Anti-psychotics

Question 1

Found to improve psychosis and block dopamine receptors

Answer 1

Chlorpromazine

Question 2

The first generation antipsychotics are

Answer 2

Haloperidol and the -azine’s

Question 3

For the first generation or typical antipsychotics, the primary antipsychotic effect is from

Answer 3

D2 receptor blockade

Question 4

Found on post synaptic CNS neurons

-G-protein coupled

Answer 4

D2 receptors

Question 5

Activates adenylyl Cyclades which increases cAMP

Answer 5

D1 receptors

Question 6

Inhibits adenylyl Cyclades which decreases cAMP

Answer 6

D2 receptors

Question 7

What is the effect of a D2 blockade?

Answer 7

Increase in cAMP

Question 8

Depresses nervous system activity

Answer 8

Neuroepileptics

Question 9

Motor dysfunction associated with decreased CNS dopamine

-Tremors and rigidity

Answer 9

Parkinson’s disease

Question 10

Has the pharmacological characteristics of: a1 = 5-HT which is greater than D2 effects

Answer 10

Chlorpromazine

Question 11

Has the pharmacological characteristics of effect of: D2 effects are greater than a1, which are greater than 5HT, which are greater than H1

Answer 11

Haloperidol

Question 12

Which Typical antipsychotics are used as anti-emetics?

Answer 12

Prochlorperazine/chlorpromazine

Question 13

Some typical antipsychotics cause an ACh muscarinic receptor blockade, which results in

Answer 13

Dry mouth and constipation

Question 14

The alpha-1 blockade seen in typical antipsychotics results in

Answer 14

Hypotension

Question 15

Response to dopamine receptor blockade

-Movement side effects

Answer 15

Extrapyramidal Symptoms

Question 16

Acute side effect of dopamine receptor blockade

-Involuntary contraction of muscles

Answer 16

Dystonia

Question 17

Anticholinergic that blocks M1 receptors and improves dystonia

Answer 17

Benztropine

Question 18

Occurs within days following dopamine receptor blockade

-Most common EPS adverse effect

Answer 18

Akathisia

Question 19

Restlessness, urge to move that is sometimes misdiagnosed as worsening agitation

Answer 19

Akathisia

Question 20

Drug-induced Parkinsonism that begins weeks after starting an anti-psychotic

Answer 20

Bradykinesia

Question 21

What can we use to treat the anti-psychotic induced Bradykinesia?

Answer 21

Benztropine

Question 22

Can occur months to years after starting an anti-psychotic

-Common symptom is choreoathetosis

Answer 22

Tardive Dyskinesia

Question 23

Irregular migrating contractions and twisting/writhing of the mouth, tongue, face, and limbs

Answer 23

Choreoathetosis

Question 24

Is often irreversible, meaning that stopping the drug doesn’t help

Answer 24

Choreoathetosis

Question 25

What are the three high potency typical antipsychotics

-Little effects on histamine and muscarinic receptors

Answer 25

Haloperidol, trifluoperazine, and fluphenazine

Question 26

The high potency typical antipsychotics haloperidol, trifluoperazine, and fluphenazine are all at high risk for

Answer 26

Extrapyramidal Side Effects (EPS)

Question 27

The two low potency typical antipsychotics with less EPS are?

Answer 27

Thioridazine and chlorpromazine

Question 28

Have more non-neurological side effects like sedation and dry mouth

Answer 28

Thioridazine and chlorpromazine

Question 29

Rare, dangerous reaction to neuroleptic

-Usually starts 7-10 days after treatment has started

Answer 29

Neuroleptic Malignant Syndrome (NMS)

Question 30

Characterized by fever and rigid muscles with mental status changes (encephalopathy)

Answer 30

NMS

Question 31

A sign of muscle damage in NMS is elevated

Answer 31

Creating kinase

Question 32

To treat NMS, give

Answer 32

Dantrolene (muscle relaxant) and Bromocriptine (dopamine agonist)

Question 33

Similar in presentation to malignant hyperthermia

Answer 33

NMS

Question 34

May block cardiac potassium channels, which prolongs the QT interval

Answer 34

Typical Antipsychotics

Question 35

May cause corneal deposits and may accelerate aging of the lens

Answer 35

Chlorpromazine

Question 36

Causes retinal deposits and may cause “browning” of vision

Answer 36

Thioridazine

Question 37

What are the 2nd generation antipsychotics?

Answer 37

-apines and -idones

Question 38

The defining feature of atypical antipsychotics is less

Answer 38

EPS adverse effects

Question 39

What are the pharmacological characteristics of clozapine as far as it’s receptor affinity:

Answer 39

Bigger affects on a1 than 5-HT which are bigger than D2

Question 40

Have fewer EPS and anti-cholinergic effects but may prolong QT interval

Answer 40

Antipsychotics

Question 41

May occur with any antipsychotic, but is especially common with clozapine and olanzapine

Answer 41

Metabolic Syndrome

Question 42

Toxic to bone marrow and has the defining side effect o agranulocytosis

Answer 42

Clozapine

Question 43

We must monitor WBCs during therapy with

Answer 43

Clozapine

Question 44

Antipsychotics are the most common drug-induced cause of

Answer 44

Hyperprolactinemia

Question 45

Dopamine blockade causes increases in prolactin. This leads to:

1. ) In Men?
2. ) In Women?

Answer 45

1. ) Gynecomastia

2. ) Amenorrhea

Question 46

The highest rates of Hyperprolactinemia are seen with which drugs

1. ) Typicals?
2. ) Atypicals?

Answer 46

1. ) Haloperidol and Fluphenazine

2. ) Risperidone and Paliperidone

Question 47

A partial D2 agonist that has less dopamine blockade adverse effects

Answer 47

Aripiprazole

Question 48

The most common side effect of aripiprazole is

Answer 48

Akathisia