Antipsychotic Medications Flashcards
Name the first generation antipsychotics
Haloperidol (Haldol), chlorpromazine (Thorazine), thioridazine
Strong antagonism of D2 receptors in both cortical & striatal areas. Oral absorption erratic
first generation antipsychotics
SE include: akinesia, EPS, tardive dyskinesia, hyperprolactinemia, QT prolongation, neuroleptic malignant syndrome
1st generation antipsychotics
consists of muscle rigidity, fever, autonomic instability, and cognitive changes such as delirium, and is associated with elevated plasma creatine phosphokinase.
neuroleptic malignant syndrome
post-synaptic blockade D2 receptors PLUS 5HT2 receptor binding
second generation antipsychotics
SE include: weight gain, hyperglycemia, hyperlipidemia, EPS, TD, NMS, hyperprolactinemia
second gen antipsychotics
Second generation antipsychotic that can cause agranulocytosis so it is not 1st line therapy
clozapine
Primarily used for IV for emergent situations
first generation antipsychotics
available as depot preparations for ease of administration for long term use and more cost effective then the atypical antipsychotics
haloperidol and fluphenazine (Prolixin)
Where are all 1st gen antipsychotics metabolized?
the liver
Most widely prescribed antypsychotic in the U.S.. Once day dosing. No anticholinergic effects
Risperidone (Risperdal)
SE include: sedation, hypotension, akathisia, prolactin elevation and weight gain
Risperidone (Risperdal)
Once day dosing. Levels decreased some by cigarette smoking
Olanzapine (Zyprexa)
Also used to treat mood and anxiety disorders, PTSD, and Parkinson disease. BID dosing recommended. Comes only as tablets. Low incidence of EPS
Quetiapine (Seroquel)
Causes minimal weight gain, but has unpredictable effect on activity of other antipsychotics
Aripipraole (Abilify)
Unique for its efficacy in otherwise treatment-resistant patients. Seizure risk increases with dose
Clozapine (Clozaril)
Treatment of akathisia side effect
Cautious antipsychotic dose reduction. Treatment w/ benzodiazepine, beta-blocker, benztropine
Treatment of Parkinsonian syndrome
Benztropine and Amantadine
Treatment of dystonia side effects
change to antipsychotic w/ lower EPS. Benztropine, diphenhydramine
Advantages and disadvantages of second generation antipsychotics compared to 1st gen antipsychotics
SGAs have been considered first-line, because of their lower risk for EPS compared to FGAs, they are more expensive and several cause more metabolic SE and weight gain than FGAs
