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Psych Drugs > Anti-Psychotics > Flashcards

Anti-Psychotics Flashcards

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1
Q

What is the main use of Antipsychotics?

A

Schizophrenia

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2
Q

What can antipsychotics also be used to manage?

A

Other forms of psychosis
Mania
Agitation

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3
Q

How are antipsychotics classified ?

A

Typical
Atypical

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4
Q

What is the main problem with typical antipsychotics?

A

Extrapyramidal side-effects

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5
Q

What is the mechanism of action of typical antipsychotics?

A

Dopamine D2 receptor antagonists

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6
Q

What do typical antipsychotics block?

A

Dopaminergic transmission in the mesolimbic pathways

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7
Q

What are the main 2 adverse effects of typical antipsychotics?

A

Hyperprolactinaemia

Extrapyramidal side effects

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8
Q

How can hyperprolactinaemia present in men?

A
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9
Q

How can hyperprolactinaemia present in women?

A
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10
Q

What are the 2 most common typical antipsychotics?

A

Haloperidol

Chlorpromazine

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11
Q

What is the mechanism of action of atypical antipsychotics?

A

Act on a variety of receptors (D2, D3, D4, 5-HT)

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12
Q

How are atypical antipsychotics classified?

A

Serotonin-dopamine 2 antagonists (SDAs)

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13
Q

Why are atypical antipsychotics classified as atypical?

A

They are atypical in the way they affect dopamine and serotonin neurotransmission in the four key dopamine pathways in the brain

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14
Q

What are the most common atypical antipsychotics?

A

Risperidone
Olanzapine
Clozapine
Aripiprazole

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15
Q

What is less common with atypical antipsychotics?

A

Extrapyramidal side-effects
Hyperprolactinaemia

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16
Q

What are the main type of adverse effects of atypical antipsychotics?

A

Metabolic effects

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17
Q

What does risperidone function like at higher doses?

A

A typical antipsychotic

18
Q

What type of side effects does risperidone have?

A

Extrapyramidal and hyperprolactinaemia

19
Q

Which atypical antipsychotic is good for elevated prolactin levels?

A

Aripiprazole

20
Q

What are the main side effects of Olanzapine?

A

Weight gain
Dyslipidaemia (hyperlipidaemia)

21
Q

In which patients would you not use olanzapine?

A

Overweight or obese

22
Q

When should clozapine be used?

A

If a patient is resistant to other antipsychotic medication

23
Q

What is the main risk of using clozapine?

A

Agranualocytosis

24
Q

When is a patient classed as resistant?

A

After the sequential use of 2 or more antipsychotic drugs, each for 6-8 weeks

25
Q

What are other side effects of clozapine?

A

Neutropenia
Myocarditis
Constipation

26
Q

What is the main risk of using clozapine?

A

Agranulocytosis

27
Q

When would you need to adjust the dose of clozapine?

A

If smoking is started or stopped during treatment

28
Q

What is essential during the treatment with clozapine?

A

Full blood count monitoring

29
Q

What should you do if someone on clozapine develops a fever?

A

Give IV broad spectrum antibiotics

30
Q

What is there an increased risk of with antipsychotics in the elderly?

A

Increased risk of:
Stroke
Venous Thromboembolism

31
Q

What are the main adverse effects of antipsychotics?

A

Tardive Dyskinesia (TD
Neuroleptic Malignant Syndrome (NMS)
Extrapyramidal side effects

32
Q

What are examples of extrapyramidal side-effects?

A

Parkinsonism
Acute dystonia
Akathisia
Tardive dyskinesia

33
Q

What is Neuroleptic Malignant Syndrome?

A 
Characterised by:
Severe muscle rigidity
Fever
Altered mental status
Autonomic instability
Elevated WBC, CPK and lfts. Potentially fatal.
34
Q

What is acute dystonia?

A

Sustained muscle contraction

35
Q

What is akathisia?

A

Severe restlessness

36
Q

What is Tardive Dyskinesia?

A

Involuntary muscle movements that may not resolve with drug discontinuation

37
Q

How often does a Full blood count (FBC), urea and electrolytes (U&E), liver function tests (LFT) need to be done on someone taking antipsychotics?

A
  • at the start of therapy
  • annually
  • clozapine- more frequent FBC- initially weekly
38
Q

How often do Lipids and weight need to be checked in someone taking antipsychotics?

A
  • at the start of therapy
  • at 3 months
  • annually
39
Q

How often does fasting glucose and prolactin need to be checked in someone taking antipsychotics?

A
  • at the start of therapy
  • at 6 months
  • annually
40
Q

How often does blood pressure need to be checked in someone taking antipsychotics?

A
  • baseline

* frequently during dose titration

41
Q

How often does an Electrocardiogram need to be done on someone taking antipsychotics?

A
  • baseline
  • Cardiovascular risk assessment
  • Annually

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