Antipsychotics Flashcards
1
Q
chlorpromazine
A
- typical antipsychotic
- D2 receptor antagonist
- effective in treating (+), but not (-) symptoms
- extrapyramidal side effects, tardive dyskinesia, hyperprolactinemia, NMS
- **TD because when you constantly antagonize the D2 receptor it will become hypersensitive to DA and kick off the neuroleptic to bind DA instead –> too much inhibition of BG –> not enough braking –> hyperkinetic (like in dyskinesias of PD tx)
- other effects: sedation, postural hypotension, weight gain, anticholinergic effects
*zine= typical antipsychotic
2
Q
haloperidol
A
- typical antipsychotic
- D2 receptor antagonist
- treats (+) but not (-) symptoms
- produces EPS effects, TD, hyperprolactinemia and NMS
- less side effects (ie: less sedation, hyoptension, anticholinergic effects) but causes more EPS effects
3
Q
extrapyramidal syndrome
A
- extrapyramidal system is part of motor system that caues involuntary movement and modulation of movement
- acute dystonia- muscular spasms
- akathisia- motor restlessness, pacing
- akinesia/bradykinesia- inability to initiate motor movements/slowness of movement
- produced by typical antipsychotics due to DA antagonism –> not enough DA to BG like in Parkinson!
- not seen with SGAs because of the “fast off theory”: DA doesnt bind to the receptor long/tight enough to block it and produce EPS effects
4
Q
Tardive Dyskinesia
A
- involuntary assymetrical muscle movements, facial tics
- grimacing, tongue protrusion, lip smacking, rapid eye blinking, etc
- tx with tetrabenazine
5
Q
Neuroleptic Malignant Syndrome (NMS)
A
- side effect of antipsychotic due to DA antagonism (sudden reduction in DA)
- occurs upon onset of initial tx with neuroleptics or LDOPA withdrawal
- FALTER
- Fever, Autonomic instability, Leukocytosis, Tremor, Elevated CPK, Rigidity of muscles
6
Q
Clozapine
A
- 2nd gen antipsychotic (SGA) - tricyclic
- D2 and 5-HT2a receptor antagonism
- no catalepsy (no EPS, no TD)
- agranulocytosis (need to monitor via weekly blood testing)
- seizure risk, metabolic complications, myocarditis
- approved for pregnancy
- “magic shotgun” targeting many key receptor subtypes (magic shotguns are more ffect than magic bullets)
7
Q
Olanzapine
A
- SGA anti-psychotic (tricyclic)
- D2 and 5-HT2a receptor antagonism
- metabolic complications
8
Q
Quetiapine
A
- SGA anti-psychotic (tricyclic)
- D2 and 5-HT2a receptor antag
- somnolence (sleepiness), metabolic effects
**think quiet
9
Q
Risperidone
A
- SGA antipsychotic
- fewer metabolic complications than tricyclics but EPS at higher doses
10
Q
Ziprazidone
A
- SGA anti-psychotic (non-tricyclic)
- fewer metabolic complications than tricyclics but cardiac effects (QT prolongation, arrhythmias)
11
Q
Paliperidone
A
- SGA anti-psychotic
- primary active metabolite of risperidone
- fewer metabolic complications compared to tricyclics
12
Q
Aripiprazole
A
- Abilify
- approved for schizophrenia, bipolar and depression (adjunct)
- partical D2 receptor agaonist, with 5HT receptor agonist and antag activity
13
Q
Asenapine
A
- atypical antipsychotic
14
Q
Lurasidone
A
- atypical antipsychotic
15
Q
Iloperidone
A
- atypical antipsychotic
- QTc prolongation
