Antipsychotic Drugs Flashcards
What are some FGAs (1st gen)
- Haloperidol
- ZUclopenthixol
- Chlopromazine
- Flupenthixol
- Pimozide
What are some SGAs (2nd gen)
- Risperidone
- Paliperidone
- Olanzepine
- Ziprasidone
- Clozapine
What are the main EPSE’s seen with antipsychotic drugs
- Dystonia: sustained muscle contraction
- Akathisia: cannot sit still, uncomfortable
- Parkinsonism:
- weeks post starting, stop or lower dose, parkinsons med wont help
- Tardive Dyskinesia: Repititve non-purposeful movement of mouth, head, limbs, trunk
- After years, no tx, stopping may worsen symps, change agent (to clozapine)
- Blood Sugar and Cholesterol
- May be due to weight gain: check fbg and TG’s
What drugs in particular mess with blood sugar and cholesterol?
Olanzapine and Clozapine worst
What are some non-EPSE’s seen with anti-psychotic drugs
- Sedation
- Postural Hypotension
- QTc prolongation
- Agranulacytosis
- Neuroleptic Malignancy Syndrome
What do you use to treat Akathisia?
Beta-clockers, Benzodiazepines
Concerns and side effects we worry about with Clozapine?
- Agranulocytosis
- Seizures
- Toxic megacolon
- Bowel Obstruction
- Blood sugar and cholesterol rise
What is Neruoleptic Malignancy Syndrome
- Rare medical emergency
- Rigidity, high fever, confusion
- Stop offending agent immediately
What are the most likely adverse effects of Risperidone?
- Sedation
- EPSE: tardive dyskinesia, akathisia, dystonia
- Weight gain
- Headache
- Raised prolactin: Headache, amenorrhoea, osteoporosis, cancers, galactorrhoea
What are the most likely adverse effects of Aripiprazole?
- Anxiety/agitation
- Akathisia and other EPSE
- Tremor
What are the most likely adverse effects of olanzapine?
- Increased appetite/weight gain
- Inc BG and cholesterol
- Sedation
What is a significant health problem associated with the treatment for schizophrenia and psychosis?
Diabetes and Metabolic Syndrome!
Due to the increased appetite and significant weight gain seen with these drugs
What do antipsychotics mess with in order to produce EPSEs
They cause a reduced availability of dopamine in parts of the brain that regulate and coordinate movement
Results in a loss of muscle control, eg twitching and tremours
When do you get tardive dyskinesia, will it stop when you remove the drug?
Why is it so dangerous
30-60% long term users of older antipsychotics have some form of movement disorder
TD may persist for months/years/permanently after drug withdrawal.
TD is distressing and socially isolating and can lead to suicide
