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35 Cards in this Set
- Front
- Back
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What is the current proposed mechanism for the therapuetic use of anti-psychotic drugs?
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Most of the drugs are dopamine antogonists so it is thought that they work through the suppression of dopamine.
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What are the main side effects of the first generation anti-psychotics?
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Extrapyramidal motor symptoms.
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What are the main side effects of the second generation anti-psychotic drugs?
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These drugs have fewer motor side effects than the first generation drugs but they induce wieght gain and type 2 diabetes in almost 1/3 of patients.
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What is the main difference in action of the first generation and the second generation anti-psychotics?
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The second generation anti-psychotics have a lower affinity for D2 receptors.
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What drug was introduced in the 1950s and led to a massive decline in hospital bed ussage for mental patients
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Chlorpromazine
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What was the first class of anti-psychotic drugs manufactured?
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Phenothiazines
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What are the three main examples of phenothiazine drugs and what is their relative potency?
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Aliphatic (chlorpromazine) -less potent.
Piperidine (thioridazine)- potent Piperazine (fluphenazine) - more potent. |
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What is the initial effect of phenothiazine drugs?
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Sedation and calming effect due to histamine receptor blockade.
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What are considered positive psychotic symptoms?
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Hallucinations and delusions. (These symptoms are effectively treated by anti-psychotics).
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What are considered negative psychotic symptoms?
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Withdrawal, catatonia. (Do not respond as well to anti-psychotics).
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Phenothiazines have what effect on temperature regulation of the body?
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They act on the hypothalamus and lead to hypothermia.
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What are the neuroendocrine effects of phenothiazines?
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They stimulate the release of prolactin from the pituitary and decrease LH and FSH.
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What is a potential side effect of phenothiazines given to an epileptic patient?
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Phenothiazines decrease the threshold for siezures.
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What are the anti-cholinergic effects of phenothiazines?
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They block muscarinic receptors causing blurred vision, constipation, dry mouth and decreased sweating.
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What are some of the uses of phenothiazines other than for the treatment of physchosis?
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They are good anti-emetics and they are given to prevent nausea and vomiting.
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Akathisia
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Motor restlessness. Innability ot remain stantionary. Side effect of phenothiazines.
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Neuroleptic malignant syndrome.
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Potential side effect of phenothiazines. Causes muscle rigidity and hyperthermia.
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Dystonias
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Side effect of phenothiazines. Prolonged abnormal contractions of the neck, tongue and mouth muscles.
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Tardive dyskinesia
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Rhythmic, involuntary movements of the tongue, lip smacking, abnormal posture, limb movement. Side effect of phenothaizines, more common in the elderly.
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What are some potential drug interactions with phenothiazines?
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Anticholinergics
CNS depressants Antihypertensives |
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Haloperidol
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Anti-psychotic drug that resebles high-potency phenothazines. High incidence of epileptic side effects.
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Molindone
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Anti-psychotic. High incidence of epileptic side effects.
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Thiothixene
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Anti-psychotic that resembles low potency phenothiazines.
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Clozapine
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New generation anti-psychotic. Used in individuals suffering from loose associations, disorganization, inappropriate affect and incoherrance.
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What is a major side effect of clozapine use?
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Can cause agranulocytosis leading to infection.
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Olanzipine
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Next generation anti-psychotic.
Usefull in treating both positive and negative symptoms. |
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What is the difference between olanzipine and clozapine?
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Olanzipine does not exhibit the white blood cell dresssion that clazapine does.
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Respiridone
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Next generation antipsychotic. Recomended for innitial onset of schizophrenia with negative symptoms. Has low extrapyramidal side effects.
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What is the major side effect assocaited with respiridone?
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Cardaic arrhythmias and prolonged Q-T interval.
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Quetiapine
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Next generation anti-psychotic related to clozapine. Reduces positive and some negative effects of schizophrenia without extrapyramidal depression.
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What are the major side effects of quetiapine?
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Can cuase orthostatic hypotension due to a1 antagonism and somnolence due to histamine antagonism.
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Ziprasidone
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Next generation anti-psychotic with decreased weight gain but increased incidence of cardiac problems
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Aripiprazole
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Next generation anti-psychotic. It is a partial agonist of dopamin receptors and 5HT1A receptors and an antagonist of 5HT2A receptors. Can be used to treat bipolar disease.
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Glutamine receptor agonists.
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Potential drug that acts on NMDA glutamine receptors. Superagonist drugs are in clinical trials.
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Anti-psychotics all inhibit dopamine receptors to some degree but what do the next generation drugs do that the classical drugs do not.
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Inhibit serotonin receptors more and dopamine recoptors to a lesser degree.
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