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Advanced Pharmacology > Antipsychotic Agents > Flashcards

Antipsychotic Agents Flashcards

1
Q

____ is due to too much neurotransmission due to too many neurotransmitters binding to postsynaptic receptors

A

Psychosis

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2
Q

The therapeutic goal of psychosis is to block access to post-synaptic receptors by administering a ___ ___

A

Receptor agonist

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3
Q

Antipsychotics, also known as neuroleptics take control of the _____

A

Neuron

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4
Q

Prior to 1950, psychotic patients were often ____

A

Institutionalized

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5
Q

What are three classifications of antipsychotics?

A

-Traditional or classic agents (1950-1990)
-Atypical agents (or second-generation antipsychotics)
-Third-generation antipsychotics

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6
Q

What are clinical indications for antipsychotics?

A

-Schizophrenia
-Schizoaffective disorder
-Bipolar disorder
-Acute psychotic symptoms (violence/agitation) or behavioral disturbances related to Tourettes, Senile Dementia, Alzheimer’s disease, etc)

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7
Q

Other uses for phenothiazines and related antipsychotic drugs include…

A

-Antiemetic/antinausea
-Antihistamine/antipruritic activity
-Potentiation of analgesics, sedatives, and general anesthetics

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8
Q

Schizophrenia is a ____ disease

A

Debilitating

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9
Q

What are symptoms of Schizophrenia?

A

-Delusions
-Hallucinations
-Disorganized speech
-Catatonia
-Deficits in attention, memory, or executive function
-Comorbidities (Mood disorders, substance use disorders, anxiety, aggression)
-Depression
-Anxiety
-Aggression
-Hostility
-Hopelessness
-Suicidality
-Flat affect
-Poverty of speech
-Lack of energy
-Lack of interest
-Social withdrawal

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10
Q

All of the symptoms of Schizophrenia lead to ____ and ____ dysfunction

A

Social and occupational

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11
Q

Excessive _____ activity underlies Schizophrenia

A

Dopaminergic

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12
Q

Drugs that increase dopaminergic activity (levodopa, amphetamines) ____ schizophrenia or induce a ____

A

Aggravate; psychosis

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13
Q

Traditional antipsychotics block the ____ receptor and clinical efficacy is directly proportional to affinity

A

D2

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14
Q

Postmortem, there has been found to be an ____ in dopamine receptor density in those with untreated schizophrenia

A

Increase

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15
Q

The clinical response of schizophrenia is correlated with a decrease in a dopamine metabolite, ____ ____, in the cerebrospinal fluid, plasma, and urine

A

Homovanillic acid

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16
Q

We know that serotonin is also involved with neurotransmitters because LSD, which produces hallucinations (like seen in schizophrenia), is a ___ ____

A

Serotonin agonist

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17
Q

We know that glutamate is involved in schizophrenia because PCP, which produces a psychosis similar to schizophrenia, is a ____ ___ at NMDA (glutamate) receptors

A

Glutamate antagonist

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18
Q

NMDA hypofunction causes glutamate ____ and the destruction of cortical neurons

A

Toxicity

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19
Q

Glutamate is like the “___ ___” in your car for neuronal transmission

A

Gas pedal

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20
Q

Traditional antipsychotics principally act via the blockage of ____ ____

A

Dopamine receptors

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21
Q

____ subtypes of dopamine receptors have been described

A

5

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22
Q

Antipsychotic activity of the classical agents correlates best with the ____ receptor blockade

A

DA2

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23
Q

Dopamine receptor blockade in the extrapyramidal tracts and the hypothalamus/pituitary account for many side effects of antipsychotics such as…

A

-Movement disorders
-Endocrine imbalances

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24
Q

Other side effects of traditional antipsychotics are related to interactions with other _____

A

Neurotransmitters

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25
Q

Atypical or second-generation antipsychotics block more than one type of _____

A

Receptor

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26
Q

Atypical/second-generation antipsychotics have a greater affinity for ____ than ____

