Pharm Winter Exam 1 Antipsychotic Drugs And Mood Stabilizers

Front 1

Phenothiazines

Back 1

1) Chlorpromazine
2) Thioridazine
3) Fluphenazine

Front 2

Thioxanthene

Back 2

Thiothixene

Front 3

Butyrophenone

Back 3

Haloperidol

Front 4

New Generation "Atypical" Antipsychotics

Back 4

1) Clozapine
2) Risperidone
3) Ziprasidone
4) Olanzepine
5) Quetiapine
6) Aripiprazole

Front 5

Mood stabilizers

Back 5

1) Lithium
2) Divalproex/Valproic acid
3) Topiramate

Front 6

Classical antipsychotics

Mechanism of action

Back 6

Block D2, alpha adrenergic and Histamine receptors, and muscarinic

Block positive symptoms

Front 7

Classical antipsychotics

Beneficial effects

Back 7

1) Blocks D2 in the limbic system
2) Decreases fear, hostility, agitation, delusions
3) Anti-emetic blockade of dopamine in chemoreceptor trigger zome

Front 8

Classical antipsychotics

Side effects

Back 8

1) Extrapyramidal effects
2) Tardive Dyskinesia
3) Endocrine effects
4) Autonomic effects
5) Seizures
6) Neuroleptic malignant syndrome

Front 9

Classical antipsychotics

Extrapyramidal effects

Back 9

1) Decreased dopamine in the Nigrostriatal system
2) Akathisia (rocking)
3) Dystonia (involuntary muscle spasm)
4) Parkinsonian Symptoms
Tx: anticholinergics

Front 10

Classical antipsychotics

Tardive dyskinesia

Back 10

1) Occurs late in treatment
2) Uncontrollable movements of mouth and tongue
3) Less likely with clozapine and olanzapine

Front 11

Classical antipsychotics

Endocrine effects

Back 11

1) Supress appetite
2) Deregulate temperature
3) Weight gain
4)Increase prolactin release-->infertility, impotence, amenorrhea

Front 12

Classical antipsychotics

Autonomic effects

Back 12

1) Anticholinergic: Dry mouth, blurred vision, tachycardia
2) Alpha blockade: Orthostatic hypotension
3) Histamamine: Sedation

Front 13

Classical antipsychotics

Neroleptic Malignant syndrome

Back 13

1) Life threatening
2) Muscle rigidity
3) Catatonia
4) Hyperthermia
5) Altered BR and HR
Tx: Dantrolene

Front 14

Phenothiazine uses

Back 14

1) Prototype Chlorpromazine
2) Nausea and vomiting
3) Pre-anesthetic
4) Psychotic mania
5) alcoholic hallucinations (other drugs too)

Front 15

Phenothiazine

Chlorpromazine Side effects

Back 15

1) Anticholinergic
2) Postural hypotension
3) Inhibition of ejaculation
4) Jaundice

Front 16

Phenothiazine

Thorioridazine

Back 16

1) High anticholinergic
2) Lower extrapyramidal effects
3) More sedation and hypotension
4) Retinal Deposits

Front 17

Phenothiazine

Fluphenazine

Back 17

1) Low anticholinergic activity
2) High Extrapyramidal symptoms
3) Less sedation and hypotension

Front 18

Haloperidol

Back 18

1) Selective D2 blocker
2) Injected in acute psychosis
3) Worst for Extrapyramidal symptoms

Front 19

Atypical antipsychotics

Clozapine

Back 19

1) Inhibits D4 and 5-HT2A, Muscarinic, histamine and alpha1
2) Very low extrapyramidal effects
3)Used in Parkinson's patients
4)Causes Agranulocytosis

Front 20

Atypical antipsychotics

Olanzapine

Back 20

1) Blocks D2,D4, 5-HT2A
2) Anticholinergic effects
3) Rarely causes extrapyramidal effect
4) Treats Negative symptoms
5)Used to treat Bipolar
6) No agranulocytosis

Front 21

Atypical antipsychotics

Olanzapine side effects

Back 21

1) Weight Gain
2)Hyperglycemia and type II diabetes

Front 22

Atypical antipsychotics

Risperidone

Back 22

1) First Line
2) Blocks D2, 5-HT2A, alpha
3) Enhances DA in basal ganglia
4) Low extrapyramidal effects
5) Low Tardive dyskinesia

