McKenna's Pharmacology for Nursing, 2e

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C H A P T E R 2 2 Psychotherapeutic agents

TABLE 22.1

DRUGS IN FOCUS Antipsychotic/neuroleptic drugs

Common side effects

Drug name

Potency

Usual dosage

Sedation Anticholinergic Hypotension Extrapyramidal

Typical antipsychotics chlorpro­ mazine (Largactil) Low

++++

+++

+++

++

Adult: 25 mg IM for acute episode, may be repeated; switch to 25–50 mg PO t.d.s Paediatric: 0.5–1 mg/kg q 4–8 hours PO, IM or PR Adult: Initially, 12.5–25 mg IM 4–6 weekly, up to 100 mg/dose Geriatric: 1–2.5 mg/day PO, adjust dose based on response Adult: 1–15 mg/day PO Geriatric: 1–3 mg/day PO Paediatric (3–12 years): 0.5 mg/day PO; 0.05–0.075 mg/kg per day PO for Tourette’s syndrome and behavioural syndromes Adult: initially 75 mg/day in divided doses, increased at weekly intervals by steps of 25 mg according to response; usual maximum 300 mg/day Geriatric: initially 15–30 mg/day in divided doses Adult: 5–10 mg PO t.d.s. to q.i.d.; 10–20 mg IM for acute states Adult: 2–5 mg PO b.d.; 1–2 mg IM q 4–6 hours in severe cases Geriatric: reduce dose Paediatric (6–12 years): 1 mg PO daily or b.d.: 1 mg IM daily or b.d. for severe cases Adult: 10–50 mg/day in divided doses, increase if necessary by 10–20 mg every 2–3 days to 75 mg; higher doses may be required; usual mainte­ nance for schizophrenia and other psychoses, 20–40 mg/day Geriatric or debilitated: initially quarter to half usual adult dose Continued on following page Geriatric: reduce dose Paediatric: 2.5 mg PO t.d.s.; 0.03 mg/kg IM for acute states; 20–25 mg/day PR

fluphenazine (Modecate)

High

+

+

+

++++

haloperidol

High

+

+/–

+

++++

(Serenace)

pericyazine (Neulactil)

Moderate +++

+++

++++

+

prochlorperazine (Stemetil)

Low

+

++

+

+++

trifluoperazine (Stelazine)

High

+

+

+

++++

zuclopenthixol (Clopixol)

High

+++

+

+++

++++