A nurse is educating a client about antipsychotic medications. Which of the following statements is true about antipsychotics?

Chlorpromazine and haloperidol belong to the first-generation antipsychotics (FGAs), which are also known as conventional or typical antipsychotics.They primarily block dopamine receptors in the brain and are effective for treating positive symptoms of schizophrenia, such as hallucinations and delusions.

ChoiceBis wrong because quetiapine is a second-generation antipsychotic (SGA), which is also known as atypical antipsychotic.It blocks both dopamine and serotonin receptors in the brain and is effective for treating both positive and negative symptoms of schizophrenia, such as anhedonia and flattened affect.

ChoiceCis wrong because olanzapine is also a second-generation antipsychotic (SGA) that has similar effects and indications as quetiapine.

ChoiceEis wrong because risperidone is also a second-generation antipsychotic (SGA) that has similar effects and indications as quetiapine and olanzapine.

Normal ranges for antipsychotic medications vary depending on the type, dose, and duration of treatment.

However, some general guidelines are:

• For chlorpromazine, the therapeutic range is 100 to 300 ng/mL and the toxic level is above 1000 ng/mL.

• For haloperidol, the therapeutic range is 5 to 20 ng/mL and the toxic level is above 50 ng/mL.

• For quetiapine, the therapeutic range is 100 to 800 ng/mL and the toxic level is above 1500 ng/mL.

• For olanzapine, the therapeutic range is 20 to 80 ng/mL and the toxic level is above 200 ng/mL.

• For risperidone, the therapeutic range is 4 to 24 ng/mL and the toxic level is above 50 ng/mL.

Antipsychotics improve psychotic symptoms by blocking dopamine and serotonin receptors in the brain.This reduces the overactivity of these neurotransmitters that are associated with psychosis.

Choice A is wrong because antipsychotics do not increase dopamine and serotonin receptors, but block them.

Choice C is wrong because antipsychotics do not increase dopamine receptors, but block them.

Increasing dopamine receptors would worsen psychotic symptoms.

Choice D is wrong because antipsychotics do not decrease dopamine receptors, but block them. Decreasing dopamine receptors would reduce the effectiveness of antipsychotics.

Normal ranges of dopamine and serotonin levels in the brain vary depending on the individual and the brain region, but generally they are between 0.1 and 0.8 nanograms per milliliter (ng/mL) for dopamine and between 101 and 283 ng/mL for serotonin.