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40 Cards in this Set
- Front
- Back
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What are the typical antipsychotic prototypes?
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Chlopromazine
Fluphenazine Haloperidol |
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What are the atypical antipsychotic prototypes?
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Risperidone
Olanzapine Aripiprazole Clozapine |
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What are positive psychotic symptoms?
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agitation
delusions hallucinations disorganized speech and behavior |
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What are negative psychotic symptoms?
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Anhedonia
No motivation Social withdrawal Emotional blunting |
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What anatomical factors are shared by schizophrenic pts?
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Enlarged ventricles
Atropic cortical layers Decreased synaptic connections in the PFC Alterations in the structures of neocortical, limbic, and subcortical areas. |
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Which neurotransmitters can cause psychosis?
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Increasing DM
Increasing 5HT Increasing Glutamate |
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What is a common adjunct for antipsychotic medication?
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Benzos for short term
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How can compliance be increased with antipsychotic drugs?
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Use depot preparations
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What is the action of typical antipsychotic drugs?
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Post synaptic D2 block
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What is the acute effect of typical antipsychotic use? What is the long term effect?
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Acute: Reflex increase in synthesis and release of DM in the mesolimbic and nigrostriatal tract.
Chronic: DM pathways inactivated by depolarization block (takes several weeks). |
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What drug property modulates the potency of typical antipsychotics?
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Affinity for D2 receptor
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Typical antipsychotics block D2 recepts. What happens in a DM block of the nigrostriatal tract? Of the hypothalamus?
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NST: EPS
Hypothalamus: prolactin release from pituitary |
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Which other receptors might become blocked by typical antipsychotics?
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mACh
Alpha 1 H1 5-HT |
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What are the low potency typical antipsychotics?
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Chlorpromazine
Triflupromazine Thioridazine |
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What are the high potency typical antipsychotics?
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Fluphenazine
Trifluoperazine Perphenazine Haloperidol Thiothixene |
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Which antipsychotic could also be used for Tourette syndrome?
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Haloperidol
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What is the mechanism for atypical antipsychotics?
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Block 5-HT(2) and D2. But greater effect on 5HT receptors.
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What class is better for the positive symptoms of schizophrena? Negative symptoms?
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Positive: Use typicals
Negative: Use atypicals |
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Which class of antipsychotics are being used to treat bipolars?
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atypicals
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What are the prototype atypicals?
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Risperidone
Olanzapine Clozapine Aripiprazole |
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What is the mechanism of resperidone? What is the metabolite?
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Blocks 5HT2, D2, H1, and A1
Paliperidone is the primary metabolite |
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What is the mechanism of olanzapine?
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Blocks 5HT2, D1, D2, H1, A1, and mACh
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Which antipsychotics has a high potential for diabetes?
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(atypicals)
Olanzapine Clozapine Aripiprazole |
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Which antipsychotic blocks D4?
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Clozapine
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What is the mechanism for Clozapine?
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Blocks 5HT, D4, H1, and mACh receptors
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What is the toxic side effect of clozapine? What pts get clozapine?
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agranulocytosis in 2%, so only pts who dont respond with other drugs get clozapine.
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What is the mechanism for aripiprazole?
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Partial agonist of 5HT(1a) and D2
Blocker of 5HT(2a), A1, and H1 |
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What is aripiprazole used for?
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atypical antipsychotic that is also used as an adjunct to control depression in pts not responding to antidepressants.
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What is quetiapine?
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atypical antipsychotic
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What is ziprasidone?
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atypical antipsychotic
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What is iloperidone?
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atypical antipsychotic
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Which atypical antipsychotic does not block any dopamine receptors?
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Ziprasidone
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What causes EPS?
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blocking D2 disrupts the function of the extrapyramidal motor system
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What are early EPS reactions?
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Acute dystonia
Parkinsonism Akathisia |
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How is acute dystonia treated?
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Anticholinergics like diphenhydramine or benztropine, or lorazepam.
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What is akathisia? How is it treated?
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restlessness and pacing caused by antipsychotic use
Treated with anticholinergics, benzos, and beta-blockers |
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What is the late EPS reaction due to antipsychotic use?
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Tardive dyskinesia
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What drug is known to cause Tardive dyskinesia? How is it treated?
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10-20% of pts using D2 blockers. Seen in pts that take resperidone. It has not effect treatment and can be irreversible in some pts. The use of anticholinergics make it worse.
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What do you suspect if a patient on antipsychotics has "lead pipe" rigidity, fever, and CV instability? How is it treated?
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Neuroleptic malignant syndrome - seen in 1-2% pts in early antipsychotic treatment (may be due to excessively rapid DM block)
Treated with drug withdrawal, diazepam or dantrolene, and bromocriptine. |
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What is bromocriptine?
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Dopamine agonist
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