Antipsychotic Flashcards

1
Q

Typical agents

A

older agents; metabolized in liver into INactivate metabolites. Binds to D2 receptors
only have effects on positive symptoms

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2
Q

Atypical agents

A

newer; less side side effects esp EPS effects at equal therapeutic doses.
Metabolized in liver to produce Active metabolites

Binds to D2 receptors and 5HT receptors

have effects on positive and negative symptoms

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3
Q

which system causes the hyperactivity of dopamine activity? and what is its clinical function?

A

Mesolimbic-mesocortical system; related to behavior and psychosis

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4
Q

Nigrostriatal system

A

coordination of voluntary movement; responsible for EPS

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5
Q

antidopaminergic effects on motor behavior

A

Blocks D2 receptors
if given high enough dose could cause EPS
-parkinson-like syndrome
-Akathesia:motor restlessness and anxiety
-dystonia
-Tardive dyskinesia

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6
Q

Tardive dyskinesia

A

due to supersensitivity of dopamine receptors– agents blocking D2 receptors.

involuntary movement of tongue, mouth, face, head
Irreversible
Affect ELDERLY more significantly

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7
Q

Neuroleptic malignant syndrome

A

hypertension, hyperthermia

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8
Q

positive symptoms of schizophrenia

A

manifesation of abnormal behavior: delusions, hallucination, agitation, paranoia, aberrant thinking, intrusion of thoughts

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9
Q

negative symptoms of schizophrenia

A

emotional apathy, socially withdrawn, inattentiveness

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10
Q

Anti dopaminergic effect on endocrine gland

A

Hyperprolactinemia
decrease testosterone production, gynecomastia, change in libido, and infertility

female: menstrual irregularities, gaactorrhea, infertility

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11
Q

What agents causes risk for diabetes?

A

Clozapine and olanzapine (atypical drugs)

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12
Q

Antihistamine effect

A

sedation, weight gain

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13
Q

Thioridazine

A

typical agent; poor antiemetic agent

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14
Q

Fluphenazine

A

typical; highly potent

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15
Q

Haloperidol

A

typical: highest potency –>increase EPS effect

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16
Q

Risperidone

A

Most strongly associated with EPS as atypical agent; tx for noncognitive symptom in AD

17
Q

which drugs are used for non cognitive alzheimers

A

olanzapine, risperidone, quetiapine

18
Q

arpiprazole

A

atypical agent

19
Q

quetiapine

A

Atypical agent; least strongly associated w/ EPS; tx for non-cog AD

20
Q

Ziprasidone

A

atypical agent

21
Q

which antipsychotic drug is more prone for orthotic hypotension

A

chlorpromazine

22
Q

EPS risk is influenced by

A
  • Rapid dose escalation
  • Target dose (concentration/receptor occupancy)
  • patient vulnerability
23
Q

What mechanism cause weight gain

A

combine H1 and serotonin blockade

24
Q

what is the least potent typical agent? most potent?

A

least: chlorpromazine, highest: haloperidol

25
Q

which atypical agent has most involvement with EPS? least effect to EPS?

A

most: Risperidone
least: Clozapine, quetiapine

26
Q

what are antipsychotic agents used for?

A

schizophrenia, psychotic behavioral, severe mania, antiemetic,tourettes, chronic neuropathic pain

27
Q

Schizophrenia pathophysiology

A

hyperactivity of mesolimbic mesocortical DA system–> excessive limbic DA activity–>psychosis

Blockade of serotonin receptor is KEY mechanism of action for atypical antipsychotic drugs’

Hypofunction of NMDA receptors located on GABAergic interneurons–>hyperstimulation of cortical nuerons–>psychosis

28
Q

what is the key mechanism of action for atypical antipsychotic drugs

A

blocking serotonin receptors

29
Q

antipsychotic effects on tuberoinfundibular

A

inhbit prolactin secretion from anterior pituitary–>amennorrhea/galactorrhea syndrome

30
Q

antipsychotic effects on medullary periventricular area

A

antiemetic effects