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Antipsychotics: Common Adverse Effects and Safety Implications in the Clinical Setting. Need Assignment Help?
Antipsychotic drugs, especially first-generation or typical antipsychotics, have been relevant to the treatment of psychiatric disorders including schizophrenia for many years. Though effective at alleviating positive symptoms - like hallucinations and delusions - their use is often marred by a wide variety of adverse effects. Being aware of these effects is essential to advanced practice providers who are providing safe, patient-centered care. The primary mechanism of action of typical antipsychotics is dopamine D2 receptor antagonism, which accounts for both the therapeutic and adverse effects of the medications (Rosenthal & Burchum, 2021).
Extrapyramidal symptoms (EPS) are among the most common and well-established adverse effects of typical antipsychotics. They include acute dystonia, parkinsonism, akathisia, and tardive dyskinesia (Rosenthal & Burchum, 2021). Acute dystonia, characterized by sustained involuntary muscle contractions, and parkinsonism, characterized by rigidity and bradykinesia, usually develop in the first few days to weeks of treatment. A side effect of long-term use is tardive dyskinesia, which is usually irreversible, and is marked by abnormal, involuntary muscle movements, primarily of the tongue, face (Muench & Hamer, 2020). Well understood, the risk of EPS necessitates routine monitoring and prompt identification, with agents such as benztropine or diphenhydramine for symptomatic control.
A second problem with typical antipsychotics is neuroleptic malignant syndrome (NMS), a rare, but life-threatening, condition characterized by hyperthermia, muscle rigidity, altered mental status, and autonomic instability. According to Rosenthal and Burchum (2021), whether or not to intervene, and the need for supportive care in the meantime, are vital to preventing serious sequela.
Cardiovascular effects, such as orthostatic hypotension and QT prolongation, are other important risks associated with antipsychotic medications, especially with haloperidol and chlorpromazine (Rosenthal & Burchum, 2021). These effects require baseline and ongoing ECG monitoring in at-risk populations. Moreover, anticholinergic side effects, including dry mouth, constipation, urinary retention, and blurred vision are known to interfere with adherence and quality of life[1, 2].
On top of these risks, individualising treatment is important. Medication selection should be guided by the patient-specific factors (age, comorbidities, and prior response to treatments). Additionally, patient education has a key function in enhancing adherences and surveying early signs of negative consequences. Educating patients regarding the need to report muscle stiffness, abnormal movements, or sudden fever will prevent Journal of Advanced Nursing 5 complications, and help achieve better therapeutic outcomes (Muench & Hamer, 2020; Correll et al., 2021).
To wrap this up, the usual antipsychotics are still an obligatory device in the psychiatric seat, however there should be a trade-off between the utilization of the earlier. Preventive measures through active and continuous vigilance, individualized healthcare provision, and educating the patient to secure the best outcome while ensuring safety should be taken into consideration.
References:
Correll, C. U., Solmi, M., Croatto, G., Schneider, L., Rohani-Montez, S. C., Fairley, L., & Kishimoto, T. (2021). Mortality risk associated with antipsychotic drug use in children and young people: A systematic review and meta-analysis of observational studies. JAMA Psychiatry, 78(5), 519-530.
Muench, J., & Hamer, A. M. (2020). Adverse effects of antipsychotic medications. American Family Physician, 101(3), 169-177.
Rosenthal, L. D., & Burchum, J. R. (2021). Lehne's pharmacotherapeutics for advanced practice providers (2nd ed.). Elsevie