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19 Cards in this Set

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NEUROLEPTICS

uses
-Schizophrenia: treats positive symptoms
-bipolar disorder
-Tourette’s
-Antiemetic: D2 blockade within CTZ
NEUROLEPTICS

MOA
-antipsychotic effects: result of dopamine D2 blockade in mesolimbic area of brain
-also block dopamine, acetylcholine, histamine, & norepinephrine receptors in CNS & throughout body
NEUROLEPTICS

Adverse effects
-acute dystonia: spasm of tongue, face, neck or back muscles
-Parkinsonism
Bradykinesia
Mask-like face
Drooling
Tremors
Rigidity
Shuffling GAIT
Cogwheeling
Jerky movement
Stooped posture
-Akathisia
Extreme restlessness
Adverse cont.
-Tardive Dyskinesia
Choreiform movements(rhythmic)
Commonly tongue & face
Result of dopamine receptor “hyperstimulation”
Not treatable
Potentially not reversible
NEUROLEPTICS

Extrapyramidal symptoms (EPS)
- acute dystonia (neurological movement disorder, in which sustained muscle contractions cause twisting and repetitive movements or abnormal postures)
- parkinsonism (neurological syndrome characterized by tremor, hypokinesia, rigidity, and postural instability)
- akathisia (unpleasant sensations of "inner" restlessness that manifests itself with an inability to sit still or remain motionless)
- tardive dyskinesia (is a disorder resulting in involuntary, repetitive body movements that can have a slow or belated onset)
Chlorpromazine

trade
type
Largactil©

LOW-POTENCY NEUROLEPTICS
Chlorpromazine

USED
1st FGA, & prototype for all other FGSs
Schizophrenia(is primary use)
Hiccups
Other psychotic disorders: antiemetic
Chlorpromazine

Pharmacokinetics
-PO, IM, IV & Rectal
-1st pass effect limits oral availability
-excreted as metabolites by renal system
Chlorpromazine

ADVERSE
-sedation
-orthostatic hypotension
-anticholinergic effects
-neuroendocrine effects
-photosensitivity
-tardive dyskinesia
-lowered seizure threshold
Chlorpromazine

Drug interactions
-CNS depressants
-anticholinergics
Haloperidol

trade
type
Haldol©

HIGH-POTENCY NEUROLEPTICS
Haloperidol

USED
Schizophrenia / acute psychosis
Tourette’s syndrome
Migraines: hypotension
Haloperidol

Pharmacokinetics
-PO, IM, IV
-hepatic metabolism
-renal excretion
Haloperidol

dose
Prep 5mg/ml – 1mlAmpoule

Dose 5mg IV/IM q 15 min PRN (max total 10mg)

Single 2.5 mg dose to pt > 65y/o
Haloperidol

MOA
-Butyrophenone family
-D2 receptor antagonists
-actions similar to Chlorpromazine
-↑chance of EPS
-↓chance other adverse effects
Haloperidol

ADVERSE:
-EPS
-Neuroendocrine
-QT interval prolongation
Haloperidol

Contra
-hypersensitivity
-CNS depression
-severe depression
-Parkinson’s
-seizure disorder
Droperidol

trade
type
Inapsine©

High-potency neuroleptics
Droperidol

USED
-Neurolept analgesia
-post-operative N/V
-no longer used prehosp for acute psychosis due to significant QT interval prolongation
Droperidol

MOA
-Butyrophenone family
-D2 receptor antagonists