Anti-psychotics drugs

Question 1

MOA 1st generation anti-psychotics

Answer 1

D2 receptor antagonists

Question 2

ADRs of 1st generation anti-psychotics

Answer 2

• motor disturbances - fix with antimuscarinics
• increase prolactin release
• inhibit insulin release
• hypothermia
• suppresses vomiting centre
• cross-react with anti-muscarinics, antihistaminic, antiadrenergics: dry mouth, blurred vision, constipation, urinary retention, sedation, orthostatic hypotension, tachycardia, hypersensitivity and allergic reactions

Question 3

clinical considerations 1st generation anti-psychotics

Answer 3

• good for positive symptoms, not for negative

- therapeutic effect in weeks, ADRs immediate

Question 4

MOA 2nd generation clozapine

Answer 4

may have D4 selectivity

Question 5

ADRs clozapine

Answer 5

absence seizures
sedation
neutropenia

Question 6

why clozapine is better than 1st generation

Answer 6

reduced tardive dyskinesia

Question 7

MOA 2nd generation risperidone

Answer 7

serotonin, D2 antagonist

Question 8

ADR 2nd generation risperidone

Answer 8

weight gain

Question 9

why risperidone over 1st generation

Answer 9

lower incidence of extrapyramidal effects and galactorrhea

can be administered parenterally

Question 10

olanzapine over 1st generation

Answer 10

• well tolerated, lower incidence of galactorrhoea

Question 11

ADRs olanzapine

Answer 11

weight gain, constipation, drowsiness

Question 12

MOA aripiprazole

Answer 12

partial D2 agonist, agonist at some 5-HT, antagonist at others

Question 13

ADRs aripiprazole

Answer 13

weight gain, drowsiness

Question 14

why aripiprazole over 1st generation

Answer 14

well tolerated, comparable efficacy to haloperidol