Anti-psychotics Flashcards
SHARK: grouped concepts
~ notes have in bold
* i think will be high yield
hurah
concept: cause of positive psychotic symptoms and goal of how we wnat to treat them
increased dopamine in the mesolimbic system; we want to treat them by DECREASING DA effects -> block D2 receptors
concept to understand s/e of treatment: Describe the mesolimbic pathway
midbrain to limbic system = emotional behavoiurs
hyperactivity = positive psychotic symptoms
**block D2 here to stope psychosis
concept to understand s/e of treatment: nigrostriatal pathway
substantia nigra to basal nigra = motor movements
when block D2 here - extrapyramidla reactiosn = funy motor movemetns like parkinson disease and such
concept to understand s/e of treatment: mesocortical pathway
midbrain to prefrontal cortex = if reduced activity then have negative and cognitive symptoms
if block D2 here get worse cognitive and negative symptoms
concept to understand s/e of treatment: tuberoinfundibular pathway
hypothalamus to anterior pituitar = DA inhibits prolactin
block D2 - prolactinema = galacthorrhoea
Name the CLASSIC antipsychotics
CFHT
-AZINEs
chlorpromAZINE
fluphenAZINE
haloperidol
thioridAZINE
Name the ATYPICAL antipsychotics CROQ-ZAP -PINE -DONE and randoms
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
Name the high potency classic antipsychotics ie the ones who will cause the most extrapyramidal reactions (inhibition of the nigrostrial pathway)
C
FluphenAZINE
Haloperidol
T
Name the low potency classic antipsychoticsc ie the drugs that will cause the least extrapyramidal reactions (lower inhibition of the nigrostiatal pathway)
ChlopramAZINE
F
H
ThioridAZINE
Which classic antipsychotics are more likely to cause sedation and postural hypotension
the low potency drugs ChlorpramAZINE F H ThioridAZINE
Describe receptors affected by ClozAPINE
atypical antipsychotic CROQ-ZAP
* high affinity for D1, D4, D4, 5HT2, muscarinic and alpha adrenergic
PROTOTYPE
~*~Special facts about Resperidone
5HT2 blockage more than D2
MOST LIKELY TO CAUSE EPR
Atypical antipsychotics least likely to cause EPR
ClozAPINE R O QuetiAPINE Z A P
Describe receptors affected by Aripiprazole
partial agonist at D2 and5HT1a
antagonist at 5HT2a
Compare and contrast side effects of atypical to typical antipsychotics
atypicals less likely to cause a) EPR, b) tardive dyskinesia c) increases in prolactin d) better at treating negative symptoms
:)
Only antipsychotics to not cause anti-emetic side effects
C
F
H
Thioidazine
C R O Q Z Apriprazole P
Why do chlorpromazine and thioridazine show less EPR than haloperidol and thioridizine
because chlorpromazine an dthioridazine have increased anticholinergic effects
What will cause ‘‘parkinsonism’’ and how will you treat it?
calssic antipsychotics C, Fluphenazine, Haloperidol, T
treat with anti muscarnics:
a) benztropines
b) trihyxyphenidyle
c) diphenhydramine
d) amantadine
What will you treat DYSTONIA with?
a) benztropine
b) trihexyphenidyl
c) diphenhydramine
What will you treat AKATHISIA with?
clonazepam
propanolol
How will you treat someone who needs antipsychotics but has tardive dyskinesia?
a) discontinue antipsychotic
b) eliminate central anticholinergics (TCA nacid, antiparkinsonina drugs)
c) diazepam
d) release antipsychotic with CLOZAPINE
Name drugs more likely to cause sedation used for anti psychotic treatment
CROQ ZAP C: clozapine R: respiridone O: olanzapine Z: ziprasidone A: airiprazole P: popilperidone... or something like that
Name antipsychotics most likely to cause seizures
Cs for seizure
chlorpromaizine = classic
clozapine - atypiocal
Describe symptoms of Neuroleptic Malignant Syndomre. How to treat?
ridigity, tremor, hyperthermia
altered mental status
autonomic instability
elevated wbc and CK
myoglobinemia with potentail nephrotoxicity
DANTROLENE or BROMOCRIPTINE
What do you have to watch out for with clozapine
agranulocytosis
check WBC regularly
(Acarbose @ diabetes check LFT)
Two antipsychotics that can have effects on the heart
Thioridazine (less EPR, more anticholinergic) = QTc and T wave changes – ventricular arrhythmias and sudden death
Ziparsidone can also prolong QTc
What two antipsychotics can produce ocular complications and esplain them please
Chlorpromaizine - deposits in cornea and lens
Thioridazine - retinal deposits
Who cares about Droperidol
people who need neurolept anesthesia with nausea and vomiting - treat in combo with fentanyl
what antipsychotic is prescribed the most in the USA
resperidone - causes EPR but rare at therapeutic doses
