antipsychotics drugs

1. Mr. Ashok Kumar
Msc nursing 1st year
(Pal college of nursing and
medical science)

2. ANTI PSYCHOTIC AGENTS
 Anti psychotic agents are the one type of psychotropic
drugs
 Anti psychotic agents are also known as
neuroleptics,major tranquillizer, or phenothaiazines
 This group of drugs has a major clinical use in the
treatment of psychosis
 Psychosis is a state in which a person ability to
recognize reality ,to communicate and to relate to
other is severely impaired

3. INTRODUCTION
Antipsychotic drugs are able to reduce psychotic
symptoms in a wide variety of conditions, including
schizophrenia, bipolar disorder, psychotic depression
and drug induced psychosis.
They have also been termed narcoleptics, because they
suppress motor activity and emotionality.
** These drugs are not a cure **
Psychotic diseases are life long and it is preferable to
prevent the psychotic episodes than to treat them.

4. Classification of antipsychotic drugs
Typical antipsychotics
 Phenothiazines
 Chlorpromazine: 40-800 mg
 Perphenazine: 12-64 mg
 Fluphenazine: 1-40 mg
 Thioridazine: 150-800 mg
 Thioxanthenes
 Thiothixene: 6-30 mg
 Butyrophenones
 Haloperidol: 1-100 mg
 Dibenzothiazepine
 Quetiapine: 150-750 mg
Atypical antipsychotics
Clozapine: 300-900 mg
Risperidone: 4-16 mg
Olanzapine: 5-20 mg

5. INDICATION AND USE
Antipsychotic agents are commonly used in following
condition ;
 schizophrenia disorder
 paranoid disorder
 mania
 organic dementia
 acute brain syndrome
Symptoms for which antipsychotic or neuroleptic drugs are
used include impaired communication, inability to relate
to other, delusion ,hallucination and inability to identify
reality, disordered thinking and emotional withdrawal

6. MECHANISM OF ACTION
 The exact mechanism is not known.
 Blocking postsynaptic dopamine receptors in the basal
ganglia, hypothalamus, limbic system, brainstem, and
medulla.
 Newer medications may exert antipsychotic properties
by blocking action on receptors specific to dopamine,
serotonin, and other neurotransmitters.
 Inhibition of Dopamine mediated transmission of
neural impulses

7. CONTRAINDICATION
 Antipsychotic are contraindicated in children under
three years of age, comatose patient, patient with
drugs hypersensitivity, severe depression and bone
marrow depression
 Antipsychotic agents should be used cautiously in
patient with a history of
epilepsy,pregnancy,parkinsons disease, peptic ulcer

8. SIDE EFFECT
 Ant cholinergic effects
 Dry mouth
 Blurred vision
 Constipation
 Urinary retention
 Nausea
 Skin rash
 Sedation
 Orthostatic hypotension
 Photosensitivity

9. SIDE EFFECT
 Hormonal effects
 Decreased libido, retrograde ejaculation,
gynecomastia, Amenorrhea, weight gain.
 ECG changes: prolongation of the QT interval, are
possible with most of the antipsychotics.
 Caution: patient with arrhythmias
 Reduction of seizure threshold.
 Agranulocytosis
 Clozapine: weekly/biweekly blood investigation.
 Hyper salivation (Clozapine)

10. EXTRA PYRAMIDAL SYMPTOMS (EPS)
 Pseudo parkinsonism
 Tremor, shuffling gait, drooling, rigidity.
 1-5 days after initiation of antipsychotics
 Akinesia-muscular weakness
 Akathisia-continuous restlessness and fidgeting (50-
60 days after initiation of therapy)
 Dystonia-involuntary muscular movement of
face,arms,legs and neck
 Men; <25

11. EXTRA PYRAMIDAL SYMPTOMS (EPS)
 Hyperglycemia and diabetes –more common with
atypical antipsychotic drugs
 Oculogyric crisis- uncontrolled rolling back of the eyes
 Treated as emergency
 Physician should be contacted immediately
 IV benztropine mesyulate

12. EXTRA PYRAMIDAL SYMPTOMS (EPS)
 Tardive dyskinesia -This occurs due to abrupt termination or
reduction of the antipsychotic drugs after long term high dose
therapy .stereotyped movements, protrusion of the tongue,
puffing of cheeks and involuntary movement of extremities and
trunk
 Neuroleptic malignant syndrome (NMS)
Symptoms include-
 Severe parkinsonian muscle ridigidity
 Hyperpyrexia Up to 1070C, tachycardia, tachypnea
 Fluctuations in blood pressure, diaphoresis, and rapid
deterioration of mental status to stupor and coma.

13. NURSES ROLE
Nurses is very significant in the therapeutic effect of the
drugs, early observation and prevention of
complications
 Close observation
 Extra pyramidal reaction
 Observe drowsiness
 Record blood pressure
 Accurate route of medication

14. NURSES ROLE
 Dry mouth may be reduced
 Blurred and impaired vision causes anxiety
encouraged to inform these symptoms immediately
 Weight record
 Intake and output chart
 Protect his skin
 Menstrual change
 Reassurance to relatives

15. Thank you