Antipsychotics Flashcards
First-generation antipsychotics AKA typical (4)
Haloperidol
Fluphenazine
Chlopromazine
Thioridazine
Mechanism of typical first gen antipsychotics
D2 receptor inhibitor
Receptor profile for first gen antipsychotics (3)
Histamine 1, alpha 1, mvuscinarinic 1
Anti- HAM (first and second generation)
weight gain, sedation, orthostasis, decrease tension, priapism (Decreased sex drive) , dry mouth,
2nd generation antipsychotics a typical (7)
Risperidal
olanzapine
ziprasidone
clozapine
quetiapine
ariprazole
lurasidone
Mechanism of action for 2nd generation antipsychotics
block D2 and Serotonin (5HT2a)
2nd generation antipsychotics are better because?
decrease EPS r/t 5HT2A inhibition
S/E of 2nd generation antipsychotics (4)
metabolic syndrome, weight gain, increased diabetes, increased cholesterol
Risperidone can cause what ADR?
Hyperprolactinemia (highest incidence) milk out of breast
HTN with MAOIs why? (4)
isocarboxiazid
phenelzine
selegiline
tranylcypromine foods
tyramine is a precursor to NE
Hypertensive crisis is life threatening how to reverse it? (3)
Stop MAOI
give phentolamine
stabilize fever
s/s of hypertensive crisis (7)
BP 180/120 mmhg or >
explosive headache (occipital region)
facial flushing (redness)
Palpitations
pupil dilation
diaphoresis
fever
How do most antipsychotics work
decrease dopamine in mesolimbic pathway
What makes an antipsychotic medication “atypcial”
a 5HT2A antagonist means the drug binds to the 5-HT2A receptor and prevents serotonin from activating it
Antipsychotics that cause least weight gain (ZAL)
Ziprasidone
Aripiprazole
Lurasidone
Least sedating antipsychotic
Ariprazole
for weight gain from antipsychotics what routine labs must be checked (4)
BMI
Hip to waist ratio (measures abdominal obesity)
glucose
lipid panel
non-pharmacologic interventions for managing antipsychotic weight gain (2)
exercise and nutritional counseling
Pharmacological interventions for AIWG
Switch to one of the ZAL medications
most important adverse effects of antipsychotic medications
urinary incontinence
What is the only antipsychotic that has been shown to reduce risk of suicide for schizophrenic patients
Clozaril
What drugs can cuase mania?
Steroids- flonase and prednisone ***
antabuse
INH
antidepressants with bipolar
there are two types of antipsychotics atypical and typical both of them have dopamine antagonism but the atypical have in addition?
5HT2A receptor antagonism (serotonin)
why are atypicals less likely to cause EPS symptoms?
due to the serotonin receptor antagonisms
if patient is coming in with first time psychotic episode what do you want to start them off with atypical or typical?
atypcials
if patient is in active psychosis you must remember the patient is an increase in danger for self and others so you can give them what form of medication?
intramuscular atypicals such as invega, abilify, geodon
