A REVIEW OF SCHIZOPHRENIA

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A REVIEW OF SCHIZOPHRENIA THE ANTIPSYCHOTIC
MEDICATIONS

• Melinda Hermanns, MSN, RN, BC

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PURPOSE/OBJECTIVES

• The purpose of this module is to allow students
  an opportunity to review Schizophrenia and
  medications to treat those disorders.
• By the end of this module, the student will be
  able to
• discuss the drug classifications of psychoactive
  medications in relation to the Schizophrenia
• improve your patient teaching by having a working
  knowledge of the critical elements of each
  medication

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This Module Will Review the Following

• Schizophrenia
• antipsychotics

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SCHIZOPHRENIA

• Is a serious and lifelong psychiatric disorder
  which affects approximately 1 of the
  population.
• Peak onset for women 24 to 30 years old and for
  men 18 to 25 years old
• Treatment anti-psychotic agents

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ANTI-PSYCHOTIC AGENTS

• 2 Classifications
• 1) traditional
• 2) atypical

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STANDARD (TYPICAL) ANTIPSYCHOTIC MEDICATIONS

• (Thorazine) Chlorpormazine
• (Mellaril) Thioridazine
• (Stelazine) Trifluoperazine
• (Trilafon) Perphenazine
• (Serentil) Mesoridazine
• (Prolixin) Fluphenazine
• (Navane) Thiothixene

• (Haldol) Haloperidol and Haloperidol deconate
• (Loxitane) Loxapine
• (Moban) Molindone

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ATYPICAL ANTIPSYCHOTICS

• MEDICATIONS
• (Clozaril) Clozapine
• (Zyprexa) Olanzapine
• (Risperdal) Risperdone

• SIDE EFFECTS
• agranulocytosis and seizures
• orthostatic hypotension

Atypical Antipsychotics have a reduced risk of EPS
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STANDARD (TYPICAL) ANTI-PSYCHOTICS

• Side Effects
• EPS (extrapyramidal syndrome)
• TD (tardive dyskinesia)
• NMS (neuromalignant syndrome)

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EXTRAPYRAMIDAL SYNDROME (EPS)

• Signs and Symptoms
• akathisia - restlessness and inability to sit
  still
• akinesia - difficulty with or absence of movement
• pseudoparkinsonism pill-rolling tremor,
  muscle rigidity, drooling, shuffling gait
• Treatment Call physician. Administer
  anticholinergic (Benadryl) Dipenhydramine,
  (Cogentin) Benztropine, administer
  anti-parkinsonian agent (Symmetrel) Amantadine,
  (Artane) Trihexyphenidyl

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TARDIVE DYSKINESIA

• The term means late appearing and TD typically
  appears after months of continuous use of
  antipsychotics. Can be irreversible
• Signs of TD lip smacking, jaw moving
  side-to-side, or protrusion of the tongue.
• Treatment No known treatment. Stopping the
  antipsychotic may not help.

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NEUROLEPTIC MALIGNANT SYNDROME

• A potentially lethal side effect of
  anti-psychotic drugs
• Signs increased vital signs (increase B/P,
  pulse, flushed face, fever, muscle rigidity,
  elevated WBC and CPK)
• Rare but fatal - an emergency
• Treatment Early detection, D/C anti-psychotic
  (neuroleptic), management of fluid balance and
  monitoring for complications.

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TEST YOUR KNOWLEDGE
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1) One of the advantages of atypical
anti-psychotics vs. typical (standard)
anti-psychotics is atypical anti-psychotics have
a reduced risk of developing EPS or tardive
dyskinesia.
TRUE
FALSE
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2) Anti-psychotics are effective in treating
Schizophrenia.
TRUE
FALSE
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3) Tardive dyskinesia appears after weeks of
continuous use of antimanic agents and can be
reversible.

TRUE
FALSE
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YOU ARE CORRECT!

• Individuals who take atypical antipsychotics have
  a reduced risk of developing EPS or TD.
• GO TO NEXT QUESTION

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YOU ARE CORRECT!

• Tardive dyskinesia develops as a result of
  antipsychotic medication and the symptoms may not
  be relieved after the drug is stopped.
• CONGRATULATIONS

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YOU ARE CORRECT!

• NMS is fatal and is an emergency.
• GO TO NEXT QUESTION

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YOU ARE CORRECT!

• Akathisia, akinesia, and parkinsonism are signs
  and symptoms of EPS.
• Congratulations

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YOU ARE CORRECT!

• Antipsychotics are effectively used to treat
  schizophrenia.
• GO TO NEXT QUESTION

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CONGRATULATIONS!

• THE END

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SORRY, THIS IS THE WRONG ANSWER
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SORRY, THIS IS THE WRONG ANSWER
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