antipsychotic pharm: segars

Question 1

what are the 1st generation (typical) antipsychotics? (FGAs)

Answer 1

• Chlorpromazine
• Fluphenazine
• Haloperidol
• Thioridazine
• Thiothixene

Question 2

What are the second generation (novel; Atypical) antipsychotics? (SGAs)

Answer 2

• Aripiprazole
• Clozapine
• Olanzapine
• Quetiapine
• Risperidone
• Ziprasidone

Question 3

what is clozapine indicated

Answer 3

suicidal behavior

Question 4

what are positive symptoms of schizophrenia?

Answer 4

• Hallucinations
• Delusions
• Disorganized speech/thinking
• agitation
• abnormal motor behavior

Question 5

What are the negative symptoms of schizophrenia

Answer 5

• apathy
• avolition
• alogia
• cognitive deficits (working memory)
• social withdrawal

Question 6

brain pathway for positive symptoms?
Negative?
EPS side effects?
Hyperprolactinemia?

Answer 6

• Mesolimbic
• Mesocortical
• Nigrostriatal
• Tuberoinfundibular

Question 7

what do FGAs primarily block

Answer 7

D2 post synaptic receptors

Question 8

what other receptors do FGAs block to create side effects

Answer 8

• muscarinic
• H1
• a1

Question 9

what drugs can be used to treat the EPS symptoms of FGAs

Answer 9

Anticholinergics

• Diphenhydramine
• Benztropine
• Trihexyphenidyl

Question 10

what subtype of FGAs are more likely to have EPS symptoms and endocrine (prolactin)

Answer 10

high potency

Question 11

What subtype of FGAs have more sedations, hypotension and seizure threshold reduction

Answer 11

-low potency

Question 12

what are the high potency FGAs

Answer 12

• Fluphenazine
• Haloperidol
• Thiothixene

Question 13

what are the low potency FGAs

Answer 13

• Chlorpromazine

- Thioridazine

Question 14

SGAs block what receptors

Answer 14

5HT-2a&raquo_space;D2

Question 15

the 5HT antagonism of SGAs increases Dopamine transmission in what pathway

Answer 15

nigrostriatal

-reduced EPS effects

Question 16

what SGA is a D2 partial Agonist

Answer 16

Aripiprazole

Question 17

what SGA is a 5HT-1A full agonist?

partial?

Answer 17

• Ziprasidone

- Aripiprazole and Clozapine

Question 18

common side effects for SGAs

Answer 18

• weight gain

- metabolic effects: hyperglycemia/insulin resistance, hyperlipidemia

Question 19

what FGA has most weight gain and DM

Answer 19

Chlopromazine

Question 20

what SGAs have the most weight gain and DM?

Answer 20

Olanzapine

Question 21

what SGAs have the least weight gain and DM

Answer 21

• Ziprasidone (girl with zipper in sketchy)

- Aripiprazole `

Question 22

what SGA has the most EPS symptoms

Answer 22

Risperidone

Question 23

what SGA has most prolactin elevation

Answer 23

Risperidone

Question 24

what SGAs have no anticholinergic side effects

Answer 24

• Aripiprazole

- Ziprasidone

Question 25

what is a rare but severe side effect of clozapine

Answer 25

Agranulocytosis . . monitor WBC

Question 26

Treatment of neuroleptic malignant syndrome (NMS)

Answer 26

Dantrolene

Question 27

what baseline needs to be monitored when on an antipsychotic

Answer 27

• medical and family history, including cardiovascular disease
• Weight
• Waist circumference
• BP
• Plasma glucose
• fasting lipid profile

Question 28

what are the long acting injectable antipsychotic agents?

Answer 28

• Haloperidol Decanoate

- Fluphenazine decanoate

Question 29

how long is needed to see a response to antipsychotics

Answer 29

-2-3 weeks

Question 30

what is used for multi drug resistant phychosis or for anti suicidal thoughts

Answer 30

Clozapine