AntiEpileptics, Lipids, Tb drugs Flashcards
Antipsychotics
Both work similiarly, you pick drug based on SEs; long half lives; concerned with tardive dyskinesias as SEs—irreversible and immediate stoppage required. Toxicity—parkinsonian effects, SNS effects from muscarinic blockade; also an Alpha adrenergic blockade=postural hypotension and failure to ejaculate, cardiac=prolonged QT Typical (first generation)–D2 antagonists: most have “-zine” cuz the make you zzzzzz -SEs: Extrapyramidal neuro effects (neuroleptic drugs–tranquilizers, bradykinesia, mild rigidity, tremor, akathisia–subjective restlessness) -Also increased release of prolactin–>lacrimation; Dystonias caused by typcals can be relieved via diphenhydramine (benadril) or benzotropine -NB: Haloperidol (haldol), chlorpromazine (thorazine), thioridazine (mellarlil) Atypical (2nd generation): 5-Ht2 antagonists > D2 antagonists; most have “-pine” -SEs: less extrapyramidal symtoms. Do have hypotension, seizures, weight gain, increased risk of type II db, ad hyperlipidemia -NB: Clozapine (clozaril), risperidone (risperdal), paliperidone (invega), olanzapine (zyprexa), quetiapine (seroquel) short half life , ziprasidone short half life, aripiprazole (abilify) Neuroleptic Malignant syndrome: Bromocriptine (ergot DA agonist) and stop antipyshcotic
Chlorpromazine
Typical Antipsychotics–D2 Antagonist; originally called neuroleptic drugs=tranquilizers SEs-Extrapyramidal effects: bradykinesia, mild rigidity, tremor, subjective restlessness (akathisia), reduced initiative and interest, emotional manifestations.
Thioridazine
Typical Antipsychotics–D2 Antagonist; Also has mACh activity which might explain less extrapyramidal effects. Orthostatic hypotension and urinary retention originally called neuroleptic drugs=tranquilizers SEs-Extrapyramidal effects: bradykinesia, mild rigidity, tremor, subjective restlessness (akathisia), reduced initiative and interest, emotional manifestations.
Haloperidol
Typical Antipsychotics–D2 Antagonist; Increased risk for extrapyramidal effect originally called neuroleptic drugs=tranquilizers SEs-Extrapyramidal effects: bradykinesia, mild rigidity, tremor, subjective restlessness (akathisia), reduced initiative and interest, emotional manifestations.
Clozapine (as opposed with Clonidine)
Clozaril; Reduced risk of extrapyrmaidal effects, saved for tx resistant psychosis, works well but risk of agranulocytosis (monitor blood counts) Atypical Antipsychotic–5-ht2 antagonists and D2r antagonist SEs-Seizures, hypotension, weight gain, increased risk for type II db, and hyperlipidemia (clonidine: central alpha 2 agonist which decreases SNS tone in HTN)
Clozapine (as opposed with Clonidine)
Clozaril; Reduced risk of extrapyrmaidal effects, saved for tx resistant psychosis, works well but risk of agranulocytosis (monitor blood counts) Atypical Antipsychotic–5-ht2 antagonists and D2r antagonist (WORKS ON D4 agonists as welL) SEs-Seizures, hypotension, weight gain, increased risk for type II db, and hyperlipidemia (clonidine: central alpha 2 agonist which decreases SNS tone in HTN)
Paliperidone
Atypical Antipsychotic–5-ht2 antagonists and D2r antagonist SEs-Seizures, hypotension, weight gain, increased risk for type II db, and hyperlipidemia
Olanzapine
Atypical Antipsychotic–5-ht2 antagonists and D2r antagonist SEs-Seizures, hypotension, weight gain, increased risk for type II db, and hyperlipidemia
Quetiapine
Atypical Antipsychotic–5-ht2 antagonists and D2r antagonist SEs-Seizures, hypotension, weight gain, increased risk for type II db, and hyperlipidemia
Ziprasidone
Atypical Antipsychotic–5-ht2 antagonists and D2r antagonist SEs-Seizures, hypotension, weight gain, increased risk for type II db, and hyperlipidemia
Aripiprazole
Abilify Atypical Antipsychotic–5-ht2 antagonists and D2r antagonist SEs-Seizures, hypotension, weight gain, increased risk for type II db, and hyperlipidemia
Datrolene
Antidote for malignant hyperthermia. Inhibits release from sarcoplasmic reticulum
NO
Inhaled Anesthetic Used as adjunct for amnesia and has analgesic actions
Isoflurane, Sevoflurane, Desflurane
Volatile Inhaled Anesthetics Sevoflurane is the most pleasant to inhale and used for induction of kids Iso>Sevo>Des (least soluable thus better (Lower) MAC=minimum alveolar concnetration)
Propofol
IV anesthetic “MJ Juice, Milk of amnesia” Used as induction agent Vasodilatory and negative inotropy, decreases tidal volume, RR and minute volume, decrease in upper airway reflexes antiemtic