A

Serotonin; dopamine

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27
Q

Atypical/second-generation antipsychotics can alleviate positive and negative symptoms and possibly help _____ deficits

A

Neurocognitive

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28
Q

Atypical or second-generation antipsychotics cause less or no ___ ___ or ___ ___

A

-Extrapyramidal symptoms
-Tardive dyskinesia

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29
Q

Atypical or second-generation antipsychotics can generally be started ____ in the disease

A

Earlier

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30
Q

In 2003, Ariprprazole (Abilify) was introduced as the ___ atypically antipsychotic

A

7th

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31
Q

Aripiprazole (Abilify) has unique synaptic actions, making it the first of a ___ generation of antipsychotic drugs

A

Third

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32
Q

Aripiprazole (Abilify) is not a dopamine antagonist, but rather a ___ ____ of dopamine receptors; it “stabilizes” hyper and hypoactivity

A

Partial agonist

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33
Q

Aripiprazole (Abilify) is also 5HT2 ____ and partial ____ at 5HT1A

A

Antagonist; agonist

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34
Q

Antipsychotics are absorbed ___, but incompletely

A

Readily

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35
Q

Antipsychotics are significantly affected by ___-___ metabolism

A

First-pass

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36
Q

Antipsychotics are ____% protein-bound

A

95

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37
Q

Antipsychotics have a much ____ clinical duration of action than estimated from the plasma half-life due to sequestration in fat tissue

A

Longer

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38
Q

Antipsychotics are mainly metabolized by ____ ____ and ____

A

Hepatic oxidation and glucoronidation

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39
Q

Active metabolite formation is not important except for with what drug, that produces a metabolite that is more potent than the parent drug?

A

Thioridazine

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40
Q

The ability to metabolize and eliminate antipsychotics diminishes with ____

A

Age

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41
Q

The typical half-life of an antipsychotic is from ___-___ hours

A

12-24

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42
Q

Smoking decreases plasma levels of what 4 antipsychotic drugs?

A

-Clozapine
-Olanzapine
-Haloperidol
-Fluphenazine

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43
Q

Antipsychotics are pure ____ blockers

A

D2

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44
Q

Chlorpromazine (Thorazine) should be given at a dose between ____-___ mg/day

A

200-1,000

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45
Q

Chlorpromazine (Thorazine) is rarely used due to its low ____

A

Potency

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46
Q

Chlorpromazine (Thorazine) causes significant central and peripheral alpha-1 adrenergic blockage, causing ___ and ____

A

Sedation and hypotension

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47
Q

Chlorpromazine (Thorazine) may cause some extrapyramidal symptoms due to ____ blockage in basal ganglia

A

Dopamine

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48
Q

Thioridazine (Mellaril) should be given at a dose between ____-____ mg/day

A

20-800

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49
Q

Thioridazine (Mellaril) has a greater potency than Aliphatics like _____, but causes a similar alpha-1 adrenergic blockage

A

Chlorpromazine

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50
Q

Thioridazine (Mallaril) causes less extrapyramidal symptoms due to significant ____ activity, but causes increased incidence of cardiac arrhythmias

A

Anticholinergic

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51
Q

Fluphenazine (Prolixin) should be given in doses of __-__ mg/day

A

5-40

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52
Q

Fluphenazine (Prolixin) is also available in ____ formulation

A

Intramuscular

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53
Q

Perphenazine (Trilafon) should be given in doses between ___-___ mg/day

A

8-64

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54
Q

Thiothixene (Navane) should be given in doses between ___-___ mg/day

A

6-60

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55
Q

Phenothiazines and Thioxanthenes cause potent ____ blockages, leading to significant extrapyramidal symptoms

A

D2 (dopamine)

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56
Q

Phenothiazines and Thioxanthenes cause less of an ____ adrenergic blockade, meaning less sedation and hypotension

A

Alpha-1

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57
Q

Haloperidol (Haldol) is an example of what drug class?

