Anti-psychotics and mood stabilizers

Question 1

MOA of traditional anti psychotics

Answer 1

D2 receptor blockers
Need to occupy 60% of D2 receptor to be effective

Muscarinic (M1) blockade
Histamine (H1) blockade
Adrenergic (α1) blockade

Question 2

MOA of clozapine

Answer 2

5-HT2A inverse agonists

Question 3

MOA of Aripiprazole

Answer 3

dopamine stabilizer

partial agonist at the D2 and 5-HT1 receptors

antagonist at 5-HT2 receptors

Question 4

MOA of Lithium

Answer 4

Blocks I3Pase (blocks IP3 increase Ca2+/DAG pathway increase PKC)

Substitutes for Na in generating action potentials

Blocks NE induced cAMP

Question 5

Uses of traditional antipsychotics

Answer 5

Treat positive symptoms

Antiemetic

Sedatives

Antipruritic action (block histamine receptors)

Question 6

Traditional antis-psychotics used to treat Tourette’s

Answer 6

(Traditional – high potency)
Haloperidol
Fluphenazine

Question 7

Uses of clozapine

Answer 7

Treat negative symptoms

Question 8

Uses of Aripiprazole

Answer 8

Treats positive and negative symptoms

Question 9

Uses of Lithium

Answer 9

Bipolar Affective Disorder

Major depression (with antidepressants)

Schizophrenia (with antipsychotics)

Question 10

ADR of chlorpromazine

Answer 10

Increased prolactin
Urinary retention 
Postural hypotension 
Failure to ejaculate
Toxic confusional state
Corneal/lens deposits

Question 11

ADR of Thioridazine

Answer 11

Increased prolactin

QT prolongation

Retinal deposits

Question 12

ADR of
Haloperidol
Fluphenazine

Answer 12

Increased prolactin

Extrapyramidal: Acute dystonia, Akathesia, Parkinsonism

Neuroleptic malignant syndrome

Question 13

Atypical antipsychotic that causes Hyperprolactinemia

Answer 13

Risperidone

Question 14

ADR of Atypical antipsychotics

Answer 14

Weight gain 
increased lipid 
potential to cause diabetes
Postural hypotension
Provoked seizures 
Agranulocytosis 
Increased salivation

Question 15

Which drug causes Ebstein’s anomaly (malformed tricuspid valve)

Answer 15

Lithium

Question 16

ADR of Lithium

Answer 16

Tremor 
Edema
Nephrogenic DI 
Hypothyroidism 
Leukocytosis

Question 17

Toxicity of Lithium:
Early signs
Later signs

Answer 17

first signs: anorexia, vomiting, gross tremor, ataxia, confusion, and sleepiness.

Later signs: impaired consciousness, nystagmus, muscle twitching, hyperreflexia, convulsions, cardiac arrhythmias, hypotension, impaired renal function

Question 18

Contraindication of Lithium

Answer 18

Sick sinus syndrome

Question 19

Antidote for Acute dystonia

Answer 19

diphenhydramine

benztropine

Question 20

Antidote for Parkinsonism

Answer 20

benztropine

trihexyphenidyl

Question 21

Antidote for NMS

Answer 21

diazepam

dantrolene

Question 22

strong D2 antagonist that can treat Tourette’s

Answer 22

Pimozide

Question 23

Drugs used in manic phase

Answer 23

Lithium, or Valproic Acid or Atypical Antipsychotics

Question 24

Drugs used in depressed phase

Answer 24

Lithium plus Antidepressant