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57 Cards in this Set
- Front
- Back
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Dopamine Receptor Antagonists (DPAs)
Indictions |
treat all psychotic disorders
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Dopamine Receptor Antagonists (DPAs)
Therapeutic Beneficts |
improve positive symptoms
hall, delusions, agitation |
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Dopamine Receptor Antagonists (DPAs)
Pharmaco |
incompletely absorbed
half life 10-12 hrs (once day) takes a few weeks to take effect IV and IM versions |
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Dopamine Receptor Antagonists (DPAs)
Classes and Relative Dose Phenothiazine |
aliphatics - chlorpromazine 100 mg
piperidine - Thioridazine 100 mg piperizine - fluphenazine 2 perphenazine 8 trifluoperazine 5 prochlorperazine 15 |
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Dopamine Receptor Antagonists (DPAs)
Classes and Relative Dose Others |
Thioxanthines 4
Dibenzoazapine 10 dihydrindoles 10 Butyrophenones - Haloperidol 2 Diphenylbutylpiperizine 1.5 |
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Dopamine Receptor Antagonists (DPAs)
minimum dose |
300 mg
can go up to 2000 mg per day |
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Dopamine Receptor Antagonists (DPAs)
Side E Mesocortical D2 antag |
neruro side E
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Dopamine Receptor Antagonists (DPAs)
Side E alpha 1 antag |
vasodilation, orthostatic hypotension
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Dopamine Receptor Antagonists (DPAs)
Side E muscarininc cholinergic receptor antag |
dry mouth
constipation, blurred vision |
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Dopamine Receptor Antagonists (DPAs)
Side E histamine receptor antag |
sedation, weight gain
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Dopamine Receptor Antagonists (DPAs)
Side E Cardiac |
Thioridazine
sudden death all inc CV incidents in elderly |
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Dopamine Receptor Antagonists (DPAs)
Side E Hematologic |
small potential for agranulocytosis
fatal 30% of the time |
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Dopamine Receptor Antagonists (DPAs)
Side E Peripheral anticholiergic |
constipation, dry mouth
transient, mostly benign glaucoma, BPH concern |
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Dopamine Receptor Antagonists (DPAs)
Side E Sexual |
ED
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Dopamine Receptor Antagonists (DPAs)
Side E Skin |
rashes, light sensitivity and skin discoloration
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Dopamine Receptor Antagonists (DPAs)
Side E Eyes |
800 mg of thioridazine and produce irr retinal pigmentation and blindness
chlorpromazine benign changes |
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Dopamine Receptor Antagonists (DPAs)
Side E neuro |
parkinsonism, acute dystonia, akathisia
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Dopamine Receptor Antagonists (DPAs)
Side E liver |
rare jaundice with chlorpromazine - due to contamination of drug
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Dopamine Receptor Antagonists (DPAs)
Side E weight gain |
common in molidone and loxapine
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Dopamine Receptor Antagonists (DPAs)
Side E Neuroleptic Malignant Syndrome features |
med. emergency
acute, fever can happen anytime, usually in first 10 days |
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Dopamine Receptor Antagonists (DPAs)
Side E Neuroleptic Malignant Syndrome Symptoms |
muscle rigidity
mutism tremor dysphagia sweating dystonia fever |
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Dopamine Receptor Antagonists (DPAs)
Side E Neuroleptic Malignant Syndrome Treatment |
dopamine agonist
muscle relaxant |
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Dopamine Receptor Antagonists (DPAs)
Overdose Symptoms |
extrapyramidial, mydriasis, resp depression
hypotension (don't treat with EPI) |
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Dopamine Receptor Antagonists (DPAs)
Overdose Severe symptoms |
delirium, resp depression, seizures
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Dopamine Receptor Antagonists (DPAs)
Overdose features |
difficult to kill yourself unless take alcohol or benzos
mellaril is cardiotoxic and datal in overdose |
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Dopamine Receptor Antagonists (DPAs)
Overdose treatment |
charcoal
not emetic b.c DRA's are antiemetic |
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Dopamine Receptor Antagonists (DPAs)
Drug Drug interactions |
antacids dec absorption
CNS depressant additive smoking inc metab hydroxyzine (tranquilizer) can lead to thioridazine toxicity |
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Dopamine Receptor Antagonists (DPAs)
Drug Drug interactions phenothiazine and pimozide |
should not be admin with other agents that affect QT interval (erythromycin)
