Antipsychotic agents

Question 1

Chlorpromazine
Fluphenazine
Haloperidol (Haldol)
Loxapine
Perphenazine
Primozide (Orap)
Prochlorperazine
Thioridazine
Thiothixene (Navane)
Trifluoperazine

Answer 1

Typical Antipsychotic agents (conventional)

Question 2

first generation

Answer 2

typical

Question 3

newer, novel antipsychotics

Answer 3

atypical

Question 4

antipsychotics work by blocking post synaptic dopamine receptors in the basal ganglia, hypothalamus, limbic system, brainstem and medulla.
-varying affinity for cholingergic alpha, -adrenergic, and histaminic receptors

Answer 4

typical antipsychotics

Question 5

possible related to inhibition of dopamine mediated transmission of neural impulses at the synapses.

Answer 5

Antipsychotic effects

Question 6

aripiprazole (Abilify)
asenapine (Saphris)
clozapine (Clozaril)
iloperidone (Fanapt)
lurasidone (Latuda)
olanzapine (Zyprexa)
paliperidone (Invega)
quetianpine (Seroquel)
risperidone (Risperdal)
ziprasidone (Geodon)

Answer 6

Atypical antipsychotics

Question 7

are weaker dopamine receptors antagonists than the conventional antipsychotics, more potent antagonists of the serotonin (5-hydroxytryptamine) type 2A (5HT2A) receptors
-They also exhibit antagonisms for cholinergic, histaminic and adrenergic receptors

Answer 7

Atypicals

Question 8

Blockage of the dopamine receptors is thought to be responsible for controlling positive symptoms of schizophrenia.
-also results in EPS side effects and prolactin elevation.

Answer 8

Antipsychotics effects

Question 9

muscle weakness

Answer 9

akinesia

Question 10

cont. restlessness and fidgeting

Answer 10

Akathisia

Question 11

involuntary muscular movements (spasms) of face, arms, legs, and neck
-men and in people younger than 25 years

Answer 11

Dystonia

Question 12

uncontrolled rolling back of the eyes

Answer 12

Oculogyric crisis

Question 13

bizarre facial & tongue movements, stiff neck and difficulty swallowing
-more common with typical antipsychotics

Answer 13

Tardive dyskinesia

Question 14

more common with typical than atypical antipsychotics
*rare, but fatal
routine temp and check for Parkinsonian symptoms. Muscle rigidity, high fever, tachycardia, tachypnea, fluc of bp, diaphoresis, rapid deteriation of mental status

stupor, coma

Answer 14

Neuroleptic Malignant syndrome (NMS)

Question 15

become 1st line of therapy, and treat both positive and negative symptoms of schizophrenia. They have a more favorable side effect profile than the conventional (typical) antipsychotics

Answer 15

Atypical antipsychotics

Question 16

most meds have their effects @ the neuronal synapse, producing changes in neurotransmitter release and the receptors to which they bind.

Answer 16

How psychotics work

Question 17

most antidepressants work by blocking the reuptake of neurotransmitters, specifically serotonin and norepinehrine

Answer 17

How most antidepressants work

Question 18

the process of neurotransmitters inactivation by which the neurotransmitters is reabsorbed into the presynaptic neuron from which it had been released.
-blocking the reuptake process allows more of the neurotransmitter to be available for neuronal transmission.

Answer 18

Reuptake

Question 19

inhibit reuptake of serotonin (5-HT)
-reduces depression, controls anxiety, controls obsessions.
side effects: nausea, agitation, headache, sexual dysfunction

Answer 19

SSRI’s

Question 20

inhibit reuptake of serotonin (5-HT), inhibits of norepinephrine (NE), blocks NE receptor blocks ACh receptor, blocks histamine (H1) receptor
-reduces depression, relief of severe pain, prevent panic attacks
side effects: sexual dysfunction, sedation, weight gain, dry mouth, constipation, blurred vision, urinary retention, postural hypotension, and tachycardia

Answer 20

Tricyclic Antidepressants

Question 21

Increase NE & 5Ht by inhibiting the enzyme that degrades them MAO-A
Reduces depression, controls anxiety
side effects: sedation, dizziness, sex dysfunction, hypertensive crisis (interaction with tyramine)

Answer 21

MAOI’s

Question 22

inhibit reuptake of NE and dopamine D
reduces depression, aids in smoking cessation, decreases symptoms of ADHD
side effects: Insomnia, dry mouth, tremor seizures

Answer 22

Bupropion

Question 23

Benzodiazepines
binds to BZ receptor sites on the GABA receptor complex; increases receptor affinity for GABA
Relief of anxiety sedation,
side effects: Dependence (with long term use)
confusion, memory impairment, motor incoordiation

Answer 23

Antianxiety meds

Question 24

Aripiprazole=Abilify
Dopamine-serotonin system stabilizer DSS
partial agonist at Dopamine receptor & serotonin (5-HT 1A)
Acts as antagonist at Dopamine receptor in high dopamine activity.
Acts as agonist in low dopamine activity
5 HT 2A antagonist.
Unwanted side effects (EPS, weight gain, prolactin elevation, gulcose & lipid abnormalities, cardiac abnormalities, prolongation of QT interval) are not a problem with this antipsychotic! Only time will prove its efficacy. Insomnia, nausea & vomiting

Answer 24

3rd generation Antipsychotics (DSS)

Question 25

Cholorpromazine

Answer 25

Thorazine; first tricyclic antihistamine

Question 26

Butyrophenone

Answer 26

Haldol; typical antipsychotic dopamine receptor antagonists

Question 27

Blocking 5-HT serotonin receptors decreases negative symptoms and EPS - Serotonin inhibits dopamine release - Positive symptoms assoc. with hyperdopaminergic condition in limbic lobe-more - D2 receptors here, so D2 blocking prevails

Answer 27

5-HT seratonin receptors

Question 28

``` Aripiprazole extended release (Abilify) Fluphenazine decanoate (fluphenazine-LAI) 4 weeks Haloperidol decanoate (haloperidol-LAI) 4 weeks Olanzapine pamoate (Zyprexa Relprevv) 3 weeks Paliperidone palmitate (Invega Sustenna) 4 weeks Risperidone microspheres (Risperdo Consta) 2 weeks ``` Deck Shot; not compliant with oral meds Sometimes need an oral dose in between to hold blood levels stable. Also may require more than one loading dose.

Answer 28

Long Acting Medication