Antipsychotics Flashcards
What make up the first generation antipsychotics?
Phenothiazines
Thioxanthenes
Butyrophenones
What are the Group 1 Phenothiazines
Chlorpromazine
Levopromazine
Promazine
What are the Group 2 Phenothiazines
Priciazine
What are the Group 3 Phenothiazines
Prochlorperazine
Fluphenazine
Trifluperazine
What are Thioxanthines?
Flupentixol
Zuclopentixol
What are Butyrophenones?
Haloperidol
Benperidol
What are the other first generation antipsychotics?
Pimozide
Sulpride
What are the second generation antipsychotics?
Amisulpride, ariprazole, olanzapine, Risperidone, clozapine, quetiapine
What are the most sedating antipsychotics?
Group 1 e.g. Chloropromazine, Levopromazine and promazine
What ones have moderate sedation?
All the other first generation antipsychotics, minus the ‘other’
Which ones have the highest extra pyramidal side effects?
Prochlorperazine, Fluphenazine, Trifluoperazine (group 3)
Benperidol and Haliperidol
Which ones have antimuscarinic effects?
Group 1: Chlopromazine, levopromazine and promazine
Flupentixol, Zuclopentixol
Which generation has the least side effects?
Second generation
Which antipsychotics prolong the QT interval?
Haloperidol and Pimozide
Which antipsychotic has the lowest incidence of lactation?
Ariprazole
Which antispychotics cause Hypotension?
Clozapine and Quetiapine
(Quite Close to the GROUND)
Which antipsychotics cause Hyperglycaemia?
Clozapine, Risperidone, Olanzapine and Quetiapine
(CROQ has the sweetest flavours)
Which antipsychotics cause weight gain?
Olanzapine, Cloxapine
(Too much time with a WOC)
What is a MHRA warning with all antipsychotics?
Neuroleptic malignant syndrome
What should you do if someone has neuroleptic malignant syndrome?
Stop treatment
Treat with Bromocriptine
Should resolve within 5-7 days
Which antipsychotics have a stroke risk?
Risperidone and Olanzapine
stROke
When should antipsychotics be monitored?
At the start, at 12 weeks, at 1 year and then yearly
What should be monitored?
ECG (Haloperidol and pimozide)
BP
FBC
U&E’s
LFT’s
everything except tft’s
When should Clozapine be used?
In resistant schizophrenia when two or more antipsychotics have been used including one second generation, and has been used for 6-8 weeks.
How many doses of clozapine can be missed before specialist reinitiating is needed?
2 doses
How often should blood counts be done for clozapine?
Weekly for 18 weeks
Fortnightly for one year
Monthly thereafter
How often should blood counts be done for clozapine?
Weekly for 18 weeks
Fortnightly for one year
Monthly thereafter
What are the side effects of Clozapine?
MAGIH
Myocarditis and cardiomyopathy: Report and stop on tachycardia
Agranulocytosis and Neutropenia: Monitor leucocyte and differential blood counts as prev mmentioned
Gastrointestinal disturbances: Report and stop on constipation - intestinal block.
Hypersalivation
what are the blood tests needed for clozapine monitoring?
Leucocyte and differential blood counts.
Body weight and blood lipids
Blood glucose
What antipsychotics can have reported sexual dysfunction?
All of them
Symptoms of neuroleptic malignant syndrome
High fever, sweating, unstable blood pressure