A

Butyrophenones

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58
Q

Haloperidol (Haldol) was the first alternative to ____

A

Phenothiazines

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59
Q

Haloperidol (Haldol) should be given in doses between ___-___ mg/day

A

5-40

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60
Q

Butyrophenones like Haloperidol (Haldol) are _____ unrelated to phenothiazines, though the pharmacological and side effects are similar

A

Structurally

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61
Q

Butyrophenones like Haloperidol (Haldol) cause high incidence of ____ ____ and ____, but less weight gain, anticholinergic effects, and hypotension than older phenothiazines

A

Extrapyramidal symptoms and sedation

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62
Q

What are three Phenothiazine alternatives of the 1970s?

A

-Molindone (Moban)
-Pimozide (Orap)
-Loxapine (Loxitane)

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63
Q

Molindone (Moban) and Pimozide (Orap) are ____ antagonists and are structurally unrelated to the phenothiazines/thioxanthenes; they have no apparent clinical advantages

A

D2 (dopamine)

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64
Q

Loxapine (Loxitane) has a similar structure to ____ ____

A

Tricyclic anitdepressants

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65
Q

Loxapine (Loxitane) has mixed ____ and ____ activity

A

Antipsychotic and antidepressant

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66
Q

What is a metabolite of Loxapine (Loxitane)?

A

Amoxapine

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67
Q

Loxapine (Loxitane) binds ____ and ____ receptors

A

Dopaminergic and serotonergic

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68
Q

Loxapine causes less ____ symptoms than piperazine phenothiazines

A

Extrapyramidal

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69
Q

Traditional antipsychotic agents have a ____ therapeutic index with respect to mortality

A

High

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70
Q

Overdoses with traditional antipsychotics are rarely fatal, except for ____ which can be cardiotoxic

A

Thioridazine

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71
Q

Side effects of traditional antipsychotic agents routinely occur at therapeutic doses as they are extensions of pharmacological actions; these include…

A

-Sedation
-Extrapyramidal symptoms (dystonia, akathisia, parkinsonism)
-Tardive Dyskinesia

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72
Q

Tardive Dyskinesia occurs in ___-___% of chronically treated patients

A

20-40

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73
Q

Tardive Dyskinesia causes abnormal, jerky movements of the ____ and ____

A

Face and tongue

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74
Q

The mechanism of tardive dyskinesia is poorly understood and unpredictable, but thought to be due to ___ ___ ____

A

D2 (dopamine) receptor supersensitivity

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75
Q

There is no treatment for tardive dyskinesia and it may be _____

A

Irreversible

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76
Q

If signs of tardive dyskinesia develop, reduce dose or discontinue the antipsychotic and eliminate all drugs with central anticholinergic action (antidepressants) OR switch to ___

A

Clozapine

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77
Q

Prevention of tardive dyskinesia is key; give minimal ____ doses for a limited time if possible

A

Effective

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78
Q

____ ____ syndrome is a rare medical emergency that affects 1% of patients, but 10% of cases are fatal

A

Neuroleptic malignant

79
Q

Neuroleptic malignant syndrome is more common in what gender?

A

Males

80
Q

80% of cases of neuroleptic malignant syndrome occur in patients under ____ years old

A

40

81
Q

What are symptoms of neuroleptic malignant syndrome?

A

-Hyperthermia or fever
-Diffuse muscular rigidity
-Severe extrapyramidal symptoms
-Fluctuating levels of consciousness

82
Q

Treatment for neuroleptic malignant syndrome is ____, and consists of rehydration, body cooling, and discontinuing with the antipsychotic

A

Supportive

83
Q

Traditional antipsychotics might be contraindicated in patients with…

A

-Parkinson’s disease
-Hepatic failure
-Hypotension
-Bone marrow depression
-Those prescribed CNS depressants

84
Q

Traditional antipsychotic drugs can have additive effects when taken with what types of drugs?

