Anti Psychotics

Question 1

Typical antipsychotics mechanism ?

Answer 1

Dopamine D2 receptor antagonists, blocking dopaminergic transmission in the mesolimbic pathways

Question 2

side effects Typical antipsychotics mechanism ?

Answer 2

Extrapyramidal side-effects and hyperprolactinaemia common

Question 3

examples typical Extrapyramidal side-effects (EPSEs)

Answer 3

Parkinsonism

acute dystonia:

1) sustained muscle contraction (e.g. torticollis,
2) oculogyric crisis - spasmodic movements of the eyeballs into a fixed position, usually upwards

akathisia (severe restlessness)

tardive dyskinesia (late onset of choreoathetoid movements, abnormal, involuntary, may occur in 40% of patients, may be irreversible, most common is chewing and pouting of jaw)

Question 4

acute dystonia may be managed with ?

Answer 4

managed with procyclidine

Question 5

antipsychotics used in elderly patients

Answer 5

increased risk of stroke
increased risk of venous thromboembolism

Question 6

examples of Typical antipsychotics

Answer 6

Haloperidol
Chlopromazine

Question 7

other side effects of antipsychotic medication ?

Answer 7

dry mouth, blurred vision, urinary retention,

constipation

sedation, weight gain

raised prolactin
may result in galactorrhoea
due to inhibition of the dopaminergic tuberoinfundibular pathway

impaired glucose tolerance

neuroleptic malignant syndrome: pyrexia, muscle stiffness

reduced seizure threshold (greater with atypicals)

prolonged QT interval (particularly haloperidol)