ANTIPSYCHTIC AGENTS

DAILY
GENERIC DOSAGE AVAILABLE FORMS
CHEMICAL CLASS
(TRADE NAME) RANGE (MG)
(MG)
Phenothiazines Chlorpromazine 75 - 400 Tabs: 10, 25, 50, 100. 200.
(Thorazine) Oral conc.: 100/ml.
Suppositories: 100.
Inj.: 25/ml
Fluphenazine (Prolixin) 2.5 – 10 Tabs: 1, 2.5, 10
Same as above Elixir: 2.5/5 ml.
Inj.: 2.5/ml.
Inj. (long-acting).: 25/ml
Perphenazine (Trilafon) 12 – 64 Tabs: 2,4, 8, 16
Oral conc.: 16/5ml.
Inj.: 5/ml.
Prochlorperazine(Compazine 15 – 150 Tabs: 5,10
) Caps (SR): 10, 15
Supp: 2.5, 5, 25
Syrup.: 5/5ml
Inj.: 5/ml
Thioridazine (Mellaril) 150 – 800 Tabs: 10, 15, 25, 50, 100, 150, 200
Conc.: 30/ml, 100/ml
Trifuoperazine (Stelazine) 4 – 40 Tabs: 1, 2, 5, 10
Thioxanthene Thiothixene (Navane) 6 – 30 Caps.: 1, 2, 5, 10, 20.
Conc.: 5/ml
Benzisoxazole Risperiodone (Risperdal) 1–6 Tabs: 0.25, 0.5, 1, 2, 3, 4
Oral solu.: 1/ml
Powder for inj.: 25, 37.5, 50
Butyrophenone Haloperidol (Haldol) 1 – 100 Tabs.: 0.5,1, 2, 5, 10, 20
Conc.: 2/ml.
Inj.: 5/ml
Inj. (long-acting): 50/ml, 100/ml
Dibenzoxazepine Loxaoine (Loxitane) 20 – 2500 Caps.: 5, 10, 25, 50
Dehydroindollone Molindone (Moban) 15 – 225 Tabs.: 5, 10, 25, 50
Dibenzodiazepine Clozapine (Clozaril) 300 – 900 Tabs.: 12.5, 25, 100
Diphenylbutylpiperidin Pimozode (Orap) 2 – 10 Tabs:1, 2
e
Thienobenzodiazepine Olanzapine (Zyprexa) 5 – 20 Tabs: 2.5, 5, 7.5, 10, 15, 20
Powder for inj.: 10
Dibenzothiazepine Quetiapine (Seoquel) 150 - 750 Tabs: 25, 100, 200, 300

ANTIPARKINSONIAN AGENTS

DESCRIPTION: Antiparkinsonian agents are the specific drugs to treat the extra-pyramidial side-effects of
antipsychotic agents. Side-effects are Parkinsonism, akathisia, acute Dystonia and tar dive dyskinesia. (Refer
side-eefects of antipsychotic agents).
INDICATIONS OR USE: Antiparkinsonian drugs are used to treat the extra pyramidial symptoms (EPS).

MODE OF ACTION: Anticholinergics drugs block the secretion, therby reducing the symptoms of akathisia and
acute dystonia. It is not effective against tar dive dyskinesia.

Antithistamines have effects like Anticholinergics drugs. Amantadines are dopamine – releasing agents from
central neurons. Studies show that this drug may affect some clients with tar dive dyskinesia.

CONTRAINDICATION: Patients with a history of closed angle glaucoma, urinary or intestinal obstruction,
hypersensitivity, prostatic hypertrophy, and tachycardia are not given these drugs. The drugs are given with
caution to patients with myasthenia gravis, atherosclerosis and chronic respiratory problems. Anticholingerics
drug: Amantadine is given with caution to patients with renal impairment as most of the medication is
expected through the kidneys.

CLASSIFICATION OF ANTIPARKINSONIAN DRUGS

Chemical and Generic Name Trade Name Dose range per Form of
day mgm/day availability
I. ANTICHOLINERGIC Cogentin 0.5 – 6 Tab, Injection
i. Benztropine
ii. Trihexyphenidyl Pacitane 2.0 – 12.0 Tab
Hydrochiride Parbenz
iii. Procyclidine Hydrochiride Biperiden HCL Akinetone 2.0 – 8.0
Hydrochiride Dyskinon
II. ANTITHISTAMINE Benadryl 75 – 100 Capsule & Syrup
i. Diphenhydramine
III. DOPAMINE DRUGS Larodopa 2gms – 3gms Tab.
i. L.Dopa
ii. Amantadines Symmetrical 100-200mgm Tab.
Hydrochiride
iii. Selegline Deprenyl 5mg – 10mg Tab.
iv. Carbidopa & L. Dopa Sinemet 10mg – 100mg Tab.

SIDE EFFECTS OF ANTIPARKINSONIAN DRUGS

ANTICHOLINERGIC-: Side effects are dry mouth, flushed, dry skin, blurred vision, photophobia, increased heart
rate, constipation, urinary retention, mental confusion, and excitement.

ANTIHISTAMINE-: Side effects are drowsiness, dizzliness, anorexia, nausea, vomiting, euphoria, orthostatic
hypotension, weight gain, weakness and tingling of hands.

Amantadine-: Side-effects are mood changes, slurred speech, insomnia, inability to concentrate, red blue
discolouration of the skin which becomes worse in winter.

NURSE’S ROLE-
  Observe the patient carefully for side-effects such as palpitation, sedation, drowsiness, and blurred
vision.
 Maintain intake output chart in case the patient has urinary retention or constipation
 Encourage adequate intake of fluid and roughage in the diet.
 Record vital sign such as BP, pulse and respiration every four hours.
 Advise the patient not to get up quickly from lying-down position to sitting because of orthostatic
hypotension.
 Record the medicine and side effects accurately
 Encourage the patient not to use hazardous machinery or driving when he is on Anticholinergics drugs.
 Encourage the patient to get his routine eye check-up done for early of blurred vision or glaucoma.
 Report and record any side-effects observed to the physician.

SUMMERIZATION-

 Indication
 Mode of action
 Contraindication
 Classifications
 Side effects
 Nurse’s role

CONCLUSION- After reading of this unit, it will help the nursing personnel to understand the types of
psychotropic drugs, antiparkinsonian drugs. It will enable us to identify side effects, plan of nursing
intervention. We will be able to identify the effect of drug change behavior of the patient.