Front 23

Atypical antipsychotics

Risperidone side effects

Back 23

1) Lengthens Q-T interval
2) Postural Hypotension

Front 24

Atypical antipsychotics

Ziprasidone

Back 24

1) Blocks D2 and 5-HT2A
2) Some antidepressant activity
3) Metabolized by CYP3A4

Front 25

Atypical antipsychotics

Ziprasidone Side effects

Back 25

1) Prolongs QT interval
2) Sedation
3) Hyperprolactinemia
4) Decreases seizure threshold

Front 26

Atypical antipsychotics

Quetiapine

Back 26

1) NO agranulocytosis
2) No hyperprolactinemia
Side effects
1) Drowsiness,
2) Weight gain
3) Xerostomia

Front 27

Atypical antipsychotics

Aripiprazole

Back 27

1) Dopamine system stabilizer
2) Partial agonist D2 and 5-HT1A
3)Blocks 5-HT2A, alpha, histamine
4)No hyperprolactinemia, weight gain or lengthened Q-T

Front 28

Atypical antipsychotics

Aripiprazole side effects

Back 28

1) Orthostatic Hypotension
2) Increase Blood glucose, worsen diabetes
3) Seizures
4)Decrease motility of esophagus
5) Low extrapyramidal effects

Front 29

Antipsychotics

Drug interactions

Back 29

1) Anticholinergics
2) Sedatives
3) Carbamazepine and smoking induce liver enzymes increasing metabolism
4) Antihypertensive drugs

Front 30

Uses of Antipsychotics

Schizophrenia

Back 30

1) Risperidone
2) Quetiapine
3) Olanzepine

Front 31

Uses of Antipsychotics

Depression and Mania with psychosis

Back 31

Antiphsychotic or Benzodiazepines (Alanzepine) with Mood stabilizers

Front 32

Uses of Antipsychotics

Tourette's syndrome

Back 32

Haloperidol
Primazide

Front 33

Uses of Antipsychotics

Alzheimer's Disease

Back 33

Resperidone for agitation and hyperactivity

Front 34

Uses of Antipsychotics

Antemetic

Back 34

Prochlorperazine

Front 35

Mood Stabilizers

Lithium

Back 35

Use with antipschotic for mania
and antidepressant for depression when initiating treatment

Front 36

Mood Stabilizers

Lithium Pharmacokinetics

Back 36

1) Monitor Serum concentration ( 0.6-1.2 mEq/L)
2) Excreted by the kidney reabsorbed by proximal tubule,
3)Competes with Na+ for reabsoption
4)Decrease in Na+, Increase in Li
5)Thiazide Diuretics, NSAIDs decrease clearance of Li

Front 37

Mood Stabilizers

Lithum Side effects

Back 37

1) Tremor
2) Nausea
3) Headache
4) Decrease Thyroid function
5) Nephrogenic Diabetes Insipidus
6) Weight Gain
7) Can be used during pregnancy

Front 38

Mood Stabilizers

Lithium Toxicity

Back 38

Extremely toxic
Mild: >2 mEq/L Nausea, vomiting, impaired memory and concentration
Severe: > 2.5 mEq/L- Cardiac arrythmias
Tx: Saline and dialysis

Front 39

Mood Stabilizers

Lithium Drug interactions

Back 39

Antidepressants: increase mania
Benzodiazepines and antipsychotics: safe
Thiazide: increase Li plasma
Amilioride: Improve Diabetes insipidus
NSAIDs: increase plasma Li

Front 40

Mood Stabilizers

Valproic acid/Divalproex Sodium

Back 40

1) Widely used mood stabilizer
2) As good or better than Li
3) Fairly Rapid onset of action

Front 41

Mood Stabilizers

Valproic acid/Divalproex Sodium
Side effects

Back 41

1) GI upset
2) Transient liver enzymes
3) Weight gain
4) Contraindicated in pregnancy

Front 42

Mood Stabilizers

Topiramate

Back 42

Effective monotherapy bipolar
Causes weight loss