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Neuro exam 2 > Antipsychotics 1.2 > Flashcards

Antipsychotics 1.2 Flashcards

1
Q

Agent Specific Information: Haloperidol

A

– treatment of Gilles de la Tourette’s

syndrome/Huntington’s Disease

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2
Q

Agent Specific Information: Chlorpromazine

A

– contraindicated in patients with seizures, lowers
threshold
– used for intractable hiccough, mechanism
unknown
– deposits in the lens and cornea common

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3
Q

Agent Specific Information: Thioridazine

A

– deposits in retina at higher doses

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4
Q

Agent Specific Information: emetics

A

All except aripiprazole and thioridazine can be used as antiemetics
– block D2 receptors in CTZ

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5
Q

Agent Specific Information: Prochlorperazine

A

– useful in treatment of “drug-induced” nausea (chemotherapy)

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6
Q

Agent Specific Information: Scopolamine

A

– drug of choice for motion sickness

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7
Q

Agent Specific Information: Droperidol

A

component of neuroleptanesthesia

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8
Q

Dopamine: Extrapyramidal side effects:

A 
• Akathisia
• Pseudoparkinsonism
• Dystonias:
o Facial grimacing,
torticollis
Treatment includes
withdrawal of
neuroleptic and use of
a centrally acting
anticholinergic drug
including:
Trihexyphenidyl
Benztropine mesylate
Procyclidine HCl
Biperidin
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9
Q

Dopamine: Extrapyramidal side effects: Drugs that cause it

A 
All
More common in more D2
specific
(Haloperidol, fluphenazine,
thiothixene)
Drugs that exhibit strong
anticholinergic effects
(Thioridazine, Chlorpromazine)
show fewer extrapyramidal effects
than neuroleptics which
preferentially block DA
transmission
Atypicals have a lower
incidence of extrapyramidal
side effects.
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10
Q

Dopamine: Extrapyramidal side effects: TX

A 
Treatment includes
withdrawal of
neuroleptic and use of
a centrally acting
anticholinergic drug
including:
Trihexyphenidyl
Benztropine mesylate
Procyclidine HCl
Biperidin
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11
Q

Dopamine: Tardive Dyskinesia

A 
Develops after
months/years of treatment
• Abnormal oral/facial
movements
Results from
“supersensitivity” to DA,
which develops during
long-term DA receptor
blockade.
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12
Q

Dopamine: Tardive Dyskinesia: Drugs

A 
All
More common in
typicals
Incidence low with
Clozapine
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13
Q

Dopamine: Tardive Dyskinesia: tx

A 
No adequate
therapy for
advanced cases;
must be
recognized early
Can worsen on
withdrawal
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14
Q

Dopamine: Neuroleptic Malignant Syndrome:

A 
POTENTIALLY FATAL
• Muscle rigidity
• elevated temperature
• altered consciousness,
• autonomic dysfunction
o tachycardia,
diaphoresis, tachypnea,
urinary and fecal
incontinence
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15
Q

Dopamine: Neuroleptic Malignant Syndrome: Drugs

A

More common in

typicals

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16
Q

Dopamine: Neuroleptic Malignant Syndrome: TX

A 
Stop antipsychotic
immediately!
Administer
Bromocriptine
(dopamine D2 agonist) &
Dantrolene
If high temp maintained
cool down patient
Switch to atypical on
recovery
17
Q

Dopamine: Prolactin

A 
increased serum prolactin by
blockade of DA receptors in
the tuberoinfundibular
pathway
• Menstrual irregularities
• Loss of libido
• Swelling of the mamillary
glands (males/females)
• Galactorrhea-spontaneous
flow of milk from nipple
• Possibly osteoporosis
18
Q

Dopamine: Prolactin: Drugs

A 
More common with
Phenothiazines
(Chlorpromazine,
Fluphenazine,
Thioridazine,
Trifluoperazine,
Mesoridazine,
Perphenazine)
19
Q

Dopamine: Prolactin: TX

A

Switch treatment

20
Q

Cholinergic (M1):

A

Dry mouth, blurred vision,
urinary retention,
constipation, confusion

21
Q

Cholinergic (M1): Drugs

A 
Thioridazine,
Chlorpromazine,
and Olanzapine
Note: Clozapine
does all of these,
but increases
salivation
22
Q

Cholinergic (M1): TX

A

Switch treatment to
drug with lower M1
activity

23
Q

Adrenergic (α1A, α2A):

A

Orthostatic hypotension: may
result in syncope
Inhibit ejaculation without
interfering with erection

24
Q

Adrenergic (α1A, α2A): Drugs

A

Chlorpromazine and
Mesoridazine most
common

25
Q

Adrenergic (α1A, α2A): TX

A

Switch treatment to
drug with lower α
activity

26
Q

Histamine (H1):

A

Sedation

27
Q

Histamine (H1): Drugs

A

chlorpromazine,
olanzapine,
quetiapine, and
clozapine

28
Q

Histamine (H1): Switch

A

Switch drug if a

problem

Neuro exam 2 (35 decks)

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