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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
Created by: Eunj