A

-CNS depressants
-Anticholinergic medications

85
Q

Traditional antipsychotics have the potential for increased metabolism when administered with agents that include ____ ____, like cigarette smoking

A

Hepatic enzymes

86
Q

What are other adverse effects of traditional antipsychotics?

A

-Autonomic and endocrine effects
-Cholestatic jaundice due to biliary obstruction
-Dermatological reactions: allergic reaction, photosensitivity
-Ocular effects
-Reproductive effects

87
Q

What are examples of ocular effects that could result from traditional antipsychotics?

A

-Opacities of the cornea and lens with chlorpromazine
-Decreased vision or blindness with high-dose thioridazine

88
Q

What are examples of reproductive effects that could result from traditional antipsychotics?

A

-In women: amenorrhea and increased libido
-In men: decreased libido and gynecomastia

89
Q

From 1975-____, not a single new antipsychotic was marketed in the US

A

1989

90
Q

What are examples of second-generation antipsychotics?

A

-Clozapine
-Risperidone
-Olanzapine
-Quetiapine
-Ziprasidone
-Lurasidone

91
Q

What is one third-generation antipsychotic?

A

Aripiprazole

92
Q

Compared to classical/traditional antipsychotics, atypical antipsychotics have…

A

-Wider range of CNS receptor interactions (particularly with 5-HT2 (serotonin) receptors)
-Different adverse effect profile

93
Q

As a group, atypical antipsychotics all produce less ___ ___ and are less likely to produce tardive dyskinesia

A

Extrapyramidal symptoms

94
Q

Atypical antipsychotics are more effective in reducing “____” symptoms of schizophrenia than older agents

A

Negative

95
Q

Haloperidol has its main effect on what receptor?

A

D2

96
Q

Clozapine has its main effect on what 3 receptors?

A

-Muscarinic
-5-HT2
-Alpha1

97
Q

Risperidone has its main effect on what 2 receptors?

A

-D2
-5-HT2

98
Q

Olanzapine has its main effect on what 3 receptors?

A

-Muscarinic
-D2
-5-HT2

99
Q

Ziprasidone has its main effect on what 2 receptors?

A

-D2
-5-HT2

100
Q

D1-antagonism has ____ effects, but potent agents may impair cognitive function

A

Unknown

101
Q

D2-antagonism has ____ effects; it causes relief of positive symptoms, induction of extrapyramidal symptoms, and increased prolactin levels

A

Antipsychotic

102
Q

5-HT1a-agonist has possible ___/___ effects

A

Antidepressant/anxiolytic

103
Q

5-HT2a-antagonism causes improvement in negative symptoms and ____ ____; this may reduce extrapyramidal symptoms

A

Cognitive impairment

104
Q

5-HT2c-antagonism may cause ____ as well as attenuate increases in prolactin levels; this contributes to weight gain and there is limited evidence for the mediation of antipsychotic effects

A

Anxiolysis

105
Q

5-HT3-antagonism has an ____ effect and this is normally lacking in antipsychotic agents

A

Antiemetic

106
Q

Alpha1-antagonism causes what clinical effects?

A

-Sedation
-Hypotension
-Reflex tachycardia

107
Q

Alpha2-antagonism causes what clinical effects?

A

-May improve depression and negative effects

108
Q

H1-antagonism causes what clinical effects?

A

-Sedation
-Contribution to weight gain

109
Q

m1-antagonism causes what clinical effects?

A

-Anticholinergic effects
-May attenuate extrapyramidal symptoms

110
Q

____ is the prototype “atypical” antipsychotic which the FDA approved in 1989

A

Clozapine (Clozaril)

111
Q

What is the mechanism of action for Clozapine (Clozaril)?

