18. Antipsychotics

Question 1

MOA of antipsychotics?
affinity for typicals?
affinity for atypicals?

Answer 1

Competitive block DA and 5-HT receptors
typicals = D2 > 5-HT2
atypicals = 5-HT2 > D2

Question 2

Dopamine drug effect at:
presynaptic short term tx -
presynaptic long term tx -
postsynaptic short term tx -
postsynaptic long term tx -

Answer 2

presynaptic short term tx - activated neurons
presynaptic long term tx - inactivated neurons
postsynaptic short term tx - receptor blockade
postsynaptic long term tx - receptor supersensitivity

Question 3

antipsycotic that deposits in retina?

Answer 3

thioridazine

Question 4

drug causing T-wave abnormalities?

Answer 4

Thioridazine

Question 5

drugs that have lower incidence of extrapyramidal side effects?

Answer 5

Atypicals

Question 6

Drug with little to no effect on weight gain, lipids and glucose?

Answer 6

Haloperidol

Question 7

3 drugs w lots of EPS effects?

Answer 7

haloperidol
fluphenazine
thiothixene

Question 8

antipsycotic used to tx drug induced nausea?

Answer 8

prochorperazine

Question 9

Receptor causing prolactin effects?
symtoms?
drugs common in?

Answer 9

Dopamine
menstrual probs, libido, mamillary gland swelling
phenothiAZINES

Question 10

Do positive or negative side symptoms respond better to antipsycotics?

Answer 10

Positive respond well

Question 11

drug with weight gain but no effect on lipids and glucose?

Answer 11

Risperidone

Question 12

3 EPS effects?

Answer 12

akathisia (reslessness)
pseudoparkinsonism
Dystonias (facial gimacing)

Question 13

drug that is a component of neuroleptanesthesia?

Answer 13

Droperidol

Question 14

4 AEs more common in typicals?

Answer 14

EPS symptoms
Tardive Dyskinesia
Neuroleptic Malignant syndrome
Prolactin

Question 15

Receptor causing orthostatic hypertention?

Answer 15

Adrenergic (α1A and α2A)

Question 16

2 drugs that exhibit strong anticholinergic effects? results?

Answer 16

Thioridazine and Chlorpromazine

–> fewer EPS

Question 17

receptor causing sedation?

Answer 17

Histamine (H1)

Question 18

Name some positive symptoms?

Answer 18

(something added)
Agitaiton
Delusions
Disorganized speech
disorganized thinking
hallucinations 
insomnia

Question 19

Receptor causing tardive dyskinesia?
drugs causing high incidence?
drug w low incidence?

Answer 19

Dopamine
AE common in typicals
AE low w clozapine

Question 20

drug to tx tourettes?

Answer 20

haloperidol

Question 21

Wt causes adverse effects of antipsycotics?

Answer 21

blockade of α1-adrenergic, Histamine H1 and Muscarinic receptors

Question 22

use for Chlorpromazine? contraindicaiton?

Answer 22

Hiccups

contraindicated in pts w seizures

Question 23

Receptor causing Neuroleptic malignant syndrome?
drugs common in?
tx?

Answer 23

Dopamine
Common w typicals
stop drug and administer bromocriptine and dantrolene

Question 24

3 drugs w high potential of weight gain, hyperlipidemia and hyperglycemia (T2DM)?

Answer 24

Clozapine, olanzapine, chlorpromazine

Question 25

drug causing QT prolongation?

Answer 25

Ziprasidone

Question 26

Atypicals?

Answer 26

-zapines

risperidone

Question 27

Problems resulting from cholinergic (M1) blockade?

Answer 27

dry mouth, blurred vision, urinary retention, constipaiton.

Question 28

Drug causing leukopenia and agranulocytosis?

Answer 28

Clozapine

Question 29

wc antipsycotics can be used as anti-emetics?

Answer 29

all except aripiprazole and thioridazine

Question 30

atypical that increases salivation?

Answer 30

Clozapine