NR 546 Week 3 Assignment; Antipsychotic Medications Table Verified and Correct
Antipsychotic Medications: NR 546 -2023
Drug name Indication (Bold =
... [Show More] FDA approved)
Target symptoms: state if positive or negative effect Potency (if noted. receptor occupancy if noted) Neurotransmitter(s) affected Half-life (T1/2),
metabolism (CYP 450
enzyme) Notable side effects (associate to pathway or NT)
Typical antipsychotics (conventional)
Haloperidol Indication:
▪ Manifestations of psychotic disorders (oral, immediate-release injection)
▪ Tics and vocal utterances in Tourette’s syndrome (oral, immediate-release injection)
▪ Second-line treatment of severe behavior problems in children of combative, explosive hyperexcitability (oral)
▪ Second-line short-term treatment of hyperactive children (oral)
▪ Treatment of schizophrenic patients who require prolonged parenteral antipsychotic therapy (depot intramuscular decanoate)
▪ Bipolar disorder
▪ Behavioral disturbances in dementias
▪ Delirium (with lorazepam) Target symptoms:
▪ Positive symptoms of psychosis
▪ Violent or aggressive behavior Potency: High
Neurotransmitter(s) affected:
▪ Blocks dopamine 2 receptors, reducing positive symptoms of psychosis and possibly combative, explosive, and hyperactive behaviors
▪ Blocks dopamine 2 receptors in the nigrostriatal pathway, improving tics and other symptoms in
Tourette’s syndrome Half Life Oral: Approximatel y 12-38
hours
Decanoate: approximatel y 3 weeks
Metabolized by CYP450 - 2D6, 3A4,
3A5 ▪ Neuroleptic-induced deficit syndrome – Blocking of dopamine two receptors excessively in the
mesocortical and mesolimbic dopamine pathways, specially at high doses, it can cause worsening of negative and cognitive symptoms
▪ Akathisia - Acute blockade of dopamine 2 receptors in the striatum
▪ Drug-induced parkinsonism - Acute blockade of dopamine 2 receptors in the striatum
▪ Tardive dyskinesia, tardive dystonia – Chronic and acute blockade of dopamine 2 receptors in the striatum
▪ Risk of potentially irreversible involuntary dyskinetic movements may increase with cumulative dose and treatment duration
▪ Galactorrhea, amenorrhea – Blocking of dopamine 2 receptors in the pituitary can cause elevations in
prolactin
▪ Dizziness, sedation – Blocking of alpha 1 adrenergic receptors
▪ Dry mouth, constipation, urinary retention, blurred vision, decreased sweating – Blockade of muscarinic cholinergic receptors
▪ Hypotension, tachycardia, hypertension – Blocking of alpha 1 adrenergic receptors
▪ Weight gain - Mechanism of weight gain and any possible increased incidence of diabetes or dyslipidemia with unconventional antipsychotics is
currently unknown
Thioridazine Indication: Half Life ▪ Neuroleptic-induced deficit syndrome – Blocking of
▪ Schizophrenic patients who fail to respond to treatment with other antipsychotic drugs
Target symptoms:
▪ Positive symptoms of psychosis in patients who fail to respond to treatment with other antipsychotics
▪ Motor and autonomic hyperactivity in patients who fail to respond to treatment with other antipsychotics
Potency: Low Neurotransmitter(s) affected:
▪ Blocks dopamine 2 receptors, reducing positive symptoms of psychosis 21–24 hours
Metabolized Primarily by CYP450 - 2D6 dopamine 2 receptors excessively in the mesocortical and mesolimbic dopamine pathways, especially at high doses, it can cause worsening of negative and cognitive symptoms
▪ Akathisia - Acute blockade of dopamine 2 receptors in the striatum
▪ Priapism – Blocking of alpha 1 adrenergic receptors
▪ Drug-induced parkinsonism - Acute blockade of dopamine 2 receptors in the striatum
▪ Tardive dyskinesia - Chronic blockade of dopamine 2 receptors in the striatum
▪ Risk of potentially irreversible involuntary dyskinetic movements may increase with cumulative dose and treatment duration
▪ Galactorrhea, amenorrhea - Blocking of dopamine 2 receptors in the pituitary
▪ Pigmentary retinopathy at high doses – may be due to blockade of retinal D2/D4 receptors
▪ Dizziness, sedation - Antihistaminic actions, blocking of alpha 1 adrenergic receptors
▪ Dry mouth, constipation, blurred vision, decreased sweating, paralytic ileus – Blocking of muscarinic cholinergic receptors
▪ Sexual dysfunction - Blockade of dopamine D2 receptors in the tuberoinfundibular pathway
▪ Hypotension – Blocking of alpha 1 adrenergic receptors
▪ Weight gain - Antihistaminic actions
▪ Mechanism of weight gain and any possible increased incidence of diabetes or dyslipidemia
with conventional antipsychotics is unknown
▪ Mechanism of potentially dangerous QTc prolongation may be related to actions at ion
channels [Show Less]