A

-Binds to multiple receptors (dopamine, serotonin, acetylcholine)
-Greater 5-HT2 (serotonin) than D2 (dopamine) blockade defines “atypical”

112
Q

Clozapine (Clozaril) is not indicated as first-line for schizophrenia due to _____ effects

A

Hematological

113
Q

To be prescribed Clozapine (Clozaril), a patient must have failed a minimum of ____ other antipsychotics due to insufficient effectiveness or signs of toxic dose/other intolerable side-effects

A

2

114
Q

Clozapine (Clozaril) salvages ____ of those patients who are considered treatment refractory

A

Half

115
Q

Clozapine can cause ____, so patients must register for a program and have bloodwork before refill

A

Agranulocytosis

116
Q

Side effects of Clozapine (Clozaril) include…

A

-Sedation (40%)
-Weight gain (80%)-> can be up to 20 pounds
-Constipation (30%)
-Agranulocytosis (1-2%)
-Seizures (3.5%)

117
Q

Agranulocytosis from Clozapine (Clozaril) usually develops within the first ___ months of treatment

A

3

118
Q

If someone is taking Clozapine (Clozaril), they need weekly monitoring of ___ ___ cell counts

A

White blood

119
Q

What are signs of agranulocytosis?

A

-Fever
-Sore throat
-Cellulitis

120
Q

Risperidone (Risperdal) has a unique _____ structure

A

Chemical

121
Q

Risperidone (Risperdal) causes a potent blockage of ___ and ____ receptors

A

D2 (dopamine) and 5HT2 (serotonin)

122
Q

Risperidone (Risperdal) improves control of psychotic symptoms with minimal ____ symptoms at therapeutic doses

A

Extrapyramidal

123
Q

Risperidone (Risperdal) is not associated with the ____ and ____ risks of clozapine

A

Hematological and seizure

124
Q

The initial dose of Risperidone (Risperdal) is ___ mg, twice a day

A

1

125
Q

Dosage of Risperidone (Risperdal) should be increased by ___-___ mg until the dose reaches 3mg twice per day

A

1-2

126
Q

Typical dosing of Risperidone (Risperdal) is less than ____ mg/day; doses above this may result in extrapyramidal symptoms and increased prolactin

A

8

127
Q

Doses above ___ mg twice per day are no more effective and cause more extrapyramidal symptoms

A

6

128
Q

Risperidone ____ is a long-acting depot form (25 mg, 37.5mg, and 50mg injections)

A

Consta

129
Q

The initial dose of Risperidone Consta is ____ mg IM every 2 weeks

A

25

130
Q

The max dose of Risperidone Consta is ___ mg IM every 2 weeks

A

50

131
Q

With Risperidone Consta, there is a ___ week lag in effect; this requires an overlap of oral risperidone

A

3

132
Q

There are no real ____ doses between oral and injection Risperidone Consta

A

Equivalent

133
Q

Dose adjustments for Risperidone Consta should not be made more than once per ____

A

Month

134
Q

Once mixed, Risperidone Consta is stable for ____ hours

A

6

135
Q

Paliperidone (Invega) is an active metabolite of _____

A

Risperidone (9-hydroxy)

136
Q

Paliperidone (Invega) utilizes a _____ delivery system

A

OROS

137
Q

Paliperidone (Invega) is a selective ____ antagonist

A

Monoaminergic

138
Q

The therapeutic effect of selective monoaminergic antagonists like Paliperidone is antagonism activity of ___ and ____ receptors

A

5HT2A (serotonin) and DA2 (dopamine)

139
Q

Selective monoaminergic antagonists cause enhanced affinity of…

A

-alpha1
-alpha2
-Histamine1

140
Q

Paliperidone (Invega) has been approved for ____ and ____ treatment of schizophrenia

A

Acute and maintenance

141
Q

Paliperidone (Invega) should be avoided in patients with…

A

-Gastrointestinal narrowing
-Concurrent medications known to prolong the QTc interval
-Congenital long QTc syndrome
-History of cardiac arrhythmias

142
Q

What are some drug interactions with Paliperidone (Invega)?

