Anastasia Anna

Faculty in Nursing
Universitas Padjadjaran
Transmitter substances on receptors :
Acetylcholine
Adrenaline and noradrenaline
Dopamine
5-hydroxytryptamine (5HT)
Gamma aminobutyric acid (GABA)
NEUROLEPTIC
PHENOTHIAZINES
Thioxanthenes
Butyrophenones : Haloperidol
Atypical antipsychotic
MINOR TRANSQUILLIZERS : benzodiazepines
ANTIDEPRESSANT : tricyclic antidepressant,
tricyclic anxiolytic, 5-HT reuptake inhibitors,
Monoamine oxidase (MAO) inhibitors, Lithium
 Are particularly useful in controlling the states of
agitation found in : acute schizophrenia, mania,
some delirium and paranoia
Block the action of dopamine on D1 and D2
receptor in : the mesolimbic system of the brain
( sedative and antipsychotic action ), on the CTZ
( antiemetic) and extrapyramidal system ( various
disorders of movement and posture )
 Group I sedative
- chlorpromazine
- promazine
Group II moderately sedative, less
pyramidal effect
- thioridazine
Group III less sedative, marked
extrapyramidal effects
- prochlorperazine
- trifluoperazine
- fluphenazine
 Take a complete drug history noting any past
incidence of drug hypersensitivity
Assess if psychotic patient has restlessness, anxiety
and agitation
Assess the severity of hallucinations
Assess the level of anxiety
Assess nausea, vomitus & pruritus
Assess jaundice ( blocking of bile canaliculi in the
liver, alergic effect )
Assess WCB ( depression ), urinalysis
Assess skin rashes : light sensitivity, contact
dermatitis
Assess BP, temperature, weight gain & dry mouth
 Assess the various disorders of movement :
- parkinson-like syndrome
- akathisia
- dystonia
- tardive dyskinesia
note any history of asthma or emphysema
1.If the medication is to be administered IV :
monitor the rate of flow carefully
take BP at frequent intervals, monitor for
hypotension,
after 1 hr slowly elevate the head of the bed and
observe for tachycardia, faintness or complaint
of dizziness,
keep side rails up and supervise activity until
drug effects realized
2. Note complaint of undue distress when in hot or
cold room
3. If the client becomes excessively active or
depressed, document and report as the
medication may need to be changed
4. Note the presence of spasms of the face,
neck, back or tongue.
5. If the client develops a sore throat,
persistent fever, malaise and weakness,
document and report ( may be associated
with agranulocytosis )
6. Measure I & O, observe for abdominal
distention. Report any urinary retention.
7. Note any changes in carbohydrate
metabolism.
 patients are not confined to bed
Two nurses should always be concerned with drug
administration
It is necessary to ensure that medication is actually
taken
Occasionally a patients paranoia may extend to drugs
they are given
Drug education is very important for relatives
The nurse should observe the effects of drug
treatment
On discharge, not to prescribe excessive quantities of
drugs
 Anastasia Anna
Faculty of Nursing
Universitas Padjadjaran