Anti-Psychosis Flashcards
What are the ATYPICAL anti-psychotics?
1) Clozapine
2) Olanzapine
3) Risperidone
4) Ziprasidone
5) Aripiprazole
6) Quetiapine
What are the Typical Antipsychotics? (3)
1) Thioridazine
2) Haloperidol
3) Chlorpromaxine
THC - hah
SIDE EFFECTS: Which drug has the greatest and least Extra Pyramidal Symptoms (EPS)
Greatest: Haloperidol (High affinity for D2 in Nigrostriatal tract)
Least: Clozapine (Low affinity for D2)
Which are REVERSIBLE neurologic toxic effects of Anti-Psychotics? (3)
1) EPS
2) Akathisia
3) Dystonia
What is Akathisia?
A state of agitation, distress, and restlessness. “Unable to sit still”
What is dystonia?
Neurological movement disorder:
- sustained muscle contractions -> twisting and repetitive movements or abnormal postures.
What is the most likely mechanism of Antipsychotic drugs?
Block Postsynaptic D2 receptors in the CNS.
- Particularly the mesolimbic-frontal system
Which of the REVERSIBLE neurologic toxic effects should be treated IMMEDIATELY and why?
1) Dystonia
2) Very painful
What drugs are given to treat Dystonia? (2)
1) Diphenhydramine (Sedative Antihistamine with anticholinergic)
2) Benztropine (Anti-Muscarinic)
What is the MOST IMPORTANT unwanted effect of antipsychotic drugs?
Tardive Dyskinesias
What is Tardive dyskinesias?
Choreoathetoid movements of the muscles of the lips and buccal cavity and may be IRREVERSIBLE.
What is Choreoathetosis?
Occurence of involuntary movements in a combination of
1) Chorea: Irregular migrating contractions
2) Athetosis: Twisting and Writhing
How does one develop Tardive Dyskinesia?
After several years of antipsychotic drug use.
- Some have it as early as 6 months.
How do you treat Tardive Dyskinesia? (3)
1) Discontinue or reduce dose of current antipsychotic
2) Eliminate all drugs with central anticholinergic action
3) Add diazepam (high dose if necessary) to enhance GABAergic activity
SIDE EFFECTS: Which drug has the greatest and least AUTONOMIC symptoms
Greatest: Thioridazine
Weaktest: Haloperidol
What causes AUTONOMIC side effects? (2)
Due to blockade of
1) Peripheral ALPHA-ADRENERGIC receptors
2) MUSCARINIC receptors
AUTONOMIC Side Effects of Alpha-Adrenergic receptor blockade: (2)
1) Postural Hypotension
2) Failure to ejaculate
AUTONOMIC Side Effects of Muscarinic Blockade. (3)
1) Atropine-like effects
2) Antimuscarinic CNS effects
3) Urinary retention
SIDE EFFECTS: Which drugs have an INTERMEDIATE autonomic effect? Exception?
Most Aytpicals
Exception: Ariprprazole, Ziprasidone
SIDE EFFECTS: Which drug has the greatest and least METABOLIC effects?
Greatest: Clozapine, Olanzapine
Weakest: Ziprasidone, Aripiprazole
What are the METABOLIC side effects: (4)
1) Significant weight gain
2) Hyperglycemia
3) Hyperlipidemia may occur
4) Some my develop DM
What are specific side effects of ENDOCRINE toxicity:
D2 receptor blockade in pituitary:
1) Hyperprolactinemia
2) Gynecomastic
3) Amenorrhea-galactorrhea syndrome
4) Infertility
Which drugs cause Atropine-like effects (Antimuscarinic Autonomic Side effect)
1) Thioridazine
2) Clozapine
3) Most atypicals except
- Ziprasidone
- Aripiprazole
Which drug is most highly associated with Hyperprolactinemia side effects?
Risperidone
