anti psychotics Flashcards
schizophrenia
dysfunctional mesolimbic or mesocortical dopaminergic pathways
chronic psychosis
major tranquilizers used
first generation antipsychotics drugs
D2 blocker ----antiemetic effect associated with EPS EXCEPT LOW POTENCY HALOPERIDOL FLUPHENAZINE CHLORPROMAZINE (low)
second generation antipsychotics
atypical low incidence EPS high risk diabetes hypercholestremia weight gain block both SEROTININ AND DOPA first line for schizophrenia anti cholinergic
clozapine
used for pt ineffective to first and second line drugs foe schizophrenia
cause salivation
limited only to refractory patients
cause bone marrow suppression seizures orthostasis
SEEVRE AGRANULOCYTOSIS
monitor wbc
block D1,D4 5HT2 MUSCARININC AND ADRENERGIC
risperidone
OLAZAPINE
blocks 5HT2A more than D2
ARIPRIPAZOLE
partial agonist at D2 AND 5 HT1A antagonist 5ht2a
second generation
only emetic drug
positive symptoms
block d2
hallucinations nd delusions gone in mesolimbic area
negative symptoms
blunted affect
apathy
impaired attention cognitive impairment
tardive dyskinesia
involuntary movements usually tongue(fly catching) lips neck trunk limbs
occurs with acute or chronic treatment of schizophrenia
seen with akathias(give beta blocker or bzd) and eps like symptoms
irreversible after treatment increased dopa receptors very sensitive to dopa causing exaggerated effects
side effects of antipsychotics
poikilothermic block D2. increase PROLACTIN SEXUal DYSFUNCTION GALATORRHEA ED GYNECOMASTIA WEIGHT GAIN DEPRESSED HYPOTHALAMUS SIGNIFICANT QT SYNDROME
prochlorperazine
first generation high potency
treat drug induces nausea
chlorpromazine
treat hiccups low potent first generation
pimozide
treat Tourette disorder
high potency first generation
risperidone (2)
haloperidol(1)
tic disorder teat
risperidone and aripripazole
manage disruptive behavior sec to autism