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12 Cards in this Set

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  • Back
Chlorpromazine
- used first in mid 50s
- first to not overly sedate the pt
Neuroleptic
- term referring to the control of motr activity
Name the phenothiazine
- chlorpromazine
Name the butyrophenone
- haloperidol
Atypical antipsychotics
- clozapine
- risperidone
- olanzapine
- quetiapine
(these all have little to do with D2 receptors - ie... that's why they are atypicals)
Mechanism of typical antipsychotics
- D2 dopamine receptor antagonists
- potency related with D2 dopamine receptor binding activity
What can produce psychotic reactions at high doses
- L-dopa and other dopamine agonists
Evidence against dopamine therapy for psychosis
- not all pts respond to D2 antagonists
- Clozapine and others appear to improve negative effects (congnition)
How do you chose an antipsychotic?
- selection based less on theraputic expectancy and MORE on anticipated side effects
- VERY important to remember that there are different side effects dependingon potencies at other receptors
More on selection of antipsychotics
- extrapyramidal symptoms due to dopamine receptor blockade
- parkinsons type symptoms
- tardive dyskinesia
- increased prolacting release (less of a problem with atypicals)
Note on Clozapine
- first approved atypical antipsychotic in this country
- less likely to cause extrapyramidal problems
Neuroleptic malignant syndrome
- life threatening
- muscle rigidity
- fever
- leukocytosis
- caused by dopamine receptor blockade
- treat this with: bromocriptine + muscle relaxant