ANTIPSYCHTIC AGENTS

8/7/2019 ANTIPSYCHTIC AGENTS

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ANTIPSYCHTIC AGENTS

CHEMICAL CLASSGENERIC

(TRADE NAME)

DAILY DOSAGERANGE

(MG)

AVAILABLE FORMS

(MG)

Phenothiazines Chlorpromazine(Thorazine)

75 - 400 Tabs: 10, 25, 50, 100. 200.Oral conc.: 100/ml.Suppositories: 100.

Inj.: 25/ml

Same as aboveFluphenazine (Prolixin) 2.5 – 10 Tabs: 1, 2.5, 10

Elixir: 2.5/5 ml.Inj.: 2.5/ml.

Inj. (long-acting).: 25/ml

Perphenazine (Trilafon) 12 – 64 Tabs: 2,4, 8, 16Oral conc.: 16/5ml.Inj.: 5/ml.

Prochlorperazine(Compazine)

15 – 150 Tabs: 5,10Caps (SR): 10, 15Supp: 2.5, 5, 25Syrup.: 5/5mlInj.: 5/ml

Thioridazine (Mellaril) 150 – 800 Tabs: 10, 15, 25, 50, 100,150, 200

Conc.: 30/ml, 100/mlTrifuoperazine(Stelazine)

4 – 40 Tabs: 1, 2, 5, 10

Thioxanthene Thiothixene (Navane) 6 – 30 Caps.: 1, 2, 5, 10, 20.Conc.: 5/ml

Benzisoxazole Risperiodone(Risperdal)

1 – 6 Tabs: 0.25, 0.5, 1, 2, 3, 4Oral solu.: 1/mlPowder for inj.: 25, 37.5, 50

Butyrophenone Haloperidol (Haldol) 1 – 100 Tabs.: 0.5,1, 2, 5, 10, 20Conc.: 2/ml.Inj.: 5/ml

Inj. (long-acting): 50/ml,100/ml

Dibenzoxazepine Loxaoine (Loxitane) 20 – 2500 Caps.: 5, 10, 25, 50Dehydroindollone Molindone (Moban) 15 – 225 Tabs.: 5, 10, 25, 50Dibenzodiazepine Clozapine (Clozaril) 300 – 900 Tabs.: 12.5, 25, 100Diphenylbutylpiperidine

Pimozode (Orap) 2 – 10 Tabs:1, 2

Thienobenzodiazepine

Olanzapine (Zyprexa) 5 – 20 Tabs: 2.5, 5, 7.5, 10, 15, 20Powder for inj.: 10

Dibenzothiazepine Quetiapine (Seoquel) 150 - 750 Tabs: 25, 100, 200, 300



ANTIPARKINSONIAN AGENTS

DESCRIPTION: Antiparkinsonian agents are the specific drugs to treat the extra-pyramidialside-effects of antipsychotic agents. Side-effects are Parkinsonism, akathisia, acuteDystonia and tar dive dyskinesia. (Refer side-eefects of antipsychotic agents).

INDICATIONS OR USE: Antiparkinsonian drugs are used to treat the extra pyramidialsymptoms (EPS).

MODE OF ACTION: Anticholinergics drugs block the secretion, therby reducing thesymptoms of akathisia and acute dystonia. It is not effective against tar dive dyskinesia.

Antithistamines have effects like Anticholinergics drugs. Amantadines are dopamine –releasing agents from central neurons. Studies show that this drug may affect someclients with tar dive dyskinesia.

CONTRAINDICATION: Patients with a history of closed angle glaucoma, urinary orintestinal obstruction, hypersensitivity, prostatic hypertrophy, and tachycardia are notgiven these drugs. The drugs are given with caution to patients with myasthenia gravis,atherosclerosis and chronic respiratory problems. Anticholingerics drug: Amantadine isgiven with caution to patients with renal impairment as most of the medication isexpected through the kidneys.

CLASSIFICATION OF ANTIPARKINSONIAN DRUGS

Chemical and Generic Name Trade Name Dose range

per daymgm/day

Form of

availabilityI. ANTICHOLINERGIC

i. BenztropineCogentin 0.5 – 6 Tab, Injection

ii. TrihexyphenidylHydrochiride

PacitaneParbenz

2.0 – 12.0 Tab

iii. ProcyclidineHydrochiride

Biperiden HCLHydrochiride

AkinetoneDyskinon

2.0 – 8.0

I. ANTITHISTAMINE

i. Diphenhydramine

Benadryl 75 – 100 Capsule &

SyrupI. DOPAMINE DRUGS

i. L.DopaLarodopa 2gms – 3gms Tab.

ii. AmantadinesHydrochiride

Symmetrical 100-200mgm Tab.

iii. Selegline Deprenyl 5mg – 10mg Tab.

iv. Carbidopa & L. Dopa Sinemet 10mg –100mg

Tab.



SIDE EFFECTS OF ANTIPARKINSONIAN DRUGS

ANTICHOLINERGIC-: Side effects are dry mouth, flushed, dry skin, blurred vision,photophobia, increased heart rate, constipation, urinary retention, mental confusion, andexcitement.

ANTIHISTAMINE-: Side effects are drowsiness, dizzliness, anorexia, nausea, vomiting,euphoria, orthostatic hypotension, weight gain, weakness and tingling of hands.

Amantadine-: Side-effects are mood changes, slurred speech, insomnia, inability toconcentrate, red blue discolouration of the skin which becomes worse in winter.

NURSE’S ROLE-

• Observe the patient carefully for side-effects such as palpitation, sedation,drowsiness, and blurred vision.

• Maintain intake output chart in case the patient has urinary retention orconstipation

• Encourage adequate intake of fluid and roughage in the diet.• Record vital sign such as BP, pulse and respiration every four hours.• Advise the patient not to get up quickly from lying-down position to sitting because

of orthostatic hypotension.• Record the medicine and side effects accurately• Encourage the patient not to use hazardous machinery or driving when he is on

Anticholinergics drugs.• Encourage the patient to get his routine eye check-up done for early of blurred

vision or glaucoma.• Report and record any side-effects observed to the physician.

SUMMERIZATION-

• Indication• Mode of action• Contraindication• Classifications• Side effects• Nurse’s role

CONCLUSION- After reading of this unit, it will help the nursing personnel to understandthe types of psychotropic drugs, antiparkinsonian drugs. It will enable us to identify sideeffects, plan of nursing intervention. We will be able to identify the effect of drug changebehavior of the patient.



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ANTIPSYCHTIC AGENTS