Lecture Notes: CNS Disorders and Drug Classifications - Anti-Manics and Antipsychotics

Introduction

• Professor Hoffman
• Continuing discussion on CNS disorder drugs, 4th in a series (1 more video to come)
• Focus topics: Anti-Manics (Bipolar Disorder) and Antipsychotics (Schizophrenia, Bipolar involvement)

Anti-Manic Drugs

General Information

• Example drug: Lithium
• Usage: Mainly for Bipolar Disorder
• Mechanism: Exact action unknown
  • Alters sodium transport in neurons
  • Influences catecholamine metabolism
  • Affects action potentials and neurons’ activity

Therapeutic Use

• Treats mood changes in Bipolar Disorder
• Black Box Warning: Narrow therapeutic window
  • Therapeutic level vs. toxic level close

Signs and Symptoms of Toxicity

• GI issues (diarrhea, vomiting)
• CNS effects (drowsiness, muscle weakness, lack of coordination)
• Severe signs: tinnitus, blurred vision, polyuria (dilute urine)
• Hyponatremia: Muscle tremor, cardiac arrhythmias, renal/cardiovascular issues, dehydration

Nursing Considerations

• Effectiveness: Monitor patient compliance
• Regular Monitoring: Serum lithium levels, signs of hyponatremia

Antipsychotic Drugs

General Information

• Categories:
  • Conventional (First Generation) e.g., Haloperidol (Haldol)
  • Atypical (Second Generation) e.g., Risperidone
• Mechanism: Blocking dopamine receptors
  • Haloperidol blocks additional catecholamines
  • Atypical are more dopamine-selective

Therapeutic Use

• Schizophrenia, effective for Tourette Syndrome
• Risperidone: Also for acute manic issues, autism with irritability, adjunct for depression

Reactions and Side Effects

• Black Box Warning: Elderly with dementia, Parkinson's, presence of Lewy bodies (protein build-ups)
• Extrapyramidal Effects: Mimic Parkinson’s symptoms
  • Dyskinesia (involuntary movements)
  • Motor instability, postural issues
  • Postural hypotension

Nursing Considerations

• Delayed Therapeutic Effect: Develops over time
• Patient Compliance: Steady drug levels, balancing therapeutic effects and side effects
• Side Effects vs. Disorder Symptoms: Assess if side effects are more disturbing than symptoms without the drug

Conclusion

• Next video will finish CNS agents and medication classes.