Antipsychotics — Typical (1st Gen)

Psychiatric

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Examples

haloperidolchlorpromazinefluphenazine

Prefix / Suffix: Often end in -azine or -idol

Physiology

Excess dopamine activity in the mesolimbic pathway is linked to positive symptoms of schizophrenia (hallucinations, delusions).

Mechanism of Action

Strongly block dopamine D2 receptors, reducing positive symptoms of psychosis.

Indications

Schizophrenia (positive symptoms)
Acute psychosis
Tourette syndrome
Severe agitation

Side Effects / Adverse Effects

Extrapyramidal symptoms (EPS): acute dystonia, akathisia, parkinsonism, tardive dyskinesia
Neuroleptic malignant syndrome (rare, life-threatening)
Anticholinergic effects
Sedation, orthostatic hypotension
Hyperprolactinemia (gynecomastia, galactorrhea)

Contraindications

Parkinson's disease
Severe CNS depression
Bone marrow suppression

Nursing Considerations

Assess for EPS regularly using AIMS scale (tardive dyskinesia may be irreversible)
Watch for neuroleptic malignant syndrome: high fever, rigidity, altered mental status, autonomic instability — medical emergency
Treat acute dystonia with anticholinergic (benztropine) or diphenhydramine
Monitor for orthostatic hypotension
Better at controlling positive than negative symptoms
Long-acting depot injections may improve adherence

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Disclaimer: PharmPal Nurse is for education only and is not medical advice. Do not use it to diagnose, treat, prescribe, or make patient-care decisions; always verify with current drug references, your instructor, facility policy, and a licensed provider. In emergencies, call local emergency services.