Antipsychotic Drugs

Question 1

General Characteristic of antipsychotic drugs

Answer 1

Are not curative
Do not eliminate chronic thought disorders
Do decrease the intensity of hallucinations and delusions
Do permit the person with schizophrenia to function in a supportive environment

Question 2

List the 3 first generation (low potency) antipsychotic drugs

Answer 2

Chlorpromazine (Throrazine)
Prochlorperazine (Compazine)
Thioridazine (Mellaril)

Question 3

List the 4 First generation (High potency) antipsychotic

Answer 3

Fluphenazine (Prolixin)
Haloperidol (Haldol)
Pimozide (Orap)
Thiothixene (Navane)

Question 4

What gives first generation antipsychotics their therapeutic properties

Answer 4

Competitive inhibitors at avariety of receptors

-Antipsychotic effects reflect competitive blocking of dopamine D2 receptors

Question 5

What side effects are expected with the High potency antipsychotics

Answer 5

These drugs bind tightly to dopaminergic receptors so we expect to have movement disorders

Extrapyramidal symptoms

Question 6

General characteristics of Second generation or atypical antipsychotics

Answer 6

activity is related to the blockade of both serotonin and dopamine

Associated with a higher risk of metabolic side effects
-Diabetes, hypercholesterolemia and weight gain

Question 7

List the 10 second generation antipsychotics

Answer 7

Aripiprazole (Abilify)
Asenapine (Saphris)
Clozapine (clozarail)
Iloperidone (Fanapt)
Lurasidone (Latuda)
Olanzapine (zyprexa)
Quetiapine (Seroquel)
Paliperidone (Invega)
Risperidone (Risperdal)
Ziprasidone (Geodon)

Question 8

When are second generation antipsychotics used

Answer 8

Generally used as first line of therapy for schizophrenia
minimize risk of EPS associated with first gen
efficacy equal to first gen

Question 9

MOA of antipsychotic drugs

Answer 9

Dopamine antagonism:
All of the first-generation and most of the second-generation antipsychotic drugs block D2 dopamine receptors in the brain and the periphery

Serotonin receptor–blocking activity:
Most of the second-generation agents appear to exert part of their unique action through inhibition of serotonin receptors

Question 10

what are the drugs with antiemetic effects

Answer 10

Meclizine (Anavert)
-Antihistamine
Dimenhydrinate (Dramamine)
-Antihistamine 
Scopolamine (Transderm Scop)
-Anticholenergic
Promethazine (Phenergan)
-Antihistamine
Domperidone (Motilium)
-Selective peripheral D2 antagonist
Holoperidol (Haldol) & Prochlorperazine (Compazine)
-First Generation antipsychotic
Metoclopramide (Reglan)
-D2 antagonist – relaxes stomach 
Thiethylperazine (Torecan)
-Phenothiazine

Question 11

What drug is used to treat intractable hiccups

Answer 11

Chlorpromazine (Thorazine)

Question 12

What drugs are used to treat tourettes

Answer 12

Pimozide (orap) is primarily indicated for motor and phonic tics of tourettes

Risperidone and haloperidol are als commonly prescribed

Question 13

What are the Extrapyramidal Symptoms

Answer 13

Dystonia
-Continuous spasms and muscle contractions leading to twisting, distorted postures
Akathisia
-Motor restlessness
Parkinsonism
-Characteristic symptoms such as rigidity, bradykinesia, and tremor
Tardive dyskinesia
-Involuntary irregular, jerky movements, usually of the tongue, lips, neck, trunk, and limbs

Question 14

What are the other adverse effects assoicated with other receptors

Answer 14

α-adrenergic receptors block
-Orthostatic hypotension and light-headedness.
H1-histamine receptor block
-Sedation
-Chlorpromazine (Thorazine), olanzapine (Zyprexa), quetiapine (Seroquel), and clozapine (Clozaril)

D2 receptors block in the pituitary
-Increases in prolactin release