Anti-Psychotics Flashcards
Chlorpromazine [Thorazine]
Phenothiazene, Typical 1st Gen Anti-Psychotic
MoA: D2 Antagonist -> Inh positive symptoms, Inc prolactin
Anti-Cholinergic -> minimize ESP
Low Potency -> Inc Anti-Cholinergic (min ESP)
PK: erratic absorp, high Vd (lipid high ProBind), cross placenta/milk, 2D6/3A4 meta (not ind)
DDI: Inh 2D6 -> Inc SSRI/TCA
ADE: juandice, skin rxn, impair glucose tolerance, anti-diuretic, OrthoHypo, CVD
Fluphenazine [Modecate]
Phenothiazene, Typical 1st Gen Anti-Psychotic
MoA: D2 Antagonist -> Inh positive symptoms, Inc prolactin
Anti-Cholinergic -> minimize ESP
High Potency -> Inc ESP, less anti-cholingeric
PK: erratic absorp, high Vd (lipid high ProBind), cross placenta/milk, 2D6/3A4 meta (not ind)
DDI: Inh 2D6 -> Inc SSRI/TCA
ADE: acute dystonia, akathesia, parkinsonian, neuroleptic malignant syndrome, perioral tremor, tardive dyskinesia
Haloperidol [Haldol]
Typical 1st Gen Anti-Psychotic
MoA: D2 Antagonist -> Inh positive symptoms, Inc prolactin
Anti-Cholinergic -> minimize ESP
High Potency -> Inc ESP, less anti-cholingeric
PK: IV/IM admin, erratic absorp, high Vd (lipid high ProBind), cross placenta/milk, 2D6/3A4 meta (not ind)
DDI: Inh 2D6 -> Inc SSRI/TCA
ADE: acute dystonia, akathesia, parkinsonian, neuroleptic malignant syndrome, perioral tremor, tardive dyskinesia
Clozapine [Clozaril]
Atypical 2nd Gen Anti-Psychotic
MoA: D2 Antagonist -> Inh positive symptoms
5HT-2a Antagonist -> Inh negative symptoms, reduce ESP
Low Potency -> Inc Anti-Cholinergic (min ESP)
PK: erratic absorp, high Vd (lipid high ProBind), cross placenta/milk, 2D6/3A4 meta (not ind)
DDI: Inh 2D6 -> Inc SSRI/TCA
ADE: Inc risk DMII, weight gain, metabolic syndrome
Dose Limit: blood dyscrasis (agranulocytosis)
Risperidone [Risperdal]
Atypical 2nd Gen Anti-Psychotic
MoA: D2 Antagonist -> Inh positive symptoms
5HT-2a Antagonist -> Inh negative symptoms, reduce ESP at low dose, inc at high dose
DOC in child/teen
PK: active metabolite Paliperadone, depot available
erratic absorp, high Vd (lipid high ProBind), cross placenta/milk, 2D6/3A4 meta (not ind)
DDI: Inh 2D6 -> Inc SSRI/TCA
Olanzapine [Zyprexa]
Atypical 2nd Gen Anti-Psychotic
MoA: D2 Antagonist -> Inh positive symptoms
5HT-2a Antagonist -> Inh negative symptoms, reduce ESP
PK: erratic absorp, high Vd (lipid high ProBind), cross placenta/milk, 2D6/3A4 meta (not ind)
DDI: Inh 2D6 -> Inc SSRI/TCA
ADE: Inc risk DMII, weight gain, metabolic syndrome (highest)
Quetiapine [Seroquel]
Atypical 2nd Gen Anti-Psychotic
MoA: D2 Antagonist -> Inh positive symptoms
5HT-2a Antagonist -> Inh negative symptoms, reduce ESP
PK: erratic absorp, high Vd (lipid high ProBind), cross placenta/milk, 2D6/3A4 meta (not ind)
DDI: Inh 2D6 -> Inc SSRI/TCA
ADE: Inc risk DMII, weight gain, metabolic syndrome (intermediate)
Ziprasidone [Geodon]
Atypical 2nd Gen Anti-Psychotic
MoA: D2 Antagonist -> Inh positive symptoms
5HT-2a/1a/2c Antagonist -> Inh negative symptoms, limited ESP
PK: erratic absorp, high Vd (lipid high ProBind), cross placenta/milk, 2D6/3A4 meta (not ind)
DDI: Inh 2D6 -> Inc SSRI/TCA
ADE: Inc risk DMII, weight gain, metabolic syndrome (intermediate/low)
Aripiprazole [Abilify]
Atypical 2nd Gen Anti-Psychotic
MoA: D2 Antagonist -> red full agonist and min positive symptoms
5HT-2a Antagonist/5HT-1a partial agonist -> Inh negative symptoms, reduce ESP
Low Potency -> Inc Anti-Cholinergic (min ESP)
PK: erratic absorp, high Vd (lipid high ProBind), cross placenta/milk, 2D6/3A4 meta (not ind)
DDI: Inh 2D6 -> Inc SSRI/TCA
ADE: minimal
Lurasidone [Latuda]
Atypical 2nd Gen Anti-Psychotic
MoA: D2 Antagonist -> Inh positive symptoms
5HT-2a Antagonist/5HT-1a partial agonist -> Inh negative symptoms
Still risk of ESP
Low Potency -> Inc Anti-Cholinergic (min ESP)
PK: erratic absorp, high Vd (lipid high ProBind), cross placenta/milk, 2D6/3A4 meta (not ind)
DDI: Inh 2D6 -> Inc SSRI/TCA
Perphenazine [Trilafon]
Phenothiazene, Typical 1st Gen Anti-Psychotic
MoA: D2 Partial Agonist -> Inh positive symptoms, Inc prolactin
Anti-Cholinergic -> minimize ESP
High Potency -> Inc ESP, less anti-cholingeric
PK: erratic absorp, high Vd (lipid high ProBind), cross placenta/milk, 2D6/3A4 meta (not ind)
DDI: Inh 2D6 -> Inc SSRI/TCA
ADE: acute dystonia, akathesia, parkinsonian, neuroleptic malignant syndrome, perioral tremor, tardive dyskinesia
Trifluoperazine [Stelazine]
Phenothiazene, Typical 1st Gen Anti-Psychotic
MoA: D2 Partial Agonist -> Inh positive symptoms, Inc prolactin
Anti-Cholinergic -> minimize ESP
High Potency -> Inc ESP, less anti-cholingeric
PK: erratic absorp, high Vd (lipid high ProBind), cross placenta/milk, 2D6/3A4 meta (not ind)
DDI: Inh 2D6 -> Inc SSRI/TCA
ADE: acute dystonia, akathesia, parkinsonian, neuroleptic malignant syndrome, perioral tremor, tardive dyskinesia