A

-Levodopa and other dopaminergic agents
-Centrally acting agents
-Agents causing orthostatic hypotension

143
Q

Paliperidone (Invega) should be given in a ____ mg dose once per day

A

6

144
Q

Initial dose ____ is not required with Paliperidone (Invega)

A

Titration

145
Q

Incremental adjustments of ____ mg/day at 5 or more day intervals are recommended for Paliperidone (Invega)

A

3

146
Q

The maximum dose of Paliperidone (Invega) is ___ mg/day

A

12

147
Q

For those with mild renal impairment (CrCl 50-80 mL/min), the maximum dose of Paliperidone (Invega) should be ___ mg/day

A

6

148
Q

For those with moderate to severe renal impairment (CrCl 10-50 mL/min), the maximum dose of Paliperidone (Invega) should be ___ mg/day

A

3

149
Q

No dose adjustment is required in patients with mild-moderate ____ impairment

A

Hepatic

150
Q

Olanzapine (Zyprexa) is structurally and pharmacologically similar to Clozapine, but _____ has not been reported with it

A

Agranulocytosis

151
Q

What is the mechanism of action with Olanzapine (Zyprexa)?

A

-Completely blocks 5HT2 (serotonin) at low doses (5 mg)
-D2 (dopamine) blockage increases with higher doses

152
Q

Olanzapine (Zyprexa) is available in doses of 2.5, 5, 7.5, 15, and 20 mg and should not be ____, since it breaks the drug down

A

Cut

153
Q

What are side effects of Olanzapine (Zyprexa)?

A

-Mild sedation
-Occasional extrapyramidal symptoms
-Weight gain/Diabetes

154
Q

Olanzapine (Zyprexa) has less impact on ___ and does not cause agranulocytosis

A

Prolactin

155
Q

The efficacy of Olanzapine (Zyprexa) is ____ to Lorazepam (Ativan) or Haloperidol (Haldol)

A

Superior

156
Q

What are the two dosage forms of Zyprexa?

A

-Disintegrating tablets
-Injectable IM

157
Q

Zyprexa ____ is the disintegrating tablet form of Zyprexa, and can be given in doses of 5, 10, 15, or 20 mg

A

Zydis

158
Q

The injectable IM dosage form of Zyprexa is indicated for acute ____ in patients already on another oral antipsychotic, but is not a substitute for oral Zyprexa

A

Agitation

159
Q

Injectable Zyprexa should be given in ___ mg doses every 2 hours, up to 3 doses in 24 hours

A

10

160
Q

A single dose of injectable Zyprexa should not exceed ____ mg

A

10

161
Q

Dosing of injectable Zyprexa in the elderly can be ___ or ___ mg

A

5 or 2.5

162
Q

Vias of Zyprexa are single-dose only and must be ____ prior to administration

A

Mixed

163
Q

There is a greater association with increased ___ and ___ with Olanzapine (Zyprexa) than other atypical antipsychotics or placebo

A

Glucose; lipids

164
Q

What should be monitored for those taking Olanzapine (Zyprexa)?

A

-Glucose
-Weight
-Lipids

165
Q

Abnormal or borderline glucose at baseline is a risk factor for further glucose ______ when taking Olanzapine (Zyprexa)

A

Increase

166
Q

The FDA mandated changes in labeling for all atypical antipsychotics to include warnings for ____ and ____

A

Hyperglycemia and diabetes

167
Q

There have been numerous reports of hyperglycemia and diabetes with ___ and ___, but fewer reports with Risperidone and Quetiapine

A

Clozapine, Olanzapine

168
Q

The Consensus Development Conference on Antipsychotic Drugs and Obesity and Diabetes stated that Aripiprazole and Ziprasidone have ____ metabolic side effects like weight gain, DM, and dyslipidemia

A

Less

169
Q

The American Diabetes Association Monitoring Recommendations for those on antipsychotics include…

