NUR 5334
EXAM 2
NOTES
NUR 5334
EXAM 2
NOTES
• Psychiatric Drugs
• Two Groups:
o First Generation
▪ Conventional Anti-psychotics
▪ Block the receptors for dopamine in central nervous system (CNS)
▪ Cause serious movement disorders (extra pyramidal symptoms, EPS)
▪ Classified by potency
• Low, Medium, High
▪ Low Potency
• Chlorpromazine
o Indications
▪ Schizophrenia
▪ Schizoaffective disorder in the manic phase of bipolar disorder
▪ Anti-nausea
▪ Relief of hiccups
▪ Control of severe behavioral problems in children
o Adverse effects:
▪ Sedation
▪ Orthostatic hypotension
▪ Anticholinergic effects
o Drug interactions
▪ Intensifies responses to CNS depressant
• Antihistamines
• Benzodiazepines
• Barbiturates
▪ Anticholinergic drugs
• Antihistamines
• Tricyclic antidepressants
• Atropine-like drugs
• Thioridazine
o Adverse effects:
▪ Prolonged QT interval
▪ Cause fatal cardiac dysrhythmias
▪ Sedation
1
, NUR 5334
EXAM 2
NOTES
▪ Orthostatic hypotension
▪ Anticholinergic effects
▪ Weight gain
o Black Box Warning:
▪ Dysrhythmias
o Treats Schizophrenia only when patients have not responded to
anything else
▪ High Potency
• Haloperidol
o Butyrophenone family
2
, NUR 5334
EXAM 2
NOTES
o Indications:
▪ Schizophrenia
▪ Acute psychosis
▪ Preferred agent for Tourette Syndrome
o Adverse effects:
▪ EPS
▪ Neuroendocrine effects
▪ Can prolong QT interval and cause dysrhythmias
• Fluphenazine
o Phenothiazines subclass
o Indications
▪ Schizophrenia
▪ Other psych disorders
o Adverse effects:
▪ EPS
▪ Acute dystonia
▪ Parkinsonism
▪ Akathisia
▪ Sedations
▪ Orthostatic hypotension
▪ Anticholinergic effects
▪ Gynecomastia
▪ Galactorrhea
▪ Menstrual irregularities
▪ Mechanism of Action (MOA)
• Block a variety of receptors within and outside the central nervous system
• Suppress symptoms of psychosis by blocking dopamine 2 receptors in the
mesolimbic area of the brain
▪ Adverse Effects
• Result of walking receptors for dopamine, acetylcholine, histamine, and
norepinephrine
• Acute dystonia
• Oculogyric crisis
• Opisthotonos
• Joint dislocation
• Impaired respiration
• Some anticholinergic meds can help
o Benztropine and diphenhydramine
• Some are irreversible, so crucial to monitor
• Can produce Parkinson-like symptoms
o Bradykinesia
o Mask-like faces
3
, NUR 5334
EXAM 2
NOTES
o Drooling
o Tremor
o Rigidity
4
EXAM 2
NOTES
NUR 5334
EXAM 2
NOTES
• Psychiatric Drugs
• Two Groups:
o First Generation
▪ Conventional Anti-psychotics
▪ Block the receptors for dopamine in central nervous system (CNS)
▪ Cause serious movement disorders (extra pyramidal symptoms, EPS)
▪ Classified by potency
• Low, Medium, High
▪ Low Potency
• Chlorpromazine
o Indications
▪ Schizophrenia
▪ Schizoaffective disorder in the manic phase of bipolar disorder
▪ Anti-nausea
▪ Relief of hiccups
▪ Control of severe behavioral problems in children
o Adverse effects:
▪ Sedation
▪ Orthostatic hypotension
▪ Anticholinergic effects
o Drug interactions
▪ Intensifies responses to CNS depressant
• Antihistamines
• Benzodiazepines
• Barbiturates
▪ Anticholinergic drugs
• Antihistamines
• Tricyclic antidepressants
• Atropine-like drugs
• Thioridazine
o Adverse effects:
▪ Prolonged QT interval
▪ Cause fatal cardiac dysrhythmias
▪ Sedation
1
, NUR 5334
EXAM 2
NOTES
▪ Orthostatic hypotension
▪ Anticholinergic effects
▪ Weight gain
o Black Box Warning:
▪ Dysrhythmias
o Treats Schizophrenia only when patients have not responded to
anything else
▪ High Potency
• Haloperidol
o Butyrophenone family
2
, NUR 5334
EXAM 2
NOTES
o Indications:
▪ Schizophrenia
▪ Acute psychosis
▪ Preferred agent for Tourette Syndrome
o Adverse effects:
▪ EPS
▪ Neuroendocrine effects
▪ Can prolong QT interval and cause dysrhythmias
• Fluphenazine
o Phenothiazines subclass
o Indications
▪ Schizophrenia
▪ Other psych disorders
o Adverse effects:
▪ EPS
▪ Acute dystonia
▪ Parkinsonism
▪ Akathisia
▪ Sedations
▪ Orthostatic hypotension
▪ Anticholinergic effects
▪ Gynecomastia
▪ Galactorrhea
▪ Menstrual irregularities
▪ Mechanism of Action (MOA)
• Block a variety of receptors within and outside the central nervous system
• Suppress symptoms of psychosis by blocking dopamine 2 receptors in the
mesolimbic area of the brain
▪ Adverse Effects
• Result of walking receptors for dopamine, acetylcholine, histamine, and
norepinephrine
• Acute dystonia
• Oculogyric crisis
• Opisthotonos
• Joint dislocation
• Impaired respiration
• Some anticholinergic meds can help
o Benztropine and diphenhydramine
• Some are irreversible, so crucial to monitor
• Can produce Parkinson-like symptoms
o Bradykinesia
o Mask-like faces
3
, NUR 5334
EXAM 2
NOTES
o Drooling
o Tremor
o Rigidity
4
