1st Generation (Typical) Antipsychotics

Question 1

name the high potency 1st generation antipsychotics
(“kid high on roof”)

Answer 1

“van gogh’s starry gAZINg” - “azine” suffix

• Haloperidol (“halo of gazing star”)
• Trifluoperazine (“kid trying to fly”)

-Fluphenazine (“kid trying to fly”)

Question 2

1st Generation antipsychotics MOA

Answer 2

-block dopamine D2 receptors in the CNS espeicalliy in mesolimbic and striatofrontal system
(“Van Gogh holding double rope “)

-FGA’s have long half life and thus long duration of action since they’re highly lipophilic
(“kid on crazy peak holding long tapered flag”)

Question 3

name the low potency 1st Generation antipsychotics

(“van gogh’s coloring tools on floor”)

Answer 3

-Thioridazine
(“color THEORYdazine”)

-Chloropromazine
(“color-pro” paint on floor)

Question 4

what can 1st Generation Antipsychotics be used for?

Answer 4

-can treat positive symptoms of Schizophrenia-hallucinations , delusions , disorganised thoughts
(“Van Goch’s right ear is cut off thus blocking positive voices”)

-useful in treatment of acute psychosis in many condition {e.g. bipolar disorder}
(“kid on crazy peak holding flag”)

-may be used to treat aggitation , aggression
(“kid on agitated peak with marionette”)

-can be used for management of Tourette syndrome
(“tourette’s marionette with agitated aggressive blacky kid”)

Question 5

what are the characteristic features and side effects seen in low potency FGAs

(low potency > high potency)

Answer 5

-they have antimuscarininc effects including

• dry mouth (“dry as a cracker”)
• constipation
• blurred vision (“blind as a bat”)
• urinary retention

-blocks α1 receptors
(“nurse holding single extinguished candle”)

• leads to orthostatic hypotension
  (“passed out couple in picture”)

​-blocks H1 histamine receptor
(“nurse holding bee swatter”)

• leads to sedation
  (“picture with Van Gogh’s bed”)

(“alice in wonderland tea party picture”)

Question 6

what are the characteristic features and side effects seen in High potency FGAs

(low potency< high potency)

Answer 6

-high potency FGAs cause Extra Pyramidal Symptoms

• Acute dystonia (“Cocked head”)/ in minutes
• ​Akathisia (“falling chair”) /in days
• ​Parkinsonism (“cogwheels of carriage”) /in weeks

-Can cause Tardive dyskinesia
(“kid in carriage sticking out his tongue”)
——————————————————————————–
-any drug blocking dopamine → hyperprolactinemia →galactorrhea, amenorrhea, impotence
(“kfc kid has white mustache”)
——————————————————————————-
-can cause Neuroleptic Malignant Syndrome
(kfc bucket says “now more spicy”)

• generalized “lead pipe” rigidity
• ​altered mental status, fever, autonomic instability
• ​characterized by Rhabdomyolysis

(“kid on roof wearing extra pyramid hat”)

Question 7

• *Side effects** seen after adminstration of First Generation Antipsychotics
• *(low/high)**

Answer 7

-FGAs can cause Torsades de Pointes fatal cardiac arrhythmia (“twisted streamer”)

-can lower seizure threshold
(“shaking kid hanging on streamer”)

Question 8

Chlorpromazine

(“color-pro paint”)

Answer 8

-can cause corneal deposits

(“corn yellow color-pro paint”)

Question 9

Thioridazine

(“color THEORYdazine”)

Answer 9

-can cause retinal deposits
(“deposits on retinal color palette”)