A

-Personal/family Hx: Baseline, annually
-Weight (BMI): Baseline, 4 weeks, 8 weeks, 12 weeks, quarterly
-Waist circumference: baseline, annually
-Blood pressure: baseline, 12 weeks, annually
-Fasting plasma glucose: baseline, 12 weeks, annually
-Fasting lipid profile: baseline, 12 weeks, generally every 5 years

170
Q

Quetiapine (Seroquel) causes no clinically significant ___ ___ or alterations in cardiac intervals

A

Cardiac arrhythmias

171
Q

Quetiapine (Seroquel) causes limited weight gain (about ____ pounds), mainly during the early weeks of treatment

A

5

172
Q

There are ____ changes in patients who are on Quetiapine (Seroquel) long-term; they should have ophthalmological exams every 6 months

A

Lens

173
Q

Quetiapine (Seroquel) is not indicated for ____

A

Sleep

174
Q

What are some common side effects of Quetiapine (Seroquel)?

A

-Headache
-Agitation
-Somnolence
-Dizziness
-Dry mouth
-Weight gain

175
Q

Ziprasidone (Geodon) is structurally similar to ____

A

Risperidone

176
Q

Ziprasidone (Geodon) blocks ____ and ____, similar to other atypical antipsychotics

A

5HT2 (Serotonin) and dopamine

177
Q

Ziprasidone (Geodon) has unique receptor actions that include…

A

-Agonist at 5HT1A receptor (a “buspirone-like” action)
-Moderately blocks 5-HT (serotonin) and norepinephrine reuptake

178
Q

Ziprasidone (Geodone) improves ___ and ____ symptoms

A

Depressive and negative

179
Q

Side effects of Ziprasidone (Geodone):

A

-Extrapyramidal symptoms
-Somnolence
-Nausea
-Constipation
-Dyspepsia
-Dizziness

180
Q

Ziprasidone (Geodone) has more ____ properties than other atypical antipsychotics

A

Proarrhythmic

181
Q

There is an absence of significant ____ ____ with Ziprasidone (Geodon)

A

Weight gain

182
Q

Ziprasidone (Geodone) can be injected _____, but injections for more than 3 consecutive days has not been studied

A

Intramuscularly

183
Q

For long-term therapy with Ziprasidone (Geodon), patients should switch to an ____ dosage form

A

Oral

184
Q

Co-administration of ____ and ____ doses of Ziprasidone (Geodon) is not recommended

A

IM and oral

185
Q

Ziprasidone (Geodone) injection has less side effects and is more effective at reducing acute symptoms than IM ____

A

Haloperidol

186
Q

Lurasidone (Latuda) is a 2nd generation atypical much like ____

A

Ziprasidone (Geodone)

187
Q

Mechanism of Lurasidone (Latuda):

A

-D2, 5HT2a, 5HT7 antagonist
-5HT1A partial agonist
-Minimal alpha 1
-No M1 or H1

188
Q

Lurasidone (Latuda) is metabolized by what CYP450 enzyme?

A

CYP3A4

189
Q

What are some adverse effects of Lurasidone (Latuda)?

A

-Insomnia
-Akathisia
-Nausea
-Parkinsonism
-Agitation
-Metabolic syndrome

190
Q

What are the dosage forms of Aripiprazole (Abilify)?

A

-Oral solution
-Tablet
-Discmelt (disintegrating tablet)
-IM injection

191
Q

Benefits of Aripiprazole (Abilify):

A

-Minimal weight gain or sedation
-Low incidence of extrapyramidal symptoms, even at high doses
-No prolactin elevation or QT prolongation

192
Q

Common side effects of Aripiprazole (Abilify) include…

A

-Headache
-Nausea
-Insomnia

193
Q

Overall, first-generation antipsychotics cause what side effects?

A

-Extrapyramidal symptoms
-Tardive dynskinesia

194
Q

Second-generation antipsychotics generally have ____ side effects

A

Metabolic

Advanced Pharmacology (10 decks)

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