Anti-psychotics

Question 1

SHARK: grouped concepts
~ notes have in bold
* i think will be high yield

Answer 1

hurah

Question 2

concept: cause of positive psychotic symptoms and goal of how we wnat to treat them

Answer 2

increased dopamine in the mesolimbic system; we want to treat them by DECREASING DA effects -> block D2 receptors

Question 3

concept to understand s/e of treatment: Describe the mesolimbic pathway

Answer 3

midbrain to limbic system = emotional behavoiurs

hyperactivity = positive psychotic symptoms
**block D2 here to stope psychosis

Question 4

concept to understand s/e of treatment: nigrostriatal pathway

Answer 4

substantia nigra to basal nigra = motor movements

when block D2 here - extrapyramidla reactiosn = funy motor movemetns like parkinson disease and such

Question 5

concept to understand s/e of treatment: mesocortical pathway

Answer 5

midbrain to prefrontal cortex = if reduced activity then have negative and cognitive symptoms

if block D2 here get worse cognitive and negative symptoms

Question 6

concept to understand s/e of treatment: tuberoinfundibular pathway

Answer 6

hypothalamus to anterior pituitar = DA inhibits prolactin

block D2 - prolactinema = galacthorrhoea

Question 7

Name the CLASSIC antipsychotics
CFHT
-AZINEs

Answer 7

chlorpromAZINE
fluphenAZINE
haloperidol
thioridAZINE

Question 8

Name the ATYPICAL antipsychotics
CROQ-ZAP
-PINE
-DONE
and randoms

Answer 8

clozaPINE
risperiSONE
olanzaPINE/aux-lanse epine
quetiaPINE
ziprasiDONE
aripiprazole
paliperiDONE

aka if a word looks like you are having a hallucination assume its a this

Question 9

Name the high potency classic antipsychotics ie the ones who will cause the most extrapyramidal reactions (inhibition of the nigrostrial pathway)

Answer 9

C
FluphenAZINE
Haloperidol
T

Question 10

Name the low potency classic antipsychoticsc ie the drugs that will cause the least extrapyramidal reactions (lower inhibition of the nigrostiatal pathway)

Answer 10

ChlopramAZINE
F
H
ThioridAZINE

Question 11

Which classic antipsychotics are more likely to cause sedation and postural hypotension

Answer 11

the low potency drugs 
ChlorpramAZINE
F
H
ThioridAZINE

Question 12

Describe receptors affected by ClozAPINE

Answer 12

atypical antipsychotic CROQ-ZAP
* high affinity for D1, D4, D4, 5HT2, muscarinic and alpha adrenergic
PROTOTYPE

Question 13

~*~Special facts about Resperidone

Answer 13

5HT2 blockage more than D2

MOST LIKELY TO CAUSE EPR

Question 14

Atypical antipsychotics least likely to cause EPR

Answer 14

ClozAPINE
R
O
QuetiAPINE
Z
A
P

Question 15

Describe receptors affected by Aripiprazole

Answer 15

partial agonist at D2 and5HT1a

antagonist at 5HT2a

Question 16

Compare and contrast side effects of atypical to typical antipsychotics

Answer 16

atypicals less likely to cause a) EPR, b) tardive dyskinesia c) increases in prolactin d) better at treating negative symptoms
:)

Question 17

Only antipsychotics to not cause anti-emetic side effects

Answer 17

C
F
H
Thioidazine

C
R
O
Q
Z
Apriprazole
P

Question 18

Why do chlorpromazine and thioridazine show less EPR than haloperidol and thioridizine

Answer 18

because chlorpromazine an dthioridazine have increased anticholinergic effects

Question 19

What will cause ‘‘parkinsonism’’ and how will you treat it?

Answer 19

calssic antipsychotics C, Fluphenazine, Haloperidol, T

treat with anti muscarnics:

a) benztropines
b) trihyxyphenidyle
c) diphenhydramine
d) amantadine

Question 20

What will you treat DYSTONIA with?

Answer 20

a) benztropine
b) trihexyphenidyl
c) diphenhydramine

Question 21

What will you treat AKATHISIA with?

Answer 21

clonazepam

propanolol

Question 22

How will you treat someone who needs antipsychotics but has tardive dyskinesia?

Answer 22

a) discontinue antipsychotic
b) eliminate central anticholinergics (TCA nacid, antiparkinsonina drugs)
c) diazepam
d) release antipsychotic with CLOZAPINE

Question 23

Name drugs more likely to cause sedation used for anti psychotic treatment

Answer 23

CROQ ZAP
C: clozapine
R: respiridone
O: olanzapine
Z: ziprasidone
A: airiprazole
P: popilperidone... or something like that

Question 24

Name antipsychotics most likely to cause seizures

Answer 24

Cs for seizure
chlorpromaizine = classic
clozapine - atypiocal

Question 25

Describe symptoms of Neuroleptic Malignant Syndomre. How to treat?

Answer 25

ridigity, tremor, hyperthermia

altered mental status

autonomic instability

elevated wbc and CK

myoglobinemia with potentail nephrotoxicity

DANTROLENE or BROMOCRIPTINE

Question 26

What do you have to watch out for with clozapine

Answer 26

agranulocytosis

check WBC regularly

(Acarbose @ diabetes check LFT)

Question 27

Two antipsychotics that can have effects on the heart

Answer 27

Thioridazine (less EPR, more anticholinergic) = QTc and T wave changes – ventricular arrhythmias and sudden death
Ziparsidone can also prolong QTc

Question 28

What two antipsychotics can produce ocular complications and esplain them please

Answer 28

Chlorpromaizine - deposits in cornea and lens

Thioridazine - retinal deposits

Question 29

Who cares about Droperidol

Answer 29

people who need neurolept anesthesia with nausea and vomiting - treat in combo with fentanyl

Question 30

what antipsychotic is prescribed the most in the USA

Answer 30

resperidone - causes EPR but rare at therapeutic doses