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Pharmacology > Antipsychotics > Flashcards

Antipsychotics Flashcards

0
Q

Haloperidol

A

Typical
High potency
MOA : blockade of dopamine D2 receptors
Uses : psychotic disorder and Tourette’s syndrome

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1
Q

Quetiapine

A

Atypical
MOA: blockade of the 5TH2A more so than dopamine D2
Uses: psychotic disorder, bipolar disorder

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2
Q

Perphenazine

A

Typical
Medium potency
MOA : blockade of dopamine d2 receptors
Uses: psychotic disorder, nausea, vomiting, migraine

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3
Q

Risperidone

A

Atypical
MOA: blockade of the 5TH2A more so than dopamine D2
Uses: psychotic disorder, bipolar disorder

At high doses can cause EPS

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6
Q

Olanzapine

A

Atypical
MOA: blockade of the 5TH2A more so than dopamine D2
Uses: psychotic disorder, bipolar disorder

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7
Q

Thioridizine

A

Typical
Low potency
MOA: Blockade of d2
Uses : psychotic disorder

Can cause retinal deposits and arrhytmias

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8
Q

Aripiprazole

A

Atypical
MOA: blockade of the 5TH2A more so than dopamine D2
Uses: psychotic disorder, bipolar disorder

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10
Q

Droperidol

A

Typical
MOA: blockade dopamine d2 and other mechanisms
Uses: nausea, vomiting, migraine

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12
Q

Clozapine

A

Atypical
MOA: blockade of the 5TH2A more so than dopamine D2
Uses: psychotic disorder, bipolar disorder, schizophrenia refractory to other agents

Works for pts that no other drug works for. But has terrrrribbbllleee side effectsso it isn’t used much. May cause Agranulocytosis

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13
Q

Ziprasidone

A

Atypical
MOA: blockade of the 5TH2A more so than dopamine D2
Uses: psychotic disorder, bipolar disorder

Can cause cardiac arrhythemia and has the risk of death- due to prolongation of the QT interval by inhibiting the rapidly activating delayed rectifier potassium current -> torsades arrhythmia

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14
Q

Clinical properties of typical antipsychotics

A
  1. High extrapyramidal symptoms compared to atypically

2. Enhance negative symptoms by blocking reward mechanisms

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15
Q

Pharmacological properties of typical antipsychotics

A

Bind tightly to dopamine D2 receptors in all pathways causing a long lasting blockade -> undesirable side effects

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16
Q

Common Side effects of typicals and their treatment

A

Acute dystonia: involuntary contractions - treat with anticholinergics ( benztropine) or diphenhydramine. Low potency less likely to cause this

Parkinsonism : Diego blockade of nigrostriatal dopaminergic path. Treat with anticholinergics or amantadine

Akathisia: motor restlessness and the urge to move. Treat: reducing doses, add propranolol, maybe uses benzodiazepines or anticholinergics

________________
all the above are early onset and reversible

Tardive dyskinesia: involuntary movements of the lips, face, tongue and limbs. In pts exposed to antipsychotics for more than 3 months, can be irreversible. May be due to super sensitivity of dopamine receptors in caudate. Treated by reducing the dose, discontinuing the drug, switching to an atypical. DONT use anticholinergics it will worsen this.

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17
Q

Common side effects of typicals because of blockade of other receptors.

A

Alpha adrenergic. - orthostatic hypotension and sexual dysfunction
Muscarninc- constipation, dry mouth, urinary retention , visual problems
Histamine and muscarinic - sedation
Dopamine d2 in pituitary- increase prolactin -> galactorrhea and amenorrhea
Weight gain
Decrease in seizure threshold

Rarely: neuroleptic malignant syndrome treat with dantrolene and dopamine agonist ( bromocriptine)

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18
Q

Clinical properties go atypicals

A
  1. Low EPS compared to typicals

2. Effective for both positive and negative symptoms

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19
Q

Pharmacological properties of atypicals

A
  1. Serotonin antagonist at 5HT2A receptors
  2. Dopamine D2 antagonist with rapid dissociation
  3. Dopamine D2 partial agonist ( aripiprazole)
20
Q

Side effects of atypicals

A

Low EPS and low anticholinergic symptoms compared to typicals

Cardiometabolic risk - blocking histamine h1 and 5HT2C receptors at the hypothalamus increase appetite and thus weight gain and increased TG, insulin resistance, diabetes and cardiovascular events

Sedation - blocking m1, h1 and alpha adrenergic receptors.

21
Q

Prochlorperazine

A

Typical
MOA: blockade dopamine d2 and other mechanisms
Uses: nausea, vomiting, migraine

23
Q

Metoclopramide

A

Typical
MOA: blockade dopamine d2 and other mechanisms
Uses: nausea, vomiting, migraine

28
Q

Chlorpromazine

A

Typical
Low potency
MOA : blocks d2 receptors
Uses : psychotic disorder, nausea , vomiting, migraine

31
Q

Fluphenazine

A

Typical
High potency
MOA : blockade of dopamine D2 receptors
Uses: psychotic disorder

Pharmacology (28 decks)

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