Antipsychotic Meds

Question 1

list the neurotransmitter most tied to antipsychotic efficacy and motor side effects

Answer 1

dopamine

all antipsychotics block D2 receptors

Question 2

state differences in adverse affects between low potency (chlorpromazine) and high potency 1st gens (haloperidol)

Answer 2

Chlorpromazine: more weight gain, more sedation

Haloperidol: more prolactin, more extrapyramidal side effects

Question 3

state unique clinical profiles (efficacy and EPS risk) and major adverse effects for clozapine

Answer 3

efficacy: efficacious! only drug with proven therapeutic superiority, some efficacy against neg symptoms

extrapyramidal symptoms risk: does not cause EPS at all!

adverse side effects: risk of agranulocytosis, seizures! drug interactions

Question 4

describe extrapyramidal adverse effects of antipsychotic meds, and which are most/least likely to cause them

Answer 4

EPS: parkinsonism, dystonia, akathisia

MOST likely to be caused by “-done/-ole” drugs (risperidone, haloperidol)

LEAST likely to be caused by “-pine” drugs (clozapine, quetiapine)

Question 5

how to medically manage adverse effects of antipsychotic meds

Answer 5

treat dystonia with anticholinergics

treat (bilateral) parkinsonism by switching drug to benztropine!

treat akathisia (restless leg syndrome) with propranolol

Question 6

describe how antipsychotics affect prolactin

Answer 6

blockade of tuberoinfundibular dopamine receptors can increase prolactin, cause gynecomastia, and galactorrhea

Question 7

drug list

Answer 7

chlorpromazine
haloperidol
clozapine
risperidone
olanzapine
quetiapine
ziprasidone
aripiprazole