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Pharmacology > Antipsychotics > Flashcards

Antipsychotics Flashcards

1
Q

Antipsychotic with the largest effect on EEG

A

Clozapine

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2
Q

Antipsychotic with the lowest effect on EEGs

A

Quetiapine

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3
Q

Receptor thought to mediate the erectile dysfunction side effects of antipsychotics

A

Cholinergic receptor antagonism

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4
Q

Causes of sexual dysfunction in antipsychotic use

A

Due to elevated prolactin levels

Anticholinergic and antiadrenergic effects independent of prolactin levels

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5
Q

Antipsychotics with greatest prolactin elevation

A

Risperidone/paliperidone

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6
Q

Antipsychotics with the greatest impact on sexual function

A

Risperidone/paliperidone

Haloperidol

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7
Q

Percentage of patients taking haloperidol and risperidone/paliperidone who report sexual dysfunction

A

70%

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8
Q

Antipsychotics with lowest sexual dysfunction effects

A

Aripiprazole
Asenapine
Lurasidone

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9
Q

Proposed mechanisms of action of antipsychotic related weight gain

A 
5HT2A and 5HT2C antagonism
D2 and D3 antagonism
H1 antagonism
M3 antagonism
Hyperprolactinaemia
Increased serum leptin leading to leptin desensitisation
Ghrelin
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10
Q

Antipsychotics with high risk of weight gain

A

Clozapine

Olanzapine

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11
Q

Antipsychotics with moderate risk of weight gain

A

Chlorpromazine
Quetiapine
Risperidone
Paliperidone

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12
Q

Antipsychotics with low risk of weight gain

A 
Amisulpride
Asenapine
Aripiprazole
Haloperidol
Sulpride
Lurasidone
Ziprasidone
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13
Q

Antipsychotic which has been seen to cause weight loss when used with clozapine or olanzapine

A

Aripiprazole

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14
Q

Antipsychotic associated weight gain liraglutide can be used for

A

Clozapine

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15
Q

Typical antipsychotic felt to be most effective in depot form - possibly with higher side effects

A

Zuclopenthixol

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16
Q

Atypical antipsychotics available in depot form

A

Risperidone - as risperdal consta or paliperidone
Olanzapine
Aripiprazole

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17
Q

Requirement for test dosing with depot antipsychotics

A

Always required for first generation antipsychotics

Should be considered for second generation antipsychotics if it is not clear if an oral dose has been taken

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18
Q

Base of second generation antipsychotic depot medications which is not known to be allergenic

A

Aqeous

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19
Q

Time during depot dosing when patients may be at highest risk of a relapse

A

Immediately after a depot dose

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20
Q

Time after withdrawing an antipsychotic depot when relapse occurs in trails

A

3-6 months after stopping

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21
Q

Site into which olanzapine depot must be injected

A

Gluteal

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22
Q

Cause of post injection syndrome in giving antipsychotic depots

A

Accidental entry into a blood vessel on administration

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23
Q

Features of post injection syndrome

A 
Sedation
Confusion
Dizziness
Agitation/aggression
EPSEs
HTN
Convulsion
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24
Q

Typical antipsychotics

A 
Chlorpromazine
Flupenthixol
Zuclopenthixol
Perphenazine
Sulpride
Haloperidol
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25
Q

Atypical antipsychotics

A 
Clozapine
Risperidone
Olanzapine
Quetiapine
Ziprasidone
Amisulpride
Aripiprazole
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26
Q

Active metabolite of thioridazine

A

Mesoridazine

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27
Q

Base of first generation antipsychotic medications

A

Coconut oil or sesame oil

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28
Q

Time after injection when depot flupentixol reaches peak levels

A

3-7 days

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29
Q

Time after injection when depot fluphenazine reaches peak levels

A

24 hours

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30
Q

Time after injection when depot haloperidol reaches peak levels

A

7 days

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31
Q

Time after injection when depot zuclopenthixol reaches peak levels

A

7 days

32
Q

Active metabolite of risperidone

A

9-hydroxyrisperidone

33
Q

Active metabolite of risperidone

A

Paliperidone

34
Q

Active metabolite of aripiprazole

A

Dihydroaripiprazole

35
Q

Depot antipsychotics which require oral cover after the first dose is administered

