22: antipsychotics and anxiolytics Flashcards
what are other names for antipsychotics?
- neuroleptics
- major tranquilizers
- psycotrophics
what is the difference between neurosis and psychosis?
- neurosis is when you are still in contact with reality
- psychosis is when you are losing contact with reality
what is schizophrenia? when does it usually occur?
- chronic psychotic disorder
- adolescence or early adulthood
what are the two main categories of antipsychotics?
- typical
- atypical
is typical traditional or nontraditional? does it treat negative or positive symptoms? what neurotransmitter does it block?
- traditional
- positive
- blocks D2 and dopamine
is atypical traditional or nontraditional? does it treat negative or positive symptoms? what neurotransmitter does it block?
- nontraditional
- both negative and positive
- blocks D4 and serotonin
what are the two main typical drug classes?
- phenothiazine
- nonphenothiazine
what are the 4 categories of phenothiazine? what drug class are these in? what is the mechanism of action for these drugs?
- Aliphatics
- Piperizine
- Piperidine
- Phenothiazine
- Block D2 and DA
what is the example for an aliphatics drug? what potency is this drug? what is a major side effect?
- chlorpramazine
- low potency
- orthostatic hypotension
what is the example for a piperizine drug? what potency is this drug? what is a strong effect of this? what are some other side effects?
- fluphenazine
- medium potency
- antiemetic
- sedation, dizziness, photosensitivity, urinary retention, peripheral edema, EPS
what is the example for a piperidine drug? what potency is this drug? what strong side effect does this have?
- thioridazine
- high potency
- sedative
what is the one drug category under atypical nonphenothiazine drugs? what are the four drug examples? what is the mechanism of action for these drugs?
- butyrephenones
- halopheridol
- loxipane
- molindone
- thiothixene
- blocks DA and DA
What is EPS? what causes this? what are 4 outcomes of this?
- adverse reaction from antipsychotic medication
- pseudoparkinsonism
- acute dystonia
- tardive dyskinesia
- akathisia
what is NMS? what causes this? is this common? what is the major symptoms of this? how do you treat?
- adverse reaction to antipsychotic drugs
- rare
- fever, altered mental status, agitation, exhaustion, hyperthermia, tachycardia
- DA agonists
what is pseudoparkinsonism? what are the treatments for this?
what is acute dystonia? what percent of patients get this? what are the treatments for this?
- facial grimacing, involuntary upward eye movement, muscle spasms of the tongue and face, and laryngeal spasms
- 5%
- treat with anticholinergics like benzotropine or benzodiazepine such as lorazepam
what is tardive dyskinesia? what percent of patients get this? what are the treatments for this?
- protrusion and rolling of the tongue, sucking and smacking of the lips, chewing motion, facial dyskinesia, and involuntary movements of the body
- 20-30%
- not all treatments are helpful for everyone
- benzodiazepines, calcium channel blockers, and beta blockers
what is akathisia? what percent of patients get this? what are the treatments for this?
- restless, trouble standing still, paces the floor, feet in constant motion, rocking back and forth
- 20%
- treat with benzodiazepine such as lorazepam or beta blockers like propanolol
what does the acronym FEVER mean regarding NMS?
- Fever
- Encephalopathy
- Vital embalances
- Elevated liver enzymes
- Rhabdoyosis: muscle breakdown
what are the 5 drugs that need to be remembered for atypical antipsychotics? which one does not cause agranulocytosis? which drugs has the worst side effects? which one can rarely cause tardive dyskinesia?
- risperidone: does not cause agranulocytosis
- clozapine: has the worst side effects
- arapriprazole
- Olanzapine
- Quatiapine: can rarely cause tardive dyskinesia
what are some side effects of atypical antipsychotics?
- hyperglycemia
- agranulocytosis
- seizures
- increased cholesterol level
what are anxiolytics also known as?
-minor tranquilizers
what do anti-anxiety medications treat?
anxiety and insomnia
what medication is given as an anxiolytic? what is it used for? what is the mechanism of action?
- benzodiazepine; lorazepam
- to treat anxiety or insomnia
- inhibiting GABA neurotransmitters
