Antipsychotics

Question 1

What is Psychosis`

Answer 1

Its an abnormal mental condition describes as “loss of conatct with reality”

Question 2

Signs exhibited by Psychotic patients

Answer 2

Personality changes
Thought disorders
Unusual/bizarre behavior
Difficulty making social interactions.
Impairment in carrying out daily activities

Question 3

What is Schizophrenia

Answer 3

Its a type of psychosis

Question 4

Characteristics of Schizophrenia

Answer 4

Delusions, hallucinations and though disorder (positive symptoms)
+
Social withdrawal, blunted emotion responses often dementia (negative symptoms)

Question 5

Aetiology of Schizophrenia

Answer 5

unknown but its agreed that its Dopamine Hyperactivity that cause +ive symptoms

Question 6

When does Schizophrenia begin

Answer 6

In adolescence/young adult life and tend to either follow a relapsing and remitting course or to be chronic and progressive

Question 7

Treatment goals for Schizophrenia

Answer 7

-reduction of psychotic symptoms
-prevent recurrences of symptomatic episodes and associated deterioration of functioning

Question 8

MOA of Neuroleptics/Antipsychotic drugs

Answer 8

1. Block postsynaptic D2 Rs: antipsychotic activation
   Neuroleptics (most) also block Cholinergic, A-adrenergic, Serotonin and Histamine Receptors= adverse effects

Question 9

Which are the Typical /Conventional Antipsychotics

Answer 9

Phenothiazines (Chlorpromazine, Fluphenazine)
Butyrophenones (Haloperidol)
Thioxanthines (Fluphenthixol)

Question 10

MOA of Typical Antipsychotics

Answer 10

Act primarily by blocking D2 Receptors
High Potency drugs: high affinity for D2 R and less for a-adrenergic and muscarinic Rs
Low Potency drugs: less affinity for D2 Rs and more for a-adrenergic and muscarinic Rs

Question 11

Example of High and Low potency Neurolepticsa

Answer 11

High: Haloperidol
Low: Chlopromazine

Question 12

What does the choice of drug depend on?

Answer 12

AE profile
Route of administration
Pateint responses to drug

Question 13

Which are the Atypical Antipsychotics

Answer 13

CORQ
Clozapine
Olanzapine
Risperidone
Quetiapine

Question 14

MOA of Atypical Antipsychotics

Answer 14

-Block Dopamine Rs more selectively than typical antipsychotics
-are less likely to cause Extrapyramidal SE
Incr. Prolactin release (slighly): Risperidone
Incr. risk of metabolic syndrome than typical=
SEs: diabetes mellitus, weight gain,)

Question 15

Extrapyramidal SEs may cause

Answer 15

Parkinsonism: esp. in older pateinets; tardive dyskinesia, akathisia, hyperprolactinaemia

Question 16

Which are the Low Potency SGAs

Answer 16

Clozapine
Quetiapine

Question 17

Which are the High potency SGAs

Answer 17

Risperidone

Question 18

MOA of Chlorpromazine

Answer 18

Low potency: has more affinity for a-adrenergic, Muscarinic and 5HT2 Receptors
Blockade of D2«<5HT2A Receptors

Question 19

Effects of Chlorpromazine

Answer 19

Improves disturbed thought and blunted effect
Changes withdrawal and autistic behvaiour
Reduces Hallucinations
Potent sedative: effective for restless aggressive patients and patients who are difficult to control

Question 20

Dosage of Chlorpromazine

Answer 20

Start with 25mg, incr. gradually unti control
Once stable administer as single bedtime dose

Question 21

What is the usual Maintenace dose of Chlorpromazine

Answer 21

75-300 mg

Question 22

AE of Chlorpromazine

Answer 22

Extrapyramidal symptoms incl. Parkinson
Anticholinergic effects
Sedation
Weight gain

Question 23

MOA of Haloperidol

Answer 23

Most potent D2 antagonist
Blockade of D2 Rs»>5HT2A Rs

Question 24

When is Haloperidol used?

Answer 24

For both acute and chronic Schizoprhenia

Question 25

Dosage of Haloperidol

Answer 25

5-10 mg IM or PO, repeat every 4-6hrs

Question 26

What is the common maintenance dose of Haloperidol

Answer 26

4 mg PO at bedtime

Question 27

AE of Haloperidol

Answer 27

Extrapyramidal symptoms
Akathisia (motor restlessness)
Anticholinergic effects

Question 28

MOA of Clozapine

Answer 28

Weak D2 Receptor antagonist
Blockade of 5HT2A R»> D2 Receptor

Question 29

Effects of Clozapine

Answer 29

USed in patients unresponsive to other antipsychotics
Improves both negative and postive symptoms
Has few or no motor AEs, minimal risk of tardive dyskinesia

Question 30

Dosage of Clozapine

Answer 30

12.5mg PO,OD or BD
Incr. daily in increments of 25-50mg/day
……