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1. 4th year > Antipsychotics > Flashcards

Antipsychotics Flashcards

1
Q

what is the risk associated with the use of antipsychotics in elderly

A

increased risk of stroke and VTE

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2
Q

how do antipsychotics work

A

block dopamine receptors therefore reduce pathological over-activity

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3
Q

antipsychotics have antimuscarinic side effects - what are these

A

dry mouth
blurred vision
urinary retention
constipation

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4
Q 
haloperidol
chlorpromazine
thioridazine
fluphenazine 
zuclopenthixol

are examples of what antipsychotics

A

typical

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5
Q

what is the biggest concern with typical antipsychotics

A

extra pyramidal side effects

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6
Q

what are EPSEs

A

acute dystonia
akathasia
parkinsonism
tardive dyskinesia

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7
Q

what is acute dystonia

A

painful sustained contraction of muscles usually in the eyes, jaw or neck

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8
Q

what is acute dystonia of the eyes called

A

oculogyric crisis

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9
Q

what is acute dystonia of the neck called

A

torticollis

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10
Q

how is acute dystonia reversed

A

procyclidine

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11
Q

what is akathasia

A

feeling of restlessness and constant need to wander

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12
Q

what are the features of parkinsonism seen in EPSE of typical antipsychotics

A

shuffling gait
tremor
reduced facial expression

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13
Q

what is tardive dyskinesia

A

repetitive, uncontrollable contraction of the muscles of the face, tongue and upper body –> excessive blinking, lip smacking, jaw pouting, chewing, facial grimacing

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14
Q

what endocrine disturbances can be seen with typical antipsychotics

A

hyperprolactinaemia

impaired glucose tolerance

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15
Q

typical antipsychotics, particularly haloperidol cause what change on an ECG

A

QT prolongation

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16
Q

True/False

Typical antipsychotics can cause sedation, increased appetite and weight gain

A

true

17
Q

Name some atypical antipsychotics

A 
olanzapine
quetiapine
aripiprazole
risperidone 
amisulpride
18
Q

what is the main advantage in the use of atypical antipsychotics

A

reduction in EPSEs

19
Q

List some side effects of atypical antipsychotics

A 
hyperprolactinaemia
impaired glucose tolerance (T2DM)
increased appetite and weight gain
drowsiness
sexual dysfunction
20
Q

atypical antipsychotics increase/decrease risk of seizure

A

increased risk of seizure by reducing seizure threshold

21
Q

which atypical antipsychotics is particularly good for prolactin elevation

A

aripiprazole

22
Q

weight gain is most pronounced with which atypical antipsychotic

A

olanzapine

clozapine

23
Q

what are the conditions for the use of clozapine

A

treatment resistant schizophrenia - when a patient has trialled 2 different antipsychotics for at least 6 weeks with no improvement, one of which is an atypical

24
Q

what are the 2 main concerning side effects of clozapine

A

myocarditis

agranulocytosis

25
Q

how are myocarditis and agranulocytosis avoided/monitored with clozapine use

A

ECG before starting

regular blood testing to see FBC

26
Q

how often should a FBC be taken with someone on clozapine

A

weekly for the first 6 months

then every 2 weeks for next 6 months and then monthly thereafter

27
Q

when should FBC be done when stopping clozapine

A

1 month after

28
Q

how do you safety net a patient starting clozapine

A

say if they have a sore throat or any other kind of infection to immediately go to their GP to get FBC

29
Q

what are other side effects of clozapine

A 
weight gain 
hypersalivation
cardiomyopathy
pulmonary embolism
neutropenia
reduced seizure threshold
constipation
30
Q

how can you treat hypersalivation with clozapine use

A

hyocine hydrobromide

31
Q

what is the significance of smoking with regard to clozapine

A

smoking reduces clozapine levels so suddenly quitting smoking could dramatically increase blood levels

1. 4th year (23 decks)

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