Antipsychotics

Question 1

What are Symptoms of Scizophrenia?

Answer 1

🟢Positive symptoms: hallucinations, delusions
,disordered thinking, agitation, paranoia

🟢 Negative symptoms: social withdrawal, emotional withdrawal, lack of motivation, poverty of speech, poor insight, poor judgment and poor self-care.

Question 2

What are classical of antipsychotic drugs ?

Answer 2

1. Conventional antipsychotics (first generation) (typical):
   المجموعة الاولى مجموع احرفها الاولى (HFTC)
   (هفتس 😆)

🌸 Haloperidol
المقطع الاول هلو المقطع الثاني بيردول😃

🌸 Fluphenazine
المقطع الاول فلو المقطع الثاني فينازين 🌝

🌸 Thioridazine
المقطع الاول ثايو و المقطع الثاني ريدازين 😃

🌸 Chlorpromazine
المقطع الاول كلور المقطع الثاني بروم و الثالث ازين 🙂

2. Atypical antipsychotics (second generation)
   كلها مجموعة بكلمة (كور )تذكرني بتطبيق كورا🙂
   1-clozapine
   المقطع الثاني زابين

2-olanzapine
المقطع الثاني زابين

2-risperidone
المقطع الاول ري الثاني سبيري الثالث دون

3. Third generaion: Aripiprazole
   المقطع الاول اري الثاني بيب الثالث رازول

Question 3

What is causes of extrapyramidal symptoms (EPS?

Answer 3

All of the conventional agents block receptors for dopamine in the CNS. As a result, they all can cause serious movement disorders

Question 4

What is causes of extrapyramidal symptoms (EPS?

Answer 4

All of the conventional agents block receptors for dopamine in the CNS. As a result, they all can cause serious movement disorders

Question 5

Why prefer use atypical drugs for treatment the Schizophrenia from typical ?

Answer 5

The atypical agents produce only moderate blockade of receptors for dopamine and much stronger blockade of receptors for serotonin. Because dopamine receptor blockade is low, the risk of extrapyramidal reactions is low as well.

Question 6

What we can give the patient if he or she did not response tomthe first or second regeneration of antipsychotic drug and what side effect of it ?

Answer 6

generation antipsychotics
 For these patients, clozapine has shown to be an effective antipsychotic with a minimal risk of EPS. However, its clinical use is limited to refractory patients because of serious adverse effects.
Clozapine can produce bone marrow suppression, seizures, and cardiovascular side effects, such as orthostasis. The risk of severe agranulocytosis necessitates frequent monitoring of white blood cell counts.

Question 7

What are receptor that clozapine has high affinity for it?

Answer 7

D1,D4,5- HT2,muscarinic and α- adrenergic receptors, but it is also have weak D2- receptors antagonisic acivity.

Question 8

What are Acions of Antipsychotic drugs ?

Answer 8

Antipsychotic efects:  All antipsychotic drugs can reduce
hallucinations and delusions associated with
schizophrenia
2. Extrapyramidal efects: Dystonias (sustained contracion of muscles leading to twising, distorted postures), Parkinson-like symptoms, akathisia (motor restlessness)

Aniemeic efects: The anipsychoic drugs have aniemeic efects that are mediated by blocking D2 receptors of the CTZ of the medulla

4. Anicholinergic efects: Some of the anipsychoics, paricularly thioridazine , chlorpromazine, clozapine, and olanzapine, produce anicholinergic efects. These efects include blurred vision, dry mouth (the excepion is clozapine,which increases salivaion),
5. Other efects:  Blockade of α-adrenergic receptors causes
   orthostaic hypotension and light-headedness

Question 9

What are the drugs that regarded potent antagonists of the H1-histamine receptor, ?

Answer 9

chlorpromazine, olanzapine,and clozapine.

Question 10

What are Therapeutic uses of Antipsychotic drug?

Answer 10

1. Treatment of Schizophrenia
2. Bipolar disorder (manic-depressive illness
3. Prevention of emesis
4. Other applications:
   neuroleptics an be used for dementia and other organic mental syndromes (psychiatric syndromes resulting from organic cause, such as infection, metabolic disorder, poisoning, injury to the brain). Also neuroleptics are used in combination with narcotic analgesics for chronic pain.
   Chlorpromazine is used to treat intractable hiccups
5. Now Risperidone& Aripiprazole are approved for the management of disruptive behavior and irritability secondary to autism.

Question 11

What are drug s use in Bipolar disorder (manic-depressive illness and schizoaffective?

Answer 11

Antipsychotic drugs are administered with lithium for the treatment of sever symptoms of manic phase, when lithium start to act (after 2 to 3 weeks), antipsychotics are then withdrawn gradually.
Lurasidone is indicated for the treatment of bipolar depression.
Paliperidone is approved for the treatment of schizoaffective disorder.

Question 12

What are Adverse efects of antipsychotic drugs?

Answer 12

1. Extrapyramidal symptoms (EPS):
   Acute dystonia: ime of onset a few hours to 5
   days. followed by akathisias occurring within
   days to weeks. Parkinson-like symptoms of
   bradykinesia, rigidity, and tremor usually occur
   within weeks to months of iniiaing
   treatment. Tardive dyskinesia(TD) : which can be
   irreversible, may occur ater months or years
   of treatment .Features: Choreoathetoid
   movements of lips, tongue, face, jaws, and
   limbs and someimes trunk.

2.Neurolepic Malignant syndrome
3. Anicholinergic efects: Anipsychoic drugs produce varying degrees of muscarinic cholinergic blockade causing dry mouth, blurred vision, photophobia, urinary retenion, consipaion and tachycardia.
4. Orthostaic hypotension: by blocking alpha 1 adrenergic
receptors on blood vessels. Alpha adrenergic blockers
prevents compensatory vasoconstricion when the
paient stands, hence blood pressure falls.
5. Neurolepics induced sedaion is thought to result from
blockade of histamine 1 receptors in the CNS.
6. Endocrine efects: Anipsychoics increase levels of
circulaing prolacin by blocking the inhibitory acion of
dopamine on prolacin release.

7. Glucose and lipid proiles
8. Thioridazine has the highest risk from the anipsychoic drugs for causing QT-interval prolongaion.

Question 13

What are means Dystonias, Parkinson-like symptoms, akathisia ,tardive dyskinesia?

Answer 13

Dystonias (sustained contracion of muscles leading to twising, distorted postures), Parkinson-like symptoms, akathisia (motor restlessness), and tardive dyskinesia (involuntary movements, usually of the tongue, lips, neck, trunk, and limbs