A

Risperidone

Pipotiazine

36
Q

Atypical antipsychotic with the shortest half life

A

Qetiapine

37
Q

Antipsychotics with a high risk of raised prolactin levels

A 
All typical antipsychotics
Risperidone
Sulpride
Amisulpride
Paliperidone
38
Q

Antipsychotics with a low risk of raised prolactin

A

Lurasidone
Olanzapine
Ziprasidone

39
Q

Antipsychotics with a very low risk of prolactin elevation/prolactin sparing

A

Clozapine
Aripiprazole
Asenapine
Quetiapine

40
Q

Advised duration of treatment with antipsychotics for schizophrenia

A

1-2 years

41
Q

Incidence of post injection syndrome

A

<0.1%

42
Q

Time frame within which post injection syndrome nearly always occurs

A

Within 1 hour of injection

43
Q

Hours for which a patient must be supervised after olanzapine depot injection

A

3 hours

44
Q

Antipsychotic associated with post injection syndrome

A

Olanzapine

45
Q

Antipsychotic which can be given at highest doses in depot form

A

Flupentixol

46
Q

Benefits to giving flupentixol in high doses compared to standard doses

A

Likely none

47
Q

Depot form of olanzapine

A

Olanzapine pamoate/emboate

48
Q

Antipsychotics most associated with postural hypotension

A 
Risperidone
Clozapine
Olanzapine
Paliperidone
Quetiapine
Ziprasidone
49
Q

Antipsychotics to consider if postural hypotension is an issue

A

Amisulpride
Sulpride
Aripiprazole
Haloperidol

50
Q

Most sedating antipsychotic

A

Clozapine

51
Q

Antipsychotic associated with pathological gambling

A

Aripiprazole

52
Q

Antipsychotic which should be given twice a day specifically at high doses

A

Amisulpride

53
Q

Antipsychotic which causes photosensitivity reactions

A

Chlorpromazine

54
Q

Antipsychotics which have high D2/low 5HT2 activity

A

Typical antipsychotics - typical of haloperidol

55
Q

Antipsychotics which have high D2/high 5HT2 activity

A

Atypical antipsychotics - olanzapine, risperidone, loxapine

56
Q

Antipsychotic which has low D2/high 5HT2 activity

A

Clozapine

57
Q

Antipsychotic which could be considered to have low D2/low 5HT2 activity

A

Quetiapine

58
Q

Antipsychotic best tolerated to treat side effects of Parkinson’s medication for patients with Parkinson’s disease

A

Quetiapine

59
Q

Possible pharmacological bases for hypersalivation associated with clozapine

A

Muscarinic M4 agonism
Adrenergic alpha-2 antagonism
Inhibition of the swallowing reflex

60
Q

Timings for patients on clozapine or olanzapine to have their lipids checked

A

3 monthly during first year of treatment

Yearly afterwards

61
Q

Antipsychotic associated with reduced seizure threshold

A

Clozapine

62
Q

Age group where antipsychotic related weight gain is more significant

A

Children

63
Q

Most effective antipsychotic for schizophrenia in patients with hyponatraemia

A

Clozapine

64
Q

Antipsychotic known for being a pure D2 antagonist

A

Sulpride

65
Q

Antipsychotic most likely to induce seizures

A

Clozapine

66
Q

Primary factor for classifying antipsychotics into first and second generation

A

Propensity for extrapyramidal side effects

67
Q

Time frame within which the greatest improvement is seen after starting an antipsychotic

A

Within the first week

68
Q

Most common cause of secondary amenorrhoea in patients on antipsychotics

A

Pregnancy

69
Q

Antipsychotic associated with a contact dermatitis

A

Chlorpromazine

70
Q

First generation antipsychotic also used as an antiemetic in palliative care

A

Chlorpromazine

71
Q

Receptor chlorpromazine acts on to make in an effective antipsychotic

A

Dopamine receptors

72
Q

Antipsychotics most likely to cause orthostatic hypotension

A

Clozapine

Risperidone

73
Q

Antipsychotic most likely to cause nausea and vomiting

A

Aripiprazole

74
Q

Antipsychotics associated with pigment deposit in the anterior lens capsule

A

Chlorpromazine

Thioridazine

75
Q

Antipsychotic with the lowest dropout rate in the CATIE study

A

Olanzapine

Pharmacology (34 decks)

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