Anti-psychotics and mood stabilizers Flashcards
MOA of traditional anti psychotics
D2 receptor blockers
Need to occupy 60% of D2 receptor to be effective
Muscarinic (M1) blockade
Histamine (H1) blockade
Adrenergic (α1) blockade
MOA of clozapine
5-HT2A inverse agonists
MOA of Aripiprazole
dopamine stabilizer
partial agonist at the D2 and 5-HT1 receptors
antagonist at 5-HT2 receptors
MOA of Lithium
Blocks I3Pase (blocks IP3 increase Ca2+/DAG pathway increase PKC)
Substitutes for Na in generating action potentials
Blocks NE induced cAMP
Uses of traditional antipsychotics
Treat positive symptoms
Antiemetic
Sedatives
Antipruritic action (block histamine receptors)
Traditional antis-psychotics used to treat Tourette’s
(Traditional – high potency)
Haloperidol
Fluphenazine
Uses of clozapine
Treat negative symptoms
Uses of Aripiprazole
Treats positive and negative symptoms
Uses of Lithium
Bipolar Affective Disorder
Major depression (with antidepressants)
Schizophrenia (with antipsychotics)
ADR of chlorpromazine
Increased prolactin Urinary retention Postural hypotension Failure to ejaculate Toxic confusional state Corneal/lens deposits
ADR of Thioridazine
Increased prolactin
QT prolongation
Retinal deposits
ADR of
Haloperidol
Fluphenazine
Increased prolactin
Extrapyramidal: Acute dystonia, Akathesia, Parkinsonism
Neuroleptic malignant syndrome
Atypical antipsychotic that causes Hyperprolactinemia
Risperidone
ADR of Atypical antipsychotics
Weight gain increased lipid potential to cause diabetes Postural hypotension Provoked seizures Agranulocytosis Increased salivation
Which drug causes Ebstein’s anomaly (malformed tricuspid valve)
Lithium
ADR of Lithium
Tremor Edema Nephrogenic DI Hypothyroidism Leukocytosis
Toxicity of Lithium:
Early signs
Later signs
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
Contraindication of Lithium
Sick sinus syndrome
Antidote for Acute dystonia
diphenhydramine
benztropine
Antidote for Parkinsonism
benztropine
trihexyphenidyl
Antidote for NMS
diazepam
dantrolene
strong D2 antagonist that can treat Tourette’s
Pimozide
Drugs used in manic phase
Lithium, or Valproic Acid or Atypical Antipsychotics
Drugs used in depressed phase
Lithium plus Antidepressant
