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Antipsychotics IV

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Antipsychotics IV

So next we’re going to talk about de autonomy adverse effects that could result from giving antipsychotics so we you would see okay we can see autonomic effects resulting from the blockade of the peripheral muscarinic and also d alpha adeno sectors so when you blow the basque are you excited and also be alpha in receptors you will see probably unwanted autonomic

Effects of the drug and this is more difficult to manage in patients who are older and with continued therapy on patients might develop tolerance to some of the autonomy effects among the older psychotic antipsychotic drugs thioridazine istra has the strongest autonomy effect whereas hello corridor has the weakest okay so this is the weakest i already say the

Strongest when it comes to having autonomy effects the most of the and typical antipsychotics the typical antipsychotics usually have moderate or intermediate autonomy effects with some rocks some of the or drugs for example that tyrosine you and those phenothiazines okay that has caught on the elevated side chains example is cpz chlorpromazine chlorpromazine

So when we use these drugs okay they tend to cause a drop in live effect okay it dropping like effects okay so if you cannot remember what are the eight roping like effects go back and try to revise what we have taught previously so basically they from like from top to bottom so at the mouth they develop dry mouth and the intestine the large intestine they have

Constipation in the player we have the urinary retention he said he cannot pass urine whatever problems passing movie and also they might develop visual problems okay so problems with vision so atropine artifacts blurred vision dry month constipation urinary retention basically parasympathetic affects parasympathetic facts and these from these effects besides some

This typical drugs and all the drugs you might also see with some of the atypical drugs okay so you can see with these some effects with even clozapine and the other either a typical drugs okay sorry i can see that almost sorry most of the typical drugs also cost these effects okay except for those two new drugs read papers all creepy creepy soul and ziprasidone

Okay so these are relatively newer drugs okay relative newer drugs probably about 1/10 of us okay oh and another thing is when you block the when you block the muscarinic receptors okay what you can work and develop itself you can get in the cns you can get tocsy confusional state okay so patients become confused which is not good especially in the elderly and again

This is the condition that mimics or is similar to the effects of atropine and also the what we call the tricyclics antidepressant okay who are you going to have another lecture on the tracer cyclic antidepressants later on tricyclic antidepressants another important auto long effect or probably sometimes the most important autumn event is postural hypotension

Okay postural hypotension so your blood pressure goes down it drops when you change position came from lying to standing and this is commonly more it’s more common vd all the drugs came community all the drugs especially the see no ties in the key in it or is it this one a few times it’s common to cost previously although its prominent cause postural hypotension

And she’s because of the blockade of l4 receptor okay so when you block we have four receptor the receptor in one get postural hypotension and this is some can be dangerous in the elderly because they might fall okay so and before me so many things can happen they might just get a bruise or they can get a fracture okay fracture nichols even for example which

Is very even wanted or i can get more severe hemorrhage a symptom-free in etc so among so this is more common among the typical drugs but among the newer drugs okay among the newer drugs clozapine lose a pin so clozapine is quite a naughty dragon if you wish even though it’s it’s useful in the sense that we can give it to patients with resistant schizophrenia

But the problem is plus the people also causes postural hypotension and besides philippi need some ziprasidone okay even though suppressor it is a new drug unfortunately so there’s always a pro and pro in contour drug candidates you know all nothing is perfect so as you proceed on you will drop but still it unfortunately causes postural hypotension orthostatic

Hypotension one more thing we finna thousands ok in italians also causes failure to eject late okay finley to eject late so this is a koala concern of course with four patients even though the i mean in an asian setting the balloon on would not say it out okay but then you have to always consider me envisions sexually active so if you want to give them a note i

Seems and this mine and soon okay this is a potential problem that will that can potentially compromise here degree of compliance to taking the run okay so they want to keep the drug every few days or don’t take it at all because they might think that this is a like a dominant thing so they might just keep it run so to keep in mind before you want to prescribe a

Famous i see in x is the endocrine and or endocrine and metabolic effects so in this effects you can see basically four things okay number one is on hyperprolactinemia increasing the product enables secondly tinyco mestia okay she poops okay for meals it’s a problem eight females not maybe not okay and then we have amy nuria collect aureus in syndrome hey so for

Females um it might be a concern because he didn’t have their menses so many many ladies they are worried when they when you don’t have menses the key but the thing it’s abnormal and some of them thing is going to affect them physically mentally etcetera okay so we do worry and then collect oriya so the nipples secret knock okay so this can happen in meal meals also

Even men can get on korea so it can be embarrassing for them okay put the improbably white all the time and then we have infertility in for t v t which can be a concern in a you know especially in the young and people who are tried trying to conceive okay so this all of this needs to be we need to consult efficiency if they are thinking of it’s it’s it’s possible

For us to allow them to have children if we are thinking of long think of children and you have to consider it consider i’m sorry don’t don’t pass it on you have we have to console them on this console them on the fact that they might be infantile if they take this especially the so many of the drugs so basically these are the probably it’s a predictable effect of

The when you block the dopamine – so these are all predictable these are all expected effects which is an extension of the pharmacodynamics of the drum so this one is when you talk to come into inner which is very bland and because this dopamine okay so dopamine actually in the p23 when your dopamine okay it’s supposed to block off okay block off the um project

In secretion okay dopamine is supposed to block off product insufficient so when you block the beam so you get extra okay so it’s not been suppressed you have product a more in being produced so gynecomastia amenorrhea no menses if no coming out of your um your nipples in the new facility you become unfit oil or some filter and so this is some pronounce the kid

Especially with risperidone which is a an atypical drug or it’s a non classic or a new drug relatively new not so new and several of the atypical drugs okay for example through 13 and olanzapine unfortunately cause windy and hyperglycemia so you so this is of course some something unwanted especially females young females it will not be happy they have weight

Gain and i put a nice email but sometimes we still have to give it to them it because probably it’s one of the best debate options for them but then we have to monitor their weight he asked them to exercise control their diet okay but they might find this a bit challenging and of course these fantasies can be like worse ok if the patient is pregnant cities can be

An extra concern if the patient is concerned and being weight gain and hypoglycemia in the end they might have like micro soumik babies and we have to undergo cesarean section or the other traumatic with boys okay methods of delivering babies like forceps delivery all day so might cause more problems for the mother and for the for the babies so in this sense okay

Every papers all and zip press it on

Transcribed from video
Antipsychotics IV By Pharmacology RCMP