chloropromazine (Thorazine) mg/day because of possible effects
characterized by an inability to Thioridazine (Mellaril pigmentary retinopathy  Blocks 5-HT2 receptors thus
concentrate on one activity for longer CLASSIFICATION OF TRADITIONAL (decrease visual acuity,impairs liberates dopamine
than few minutes and states of ANTIPSYCHOTICS night vision, and pigmented Side effects
hyperkinesis. (frequent in school  Introduced in 1950 deposits in the fundus  Clozapine:
children) they manifest  Chlorpromazine was the ATYPICAL ANTIPSYCHOTICS agranulocystosis( Nuetrophil <
inattentiveness, over activity, and first antipsychotic developed  CLORAZAPINE (CLORAZIL) 500/mm3) dose related seizures,
impusiveness. This children are  PISPERIDONE (Resperdal) exessive salavation, and myocarditis
 Respiridone: orthostatic  Painful and freightening to  Most common EPSE and 30mmHg( from lying to sitting to
hypotension, sedation, appetite the client respond poorly to treatment standing position)
stimulation,  Immediate treatment with  Major reason why patient Hormonal effects with used of anti
insomia,agitation,headache, and Anticholinergic drugs,such as IM taking medications psychotic drugs EPSEs
rhinitis in higher doses it can cause benztropine meesmylate  Treatment by change in  Decrease libido
EPSEs and hyperprolactinemia (Cogentin)or IM or IV. antipsychotic medication or by  Retrograde ejaculation and
 Olanzapine has similar side Diphenhydramine (benadryl), adding an oral agents such as gynecomastia(MEN)
effects with respiridone usually brings rapid relief. beta-blocker, anticholinergic, or  Amenorrhea (women)
New Generation of Antipshotics  Stay with the client and benzodiazepine  Weight gain
 Aripipazole (Abilify) offer reassurance and support. Akinesia/Bradykinesia  Provide an explanation of
 Introduced in 2002 Endce Parkinsonism/Side effect of  Akinesia- absence of effects and reassurance of
 This is dopamine system antipsychotic drug movement reversibility of sexual dysfunction
stabilizers (stabilizes dopamine  Tremor,  Bradykinesia- slowed  Instruct patient to continue
output) shuffling/festinating gait, drolling, movement contraception
 Increase/Decreases dopamine cogwheel regigity  Weakness, fatigue, painful  Weigh the client daily, Provide
if levels are high/low  Stiff, stopped posture, muscles, and anergia high calorie-controlled diet and
 Controls sysmtoms without mask-like faces, decrease arm  They respond to exercise
sides effects of other antipsychotics. swing, anticholinergic
SIDE EFFECTS OF ANTIPSYCHOTICS  Bradycardia, coarse pill Pisa syndrome an EPSEs
 Sedation- provide safety the rolling movements of the tumb  Leaning torwards one
patient and fingers while at rest sides
  Consideration would
Side effects of Antipsychotic Nursing consideration of patient include
 CAN CAUSE EXTRAPYRAMIDAL who has Enduce  Older individual are more
EFFECTS Psuedoparkinsonism succeptable to this side effect
 Dystonia- acute mascular  Symtom may appear 1-5  Higher doses of
regidity, days following initiation of antiparkinsonian drugs may be
 Torticollis-contracted position antipsychantichotic medication helpul and maintain saftey
of the neck  Occurs most often in Orthostatic hypotension an EPSEs
 Oculogyric crisis contracted women, the elderly, and after taking antipsychotic drug
position of the eyes upward dehydrated clients
 Writer’s Clamp- fatigue spasm  Treated by shifting to an  Occurs more often in
affecting the hand antipsychotic medication with adults meanwhile accomodation
 Laryngeal-Pharyngeal Spasm- lower incidence of EPSEs or by occurs in a few weeks in younger
life treatening adding an anticholinergic agent individuals
 Opisthothonus- arching of the or amatadine (symmetrical), a  Instruct the client to rise
back dopamine agonist. slowly from lying or sitting
NURSING CONSIDERATION for position (dangle feet first) and
Consideration in patient with Dystonia AKATHESIA as EPSEs of provide support stockings
 Occurs in males and in those Antipaychotic drugs  Monitor BP at each shift
receiving High potency drugs  Akathesia is a continous and before giving medication
(haloperedol and thiothexine) restlessness, fidgeting, jittery  Hold the medication if
fellings, and nerousness. there is a rise by 30 beats or