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\author{adrianao}
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  /Title (antipsychotics-first-generation-conventional.pdf)
  /Creator (Cheatography)
  /Author (adrianao)
  /Subject (Antipsychotics: First-Generation (Conventional) Cheat Sheet)
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    \vspace{-2pt}\large{\bf{\textcolor{DarkBackground}{\textrm{Antipsychotics: First-Generation (Conventional) Cheat Sheet}}}} \\
    \normalsize{by \textcolor{DarkBackground}{adrianao} via \textcolor{DarkBackground}{\uline{cheatography.com/168237/cs/35343/}}}
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  \mymulticolumn{2}{p{5.377cm}}{\bf\textcolor{white}{Cheatographer}}  \\
  \vspace{-2pt}adrianao \\
  \uline{cheatography.com/adrianao} \\
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  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Cheat Sheet}}  \\
   \vspace{-2pt}Published 8th November, 2022.\\
   Updated 8th November, 2022.\\
   Page {\thepage} of \pageref{LastPage}.
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  Measure your website readability!\\
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\begin{multicols*}{3}

\begin{tabularx}{5.377cm}{X}
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\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Medications}}  \tn
% Row 0
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\mymulticolumn{1}{x{5.377cm}}{Chlorpromazine: low potency} \tn 
% Row Count 1 (+ 1)
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\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Haloperidol: high potency} \tn 
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\mymulticolumn{1}{x{5.377cm}}{Fluphenazine: high potency} \tn 
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% Row 3
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\mymulticolumn{1}{x{5.377cm}}{Thiothixene: high potency} \tn 
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% Row 4
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\mymulticolumn{1}{x{5.377cm}}{Perphenazine: medium potency} \tn 
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\mymulticolumn{1}{x{5.377cm}}{Loxapine: medium potency} \tn 
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% Row 6
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\mymulticolumn{1}{x{5.377cm}}{Trifluoperazine: high potency} \tn 
% Row Count 7 (+ 1)
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\begin{tabularx}{5.377cm}{X}
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\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Purpose}}  \tn
% Row 0
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\mymulticolumn{1}{x{5.377cm}}{Block dopamine acetylcholine, histamine, and norepinephrine receptors in the brain and periphery} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Inhibition of psychotic manifestations, believed to be a result of dopamine blockade in the brain} \tn 
% Row Count 4 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
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\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
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\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Therapeutic Uses}}  \tn
% Row 0
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\mymulticolumn{1}{x{5.377cm}}{Acute chronic psychotic disorders} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Schizophrenia spectrum disorders} \tn 
% Row Count 2 (+ 1)
% Row 2
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\mymulticolumn{1}{x{5.377cm}}{Bipolar disorders (primarily the manic phase)} \tn 
% Row Count 3 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Tourette syndrome} \tn 
% Row Count 4 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Agitation} \tn 
% Row Count 5 (+ 1)
% Row 5
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Prevention of nausea/vomiting through blocking of dopamine in the chemoreceptors trigger zone of the medulla} \tn 
% Row Count 8 (+ 3)
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Complications, Extrapyramidal Side Effects (EPSs)}}  \tn
% Row 0
\SetRowColor{LightBackground}
Complication & Nursing Action and Education \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
Acute Dystonia: the client experiences severe spasms of tongue, neck, face, or back. If the laryngeal muscle are affected, respirations can decrease. This is a crisis situation, which requires rapid treatment & Monitor for acute dystonia between a few hrs to 5 days after administration of the first dose. Treat with anticholinergic agents, such as benztropine or diphenhydramine. Use oral dose for less acute effects and IM or IV doses for serious effects. Expect improvement within 5min (IV dosing) to 20min (IM dosing) \tn 
% Row Count 18 (+ 16)
% Row 2
\SetRowColor{LightBackground}
Parkinsonism: findings including bradykinesia, rigidity, shuffling gait, drooling, tremors & Occurs within 1 month of initiation therapy. Treat with benztropine, diphenhydramine, or amantadine. Discontinue these medications to determine f they are still needed. If manifestations return, administer atypical antipsychotics as prescribed. \tn 
% Row Count 31 (+ 13)
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Complications, Extrapyramidal Side Effects (EPSs) (cont)}}  \tn
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Akathisia: client is unable to stand still or sit, and is continually pacing and agitated & Within 2 months of the initiation of treatment. Manage effects with betablocker, benzodiazepine, or anticholinergic medications \tn 
% Row Count 7 (+ 7)
% Row 4
\SetRowColor{white}
Tardive Dyskinesia (TD): involuntarily movements of the tongue and face, lip smacking, which causes speech or eating distrubances & TD are late EPS that can occur months to years after the start of therapy, and can improve following medication change or can be permanent. Administer the lowest dosage possible. Evaluate the client after 12 months of therapy and then every 3 months. Valbenazine can be prescribed to treat TD for adult clients \tn 
% Row Count 23 (+ 16)
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Other Adverse Effects}}  \tn
% Row 0
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Complication & Nursing Action and Education \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
Neuroleptic Malignant Syndrome: Life Threatening Medical Emergency. Sudden high grade fever, blood pressure fluctuations, dysrhythmias, muscle rigidity, diaphoresis, tachycardia, and change in LOC developing into coma & Stop medication. Monitor vital signs. Apply cooling blankets, administer antipyretics, increase fluids, administer diazepam, administer dantrolene and bromocriptine to induce muscle relaxation, ICU immediately, with 2 weeks before resuming therapy \tn 
