Mecnhie Poloyapoy-Palmejar, RN,

MAN

TYPICAL ANTIPSYCHOTICS

benperidol
chlorpromazine
flupentixol
fluphenazine
haloperidol
levomepromazin
e
pericyazine
Perphenazine

prochlorperazine
Promazine
hydrochloride
sulpride
Triflouperazine
Zuclopenthixol
acetate
Zulcopenthixol
dihydrochloride
2

ATYPICAL ANTIPSYCHOTIC

DRUGS

amisulpride
aripiprazole
clozapine
olanzapine

quietiapine
resperidone
sertindole
zotepine

MECHANISM OF ACTION
OF ANTIPSYCHOTIC DRUGS
Neuroleptics are different from one
another
Most but not all blocks dopamine (D2),
and at CTZ
Sedative effect
Antipsychotic action
Antiemetic
Block action of dopaminegic nerves
4

THERAPEUTIC USE
OF ANTIPSYCHOTIC DRUGS
PHENOTHIAZENES

Have antipsychotic effect

Reduces
Restlessness
Agitation
Hallucination

Classified: sedative
Antimuscarinic
Extrapyramidal
effect (Box 20.1)

CHLORPROMAZINE

Treat hiccup (persistent)

Produce sedation

Well absorbed

Many have anti emetic

effect

PO dsage

Metabolized in the liver

Low dose for

psychoneurosis w/
anxiety

ADVERSE EFFECTS OF
PHENOTHIAZINES
Jaundice
Movement
disorders
Parkinsonism
Akathisia
Dystonia
Tardive dyskinesia
Leukocytosis

Skin rashes
blocking effect
Hypothermia
Weight gain
Dry mouth
Sedation
Neuroleptic
malignant
syndrome
6

THIOXANTHENES

Similar to phenothiazines
Antipsychotic
Antiemetic
Tx of schizophrenia
Less sedative (phenothiazines)
Akathisia common
Ex. Flupentixol
Injected depot q 2 wks.
Or OD PO/tablet
7

BUTYROPHENONES

Similar to phenothiazines
Less sedative
Extrapyramidal (parkinsonism-like)
Ex. Haloperidol
Manic
Confused
Ex. Droperidol
Similar but more rapidly acting
8

OTHER NEUROLEPTICS
Pimozide
Antipsychotic
drug
Schizophrenia
Manic states
Longer-acting
Less sedative
(than
chlorpromazine)
Adverse effects
Cardiac
arrythmias

SULPIRIDE
Specific: dopamine
blocking action
Less adverse
effects
(+) Movement
disorders
Associated
hepatitis

THERAPEUTIC USE OF ATYPICAL

ANTIPSYCHOTIC DRUGS
Clonazepam
Differ from older
For resistant pts
neuroleptics
High adverse
D2 blocking
effect profile
(schizophrenia)
Should be started
Lowers prolactin
in hosp.
Blocks serotonin (5-HT)
Careful
Blocks adrenorecptors
supervision
Less extrapyramidal or
Neutropenia
posture disorders
Seizure
Hypotension 10

THERAPEUTIC USE OF ATYPICAL

ANTIPSYCHOTIC DRUGS
Excessive
Olanzapine
salivation
Similar to clona
Seadation
and resperi.
Very expensive
No leukocytosis
Only for special
Drowsiness
cases
Weight gain
Resperidone
Amisulpride and
Blocks several
aripiprazole
receptors
Indicated for schitz
Useful in neg.sx
of schitz
11
Extrapyramidal is

ANXIOLYTICS DRUGS
benzodiazepine
s
buspirone
-blockers
antidepressant
s

Benzodiazepines
alprazolam
chlordiazepoxide
clorazepate
diazepam
lorazepam
oxazepam

12

TRICYCLIC ANXIOLYTICS
Doxepin
Dosulpin
Maprotiline

13

HYPNOTICS

Chloral hydrate
Promethazine (antihistamine)
Chlomethiazole
Bennzodiazepines
Zaleplon
Zopiclone
Zolpidem
Ethyl alcohol

14

TRICYLIC ANTIDEPRESSANTS

amytriptylline
clomipramine
desipramine
imipramine
lofepramine
nortriptiyline
protriptyline

15

16

NEXT SESSION 21

STUDY AHEAD OF
TIME
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