ANTIPSYCHOTIC DRUG

1. DEFINATION
Antipsychotic drug are those drugs which are used for treatment of psychotic
symptoms. These drugs are also known as neuroleptic, major tranquilizer,
D2 receptor blocker and anti-schizophrenic drugs. Psychosis is the older
terminology to refer to distorted or non-existent sense of reality.
Antipsychotic drug does not cure the disorder but decrease the intensity of
symptom.

2. TYPES OF ANTIPSYCHOTIC DRUGS

There are two types of antipsychotic drugs:
a. Conventional (Typical).
b. Atypical or first generation and second generation.

TYPES EXAMPLES DOSE ROUTE

1. Typical Tab. CHLORPROMAZINE 300mg – 1500mg ORAL

antipsychotic drug Inj. CHLORPROMAZINE 50mg – 100mg IM

Inj. FLUPHENAZINE 25mg – 50mg IM

DECANOTE

Tab. HALOPERIDOL 5mg – 100mg ORAL

Inj. HALOPERIDOL 5mg – 20mg IM

2. Atypical Tab. RESPERIDONE 2mg – 10mg ORAL

antipsychotic drug
Tab. RESERPINEASI 0.5mg – 50 mg ORAL

Tab. ZIPRASIDONE 20mg – 80mg ORAL

Tab. QUETIAPINE 150mg – 750mg ORAL

Tab. OLANZAPINE 10mg – 20mg ORAL

 3. MECHANISM OF ACTION
1. Typical antipsychotic drug
 Typical antipsychotic drug blocks D2(dopamine) receptor in mesolimbic
and mesofrontal system(brain) preventing neurotransmitter (dopamine)
binding to post synaptic receptor causing blockage of electric impulses to
generate further thereby decreasing psychosis symptoms.
 Sedation is caused by alpha-adrenergic blockade
 Chronic blockade of D2 receptor causes extra-pyramidal syndrome.

2. Atypical antipsychotic drug

 Atypical drug blocks 5-HT (serotonin) so it has antiserotonergic, anti-
adrenergic and antihistamine actions are also called as serotonin-
dopamine antagonist.
 Risk for EPS is less and better tolerated.

4. ADVERSE EFFECT
1. Typical antipsychotic drug.
 Muscle stiffness
 Tremor or seizure
 Abnormal movement
 Sedation

 EXTRAPYRAMIDAL SYNDROME:
1. 1. Akinetic form (difficulty in masticating movement, weakness and
muscle fatigue.
2. 2. Agitating form (rigidity of muscles, motor retardation, salivation,
slurred speech, mask-like face.
3. 3. Akathisia (motor restlessness)
4. 4. Dystonia

5. Tardive -Dyskinesis
2. Atypical antipsychotic drug.
 High risk for cardiovascular disease such as hypotension, tachycardia
 Agranulocytosis (decrease WBC count) less than 3000 should
discontinue.
 Weight gain
 Hyperglycaemia
 Failure to ejaculate
 Sialorrhea
 Abnormal menstrual cycle and infertility.
 Both male and breast get enlarge and fluid oozes out because it increase
prolactin level.

7. NURSES RESPONSIBILITIES.
 Instruct patient to take sips of water frequently to relieve mouth
dryness.
 Intake of high fiber diet to reduce constipation.
 Advise patient to get up slowly from bed and sit on edge of bed for
one minute dangling his feet before getting up and check blood
pressure before and after medication.
 Observe patient regularly for abnormal movement.(EPS)
 Administer antiparkinsonian as prescribed.
 Warned about driving.
 Use sunscreen and measure.
 Dose should be given at bed time.
 Teach importance of compliance.
 Monitor WBC count.
 Seizure precaution.