Anticholinergic Side Effects

Anticholinergic side effects often occur with the use of antipsychotics and include:

Orthostatic hypotension Dry mouth Constipation Urinary hesitance or retention Blurred near vision Dry eyes Photophobia Nasal congestion Decrease memory

These side effects usually decrease within 3 to 4 weeks but do not entirely remit. The client taking anticholinergic agents for EPS may have increased problems with anticholinergic side effects. calorie-free beverages or hard candy may alleviate dry mouth Stool softeners Adequate fluid intake And the inclusion of grains and fruits in the diet may prevent constipation.

ANTIPSYCHOTIC DRUGS
Divided into 3 categories:
1.

2.
3.

Conventional Antipsychotics Atypical Antipsychotics New Generation Antipsychotics

Conventional Antipsychotics
Phenothiazines
Cholpromaxine (thorazine)- for psychosis, schiszophrenia, intractable hicups, preoprerative sedation, behavioral problems in children, nausea and vomiting Perphenazine (Trilafon)- for psychotic disorders to control severe nausea and vomiting, to treat intractable hiccups. Used also before chemotheraphy to prevent nausea. Fluphenazine (prilixin) to manage sypmtoms of psychosis including schizophrenia blocks dopamone receptors in the brain and controls psychotic symptoms.

Thioridazine (Mellaril)- For psychosis only when unresponsive to other medication. Higher doses fo severe psychosis. Lower doses (10-50mg t.i.d) for marked depression, alcohol withdrawal, intactable pain.

 Thioxanthenes
Thiothixene (navane)- Management of psychotic disorders, especially acute and chronic schizophrenia.

 Butyrophenones
Haloperidol (haldol)- treat chronic acute and chronic pyschose. To treat children with severe behavior problems.

 Dibezazepine
Loxapine (loxitane)- for acute psychosis and schizophrenia. Likely to cause ESP. Overdose can cause cardiac or neurotoxicity.

 Dihydroindolone
Molidone (Moban)- Management of schizophrenia, can cause ESP. Has less sedative effect.

Atypical Antipsychotics

Clozapine (Closzaril)- For severly ill schizophrenia clients, especially those who do not respond to other psychotics. With long term use monitor white blood cell count.
Risperidone (Risperdal)- for management of schizophrenia.

Olanzapine (Zyprexa)- Treatment of schizophrenia. Does not cause ESP sypmtoms . May cause headaches, dizziness, agitation, insomia, and samnolence.

Quetiapine (Seroquel)- Treatment of schizophrenia. Not likely to cause ESP. May cause dizziness, head ache , sedation.
Ziprasidone (Geodon)- For management of schizophrenia.

Paliperidone (Invega)- Treatment of schizophrenia.

New Generation Antipsychotic

Aripiprazole (Abilify)- For management of schizophrenia.

Fluphenazine (prolixin)
Drug Class: antipsychotic Dosage: PO: 5-10mg/d; max:20m/d IM: 2.5-10mg/d q6-8h; max:10mg/d Elderly: 1-2.5 mg/d Contraindication: Hypersensitivity, sucortical brain damage, blood dyscrasias, renal or liver damage, coma Therapeutic effects: to manage sypmtoms of psychosis including schizsophrenia Mode of action: Blocks dopamine receptors in the brain and cotrols psychotic symptoms.

Side effects: Sedation, dizziness, headache, dry mouth, nasal congestion, blurred vision, photosensitivivity, nausea, constipation, urinary retention, polyuria, peripheral edema. Adverse reactions: hypertension, hypotension. Tachycadia, tardive dyskinesia, impaired thermoregulation, extra pyramidal symptoms, convulsions