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Neuroleptics
Pharmacology
Question | Answer |
---|---|
psychosis | general term for disturbances in the perception of reality |
hallucinations | false sensory experiences |
delusions | false beliefs firmly held despite evidence and not typical of culture, faith, and family |
thought disorganization | disruption of logical process of thought - loose associations, nonsensical speech |
positive (active) symptoms | experiences in addition to normal experiences -hallucinations, delusions, thought disorganization |
negative (passive) symptoms | withdrawal, blunted mood, loss of motivation, social interest, communication |
cognitive symptoms | disruptions in memory, attention |
affective symptoms | depression |
neuroleptics | same as antipsychotic drug -all pear effective in treating psychoses but differ in tolerability -all excepto one block one or more types of DOPAMINE receptor -show significant delay before the effect -significant adverse effect |
Typical neuroleptics RX | *phenothiazines: chlorpromazine (Thorazine), perphenazine (Trilafon), fluphenazine (Prolixin), *other: haloperidol (Haldol) |
Atypical neurolpeptics RX | clozapine (Clozaril) quetiapine (Seroquel) olanzapine (Zyprexa) risperidone (RisperdaL) ziprasidone (Geodon) aripiprazole (Abilify) |
About TYPICAL Nueroleptics | -older agents; involves extrapyramidal motor system as the side effect -block the dopamine2 receptor -more effective in positive symptoms -Rx for agitation and violence -chloropromazine: low potency, haloperidol: high potency |
therapeutic effects of TYPICALs | -all appear equally effecitve; choice based on tolerabiltiy of side effects -latency: 4-6 wk is common -individual PK is different -70-80% respond: 30-40%: partial respond -replapse is common (w/i 2 years -50%) |
therapeutic effects of TYPICALs | -LOW POTENCY-> MORE SEDATING -no longer considered as first-line drugs -can be used if severe agitation-> IM haloperidol, chlorpromazine, fluphenazine -compliance-> depot preps of haloperidol or fluphenazine -no addiction -no CNS depression |
other uses of TYPICALs | -adjunctive Rx of acute manic episodes -Tourette's syndrome - haloperidol -Autism-haloperiol -drug induced psychoses - IM haloperidol -phenothiazines as anti-emetics (esp. prochlorperazine (Compazine)) -also anti-migraine |