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18 Cards in this Set
- Front
- Back
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What are the differences between first-generation (typical) antipsychotics and second-generation (atypical) antipsychotics? |
The second-generation antipsychotics have fewer neurological side effects, but more metabolic side effects. Also, the second-generation ones are effective at treating the negative symptoms of schizophrenia, whereas the first-generation ones are not. |
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Name two low-potency first-generation antipsychotics |
Chlorpromazine, thioridazine |
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Name two high-potency first-generation antipsychotics |
Haloperidol, fluphenazine |
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What is the main difference between haloperidol and chlorpromazine? |
Haloperidol is a "high potency" antipsychotic while chlorpromazine is a "low potency" antipsychotic, referring to their affinity to the D2 receptors. |
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What is the mechanism of action of first generation antipsychotics? |
They block postsynaptic dopamine D2 receptors |
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Which two pathways in the brain are thought to be overactive in schizophrenia? |
The mesolimbic "reward" pathway and the mesocortical pathway. Both are dopaminergic. |
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What are the indications of first generation antipsychotics? |
- Schizophrenia - Acute psychosis - To calm down violent or aggressive patients |
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Which other receptors are blocked by low-potency first generation antipsychotics? |
Muscarinic receptors, α1 adrenergic receptors and histamine H1 receptors. |
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What are the side effects of low potency first generation antipsychotics? |
- Dry mouth
- Constipation - Orthostatic hypotension - Sedation - Prolonged QT |
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What are the side effects of high potency first generation antipsychotics, like haloperidol? |
- Extrapyramidal symptoms - Hyperprolactinaemia - Prolonged QT |
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Which potentially fatal syndrome can occur with any antipsychotic?
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Neuroleptic malignant syndrome |
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What are the characteristics of neuroleptic malignant syndrome? |
Muscle rigidity, fever, altered mental status and rhabdomyolysis |
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Name two second generation antipsychotics |
Clozapine, olanzapine |
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What are the indications of second generation antipsychotics? |
- Schizophrenia - Bipolar disorder - Treatment-resistant depression - OCD |
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What is the mechanism of action of second generation antipsychotics? |
They block postsynaptic dopamine D2 receptors |
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What are the side effects of second generation antipsychotics? |
Dry mouth, constipation, orthostatic hypotension, sedation. Metabolic symptoms, like weight gain, diabetes. Decreased threshold for seizures. Prolonged QT interval Same neurologic symptoms as for first generation, but less commonly. |
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Which side effects are specific for clozapine? |
- Agranulocytosis - Cardiomyopathy - Myocarditis |
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What is a unique side effect of chlorpromazine? |
Corneal deposits
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