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BBDA Spring (Exam 4) > Antipsychotic Drugs and Lithium > Flashcards

Antipsychotic Drugs and Lithium Flashcards

1
Q

Thorazine

A

Chlorpromazine (1st) (sedation, weight gain), anticholinergic, A-1 antagonists

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2
Q

Haldol

A

Haloperidol (1st) (Butyrophenones)

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3
Q

Prolixin

A

Fluphenazine (1st)

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4
Q

Trilafon

A

Perphenazine (1st)

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5
Q

Navane

A

Thiothixene (1st) (Thiothixenes)

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6
Q

Clozaril

A

Clozapine (2nd) for treatment resistant schizophrenia

reduces risk of suicide in schizophrenia

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7
Q

Zyprexa

A

Olanzapine (2nd) like clozapine (sedating, antichol. and alpha block)

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8
Q

Latuda

A

Lurasidone (2nd) new, w/ 350calorie meal, akathisia, for bipolar depression

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9
Q

Seroquel

A

Quetiapine (2nd) used as sleeping pill (bad), weight/metabolic effects, first-line agent for depression in bipolar disorder

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10
Q

Risperdal

A

Risperidone (2nd) significant weight/metabolic effects, more EPS above 6mg/day, syncope due to a1 block, prolactin increase, decreased libido

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11
Q

Geodon

A

Ziprasidone (2nd) temporary akathesia common, should be taken with 500 calorie meal which doubles the absorption, cardiac conduction disturbances possbily

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12
Q

Invega

A

Paliperidone (2nd) metabolite of risperidone, same effect profile, renal excretion instead of hepatic

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13
Q

Fanapt

A

Iloperidone (2nd) similar to risperidone for effects, little prolactin elevation, VERY slow dose titration b/c of hypotension

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14
Q

Saphris

A

Asenapine (2nd) SUBLINGUAL, no food or liquid 10 min after dosing,

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15
Q

Compazine

A

Prochlorperazine (1st)

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16
Q

Abilify

A

Aripiprazole, akathesia in beginning, increased DA in frontal cortex

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17
Q

Schizophrenia

A

Illogical thinking, hallucinations, emotion uncontrolled from thinking, bizarre erratic behavior, relationships disrupted, genetic component, environment may precipitate

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18
Q

Schizophrenia Positive Symptoms

A

Hallucinations, Delusions, Disorganized Speach, Paranoia, Hostility, Tension, Hyperactivity

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19
Q

Schizophrenia Negative Symptoms

A

Flat/Absent, Alogia (doesn’t speak much), Anhedonia (decreased pleasure), Avolition (lack of drive), decreased socialization/connectedness

20
Q

Schizophrenia Cognitive Symptoms

A

Impairment of: Attention, Info processing speed, Working Memory

21
Q

Meso-limbic

A

OVER activity, causes positive mood symptoms

22
Q

Meso-Cortical

A

UNDER activity, causes negative/cognitive symptoms

23
Q

NigroStriatal

A

Movement disorders

24
Q

Tuberoinfundibular

A

Associated with prolactin

25
Q

Schizophrenia Treatment

A

Pharmacotherapy (for symptoms), Psychosocial Important, 2nd Gen (atypical) first line, 1st Gen (typical)

26
Q

Chlorpromazine MOA

A

D2 receptor antagonist, Treats mostly positive symptoms, causes parkinson’s-like movement disorders

27
Q

High Dose / Low Potency

A

Chlorpromazine (sedative), Acute EPS less common! 300-600mg daily

28
Q

Low Dose / High Potency

A

Haldol, Fluphenazine, Perphenazine, less sedation/orthostasis/anticholinergic block, acute EPS more common, 6-12mg per day

29
Q

1st Gen. Problems

A

movement disorders, tardive syndromes, increased prolactin, lack of effect on negative symptoms, may not work in up to 30% of patients

30
Q

Movement Disorders

A 
Early onset, reversible:
Dystonia- spasms of voluntary muscles
Parkinsonism- resting tremor, muscular rigidity
Akathisia- feeling of inner restlessness
due to blockade of D2 receptors in CNS
31
Q

2nd Gen.

A

act differently, not more effective (except clozapine!)

32
Q

2nd Gen. “The Good”

A

Treat schizophrenia, mania, depression, Bi-polar, less movement disorder issues, less prolactin elevation

33
Q

2nd Gen. “The Bad”

A

increased weight gain, precipitate diabetes, cardiac risk, many people still treatment resistant

34
Q

2nd Gen. “The Ugly”

A

Clozapine causes: More wight gain, seizures at high doses, excessive salivation, potentially fatal agranulocytosis (decreased WBC)

35
Q

2nd Gen. Weight Gain, Increased Lipids (metabolic)

A

Clozapine>olanzapine>lurasidone=ziprasidone

36
Q

2nd Gen. Sedation

A

Clozapine=quetiapine=olanzapine>lurasidone=ziprasidone

37
Q

Akathesia-like symptoms

A

Aripiprazole, Ziprasidone, Lurasidone

38
Q

Monitoring

A

Tardive Dyskinesia for all antipsychotics

Weight, BP, glucose and lipids 2nd and possibly 1st

39
Q

Aripiprazole MOA

A

Partial agonism at D2 receptors (lowers DA)

40
Q

Bi-polar Disorder

A

episodes of depression and at least one episode of mania or hypomania

41
Q

Hypomania

A

less severe than mania, 4-7 days, NO psychotic symptoms, less impairment of functioning

42
Q

Treatment of Bi-polar disorder

A

Lithium and Antipsychotic 2nd Gen. b/c lithium has delayed onset of action (7-10 days), also antiepileptics like depakote and epitol

43
Q

Bi-polar disorder

A

meds. used for mood stabilization, antidepressants not very good to treat depression of bi-polar disorder

44
Q

Lithium

A

Reduces suicidality!!!, renally cleared, slowed absorption b/c of food, .5-1mEq/L blood levels,

45
Q

Lithium Side Effects

A

tremor at therapeutic doses “intention tremor”, can add propranolol, GI DISCOMFORT, possible weight gain, intoxication >1.5 (slurred speech, disorientation)

46
Q

Lithium Cautions

A

changes in diet, furosemide okay, dehydration, NSAID’s cause Li retention, no abrupt discontinuation.

47
Q

Lithium Monitorin

A

Li inhibits thyroid gland, increased parathyroid, Li induced renal function, Li induced diabetes insipidus (very dilute urine)

BBDA Spring (Exam 4) (3 decks)

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