ANTIPSYCHOTIC AGENTS AND LITHIUM

Question 1

caused by a relative excess of dopamine in the mesolimbic-mesocortical pathway

Answer 1

Schizophrenia

Question 2

Positivr symptoms

Answer 2

HIDES
Hallucination
Illusion
Delusion
Excitement
Suspciousness

Question 3

Negative Signs

Answer 3

Anhedonia
Avolition
Anergia

Question 4

D1 receptor family?

D2 receptor family?

Answer 4

D1 fam - D1, 4, 5

D2 fam - D2, 3

Question 5

addresses more of the positive symptoms

Answer 5

TYPICAL ANTIPSYCHOTICS

Question 6

addresses both positive and negative symptoms

Answer 6

ATYPICAL ANTIPSYCHOTICS

Question 7

higher chances of causing EPS

Answer 7

high potency typical antipsychotics

- haloperidol, droperidol

Question 8

more likely to cause sedatiom and postural hypotension due to alpha receptor blockade

Answer 8

Low Potency Typical Antipsychotics

- thioridazine, chlorpromazine

Question 9

with higher propensity to cause metabolic derangements (weight gain, endocrine problems)

Answer 9

Atypical antipsychotics

Question 10

Blocks more D2 receptors than 5HT2A

Answer 10

Typical Antipsychotics

Atypical - blocks more 5HT2A receptors

Question 11

TYPICAL ANTIPSYCHOTICS

Answer 11

PHENOTHIAZINES
PIPERIDINES
BUTYROPHENONE

Question 12

PHENOTHIAZINES

Answer 12

Chlorpromazine
Levomepromazine
Prochlorperazine
Promethazine

Thiothexene
Flupentixol

Thioridazine
Fluphenazine
Perphenazine
Trifluoperazine

Question 13

AE: RETINAL DEPOSITS

Answer 13

thioridazine

Question 14

Phenothiazine with the most muscarinic blockade therefore has the least EPS amongst typical antipsychotics

Answer 14

Thioridazine

Question 15

phenothiazine with quinidine like actions (prolongation of QT interval)

Answer 15

Thioridazine

Question 16

Phenothiazine with significant Parkinson-like effect

Answer 16

Fluphenazine and Trifluoroperazine

Question 17

BUTYROPHENONE

Answer 17

Haloperidol

Droperidol

Question 18

USE: BUTYROPHENONE

Answer 18

Schizophrenia
BPD - manic phase
Huntington’s Disease
Tourette’s Syndrome

Question 19

major tranquilizer with highest potential for EPS and neuroleptic malignant syndrome

Answer 19

Haloperidol

Question 20

least sedating among typical antipsychotics

Answer 20

Haloperidol

Question 21

ATYPICAL ANTIPSYCHOTICS

Answer 21

DIBENZODIAZEPINE
THIENOBENZODIAZEPINE
DIBENZOTHIAZEPINE
BENZISOXAZOLE
DIHYDROINDOLONE
DIHYDROCARBOSTYRIL

Question 22

DIBENZODIAZEPINE

Answer 22

CLOZAPINE

Question 23

THIENOBENZODIAZEPINE

Answer 23

OLANZAPINE

Question 24

DIBENZOTHIAZEPINE

Answer 24

QUETIAPINE

Question 25

BENZISOXAZOLE

Answer 25

RISPERIDONE | PALIPERIDONE

Question 26

DIHYDROINDOLONE

Answer 26

ZIPRASIDONE

Question 27

DIHYDROCARBOSTYRIL

Answer 27

ARIPIPRAZOLE

Question 28

DOC for refractory and suicidal schizo

Answer 28

Clozapine

Question 29

With the highest tendency to cause weight gain among atypical

Answer 29

Clozapine, Olanzapine

Question 30

Only antipsychotic that reduces the risk of suicide

Answer 30

Clozapine

Question 31

Most feared complications of clozapine

Answer 31

Agranulocytosis and seizures

Question 32

Clozapine is not associated with seizure because?

Answer 32

it blocks the D2C receptors (mesocortical mesolimbic area) not the D2A (nigrostriatal pathway) D4=a1>5HT2A>D2=D1

Question 33

causes minimal or no increase in prolactin and has reduced risk of EPS (MINIMAL D2 antagonism)

Answer 33

Olanzapine, Quetiapine, Aripiprazole

Question 34

atypicals least likely to cause tardive dyskinesia

Answer 34

Quetiapine and Clozapine

Question 35

atypical that causes somnolence, sleep paralysis, hypnagogic hallucinations, cataracts, priapism and QT prolongation

Answer 35

Quetiapine

Question 36

atypical with the highest propensity to cause hyperprolactinemia (amenorrhea, galactorrhea)

Answer 36

Risperidone

Question 37

only antipsychotic approved for schizophrenia in the youth

Answer 37

Risperidone

Question 38

atypical causing marked QT prolongation

Answer 38

Ziprasidone

Question 39

atypical - partial agonist at the D2 receptor

Answer 39

Aripiprazole

Question 40

Least sedating atypical

Answer 40

Aripiprazole

Question 41

Safe in pregnancy - atypical

Answer 41

Olanzapine and quetiapine

Question 42

No atropine-like effects - atypical

Answer 42

Aripiprazole, Ziprasidone

Question 43

QT prolongation - atypical

Answer 43

Ziprasidone, Quetiapine

Question 44

Atypical can also be used in anorexia nervosa and depression

Answer 44

Olanzapine

Question 45

Atypical can also be used in sleep promotion and maintenance

Answer 45

Quetiapine

Question 46

Atypical can also be used in depression, intractable hiccups, tourette syndrome

Answer 46

Risperidone, Paliperidone

Question 47

Atypical can also be used in MDD, autism, cocaine, dependence

Answer 47

Aripiprazole

Question 48

MOOD STABILIZER

Answer 48

LITHIUM

Question 49

DOC FOR BIPOLAR DISORDER

Answer 49

LITHIUM

Question 50

most common side effect of lithium

Answer 50

tremor

Question 51

lithium is contraindicated in

Answer 51

sick sinus syndrome or brady tachy syndrome

Question 52

AE of LITHIUM

Answer 52

LiTHIUM Low Thyroid hormone Heart - Ebstein Anomaly Insipidus - nephrogenic Unintentional Movement (Tremor)

Question 53

Threshold for toxicity

Answer 53

2meq/L

Question 54

Treatment for Lithium Overdose

Answer 54

Hemodialysis Manifestation brady, hypotension agitation, tremor, twitching