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Psychiatry * > Antipsychotics > Flashcards

Antipsychotics Flashcards

1
Q

mesocortical pathway

A

negative symptoms if too little dopamine

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2
Q

mesolimbic pathway

A

positive symptoms if too much dopamine

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3
Q

typical antipsychotics - MOA

A

dopamine D2 receptor antagonists,

blocking dopaminergic transmission in mesolimbic pathway

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4
Q

typical antipsychotics - common adverse effects

A

extra-pyramidal effects

hyperprolactinaemia - galactorrhoea

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5
Q

typical antipsychotics - Ex

A

haloperidol

chlopromazine

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6
Q

Atypical antipsychotics: MOA

A

act on variety of receptors

D2, D3, D5, 5-HT

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7
Q

Atypical antipsychotics - ex

A

clozapine
risperidone
olanzapine

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8
Q

extrapyramidal side effects

A

parkinsonism
acute dystonia
akathisia
tardive dyskinesia

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9
Q

how can acute dystonia secondary to antipsychotics be managed

A

procyclidine

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10
Q

warnings when antipsychotics used in elderly

A

inc risk stroke

inc risk VTE

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11
Q

antimuscarinic side effects

A

dry mouth
blurred vision
urinary retention
constipation

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12
Q

other side effects

A 
sedation
weight gain 
raised prolactin - galactorrhoea
impaired glucose toleance
Neuroplegic malignant syndrome 
reduced seizure threshold
prolonged QT interval
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13
Q

neuroplegic malignant syndrome

A

pyrexia

muscle stiffness

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14
Q

adverse effects atypical antispsychotics

A

weight gain
agranulocytosis (clozapine)
hyperprolactinaemia

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15
Q

what parameters need monitored

A 
FBC
U&Es
LFTs
lipid
weight 
fasting Glc 
prolactin
BP 
ECG 
CVS risk assessment
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16
Q

FBC, U&Es, LFT monitoring

A

at start of therapy
annually

more often FBCs for clozapine - weekly initially

17
Q

lipids and weight monitoring

A

at start of therapy
3mo
annually

18
Q

fasting blood Glc monitoring

A

start of therapy
at 6mo
annually

19
Q

prolactin monitoring

A

start of therapy
at 6mo
annually

20
Q

BP monitoring

A

baseline

frequently during dose titration

21
Q

monitoring ECG

A

baseline

22
Q

monitoring CVS risk assessment

A

annually

23
Q

clozapine - when to use

A

resistant schizophrenia

24
Q

clozapine - adverse effects

A 
agranulocytosis - freq FBC 
reduced seizure threshold
constipation 
myocarditis - baseline ECG 
hypersalivation
25
Q

effect of smoking on clozapine

A

smoking cessation can cause a rise in blood clozapine levels

Psychiatry * (21 decks)

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