Antipsychotic drugs

Question 1

characteristics of typicals

Answer 1

older
more extrapyramidal side effects
treat positive symptoms

Question 2

effects of typicals

Answer 2

induce state of apathy, lack of initiation, limited range of emotion
reduce confusion and agitation in psychotic patients

Question 3

characteristics of atypicals

Answer 3

newer
less extrapyramidal side effects
first line for out patient
treat positive and negative symptoms

Question 4

major receptor target for typicals

Answer 4

D2 dopamine receptor

Question 5

off target receptors for typicals and their effects

Answer 5

alpha and muscarinic- anticholinergic side effects
H1- weight gain, sedation
serotonin 2c- weight gain

Question 6

what makes one atypical

Answer 6

5HT2a receptor

Question 7

relationship between receptor and dose

Answer 7

higher D2 affinity= lower dose recquried

Question 8

nigrostriatal pathway

Answer 8

substantia nigra to basal ganglia
movement
hyperactive in schizophrenia
degeneration in parkinson’s

Question 9

mesolimbic pathway

Answer 9

VTA to nucleus accumbent

hyperactive in schizophrenia- positive symptoms

Question 10

mesocortical pathway

Answer 10

tegmental area to cortex

hypoactive in schizophrenia- negative symptoms

Question 11

tubuloinfundibular pathwya

Answer 11

tegmental area to hypothalamus

controls prolactin release

Question 12

typical antipsychotics

Answer 12

haloperidol
trifluoperazine
fluphenazine
thioridazine
chlorpromazine

Question 13

high affinity for D2 typical

Answer 13

trifluoperazine
fluphenazine
haloperidol

Question 14

low affinity for D2 typical

Answer 14

thioridazine

chlorpromazine

Question 15

atypicals

Answer 15

aripiprazole
clozapine
olanzapine
quetiapine
risperadone
ziprasidone

Question 16

clinical indications for typicals

Answer 16

schizophrenia- positive symptoms
acute mania- temporarily for slow onset of Li
psychosis
tourette's syndrome
parities
intractable hiccups
nausea and vomiting
movement disorders

Question 17

treatment concerns with typicals

Answer 17

non adherance- cause of relapse
inadequate dosing- treatment failure
look for organic cause if no improvement

Question 18

major effects of high potency typicals

Answer 18

can’t pee can’t see can’t spit can’t poop

EPS

Question 19

EPS of high potency typicals

Answer 19

acute dystonia
parkinsonism
akathisia
tardive dyskinesia

Question 20

acute dystonia

Answer 20

4 h onset

spasm of head/neck/face muscles

Question 21

parkinsonism

Answer 21

days/weeks onset

muscle rigidity, bradykinesia, tremor, shuffling gait

Question 22

akthisia

Answer 22

days/weeks onset

urge to move

Question 23

treatment of acute dystonia, parkinsonism, akthisia

Answer 23

benztropine
trihexyphenidyl
diphenydramine

Question 24

treatment for tardive dyskinesia

Answer 24

switch to lower dose or an atypical

Question 25

tardive dyskinesisa

Answer 25

4 month onset
involuntary repetitive men tents of face/neck
worse with directed movement
irreversible

Question 26

major side effect low potency typical

Answer 26

increased non specific effects
sedation- histamin antagonist
orthostatic hypotension, sexual dysfunction- alpha
dry mouth, constipation, vision problems- muscarinic

Question 27

specific ADR with chlorpromazine

Answer 27

corneal deposits

Question 28

specify ADR with thirodazine

Answer 28

retinitis pigments

retrograde ejaculation

Question 29

side effects of all typicals

Answer 29

hyperprolactinemia

neuroleptic malignant syndrome

Question 30

neuroleptic malignant syndrome

Answer 30

stiff
hot
altered consciousness
elevated CK
autonomic instability

Question 31

treatment of neuroleptic malignant syndrome

Answer 31

dantrolene
bromocriptine
amatadine
benzodiazepines