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14 Cards in this Set
- Front
- Back
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Neuroleptics
A. mechanism |
1. dopamine receptor blocking
- anatgonized by those that raise [] = levodopa, amphetamines or dopa mimcs = bromocriptine 2. serotonin receptor blocking: newer atypicals |
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Neuroleptics Actions
A. antipsychotic |
A. dopamine-blocking = alleviate positive schizo sx
- atypicals for neg sx - all have calming effect, reduce spon mvmt - does not reduce intellectual fxn like CNS depressants |
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Neroleptic actions: others
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A. extrapyramidal: dystonia, parkinson like, tardiv dyskinesia (bc block dopamine recpetors in nigrostriatal)
B. antiemetic: all except aripiprazole, thioridazine C. antimuscarinic (anti-Ach): blurred vision, dry mouth, constipation, urinary retention D. block alpha R: orthostatic hypo, E. H1 receptor antagonist: sedation |
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Tx nausea due to vertigo
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- meclizine
- dimenhydrinate |
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Tx nausea due to motion sickness
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- scopolamine
-promethazine |
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Tx nausea due to cancer chemo
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-domperidone
-haloperidol -metoclopramide -proclorperazine |
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tx nausea due to radiation therapy
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- thiethylperazine
-domperidone |
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Tx tics of Tourette's disorder
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- pimozide
- risperidone - haloperidol |
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Neuroleptics: metabolism
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- bass to brian, bind well to proteins, metabolized by P450
- slow release injectable: fluphenazine, haloperidol, risperidone = less EPS for outpatient |
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Neuroleptics: adverse effect
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- tardive dyskinesia: incr # dopamine recepotrs syn to compensate long-term dopamine receptor blocade
- neuroleptic malignant sn: muscle rigidty, fever, AMS, stupor, myoglobinemia (tx: dantrolene, bromocriptine) - postural hypotension, tremors - constipation, urinary retention - confusion, sexual dysfxn |
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Use of antiphyschotics
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- 1st line: resperidone while clozapine reserved for refractory to traditional therapy
- clozapine: cadio, seizures, agranulocytosis = WBC monitor - other atypicals all lower extrapyramida and tardiv |
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Contraindications
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- all antipsychotics lower seizure threshold
- chlorpromazine, clozapine contraindicated in seizure - clozapine: agranulcytosis |
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Typical neuroleptis
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- fluphenazine: slow release depot form
- haloperidol: slow release form, high risk for EPD effect - thioridazine: muscarinic antagonist |
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Atypical neuroleptics
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In least to most wt gain
1. aripiprazole: bipolar depression 2. clozapine: agranulcyotsis, wt gain, seizures, myocarditis, hypotension 3. olanzapine: bipolar depression 4. quetiapine: bipolar depression 5. risperidone: min sedation, autism, bipolar depression 6. contraind hx of arrhythmias, min wt gain - bipolar depression |
