ANTIPSYCHOTIC DRUGS 5.

)  Neuroleptic Malignant Syndrom SIDE EFFECTS:

- used to treat Schizophrenia -         Fatal G- Gynecomastia
-used to treat psychotic brain syndrome -         manifested by symptoms of inc. TEMP,PR,RR AND BP O- Observe for Arrythmias
-blocks the receptor of the dopamine (D1,D2,D3) -         Delerium and convulsion L- Lethargy
POSTIVE SYMPTOMS: hallucinations and delusions -         Med: Amantadine( Dopamine Agonist) D- Dizziness & Drowsiness
NEGATIVE SYMPTOMS: flat affect   F- Fast wt. gain
  -         Anticholinergic – Meperidine Hydrochloride I- Inc. Appetite
2 CLASSIFICATIONS:                              - Akineton , Cogentin and Benadril  S- Sedation
1.)   Typical:   H- Hypotension
-         Traditional neuroleptic, effective of all the + symptoms of schizophrenia, SIDE EFFECTS OF ANTIPSYCHOTIC DRUGS:  
no effect on its –common side effets of EPS. B- Blurred Vision – avoide exp. To sunlight  2.) Monoamine oxidase Inhibitor (MAOI)
U- Urinary Retention – Monitor I&O, catheter if worst - Metabolizes neurotransmitters of norepinephrine & serotonin.
 Chlorpromazine (Thorazine) C- Constipation – inc. fluid intake (sips of water)  - 2-3 weeks (initial effect); 3-4 weeks ( full effect) 
 Haloperidol (Haldol) O- Orthostatic Hypotension – Change positions slowly (sit and dangle feet)  
 Mellaril (Thioridazine) A- Agranulocytosis COMMON DRUGS: (administered AM)
 Prolixin (Fluphenazine) T- Tardive Dyskenisia (Pamana ko kay MAOI)
P- Pseudoparkisonism P- Parnate (Tranylcypromine)
A- Akathisia M- Marplan (Isocarboxazid)
2.)  Atypical:
N- Nausea & Vomiting N- Nardil (Phenelzine)
D- Dizziness & Drowsiness  
-         Effective both + and – symptoms of schizophrenia, minimal risk of EPS
A- Anxiety SIDE EFFECTS:
N- Neuroleptic Malignant syndrome H- Hypertensive Crisis
 Clozapine (Clozaril)
  I- Insomnia
 Olanzapine (zyprexia)
v ANTIDEPRESSANT T- Thyamine Rich foods (Avoid)
 Risperidone (risperdal)
- Treatment of major depressions, anxiety disorders O- Orthostatic hypertension
- Manic disorders  
NSG CONSIDERATIONS: - Bipolar Disorders AVOID THYAMINE RICH FOODS such as:
a.)  Take the BP- should not be given if 90/60 -Psychotic depression A- Apple, Avocado
Side effects: hypotension   B- Banana
EXTRAPYRAMIDAL SIDE EFFECTS: 3 CLASSIFICATIONS C- Cheese
    W- Wine
1.)  Dystonia 1.) Trycyclic Antidepressants (TCA)  
 -acute muscular rigidity - affective disorders, depression, bipolar disorders 3.) Selective Serotonin Reuptake Inhibitor (SSRI)
  -2-3 weeks (initial effect) ; 3-6 weeks (full effect) - for Depression and bipolar disorders
2.)  Tardive Dyskinesia (TDI) - Interacts with norepinehprine and serotonin - reuptake of Serotonin
-exaggerated movements of tongue, reduce dosage of drug. To control mood, appetite, arousal, attention, sensory processing  
    COMMON DRUGS: (administered AM)
3.)  Pseudoparkinsonism COMMON DRUGS: (administered PM) P- Prozac (Fluoxetine)
-long term use of antipsychotic drug P- Pamelor (Nortiptyline) L-  Luvox (Fluvoxamie)
 - Drug induced Parkinsonism E- Elavil (Amitriptyline) P- Paxil (Paroxetine Hydrochloride)
 -  Rigidity, tremors, stiff N- Norpramin ( Despiramine)  
  T- Tofranil (Imipramine)  
4.)   Akathisia A- Anafranil (Clomipramine)
-         Exagerrated body movement S- Sinequan (Doxepin)  
     
SIDE EFFECTS:  
I- Insomnia COMMON DRUGS:
S- Sexual Dysfunction V- Valium (Diazepam)
D-Dizziness S- Serax (Oxazepam)
A- Anxiety, Akathisia, Agitation A- Ativan (Lorazepam)
  L- Librium (Chlordiazepoxide)
v MOOD STABILIZERS: (Anti manic) X- Xanax (Alprazolam)
- decreases hyperactivity  
- Manic disorders 2.) Non- Benzodiazepines (Buspar)
-1-14 days (Initial Effect); 3-4 wks (Full effect) -used for short term treatment of insomnia
MGT:  
-antidote (Mannitol) 3.)   Azaperone (Fluoperidol)
-avoid caffeine diuretics  
  SIDE EFFECTS: (anxiolytic)
1.) Lithium Carbonate D- Dizziness & Drowsiness
-Monitor serum lithium level ; NV: 0.5- 1.2meq/L A-  Abnormal eye
-increased level- Lithium toxicity L- Lethargy
- How many times- 2-3 days; weekly; once a month A-  Ataxia
- administered  AM G- Gastrointestinal disturbances
  S- Sedation
SIDE EFFECTS:  
N- Nausea v CNS STIMULANTS
A- Anorexia -administered AM not beyond 2pm
V- Vomiting -(Ritalin)- 6 hours before bedtime
D- Diarrhea -for ADHD
A-Abdominal Cramps  
  v ANTIPARKINSONISM
2.) Carbamazepine (Tegritol) -To prevent pseudoparkinsonism
3.) Valproic acid (Depakote, Depakene)  
  1.)  Dopaminergic
SIDE EFFECTS: (carba & valpro) -Amantindine(NMS)
B- Blurred Vision       2.) Anticholinergic (After meals)
R- Rashes            -Cogentin
O- Orthostatic Hypotension            -Avoid protein rich foods
D- Dizziness, Drowsiness & Dry moth SIDE EFFECTS:
W- Weight gain H- Hypotoxicity
A- Anxiety; Alopecia A- Agranulocytosis
S- Sedation L-Leukopenia
H- Hand tremors S- Seizure
  B- Blurred Vision
v ANXIOLYTIC DRUGS
-administered before meals.
3 CLASSIFICATIONS:
 
1.)Benzodiazepines