% Row Count 15 (+ 13)
% Row 2
\SetRowColor{LightBackground}
Anticholinergic Effects: dry mouth, blurred vision, photophobia, urinary hesitancy/retention, constipation, tachycardia & Chewing sugarless gum, sipping water, avoid hazardous activities, wearing sunglasses outdoors, eating high fiber, regular exercising, 2-3L of water daily, voiding before medications \tn 
% Row Count 25 (+ 10)
% Row 3
\SetRowColor{white}
Neuroendocrine Effects: gynecomastia (breast enlargement), galactorrhea, and mensural irregularities & Observe for manifestations and notify provider if these occur \tn 
% Row Count 30 (+ 5)
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Other Adverse Effects (cont)}}  \tn
% Row 4
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Seizures: greatest risk for developing seizures is existing seizure disorder & Increase in anti-seizure medication can be necessary \tn 
% Row Count 4 (+ 4)
% Row 5
\SetRowColor{white}
Skin Effects: photosensitivity resulting in severe sunburns, and contact dermatitis from handling medications & Avoid excessive exposure to sunlight, use sunscreen. Avoid direct contact with medications \tn 
% Row Count 10 (+ 6)
% Row 6
\SetRowColor{LightBackground}
Orthostatic Hypotension & Monitor blood pressure and heart rate for orthostatic changes. If significant decreases in BP or increases in HR is noted don't administer medication. Tolerance should develop in 2-3months. If lightheadedness or dizziness occurs, sit or lie down. Change positions slowly \tn 
% Row Count 24 (+ 14)
% Row 7
\SetRowColor{white}
Sedation & Effects should diminish within a few weeks. Take this medication at bedtime to avoid daytime sleepiness. Don't drive until sedation has subsidede \tn 
% Row Count 32 (+ 8)
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Other Adverse Effects (cont)}}  \tn
% Row 8
\SetRowColor{LightBackground}
Sexual Dysfunction: altered libido, difficulty achieving orgasm, erectile and ejaculatory dysfunction & Report to provider. Lower dosage or chaging to high-potency agents can minimize these effects \tn 
% Row Count 6 (+ 6)
% Row 9
\SetRowColor{white}
Agranulocytosis & Indications of infections appear, obtain baseline WBC. Medication should be discontinued if infection. Observe for infection. \tn 
% Row Count 13 (+ 7)
% Row 10
\SetRowColor{LightBackground}
Severe Dysrhythmias & Obtain baseline ECG and potassium level prior to treatment and periodically throughout treatment. Avoid concurrent used with other medications that prolong QT interval \tn 
% Row Count 22 (+ 9)
% Row 11
\SetRowColor{white}
Liver Impairments & Assess baseline liver function and monitor liver function. Observe for anorexia, nausea, vomiting, fatigue, abdominal pain, jaundice \tn 
% Row Count 29 (+ 7)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
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\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Contraindications/ Precautions}}  \tn
% Row 0
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\mymulticolumn{1}{x{5.377cm}}{Contraindicated in clients in a coma, and clients who have Parkinson's disease, liver damage, prolactin dependent cancer of the breast, and severe hypotension} \tn 
% Row Count 4 (+ 4)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Contraindicated in older clients who have dementia} \tn 
% Row Count 5 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Use cautiously in clients who have glaucoma, paralytic ileus, prostate enlargement, heart disorders, liver or kidney disease, and seizure disorders.} \tn 
% Row Count 8 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
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\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Interactions}}  \tn
% Row 0
\SetRowColor{LightBackground}
Interaction & Nursing Action and Education \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
Anticholinergic agents & Avoid over the counter medications containing anticholinergic agents, such as sleep aids and antihistamines \tn 
% Row Count 8 (+ 6)
% Row 2
\SetRowColor{LightBackground}
CNS Depressants: alcohol, opioids, and antihistamines have additive CNS depressant effects & Avoid alcohol and other medications that cause CNS depression, Avoid hazardous activities such as driving \tn 
% Row Count 14 (+ 6)
% Row 3
\SetRowColor{white}
Levodopa: by activating dopamine receptors, levodopa counteracts the effects of antipsychotic agents & Avoid concurrent use of levodopa and other direct dopamine receptors agonists \tn 
% Row Count 19 (+ 5)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
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\begin{tabularx}{5.377cm}{X}
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\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Nursing Administration}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{These medications are reserved for clients who are using them successfully and can tolerate the adverse effects, or violent/particularly aggressive} \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Use the abnormal involuntary movement scale (AIMS) to screen for the presence of EPS} \tn 
% Row Count 5 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Assess the client  to differentiate between EPS and worsening of psychotic disorder} \tn 
% Row Count 7 (+ 2)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Administer anticholinergics, beta blockers, and benzodiazepines to control early EPSs. If adverse effects are intolerable, the client can be switched to a low potency or atypical antipsychotic agent.} \tn 
% Row Count 11 (+ 4)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Consider depot preparation administration IM once every 2-4 weeks for clients who have difficulty maintaining medication regimen. Inform the client that lower doses can be used with depot preparations, which will decrease the risk of adverse effects} \tn 
% Row Count 16 (+ 5)
% Row 5
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Antipsychotic medications don't cause addiction} \tn 
% Row Count 17 (+ 1)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Some therapeutic effects can be noticeable within a few days, but significant improvements can take 2-4weeks, and possibly several months for full effects} \tn 
% Row Count 21 (+ 4)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
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% That's all folks
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