Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/47

Click to flip

47 Cards in this Set

  • Front
  • Back
Chlorpromazine: typical/atypical?
typical
Thioridazine: typ/atyp?
typ
trifluoperazine: typ/atyp?
typ
fluphenazine: typ/atyp
typ
thiothixene: typ/atyp
typ
haloperidol: typ/atyp
typ
clozapine: typ/atyp
atyp
risperidone: typ/atyp?
atyp
olanzapine: typ/atyp?
atyp
quetiapine: typ/atyp?
atyp
ziprasidone: typ/atyp?
atyp
aripiprazole: typ/atyp?
atyp
suppport for DA hypothesis
most antipsych meds strongly block post-synaptic D2 receptors in CNS
Drugs that increase DA can aggravate or create psychosis de novo
DA receptor density increased in untreated schizophrenics
PET shows increased DA receptor density
Successful tx shows change in amt fo DA metabolites
probs with DA hypothesis
atypicals are not potent D2 receptor antagonists, but are effective
absorption of antipscyhotics
readily, but incompletely absorbed orally --> erratic/unpredictable absorption
1st pass metabolism of antipsychotics
high, bioavailabilty it 25-35% (haloperidol = 65%)
lipid solubility of antipsychotics
plasma protein bindign
very lipid soluble, readiy enters CNS, acumulates in brain, lung and other tissue
can enter fetal circulation and breast milk
92-99% bound to plasma proteins
metabolism of antipsychotics
p450
metabolites produced are not impt for therapeutic action, w exceptionf of mesoridazine (metabolite of thioridazine... more active than parent compound)
which antipsychotics are good for rapid initiation of therapy
fluphenazine
haloperidol
which antipsychotics have depot preparations
haolperidol decanoate
fluphenazine decanoate
which antipsychotic has the shortest t1/2
quetiapine
which antipsychotic has the longest t1/2
aripiprazole
which are the only 2 drugs that have D4 activity
clozapine
aripipirazole
other than to treat schizophrenia, what are other psych indications for antipsychotics
used with lithium to treat mania
olanzapine can be used to treat mania, and can act as mood stabilizer in bipolar
schizoaffective d/o
treats toxic psychoses
Tourette's
psychotic sx in Alzheimer's and Parkinson's
which antipsychotic is used to treat Tourette's
molindone (rarely used to treat schizo)
What are some nonpsychiatric indications for antipsychotics?
phenothiazines (anti-emetic, anti-pruritics, sedative)
typical antipsychotics
treat positive sx, not negative
provoke EPS
increases PRL secretion
atypical antipsychotics
treat + and - sx
decreased EPS
increased PRL secretion
what accounts for the difference between typicals and atypicals?
atypicals have 5HT2>D2 blockade compared with typicals
atypicas produce increased DA blockade of neurons from mesolimbic regions as compared ot nigrostriatal
behavioral adverse effects of antipsychotics
pseudodepression (responds to anti-parkinsons meds)
which drugs are most likely to cause EPS
haloperidol
phenothiazines
how can neurological effects be treated
diphenhydramine
antimuscarinics
what is the most unwanted adverse effect of antipsychotics
tardive dyskinesias (mov'ts of muslces and lips... can be irreversible)
develops after several years of use (although can occur after 6 mos)
treatment of TD
stop or reduce dose of med
eliminate all drugs with anti-cholinergic actions
add diazepam to enhance GABAergic activity
drug that doesn't exacerbate TD
clozapine
which drug has the strongest autonomic effects? middle? weakest?
thioridazine

clozapine and other atypicals

haloperidol
what are the autonomic effects seen with antipsychotics
muscarinic blockade
toxic confusional states
urinary retention

a-adrenergic blockade
postural hypotension
failure to ejaculate (esp with phenothiazines)
NMS
muscle rigidity
aphoresis
hyperpyrexia
autonomic instability (life threatening)
treatment for NMS
dantrolene
DA agonist
when is maximal risk for NMS to occur
how long can it last after stopping med
within weeks
can persist for severatl days
which antipsychotic produces the most sedation?
least sedating?
phenothizines

fluphenazine, haloperidol, aripiprazole
specific toxicities seen in thioridazine
visual impairment (retinal deposits)
conduction defects
toxicity of ziprasidone
QT prolonged
toxicity of clozapine
reversible agranulocytosis (1-2%)
seizures
reserved for non-responders
which antipsychotic is fatal in OD
thioridazine
are typicals or atypicals more $$?
atypicals
which area of the brain is thought to be successful at treating, with reduced EPS sx?
mesolimbic