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Serotonin Dopamin Antag
SDAs Clozapine |
Standard, fatal agranulocytosis, must be monitored closely
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Serotonin Dopamin Antag
SDAs Clozapine Indications |
Schizo and Schizoaffective
Mania MdD positive and negative symptoms |
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Serotonin Dopamin Antag
SDAs Risperidone pharmaco and dose |
75% absorbed, first pass metab
20 hr half life 1-2 mg to 6-8 mg more extrapyramidal at high doses |
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Serotonin Dopamin Antag
SDAs Risperidone Side E |
extrapyramidal
hyperkinesia, nausea interacts with CYT 3A4 enzyme |
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Serotonin Dopamin Antag
SDAs Paliperidone features |
metablite of resperidone
23 hr half life 3-12 mg dose; |
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Serotonin Dopamin Antag
SDAs Paliperidone Side E |
prolong QT interval; (careful of interactions)
parkinsonian, drooling NO liver enz interactins |
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Serotonin Dopamin Antag
SDAs Olanzapine Pharmaco |
55% absorbed, 40% first pass metab
half life 12-54 hrs D2, 5HT, M, a1 receptors. (broad) |
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Serotonin Dopamin Antag
SDAs Olanzapine Side E |
somulence
dry mouth, inc appetite, tremor |
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Serotonin Dopamin Antag
SDAs Quetiapine Pharmaco |
2-3 times per day dosing
half life 6 hrs |
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Serotonin Dopamin Antag
SDAs Quetiapine Side E |
somnolence, post hypotension, modest wt. gain
NO extrapyramidal symptoms |
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Serotonin Dopamin Antag
SDAs Ziprazodone Pharmaco |
5-10 hr half life
absorption doubled with food |
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Serotonin Dopamin Antag
SDAs Ziprazodone Side E |
largest QT interval inc
no wt gain |
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Serotonin Dopamin Antag
SDAs Clozapine Pharmaco |
D2 and 5HT1A antag, broad profile
schizophrenia - treatment resistant |
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Serotonin Dopamin Antag
SDAs Clozapine Side E |
fatal agranulo
antihistaminic, wt gain, diabetes must do weekly blood tests dirty drug |
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Serotonin Dopamin Antag
SDAs Aripiprazol Pharmaco |
5HT2 antag
75-150 hr half life, well absorbed partial D2 agonist |
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Serotonin Dopamin Antag
SDAs Overdose |
CND depression, tachycardia, hypotension, extrapyramidal effects
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Anticholinergic Agents
Indications |
medication induced movement disorders associated with dopamine receptor blockers
1. Parkinsonism 2. Neuroleptic induced acute dystonias |
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Anticholinergic Agents
Indications Parkinsonism |
tremor, rigidity, cogwheeling, bradykinesia
sialorrhea festinating gait - involuntary short and accelerating steps |
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Anticholinergic Agents
Indications Parkinsonism Rabbit Syndrome |
rare form of parkinsonism, see with high potency antipsychotics
invol. twitching of nose and lips, chewing tongue not involved |
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Anticholinergic Agents
Indications Neuroleptic induced acute dystonias |
torticollis, opisthotonos
young males laryngeal dystonia - med emergency, |
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Anticholinergic Agents
Indications Akathisia |
restlessness, anziety and agitation
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Anticholinergic Agents
Indications tardive dyskinesia |
invol movement of lips and fasciculations of tongue
progressing to prox limbs and trunk elderly women |
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Anticholinergic Agents
Benztropine |
least stimulating, some effect
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Anticholinergic Agents
Trihexyphenody |
most stim, some abuse potential
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Anticholinergic Agents
Side E |
tachycardia, hypotensin
dry mouth constipation confusion, blurred vision, dont' use in BPH or narrow angle glaucoma |
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Anticholinergic Agents
Amantadine Pharmaco |
half life 12-18 hr
unmetabolized inc dopamine transmission |
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Anticholinergic Agents
Amantadine Uses |
parkinsonism, akathisia
NOT for neuro or tardive dyskinesia |
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Anticholinergic Agents
Amantadine Side E |
dizziness, irritability, depression
over dose is life threatening psychosis |
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Anticholinergic Agents
Amantadine Interactions |
MAOIs and stimulants
seizures; renal disease, CV |
