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Dental Pharmacology > Antipsychotic Drugs > Flashcards

Antipsychotic Drugs Flashcards

1
Q

typical: first generation antipsychotics (FGAs)

A

phenothiazenes; thioxanthenes; dibenzoxazapines; butyrophenones and diphenylbutylpiperidines; dihydroindolone

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2
Q

phenothiazenes

A

chlropromazine; thioridazine; mesoridazine; fluphenazine; trifluoperazine; perphenazine

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3
Q

thioxanthenes

A

chlorprothixene; thiothixene

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4
Q

dibenzoxazapines

A

loxapine

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5
Q

butyrophenones and diphenylbutylpiperidines

A

haloperidol and pimozide

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6
Q

dihydroindolone

A

molindone

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7
Q

atypical: second generation antipsychotics (SGAs)

A

clozapine; risperidone; olanzapine; quetiapine; aripiprazole

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8
Q

delusions (false beliefs); hallucinations; disorganized thoughts and speech; restlessness

A

positive/active symptoms of schizophrenia

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9
Q

flat affect; social withdrawal; loss of drive; paucity of speech; impaired process planning and memory and personal hygiene

A

negative/passive symptoms of schizophrenia

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10
Q

most anti psychotic drugs block …

A

dopamine receptors

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11
Q

schizophrenia patients have increased density of …

A

dopamine receptors

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12
Q

newer neuroleptic drugs bind preferentially to … and …

A

serotonin 5-HT2 and dopamine D4 receptors

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13
Q

typical (FGAs) do not alleviate …

A

negative symptoms

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14
Q

atypical (SGAs) alleviate …

A

both positive and negative symptoms

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15
Q

hypo-frontality hypothesis of schizophrenia: 3 components

A

positive symptoms; negative symptoms; impaired cognition

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16
Q

meso cortical pathway

A

negative symptoms

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17
Q

meso limbic pathway

A

positive symptoms

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18
Q

instead of just affecting dopamine, now the idea is to balance the 3 neurotransmitters thought to be involved … … and …

A

dopamine, serotonin, glutamate

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19
Q

clinical potency of FGAs is generally correlated with degree of …

A

dopamine D2 antagonism

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20
Q

high liability for metabolic syndrome, weight gain, blood disorders

A

SGAs

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21
Q

phenothiazine; aliphatic chain at R1; low potency; high sedating potential

A

chlorpromazine

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22
Q

phenothiazine; aliphatic chain at R1; hight potency

A

trifluoperazine

23
Q

phenothiazine; piperidine ring at R1; low potency; higher sedating potential; hypotensive

A

thioridazine

24
Q

phenothiazine; piperazine ring at R1; hight potency; strong EPS; least sedating of the three groups

A

fluphenazine

25
Q

thioxanthene; N replaced by C at position 10; high potency; EPS

A

thiothixene

26
Q

thioxanthene; N replaced by C at position 10; high potency; high EPS

A

chlorprothixene

27
Q

buterophenone; unrelated in structure to other 2 classes; hight potency; less sedating; strong EPS

A

haloperidol

28
Q

dihydroindolone; structurally not related to other classes; pharmacologic profile resembles that of piperazine group of phenothiazine

A

molindole

29
Q

dibenzoxapine; resembles TCA in structure; pharmacologic and clinical profile is similar to piperazine group of phenothiazine

A

loxapine

30
Q

diphenylbutylpiperidine; approved for Tourettes syndrome; alleviates pos. symptoms of schizophrenia; selective D2 antagonism with anti psychotic and parkinson like side effects

A

pimozide

31
Q

4 major pathways to dopaminergic system:

A

mesolimbic pathway; mesocortical pathway; nigrostriatal pathway; tuberoinfundibular pathway

32
Q

Dopamine D2 blockade in … and … may be responsible for antipsychotic effects of FGAs

A

meso limbic and meso cortical

33
Q

D2 blockade by FGA in … may cause EPS

A

basal ganglia (nigrostriatal)

34
Q

D2 super sensitivity in … may cause tardive dyskinesia

A

nigrostriatal

35
Q

involuntary muscle contraction, torticollis; Rx: anticholinergic (bentropine)

A

acute dystonia

36
Q

inner restlessness and constant urge to move, restless leg syndrome; Rx: BZDs, propanolol

A

akathisia

37
Q

bradykinesia, tremor, rigidity, postural instability; Rx: levo-dopa, bromocriptine

A

pseudoparkinsonism

38
Q

repetitive, involuntary, purposeless movements; Rx: up the dose of neuroleptic; switch to an atypical neuroleptic drug (clozapine)

A

tardive dyskinesia

39
Q

F of FEVER of neuroleptic malignant syndrome

A

fever (hypothalamic dopamine blockade)

40
Q

1st E of FEVER of neuroleptic malignant syndrome

A

encephalopathy (delirium; coma)

41
Q

V of FEVER of neuroleptic malignant syndrome

A

vital signs (autonomic instability; tachycardia; sweating; urinary and fecal incontinence)

42
Q

2nd E of FEVER of neuroleptic malignant syndrome

A

Enzymes (muscle breakdown; myoglobinuria w/o RBC in urine; high creatine phosphokinase

43
Q

R of FEVER of neuroleptic malignant syndrome

A

rigidity of muscles (dopamine blockade in the basal ganglia)

44
Q

SGA dibenzodiazepines

A

clozapine and quetiapine

45
Q

SGA benzisoxazole and most frequently prescribed in US

A

risperidone

46
Q

SGA thienobenzodiazepine

A

olanzapine

47
Q

SGA dihydrocarbostyril

A

aripiprazole

48
Q

2 main side effects of clozapine

A

weight gain and agranulocytosis

49
Q

used with lithium for treatment of bipolar disorder

A

risperidone

50
Q

high potential for abuse with effects similar to barbiturates and other hypnotics

A

quetiapine

51
Q

first of 3rd gen antipsychotic drug; also used for bipolar and autism spectrum disorders; lower liability for weight gain

A

aripiprazol

52
Q

most frequently prescribed FGAs

A

haloperidol; chlorpromazine; thioridazine

53
Q

most commonly prescribed SGAs

A

risperidone; olanzapine; aripiprazole

Dental Pharmacology (30 decks)

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