NSG 552 Psychopharmacology Exam 1 Study
Guide
Content Covered
• Schizophrenia spectrum and other psychotic disorders
• Bipolar disorder
• Depressive disorder
Antipsychotics
Basic Terminology
• Psychopharmacology: the use of psychotropic medications in the treatment
of psychiatric disorders
• Pharmacokinetics: the study of what the body does to drugs, such as
absorption, distribution, metabolism, and excretion.
• Pharmacodynamics: the study of what the drugs do to the body. For
example, target sites for drugs- receptors, ion channels, enzymes (MAOIs),
and carrier proteins/reuptake pumps.
Management of Acute Psychosis
• Psychotic symptoms can increase patients’ risk for harming themselves or
others or being unable to meet their basic needs.
• Psychosis may be seen in many psychiatric disorders
• Psychosis is the core feature of schizophrenia and other conditions in the
schizophrenia spectrum
• Acute psychosis may occur in bipolar disorder and major depression with
psychotic features
• We consider agitation to be a psychiatric emergency
, • For agitated patients not willing or able to take oral medications, IM
medications such as olanzapine (Zyprexa) and haloperidol (Haldol) can be
used.
• IM haloperidol should be administered with benztropine (Cogentin) or
diphenhydramine (Benadryl) to reduce the risk of severe EPS
(Extrapyramidal symptoms) or dystonia o
EPS- tremors, stiffness, restlessness
o Dystonia- a chronic neurological movement disorder causing
involuntary, sustained, or repetitive muscle contractions, resulting in
painful twisting, spasms, and abnormal postures.
• For severely agitated patients, it is suggested to use a benzodiazepine in
combination with the antipsychotic. For example, Haldol with lorazepam
and Cogentin.
Typical/ First Generation/ Neuroleptics/ Conventional Antipsychotics
• Introduced in the 1950’s
• Block D2 receptors (Dopamine 2 receptors)
• Effective for positive symptoms
• They can worsen negative symptoms secondary to the decrease of DA
(dopamine) in the mesocortical pathway
• Long-acting forms available (Decanoate
• Examples of first-generation antipsychotics include haloperidol (Haldol),
Chlorpromazine (Thorazine), Fluphenazine (Prolixin), Loxapine (Adasuve),
Perphenazine (Trilafon), and Thioridazine
• Carry a higher risk of movement-related side effects like tardive dyskinesia
compared to newer meds
Atypical/Second-generation antipsychotics
• First-line treatment
• They have fewer neurological side effects
• Effective for both positive and negative symptoms
• They are serotonin-dopamine antagonist (D2/ 5HT2A)
• They can cause EPS, but at a lower risk
Guide
Content Covered
• Schizophrenia spectrum and other psychotic disorders
• Bipolar disorder
• Depressive disorder
Antipsychotics
Basic Terminology
• Psychopharmacology: the use of psychotropic medications in the treatment
of psychiatric disorders
• Pharmacokinetics: the study of what the body does to drugs, such as
absorption, distribution, metabolism, and excretion.
• Pharmacodynamics: the study of what the drugs do to the body. For
example, target sites for drugs- receptors, ion channels, enzymes (MAOIs),
and carrier proteins/reuptake pumps.
Management of Acute Psychosis
• Psychotic symptoms can increase patients’ risk for harming themselves or
others or being unable to meet their basic needs.
• Psychosis may be seen in many psychiatric disorders
• Psychosis is the core feature of schizophrenia and other conditions in the
schizophrenia spectrum
• Acute psychosis may occur in bipolar disorder and major depression with
psychotic features
• We consider agitation to be a psychiatric emergency
, • For agitated patients not willing or able to take oral medications, IM
medications such as olanzapine (Zyprexa) and haloperidol (Haldol) can be
used.
• IM haloperidol should be administered with benztropine (Cogentin) or
diphenhydramine (Benadryl) to reduce the risk of severe EPS
(Extrapyramidal symptoms) or dystonia o
EPS- tremors, stiffness, restlessness
o Dystonia- a chronic neurological movement disorder causing
involuntary, sustained, or repetitive muscle contractions, resulting in
painful twisting, spasms, and abnormal postures.
• For severely agitated patients, it is suggested to use a benzodiazepine in
combination with the antipsychotic. For example, Haldol with lorazepam
and Cogentin.
Typical/ First Generation/ Neuroleptics/ Conventional Antipsychotics
• Introduced in the 1950’s
• Block D2 receptors (Dopamine 2 receptors)
• Effective for positive symptoms
• They can worsen negative symptoms secondary to the decrease of DA
(dopamine) in the mesocortical pathway
• Long-acting forms available (Decanoate
• Examples of first-generation antipsychotics include haloperidol (Haldol),
Chlorpromazine (Thorazine), Fluphenazine (Prolixin), Loxapine (Adasuve),
Perphenazine (Trilafon), and Thioridazine
• Carry a higher risk of movement-related side effects like tardive dyskinesia
compared to newer meds
Atypical/Second-generation antipsychotics
• First-line treatment
• They have fewer neurological side effects
• Effective for both positive and negative symptoms
• They are serotonin-dopamine antagonist (D2/ 5HT2A)
• They can cause EPS, but at a lower risk
