antipsychotics Flashcards
paliperidone (trade name) is….
Invega
SGA
xanomeline-trospium (trade name) is….
KarXT
cariprazine (trade name) is….
Vraylar
lumaterperone (trade name) is….
caplyta
the most problematic side effect of clozapine is….
agranularcytosis
in general, antipsychotics have a _____ potential for dependence, and a ____ potential for tolerance
weak ; weak
an off label use for risperidone is…
OCD
the percentage of the world’s population suffering with schizophrenia is….
1%
examples of positive symptoms of schizophrenia
disordered thinking, hallucinations, delusions
flat affect is a ______ symptom of schizophrenia
negative
cariprazine should not be used by….
elderly patients with dementia-related psychosis
chloropromazine was originally develloped to be a….
sedative
the word “tardive” in tardive dyskinesia indicates that….
the symptoms show up later in treatment
the single best predictor of efficacy for an antipsychotic drug is an affinity for ____ receptors
D2
loxapine is the only antipsychotic that …
is administered via inhalation
what class were the first antipsychotics
phenothiazines
issues with FGAs
bad motor sx
pharmacological causes of schizophrenia
dopamine hypothesis (too much DA)
phenothiazines binding profile
DA D2, AChM, H, NE
EPS versus TD
EPS are reversible and have rapid onset ; TD is permanent and develops over time
butyrophenones side effects
High incidence of EPS, particularly PD-like symptoms, dystonia, TD
Anticholinergic effects
Neuroleptic Malignant Syndrome (NMS)
molindone / moban advantages
use?
induces weight loss
what is pimozide (Orap) used for?
tourettes syndrome
issues with pimozide (Orap)
higher incidence of cardia abnormalities
common side effects of SGAs
“Metabolic Syndrome”
– Weight Gain
– Diabetes/Hyperglycemia
– Cardiac Abnormalities
what are some of the SGAs?
Clozapine (Clozaril)
Olanzapine (Zyprexa)
Risperidone (Risperidol)
Sertindole (Serlect)
Quetiapine (Seroquel)
Ziprasidone (Geodon)
Aripiprazole (Abilify)
Amisulpride (Solian)
Phenothiazines are in the class of antipsychotics known as
FGAs
Amisulpiride is a good choice of antipsychotic for patients who have a high risk for
diabetes
Cariprazine should not be used by
Elderly patients with dementia related psychosis
What is the most common side effect of treatment with olanzapine
weight gain
Chlorpromazine was originally developed to be a
sedative
The major side effect of the first-generation antipsychotics is
motor impairment
phenothiazines binding profile
Binding Profile: Primarily block DA D2, but also AChM1, H1, NEα1
– Blockade of AChM produces dry mouth, pupil dilation, blurry vision, cognitive impairment, constipation, urine retention, tachycardia (Sympathetic NS)
– H blockade produces sedation, antiemesis
– NE blockade produces sedation and hypotension
phenothiazines sites of action (in brain)?4
– 1: Medulla
2: Limbic System/Frontal Lobes
3: hypothalamus
4: basal ganglia
symptoms of Neuroleptic Malignant Syndrome (NMS); what drugs have this as a SE?
fever, muscle rigidity, autonomic fluctuations, alterations in consciousness.
phenothiazines
QT prolongation occurs with what types of drugs?
SGAs
diabetes occurs as a SE of ______
SGAs
clozapine (trade name, drug class)
Clozaril ; SGA
why was/is clozapine special?
reduces negative symptoms as well as positive sx ; effective in tmt resistant pts
most serious SE of clozapine?
agranularcytosis
olanzapine special because it is effective at _______
reducing negative symptoms
sertindole is special because _______
Does not bind to H receptors, so no sedative effects
_________ is a commonly abused SGA due to __________ and _____ effects
quetiapine (Seroquel) ; anxiolytic and sedative
ziprasidone (Geodon) also has _________ and _______ actions, and may be used for treatment of ___________ disorder
antidepressant ; anxiolytic ; schizoaffective
ziprasidone has a risk of __________
QT prolongation
ziprasidone has the benefit of __________
low weight gain
amprisulfride has the benefit of _________
low diabetogenic effects
Chlorpromazine (Trade name; class of drug)
Thorazine
FGA
