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28 Cards in this Set
- Front
- Back
antipsychotic first generation (conventional)
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prototype: chlorpromazine (Thorazine)-low potency
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haloperidol (Haldol)-high potency
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antipsychotic 1st gen
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fluphenazine- high potency
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antipsychotic 1st gen
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thiothixene (Navane)-high potency
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antipsychotic 1st gen
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perphenazine- medium potency
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antipsychotic 1st gen
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antipsychotic 1st gen MOA
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blocks dopamine, acetylcholine, histamine, norepinepherine receptors in the brain and periphery
inhibition of psychotic manifestations, believed to be a result of D2 blockade in the brain |
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antipsychotic 1st gen Use
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treats acute and chronic psychotic disorders
schizophrenia disorders bipolar disorder Tourette's prevention of nausea/vomiting through blockage of dopamine in CTZ of medulla |
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antipsychotic 1st gen adverse
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acute dystonia
parkinsonism akathisia tardive dyskinesia neuroleptic malignant syndrome anticholinergic effects neuroendocrine effects seizures skin effects orthostatic hypotension sedation sexual dysfunction agranulocytosis severe dysrhythmias |
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antipsychotic 1st gen contraindications
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coma, severe depression, parkinson's, prolactin-dependent cancer of breast, dementia, kidney disease, and seizure disorder
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antipsychotic 1st gen interactions
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anticholinergics with other anticholinergics will increase anticholinergic effects
alcohol, opioids, and antihistamines have additive CNS depressant effects levodopa counteracts the effects of antipsychotic meds |
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antipsychotic 1st gen administration
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screen for EPS
administer anticholinergics, beta-blockers, and benzodiazipines to control early EPS may take 2-4 weeks for full effect take at bedtime to promote sleep and decrease daytime drowsiness |
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Antipsychotics 2nd gen (atypical)
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risperidone (Risperdal)
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olanzapine (Zyprexa)
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antipsychotics 2nd gen
low risk of EPS high risk of for DM, weight gain, dyslipidemia sedation, orthostatic hypotension, anticholinergic effects |
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quetiapine (Seroquel)
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antipsychotic 2nd gen
moderate risk of DM, weight gain, dyslipidemia cataracts, sedation, orthostatic hypotension, anticholinergic effects |
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aripiprazole (Abilify)
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antipsychotic 2nd gen
low or no risk of DM, EPS, weight gain, dyslipidemia, hypotension, and anticholinergic effects headache, anxiety, insomnia, sedation, and gastrointestinal upset |
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ziprasidone (Geodon)
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antipsychotic 2nd gen
low risk of EPS, DM, weight gain and dyslipidemia sedation, orthostatic hypotension, anticholinergic effects, and rash ECG changes, QT prolongation may lead to torsades de pointes |
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clozapine (Clozaril)
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antipsychotic 2nd gen
first atypical antipsychotic low risk of EPS high risk of weight gain, DM, dyslipidemia agranulocytosis may occur sedation, orthostatic hypotension and anticholinergic effects |
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asenapine (Saphris)
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antipsychotic 2nd gen
low risk of DM, weight gain, dyslipidemia, and anticholinergic drowsiness, prolonged QT, numbing of the mouth |
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lursidione (Latuda)
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antipsychotic 2nd gen
sedation, akathisia, parkinsonism, agitation, anxiety low risk of DM, weight gain, dyslipidemia |
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paliperidone (Invega)
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antipsychotic 2nd gen
high risk of DM, weight gain, dyslipidemia sedation, prolonged QT interval, orthostatic hypotension, anticholinergic effects, and mild EPS |
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Iloperidone (Fanapt)
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antipsychotic 2nd gen
dry mouth, sedation, fatigue, nasal congestion significant risk for weight gain, prolonged QT interval and orthostatic hypotension low risk for DM, dyslipidemia, and EPS |
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antipsychotic 2nd gen MOA
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blocking serotonin and to a lesser degree, dopamine receptors
also blocks norepinepherine, histamine, acetylcholine receptors |
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antipsychotic 2nd gen Use
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schizophrenia
psychotic episodes psychotic manifestations |
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antipsychotic 2nd gen adverse
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new onset of DM or loss of glucose control
weight gain, hypercholesterolemia with increased hypertension and other cardiovascular disease orthostatic hypotension anticholinergic effects agitation, dizziness, sedation, sleep disruption, mild EPS such as tremor |
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antipsychotic 2nd gen contraindications
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dementia
all atypical antipsychotics can cause death related to CVA or infection |
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antipsychotic 2nd gen interactions
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immunosuppressive meds- avoid with clozapine
alcohol, opioids, and antihistamines-additive CNS depressant levodopa counteracts effects of antipsychotics by activating dopamine receptors TCAs, amiodarone and clarithromycin prolong QT interval barbiturates and phenytoin (Dilantin) decrease levels of aripraprazole, quetiapine, and ziprasidione fluconazole increases levels of aripiprazole, quetiapine, and ziprasidone |
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antipsychotic 2nd gen admin
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lurasione with food to increase absorption
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antipsychotic 2nd gen effectiveness
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improvement of psychotic manifestations
ability to perform ADLs ability to interact socially with peers improvement of sleeping and eating patterns |