Antipsychotics Flashcards
How to maximize patient adherence x4
Patient education
Minimize side effects
Convenient dosing schedule
Reduce pill burden
Examples of diffuse neurotransmitters x2
Glutamate
GABA
Circumscribed neurotransmitters x5
Dopaminergic
Serotonergic
Histaminergic
Cholinergic
Noradrenergic
Clinical manifestations of acute dystonia x4
Oculogyric crisis
Opisthotonus
Torticollis
Trismus
Blockage of which dopamine pathway gives rise to extrapyramidal side effects
Nigrostriatal pathway
Define neuroleptic malignant syndrome
Sudden marked reduction in dopamine activity caused by dopamine blockade or reduced dopamine agonists
Clinical manifestations of NMS neuroleptic malignant syndrome x5
Fever
Delirium
Seizures
Muscle rigidity
Autonomic instability
Effects if blocking nigrostriatal pathway x4
Extrapyramidal side effects
Acute dystonia
Akathisia
Parkinsonism
Tardive dyskinesia
Effect of blocking mesolimbic pathway
Relief of positive symptoms of psychosis
Effect of blocking tuberoinfundibular pathway x2 and what gives rise to it
‘lactating women symptoms’
Amenorrhea
Gynecomastia
Blockade of dopamine > loss of its prolactin inhibiting function
Effects of blockade of mesocortical pathway x5
Negative symptoms
Alogia
Anhedonia
Avolition
Asociality
Flat effect
Contraindications of antipsychotics x4
Arrhythmias
Pheochromocytoma
Basal ganglia disorders
Severely reduced level of consciousness
Other receptors blocked by typical antipsychotics and their effect x3
A1 adrenoceptors- hypotension
H1 receptors- impaired sensorimotor function
Muscarinic cholinergic receptors- bronchodilation and increased HR
Receptor blocked by chlorpromazine x4 and major S.E
DA, Ach, NE, His
Sediment deposition in cornea
Antihistaminic effects x2
Sedation
Weight gain
Anticholinergic effects x5
Dry mouth
Constipation
Blurred vison
Urinary hesitancy
Decreased sweating
Features of metabolic syndrome x5
High BP
Central obesity
Insulin resistance
High triglycerides
Low HDL cholesterol
Lab findings of NMS
Raised creatinine phosphokinase
Indications of antipsychotics x5
Delirium
Dementia
Schizophrenia disorders
Prophylaxis in bipolar disorder
Depression or mania with psychotic features
Describe treatment resistant schizophrenia
Persistence of symptoms after being on 2 antipsychotic of different generations with an adequate dose for an adequate duration with documented adherence
