Anti-psychotics Flashcards
What are the two main types of anti-psychotics
Atypicals and typicals
What are the general uses of anti-psychotics
Psychosis in schizophrenia, mood stabilizers in bipolar and adjunct therapies in depression
Give examples of atypicals
Clozapine, olanzapine, risperedone, quetapine, amisulpride, paliperidone, arpiprazole and clozapine
How do atypicals work
Dopamine antagonism and 5-HT antagonism
When are atypicals used
Acute psychotic episode, chronic schizo symptoms, treatment and prophylaxis of both manic/hypomanic and depressed mood states in bipolar disorder, combine with antidepressant in psychotic unipolar depression, can also be used as an adjunct to an anti-depressant even in unipolar depression with psychotic symptoms
Side effects atypicals
Extra pyramidal side effects, sedation, weight gain, metabolic syndrome, constipation, QT prolongation and neuroleptic malignant syndrome.
Which atypical has different side effects and what
Arpiprazole has insomnia, GI upset, agitation, akathisia, orthostatic hypotension, headache and constipation
Extra-pyramidal side effects
Acute dystonic reaction (freezing of muscles, arching of back, eyes roll back), tardine dyskinesia (involuntary, repetitive body movements. Includes grimacing, smacking of the lips
- Akathisia (extreme restlessness)
- Chloreiform movements (repetitive, rapid, jerky, involuntary movements that appear well-coordinated)
What atypical is used for metabolic syndromes and sedation and what is it’s side effect
Clozapine and agranulocytosis
Give examples of typicals
Chlorpromazine, thiordiazine, fluphenazine, haloperidol and zuclopentixol
How do typicals work
Dopaine 2 receptor blockade
Side effects of typicals
Extrapyrimidal side effects, sedation, dizziness, QT prolongation, hyperprolactinaemia, neuroleptic malignant syndrome
Which atypical can be given IM
Risperidone
Which is less likely to produce extra-pyramidal side effects
Atypicals are less likely to produce epse and are therefore used more frequently than typicals
