Antipsychotic medications Flashcards

1
Q

What is the mechanism of action of antipsychotics?

A

Block dopamine receptors, particularly D2 receptors.

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2
Q

Clinical indications for antipsychotics

A
  1. Delusions
  2. Hallucinations
  3. Thought disorder
  4. Agitation
  5. Short term use for dementia symptoms
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3
Q

What are the main extra-pyramidal side effects of antipsychotic use? (anti-dopaminergic)

A
  1. Dystonia e.g. torticollis
  2. Akathisia - physical restlessness
  3. Parkinsonisms
  4. Tardive dyskinesia (involuntary movements of the neck and face)
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4
Q

Anti-adrenergic side effects of antipsychotics

A
  1. sedation
  2. postural hypotension
  3. inability to ejaculate
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5
Q

Anticholinergic side effects of antipsychotics

A
  • dry mouth
  • constipation
  • blurred vision/dry eyes
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6
Q

Cardiac side effects of antipsychotics

A
  • prolongation of the QT interval > Torsades de Pointes and sudden death
    (RARE)
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7
Q

What is the 3rd line treatment for schizophrenia?

A

Clozapine

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8
Q

Why is Clozapine not used much/third line?

A

Has severe side effects e.g.
Agranulocytosis, myocarditis

Hypersalivation, sedation, weight gain, constipation

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9
Q

Monitoring regime for Clozapine

A

Weekly FBC for first 18 weeks

Then fortnightly until 1 year.

Thereafter monthly

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10
Q

What are extra-pyramidal side effects?

A
  1. Parkinsonism
  2. Acute dystonia
  3. Akathisia
  4. Tardive dyskinesia
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11
Q

What drug is given to patients with acute dystonia e.g. torticollis and oculogyric crisis?

A

Procyclidine

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12
Q

How does Procyclidine work?

A

blocking central cholinergic receptors and balancing the cholinergic-dopamine activity in the basal ganglia

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13
Q

What are the 2 specific warnings issued about antipsychotics in elderly patients?

A
  1. Increased risk of stroke
  2. Increased risk of Venous thromboembolism
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14
Q

What anti-psychotic is switched to if a patient experiences galactorrhoea/elevated prolactin?

A

Aripiprazole

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