Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
14 Cards in this Set
- Front
- Back
Chlorpromazine
- trade name? - class - mechanism - indications - contraindications - SE - drug interactions? |
- throazine
- typical antipsychotic - blocks a1 and 5HT-2 > D2 > D1 receptors; it has an effect of all of these, in decreasing order. - psychosis, N&V, sedation, intractable hiccups, tetanus (adjunct), actue intermittent porphyria - hyperS, CNS depression, BMD, hypotension, parkinsonism, hepatic dysfunction, glaucoma - drowsiness, seizures, agranulocytosis, aplastic anemia, thrombocytopenia, neuroleptic malignant syndrome, tardive dsykinesia - antacids, alcohol, BP meds, anticoags, phenytoin |
|
Haloperidol
- class - mechanism - indications - contraindications - SE - drug interactions? - admin? |
- antipsychotic (typical)
- bl/ D2 >D1, D4 > a1 > 5-HT2 - psychosis (schizo), Tourette's - *Prolonged QT*, hyperS, CNS depression, Parkinson's dz - Parkinson-esque sx, tardive dyskinesia, torsade de pointes, orthostatic hypotension, neuroleptic malignant syndrome - lithium, CNS depressants - DO NOT give via IV |
|
Risperidone
- class - mechanism - indications - contraindications - SE - drug interactions? |
- ATYPICAL antipsychotic
- bl/ D2, 5HT-2. Also blocks M, a1, and H1 receptors. - psychosis (schizo), dementia - hyperS, prolonged QT, renal/liver dz - insomnia, agitation, anxiety, Parkinson's sx, constipation, rhinitis - carbamazepine, clozapine, drugs to tx Parkinson's, anti HTN |
|
Clozapine:
- class - effectiveness wrt other atypical antipsychotics? - mechanism - indications - contraindications - SE - drug interactions? |
- ATYPICAL antipsychotic
- more effective, but dangerous side effect - bl/ D4, a1 > 5HT-2 > D2, D1; also blocks M1 and H1. - schizo (resistant)... it is only FDA approved for resistant b/c of the agranulocytosis risk, suicided risk associated w/ schizo. - WBC <3500, myloproliferative dz, renal/liv dz, heart dz, hyperS - *agranulocytosis*, Drowsiness, dizz/vertigo, HA, tachycardia, constipation, hypersalivation, aspiration pneumonia, tremor, disturbed sleep, hypokinesia, seizures, - drugs suppressing BM function (ties in w/ the WBC requirement), benzodiazepines, and psychotropic drugs. |
|
Olanzapine
- trade name? - class - mechanism - indications - contraindications - SE - drug interactions? |
- zyprexa
- ATYPICAL antipsychotic - 5HT-2 > D1-D4 & a1. also M & H1. - bipolar dz, psychosis - hyperS - drowsiness, flu-like, increased salivation, nausea, highest incidence of clinically significant weight gain, (maybe tardive dyskinesias... would be more rare than in a typical APD tho') - antiHTN, L-DOPA, dopamine agonists, carbamazepine (p-450 inducer) |
|
What are the differences between atypical and typical antipsychotics? Classic examples of each?
|
typical: cause EPS, elevated serum prolactin, induce tardive dyskinesias w/ chronic use
- classic example = Haloperidol Atypical: minimal EPS, minimal elevation of prolactin, less propensity for tardive dyskinesia due to less antagonism of D2 receptors. - clozapine |
|
In most cases, we select antipsychotics based on what?
|
side effect profile.
|
|
What is a dystonic reaction? What can cause it? tx?
|
- dystonia (contortion movements, tensing...), swelling of tongue, oculogyric crisis....
+ acute onset (hours/days) after chance in dose/drug or compliance - responds rapidly to IM or IV anticholinergic drugs (benztropine, diphenhydramine [1st gen antihistamine: as such has anticholinergic properties]) |
|
What types of drugs work to tx APD-induced parkinsonism?
|
antimuscarinics.
|
|
What is Akathisia? Can be a side effect of which drugs?
|
restless leg syndrome
Antipsychotic (typicals) |
|
What is the rarest of all EPS?
- potentially fatal? - triad of which sx? + other sx? + lab value changes? - what should you do? |
Neuroleptic malignant syndrome
- yes - fever, rigidity, cognitive change - autonomic instability (sweating, BP/HR) - ^CPK and ^WBC - stop the APD and hospitalize |
|
What side effects can the DA antagonism of APD drugs have via their elevation of prolactin lvls?
|
breast engorgement, amenorrhea, gynecomastia, reduced libido, sexual dysfunction.
|
|
Although MANY APD's can affect QTc, which two have the larger effects?
- what does this mean re: our perscriptions of APDs in general? |
thioridazine and ziprasidone
- monitory EKG, avoid using APDs in combo with other QTc drugs (amiodarone, chlorpromazine, cisapride, quinidine, procainamide, etc.) |
|
Antipsychotics induce sedation by which mechanism?
|
histamine receptor activation; perhaps w/ some help from 5HT-2a antagonism in the atypicals.
|