Antipsychotic Drugs

Front 1

drug that was major factor to significant increase in discharge of mental patients?

Back 1

chlorpromazine

Front 2

prototype phenothiazine?

Back 2

chlorpromazine

Front 3

differences between high to low potency phenothiazines?

Back 3

high potency have high incidence of extrapyramidal side effects but lower incidence of anticholinergic and antiadrenergic side effects conpared with low-potency phenothiazine; have roughly the same therapeutic efficacy

Front 4

CNS effects of phenothiazines?

Back 4

sedation, calming effect;
anti-emetic;
impairment of temp regulating system;
neuroendocrine effects (hyperprolactinemia);
decreased seizure threshold

Front 5

which class of phenothiazines are ANS effects most often seen?

Back 5

low potency

Front 6

ANS effects of phenothiazines?

Back 6

block M receptors;
block α receptors

Front 7

phenothiazines mechanism of action?

Back 7

inhibit DA neurotransmission in CNS by blocking postsynaptic receptor sites in the limbic system

Front 8

phenothiazine side effects?

Back 8

orthostatic hypotension;
obstructive jaundice;
blood dyscrasias;
extrapyramidal reactions

Front 9

extrapyramidal reactions associated with phenothiazines?

Back 9

parkinsonian syndrome;
akasthisia;
neuroleptic malignant syndrome;
dystonias;
tardive dyskinesia

Front 10

neuroleptic malignant syndrome?

Back 10

typically after IM dose of haloperidol;
onset in 30 mins, symptoms may persis 3-4 weeks;
muscle rigidity, hyperthermia

Front 11

chlorpromazine?

Back 11

less potent phenothiazine

Front 12

thioridazine?

Back 12

potent phenothiazine

Front 13

fluphenazine?

Back 13

more potent phenothiazine

Front 14

dystonias?

Back 14

appears late with chronic, long term treatment with phenothiazines;
prolonged abnormal contractions of the neck, tongue, and mouth muscles

Front 15

tardive dyskinesia?

Back 15

after month or years of phenothiazine therapy;
rhythmic, involuntary movements of tongue, lip smaking, abnormal postures and involuntary limb movements;
exacerbated by rapid withdrawal of drug;
symptoms may persist long after withdrawal

Front 16

phenothiazine drug interactions?

Back 16

potentiates anticholinergics;
potentiates other CNS depressants;
potentiates adrenergic blocking antihypertensives

Front 17

other antipsychotic drugs?

Back 17

haloperidol
molindone
thiothixene
(chemically distinct from phenothiazines but have similar therapeutic and side effect profiles)

Front 18

haloperidol?

Back 18

resembles high potency phenothiazines;
high incidence of EP side effects;
few ANS side effects

Front 19

molindone?

Back 19

antipsychotic;
high incidence of EP side effects;
possible antidepressant activity

Front 20

thiothixene?

Back 20

resembles low potency phenothiazines

Front 21

atypical antipsychotic mechanism of action?

Back 21

greater occupancy at 5-HT receptors relative to D2 receptors;
selectively block DA receptors on mesolimbic neurons rather than nigrostriatal neurons

Front 22

atypicals main advantage over phenothiazines?

Back 22

low incidence of EP side effects

Front 23

phenothiazines are generally more effect for which symptoms of schizophrenia?

Back 23

positive symptoms

Front 24

main side effect of clozapine?

Back 24

agranulocytosis

Front 25

clozapine (clozaril)?

Back 25

atypical antipsychotic

Front 26

clozapine mechanism?

Back 26

weak blocker of D1 and D2 receptors;
5-HT receptor;
α1 receptor (relatively weak);
M receptor (relatively weak);
H1 receptor (relatively weak)

Front 27

side effects of clozapine?

Back 27

sedation, hypotension, tachycardia, fever, increased salivation, dizziness, weight gain;
more prominent with dose escalation

Front 28

olanzipine (zyprexa)?

Back 28

atypical antipsychotic;
also approved for use in mania

Front 29

olanzipine mechanism?

Back 29

similar to clozapine without wbc problems;
higher affinity for D2;
lower affinity for 5-HT2;
blocks Ach

Front 30

respiridone (risperdol)?

Back 30

atypical antipsychotic;
recommended in first episode of schizophrenia where negative symptoms predominate

Front 31

which atypical antipsychotic produces agranulocytosis?

Back 31

clozapine

Front 32

contraindications for respiridone?

Back 32

arteriosclerotic cardiovascular disease

Front 33

which atypical antipsychotic is contraindicated in ateriosclerotic cardiovascular disease?

Back 33

respiridone

Front 34

respiridone mechanism?

Back 34

potent blocker of D2 receptors and 5-HT2 receptors

Front 35

quetiapine (seroquel)?

Back 35

atypical antipsychotic;
monotherapy for bipolar mania

Front 36

major side effect of quetiapine?

Back 36

marked somnolence

Front 37

quetiapine mechanism?

Back 37

potent 5-HT2 antagonist;
moderate D2 antagonism;
(also 5-HT1, D1, H1,α1, α2 antagonist)

Front 38

ziprasidone (geodon)?

Back 38

atypical antipsychotic

Front 39

major side effect of ziprasidone?

Back 39

fatal cardiac arrythmias

Front 40

which atypical antipsychotic is associated with fatal cardiac arrythmias?

Back 40

ziprasidone

Front 41

aripirazole (abilify)?

Back 41

atypical antipsychotic

Front 42

theories for mechanism of schizophrenia?

Back 42

DA overstimulation;
hypofunctional NMDA receptor

Front 43

antipsychotic therapeutic indications?

Back 43

schizophrenia;
bipolar with psychotic features;
Tourettes;
disturbed behavior in dementia;
antiemetic;
preoperatively for neuroleptic anesthesia

Front 44

glycine and schizophrenia?

Back 44

coagonist with glu at NMDA;
large doses reported to improve negative symptoms

Front 45

d-cycloserine?

Back 45

glycine partial agonist for stimulation of NMDA

Front 46

evidence supporting hypofunctional NMDA receptor theory?

Back 46

blockade induces schizophrenia symptoms;
SNPs in subset of schizophrenics results in reduced glu binding

Front 47

future directions for antipsychotic therapy?

Back 47

NMDA superagonists;
gly transporter inhibitors