Antipsychotics

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Author:
egavett
ID:
94773
Filename:
Antipsychotics
Updated:
2011-07-21 13:00:03
Tags:
antipsychotic typical medication atypical
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Description:
Antipsychotics
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  1. High-potency typical antipsychotics: name of medications (5), starting dose, dose range (mg/day), class
    • Haloperidol (haldol): 0.5-6mg/day, 2-10, butyrophenone
    • Trifluoperazine (stelazine): 2-10mg/day, 5-60, phenothiazine (C)
    • Pimozide (orap): 1-2, 1-10, butyrophenone
    • Fluphenazine (prolixin): 2.5-10, 5-50, phenothiazine (C)
    • Thiothixine (navane): 2-10mg/day, 5-60, thioxanthenes
  2. Common side effects associated specifically with high-potency antipsychotics
    • dystonia
    • akathisia
    • parkinsonism
    • (less likely to have sedation, hypotension, weight gain, anticholinergic symptoms)
  3. Mid-potency typical antipsychotics: name of medications (3), starting dose, dose range (mg/day), class
    • Perphenazine (trilafon): 8-24mg/day, 8-64, phenothiazine (C)
    • Loxapine (loxitane): 10-50mg/day, 30-250, dibenzapine
    • Molindone (Moban): 50-75mg/day, 10-225, indole
  4. Low-potency typical antipsychotics: name of medications (3), starting dose, dose range (mg/day), class
    • Chlorpromazine (thorazine): 100-200mg/day, 100-2,000, phenothiazine (A)
    • Thioridazine (mellaril): 50-300mg/day, 100-600, phenothiazine (B)
    • Mesoridazine (serentil): 50-150mg/day, 100-400, phenothiazine (B)
  5. Common side effects associated specifically with low-potency antipsychotics
    • sedation
    • hypotension
    • weight gain
    • anticholinergic symptoms (dry mouth, urinary retention, constipation, blurred vision)
    • (less likely to have dystonia, akathisia, parkinsonism)
  6. Side effects of typical antipsychotics (other than those listed previously for high-potency and low-potency agents)
    • hyperprolactinemia (amenorrhea, galactorrhea, sexual dysfunction)
    • tardive dyskinesia
    • NMS
    • poikilothermia (impaired heat regulation)
    • pigmentary retinopathy (esp thioridazine >800mg/day)
    • EKG changes (esp with pimozide, chlorpromazine, and thioridazine)
  7. Mechanism of action of typical antipsychotics
    D2 antagonism, acutely block 75-90%
  8. Different pathways in brain associated with positive symptoms, negative symptoms, and EPS
    • nigrostriatal (midbrain to neostriatum): EPS
    • mesolimbic (midbrain to limbic structures): positive symptoms
    • mesocortical (midbrain to frontal and temporal cerebral cortex pathway): negative symptoms

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