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Psych > Anti-psychotics > Flashcards

Anti-psychotics Flashcards

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1
Q

Mesocortical

A

Cognitive and negative symptoms

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2
Q

Nigrostriatal

A

SN to striatum
Basal ganglia motor loop
-> extra pyrimidal side effects

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3
Q

Tuberoinfundibular

A

Arcuate nucleus to infundibular pathway
Prolactin secretion from ant. Pit.
-> hyperprolactinemia

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4
Q

Antipsychotics Mechanism of action

A 
Competitive antagonism of D2 receptors 
Post synaptic 
Antagonise mesolimbic and mesocortical -> positive effects
Also nigrostriatal and tuberoinfundibular -> side effects 
Also block 
-muscarinic
-histaminergic
-a adrenergics
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5
Q

Baseline investigations

A 
ECG
weight and height 
BP
FBC
U and E
LFT
prolactin
Glucose
Fasting lipids
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6
Q

Examples of typical antipsychotics

A

Chlorpromazine
Fluphenazine
Flupentixol
Haloperidol

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7
Q

Examples of atypical antipsychotics

A 
Aripiprazole 
Amisulpride
Olanzipine
Quetiapine
Risperidone
Clozapine
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8
Q

Neurological side effects of typical antipsychotics

A 
Neuroepileptic syndrome 
EPSE's 
-Parkinson motor symptoms
-acute dystonia * oculogyric crisis
-akathisia 
-tardiness dyskinesia 
Decreased seizure threshold 
Sedation
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9
Q

Neuroepileptic syndrome

A 
0.07-0.2% per year
Hyperthermia
Muscle rigidity
Confusion
Tachycardia
Tremor
Raised CK
Decreased pH
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10
Q

Cardiac side effects of typical antipsychotics

A

Long QT
Arrhythmias
Myocarditis
Sudden death

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11
Q

Other side effects of typical antipsychotics

A 
Decreased BP
Hypersensitivity, liver, bone marrow, skin 
Hyperprolactinemia 
Apathy 
Confusion
Depression
Muscarinic
A1 adrenoceptor
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12
Q

Side effects of atypical antipsychotics

A 
Sedation *olanzipine, clozapine
Weight gain *olanzapine, clozapine 
Increased TG's 
Proglycaemia 
Hyperprolactinemia 
Sexual dysfunction
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13
Q

Metabolic syndrome

A 
Central obesity 
Insulin resistance 
Impaired glucose regulation 
Hypertension 
Increased TG's 
Increased LDL
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14
Q

Clozapine specific side effects

A

Agranulocytosis
Myocarditis
Cardiomyopathy
Orthostatic hypertension

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15
Q

NICE guidelines

A

1st line -> atypical or typical-> patient preference
2nd line-> a different one or two together
3rd line-> clozapine
Continue 1-2 years post recovery

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16
Q

Mesolimbic pathway

A 
VTA to limbic system
Motivation
Emotion
Learning
Memory 
-> positive psychotic symptoms

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