Antipsychotic and Anxiolytic Drugs Flashcards
What are antipsychotic drugs
Drugs which eliminate the symptoms of psychotic diseases
Antipsychotic drugs synonym
Neuroleptics
What is psychosis
Psychotic disorder with a significant impairment of thinking and sensations
Symptoms of psychosis
Positive
1.delusions(false ideas, beleifs)
2.hallucinations
Negative
1.emotional blunting(lack of emotions)
2.social withdrawal(lack of communication)
Most accepted pathogenesis of schizophrenia
Dopamine hypothesis
(Symptoms caused by exclusive influence of dopaminergic neurons on mesolimbic area of brain
Other pathogenesis of schizophrenia
Serotonin hypothesis
(Increased influence of serotonin)
Glutamate hypothesis
(Decreased influence of glutamate)
Classification of antipsychotic drugs
Typical
1.phenothiazine derivatives
2.other chemical groups
Atypical
Typical antipsychotic drugs
Phenothiazine derivatives-
Chloropromazine(aliphatic)
Trifluoperazine,
fluphenazine,
decanoate,
prochlorperazine(piperazine)
Thioridazine(piperadine)
Other-
Haloperidol
Trifluperidol
Droperidol
Chlorprothixene
Atypical antipsychotic drugs
Clozapine
Olanzapine
Risperidone
Quetiapine
Ziprasidone
Aripiprazol
Mechanism of typical antipsychotic drugs
Blocking dopamine D2 receptors
Mechanism of atypical psychotic drugs
Block serotonin 5-HT2 receptors
Which receptors does antipsychotic drugs have an affinity
Block
Muscarinic cholinoceptors
Alpha adrenergic receptors
Histamine H1 receptors
Which drug is most significant for affinity to all three receptors
Chloropromazine
Features of atypical antipsychotic drugs mechanism
1.significant antagonist properties for serotonin 5-HT2 receptors
2.low affinity or rapid dissociation form D2 receptors(quatiapine)
3.high affinity to D4 than D2(clozapine)
4.partial agonist of D2 and D3(aripiprazole)
Sedative effects
(Drowsiness ,impaired memory )
Blockade of cholinoceptors
Adrenoceptors
Histamine H1 receptors
Early extrapyramidal disorders
(Parkinsonism, akathisia, acute dystonia, malignant neuroleptic syndrome)
Blockade of D2 in neostriatum
Late extrapyramidal disorders
(Tardive dyskinesia)
Increase number of D2 receptors
Increase of appetite, weight
Increased synthesis of prolactin
Decreased synthesis of gonadotropine
Blockade of D2 and serotonin 5-HT2 receptors in hypothalamus
Dry mouth
Increased occular pressure
Constipation
Urinary retention
Blockade of M-cholinoceptors
Orthostatic hypotension
Blockade of alpha adrenoceptors
What are extrapyramidal disorders caused by antipsychotic drugs
Parkinsonism
Akathisia
Acute dystonia
Malignant neuroleptic syndrome
Treatment of drugs induced parkinsonism
Centrally acting Anti muscarinic drugs
Trihexyphenidyl
Benztropine
What is akathisia
expressed by Feeling restlessness,
Tension
Making movements such as to rock or to walkabout
Treatment for akathisia
Beta adrenoblockers
Propranolol
Clonazepam
What are manifestations of acute dystonia
Spastic long term contractions of group of muscles
Muscle spasm of face,tongue,neck,back
Involuntary eye movements
Facial grimacing
Abnormal postures
Treatment for acute dystonia
Central anti muscarinic drugs
Trihexyphenidyl
Benztropine
Antihistamine drug(diphenhydramine)
Botulinum toxinum
Manifestations of malignant neuroleptic syndrome
Rapidly progressing muscle rigidity
High fever
Impairment of consciousness
Coma
Death
Laboratory marker of malignant neuroleptic syndrome
Increased creatine kinase
Treatment or management of malignant neuroleptic syndrome
Bromocriptine (D2 agonists)
Muscle relaxant dantrolene
Cooling by ice
Control of cardiovascular and respiratory system
Tardive dyskinesia
Appears after a long-term treatment of antipsychotic drugs
Increased D2 dopamine receptors
Uncontrolled movements of face ,tongue, lips, jaws, extremities
Treatment of tardive dyskinesia
Difficult for correction or irreversible
Decrease level of dopamine in CNS(tetrabenzine)
Clonazepam
Comparison of phenothiazine derivatives
Which dugs resembles chloropromazine
Droperidol
Chlorprothixene
Which drugs resemble trifluoperazine
Haloperidol
Fluphenazine
Distinctive features of atypical antipsychotic drugs
Low possibility of extrapyramidal disorders
Higher possibility of increased appetite and weight
More effective against negative symptoms
Higher risk of stroke
Which drug has high risk of agranulocytosis
Clozapine
Distinctive features of aripiprazole
Lower possibility of weight gain
Improve results of treatment of depressions if added to antidepressant
Nicotine dependence
Hypersexuality
Gambling
Application of antipsychotic drugs
Schizophrenia
Psychotic disorders
Neuroleptanaglesia
Prevention or releif of vomiting
What is neuroleptanaglesia
Method of analgesia
Simultaneous administration of fentanyl and droperidol
Causes state of tranquility and calmness
Releiving pain in myocardial infarction
Some operations
Which drugs are used to releif of vomiting
Prochlorperazine
Perphenazine
Block D2 receptors of vomiting center
What are anxiolytic drugs
Drugs that reduce anxiety
Classification of anxiolytic drugs
Benzodiazepines derivative
1.short acting (triazolam)
2.intermediate acting (oxazepam,lorazepam,alprazolam)
3.long acting (diazepam,chlordiazepoxide,medazepam,nitrazepam).
Agonists of seratonin 5-HT receptors
Buspirone
