antipsychotic pharm: segars Flashcards
what are the 1st generation (typical) antipsychotics? (FGAs)
- Chlorpromazine
- Fluphenazine
- Haloperidol
- Thioridazine
- Thiothixene
What are the second generation (novel; Atypical) antipsychotics? (SGAs)
- Aripiprazole
- Clozapine
- Olanzapine
- Quetiapine
- Risperidone
- Ziprasidone
what is clozapine indicated
suicidal behavior
what are positive symptoms of schizophrenia?
- Hallucinations
- Delusions
- Disorganized speech/thinking
- agitation
- abnormal motor behavior
What are the negative symptoms of schizophrenia
- apathy
- avolition
- alogia
- cognitive deficits (working memory)
- social withdrawal
brain pathway for positive symptoms?
Negative?
EPS side effects?
Hyperprolactinemia?
- Mesolimbic
- Mesocortical
- Nigrostriatal
- Tuberoinfundibular
what do FGAs primarily block
D2 post synaptic receptors
what other receptors do FGAs block to create side effects
- muscarinic
- H1
- a1
what drugs can be used to treat the EPS symptoms of FGAs
Anticholinergics
- Diphenhydramine
- Benztropine
- Trihexyphenidyl
what subtype of FGAs are more likely to have EPS symptoms and endocrine (prolactin)
high potency
What subtype of FGAs have more sedations, hypotension and seizure threshold reduction
-low potency
what are the high potency FGAs
- Fluphenazine
- Haloperidol
- Thiothixene
what are the low potency FGAs
- Chlorpromazine
- Thioridazine
SGAs block what receptors
5HT-2a»_space;D2
the 5HT antagonism of SGAs increases Dopamine transmission in what pathway
nigrostriatal
-reduced EPS effects
what SGA is a D2 partial Agonist
Aripiprazole
what SGA is a 5HT-1A full agonist?
partial?
- Ziprasidone
- Aripiprazole and Clozapine
common side effects for SGAs
- weight gain
- metabolic effects: hyperglycemia/insulin resistance, hyperlipidemia
what FGA has most weight gain and DM
Chlopromazine
what SGAs have the most weight gain and DM?
Olanzapine
what SGAs have the least weight gain and DM
- Ziprasidone (girl with zipper in sketchy)
- Aripiprazole `
what SGA has the most EPS symptoms
Risperidone
what SGA has most prolactin elevation
Risperidone
what SGAs have no anticholinergic side effects
- Aripiprazole
- Ziprasidone
what is a rare but severe side effect of clozapine
Agranulocytosis . . monitor WBC
Treatment of neuroleptic malignant syndrome (NMS)
Dantrolene
what baseline needs to be monitored when on an antipsychotic
- medical and family history, including cardiovascular disease
- Weight
- Waist circumference
- BP
- Plasma glucose
- fasting lipid profile
what are the long acting injectable antipsychotic agents?
- Haloperidol Decanoate
- Fluphenazine decanoate
how long is needed to see a response to antipsychotics
-2-3 weeks
what is used for multi drug resistant phychosis or for anti suicidal thoughts
Clozapine
