Antipsychotics

Question 1

What are the first generation antipsychotics?

Answer 1

-Phenothiazines
-Thioxanthenes
-Butyrophenones

Question 2

What are the first generation antipsychotics of the phenothiazines class?

Answer 2

-Promethezine
-Chlorpromazine (Thorazine)*
-Prochorperazine (Compazine)
-Fluphenazine (Prolixin)
-Trifluoperazine (Stelazine)
-Perphenazine (Trilafon)
-Acetophenazine (Tindal)
-Carphenazine (Proketazine)
-Trifulpromazine (Vesperin)
-Mesoridazine (Serentil)
-Thioridazine (Mellaril)

Question 3

What are the first generation antipsychotics of the thiozanthenes class?

Answer 3

-Thiothixene (Navene)
-Chlorprothixene (Taractan)
-Clopenthixol (Sordinol)
-Flupenthixol (Depixol)
-Zuclopenthixol (Acuphase)
-Thioxanthenes are similar to phenothiazines, where they are D2 antagonists, but they also have 5-HT, NE, H effects as well

Question 4

What are the side effects of butyrophenones?

Answer 4

-There is a high incidence of EPS, particularly PD-like symptoms, dystonia, tardive dyskinesia*

Question 5

What is loxapine (Loxitane)

Answer 5

-It has a similar structure to clozapine and has a high affinity for D2 and 5-HT receptors
-There is an inhaled version (Adasuve) that was approved by the FDA in 2012*

Question 6

What is molindone (Moban)?

Answer 6

-Molindone has a similar structure to 5-HT and has a similar treatment profile to phenothiazines
-It is induces weight loss, which is an important advantage of traditional antipsychotics*

Question 7

What is pimozide (Orap)?

Answer 7

-Primozide is used more for Tourette’s Syndrome in the USA

Question 8

What is clozapine (Clozaril)?

Answer 8

-Clozapine is the first second generation antipsychotic and is still the model for antipsychotics*
-It also induces agranulocytosis which is low white blood cell count but it is reversible with the discontinuation of the drug. It requires constant monitoring

Question 9

What is olanzapine (Zyprexa)

Answer 9

-Olanzapine is a second generation antipsychotic that reduces positive symptoms and improves negative symptoms*

Question 10

What is Sertindole (Serlect)?

Answer 10

-Sertindole is a 5-HT2 antagonist (highest affinity) and a D2 antagonist
-It does not bind to H receptors so there is no sedative effects*

Question 11

What is quetiapine (Seroquel)?

Answer 11

-Quetiapine is a second generation antipsychotic that effectively reduces positive symptoms
-Although it is abused more frequently than other antipsychotics, primarily due to sedative and anxiolytics effects*

Question 12

What is ziprasidone (Geodon)

Answer 12

-Ziprasidone is a 5-HT2, D2 antagonist, 5-HT 1A partial agonist; 5-HT, NE reuptake inhibitor
-It has anxiolytic and antidepressant actions*
-It also has low weight gain*

Question 13

What is amisulpiride (Solian)?

Answer 13

-Amisulpiride is a highly selective D2/D3 antagonist but only in the limbic system
-It has low diabetogenic effects*

Question 14

Which of the following is NOT a negative symptom of schizophrenia?

Answer 14

Disorganized behavior

Question 15

Phenothiazines are in the class of antipsychotics known as

Answer 15

First generation antipsychotics

Question 16

What is the primary indication of haloperidol?

Answer 16

Psychosis

Question 17

The word tardive in tardive dyskinesia indicates that the symptoms

Answer 17

Appear later in treatment

Question 18

Amisulpiride is a good choice of antipsychotic for patients who have a high risk for

Answer 18

Diabetes

Question 19

In general, antipsychotics have a __________ potential for dependence, and a ___________ potential for tolerance.

Answer 19

Weak and weak

Question 20

The most problematic side effect caused by clozapine is

Answer 20

Agranulocytosis

Question 21

The single best predictor of antipsychotic efficacy in a drug is an affinity for __________ receptors.

Answer 21

D2

Question 22

Which of the following is NOT a positive symptom of schizophrenia?

Answer 22

Flat affects

Question 23

An off-label use for risperidone is

Answer 23

OCD

Question 24

Cariprazine should not be used by

Answer 24

Elderly patients with dementia related psychosis

Question 25

What is the most common side effect of treatment with olanzapine

Answer 25

Weight gain

Question 26

The percentage of the world’s population suffering from schizophrenia is

Answer 26

1%

Question 27

Chlorpromazine was originally developed to be a

Answer 27

Sedative

Question 28

Loxapine is the only antipsychotic that

Answer 28

Is administered via inhalation

Question 29

The uncontrollable movements of muscles commonly in the limbs, face, and tongue produced by ACUTE treatment with antipsychotics are called

Answer 29

Dystonia

Question 30

The major side effect of the first-generation antipsychotics is

Answer 30

Motor impairment