Anti-Psychotic Drugs

Question 1

Typical and Atypical Antipsychotic Drugs

All drugs MOA

Answer 1

Typical:
Haloperidol, flupenthixol, zuclopenthixol,

Atypical: Clozapine, olanzapine, risperidone, aripriprazole.

Question 2

SE of All Antipsychotics

Answer 2

Extra-pyramidal SE: akathisia, parkinsonianism, acute dystonia (spasm tongue, neck, face and back)

Sedation and weight gain.

Question 3

Difference of SE between atypical and typical

Answer 3

Typical: eg haloperidol, flupenthixol, zuclopenthixol are more likely to cause extrapyramidal SE.

Question 4

Clozapine
Indication
SE

Answer 4

Most effective antipsychotic
Used in schizophrenia after two antipsychotics have not worked.

SE: neutropenic sepsis via agranulocytosis.
Bowel obstruction via constipation.
Salivation, urinary incontinence.

Question 5

Monitoring

What bloods need to be done.

Answer 5

Baseline: FBC, lipid, LFT, UandE, ECG, HbA1c, Weight.

Three months bloods, yearly bloods
Then weekly weights.

Question 6

How to stop EPSE

Answer 6

If we have decrease amounts of dopamine we can adjust the level of noradrenaline to adjust the ratio and avoid EPSE.

To counter the decrease of dopamine, we antagonise Ach.
Eg: Procyclidine.