Anti-Psychotics Flashcards
Typical Mid Potency Anti-Psycotics
Perphenazine
Molindone
Typical Low Potency Anti-Psychotics
Chlorpromazine
Thioridazine
Typical High Potency Anti-Psychotics
Haloperidol
Fluphenazine
Trifluoperazine
Thiothixene
Typical Low Potency Side Effect Profile
Anticholinergic: increased temperature, decreased sweating, dry mouth, constipation, urinary retention, cognitive deficits, decreased seizure threshold, prolonged QT interval, blurred vision, closed angle glaucoma Anti-alpha 1: orthostatic hypotension Antihistaminic: sedation, weight gain Tardive Dyskinesia Neuroleptic Malignant syndrome
Typical High Potency Side Effect Profile
Extra pyramidal symptoms (EPS): acute dystonia, akathisia, parkinsonism, Tardive Dyskinesia NMS Hyperprolactinemia Treat EPS with anticholinergics
Chlorpromazine
Typical AP: blocks D2 receptor
Low potency
Most sedation AP, retinal pigmentation
Thioridazine
Typical AP: blocks D2 receptor
Low potency
Worst QT prolongation, retinal pigmentation
Perphenazine
Typical AP
Mid potency
Molindone
Typical AP: blocks D2 receptor
Mid potency
Only typical AP that doesn’t cause weight gain
Haloperidol
Typical AP: blocks D2 receptor
High potency
Most common AP in emergency setting
Fluphenazine
Typical AP: blocks D2 receptor
High potency
Trifluoperazine
Typical AP: blocks D2 receptor
High potency
Thiothixene
Typical AP: blocks D2 receptor
High potency
Typical Anti-Psychotics
1st generation
TD, NMS
Block D2 receptor
Atypical Low Potency Anti-Psychotics
Clozapine
Quetiapine
Atypical Anti-Psychotics
2nd generation Metabolic syndrome Block a variety of receptors (less D2 activity) 1st line of treatment (except Clozapine) Increased risk of stroke
Atypical Mid Potency Anti-Psychotics
Olanzapine
Ziprazidone
Atypical High Potency Anti-Psychotics
Risperidone Aripiprazole (Abilify)
*Clozapine
Atypical AP Low potency Many receptors: D2/3/4; 5HT1/2/3; M1; Alpha-1; H1 Most efficient AP LAST RESORT Worst side effects: metabolic syndrome, weight gain, sedation, orthostatic hypotension, AGRANULOCYTOSIS (blood tests every week for 6 months, 2 weeks forever), anticholinergic, antihistaminic, anti alpha-1, prolonged QT, myocarditis Hyper salivation Short half life
Quetiapine
Atypical AP
Low potency
Weight gain and moderate metabolic risk, less anticholinergic than clozapine
Cataracts in animals
Ziprazidone
Atypical AP
Mid to low potency
No weight gain, LEAST RISK OF METABOLIC SYNDROME, low risk of QT prolongation
Sedation
*Olanzapine
Atypical AP
Mid to high potency
Similar to clozapine molecularly
Significant weight gain, metabolic risk, increased liver enzymes, hypertriglyceridemia, bad lipid profile, decreased HDL, no agranulocytosis
Risperidone
Atypical AP
High potency
High affinity for 5HT2 and D2
Most typical of atypical APs: EPS, TD, Hyperprolactinemia
Aripiprazole (Abilify)
Atypical AP High potency D2, 5HT2, Partial D1 agonist No weight gain, increased risk of akathisia (treat with beta blocker) Activator, so only give in the morning
Anti-Cholinergics for psychotic disorders
Benzatropine/Atropine
Diphenhydramine (Benadryl)
Benzatropine/Atropine
Psychotic disorders and Alzheimer’s disease
Anticholinergic
Treat EPS but not TD
Diphenhydramine (Benadryl)
Psychotic disorders, insomnia, anxiety disorders
Anticholinergic, antihistamine
Treat EPS, not TD
Sedative
Cholinergics
Betachenol
Betachenol
Cholinergic
Stimulates M1 receptor (CNS)
Reduces anticholinergic effects
