Antipsychotics

Question 1

First-generation antipsychotics AKA typical (4)

Answer 1

Haloperidol
Fluphenazine
Chlopromazine
Thioridazine

Question 2

Mechanism of typical first gen antipsychotics

Answer 2

D2 receptor inhibitor

Question 3

Receptor profile for first gen antipsychotics (3)

Answer 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,

Question 4

2nd generation antipsychotics a typical (7)

Answer 4

Risperidal
olanzapine
ziprasidone
clozapine
quetiapine
ariprazole
lurasidone

Question 5

Mechanism of action for 2nd generation antipsychotics

Answer 5

block D2 and Serotonin (5HT2a)

Question 6

2nd generation antipsychotics are better because?

Answer 6

decrease EPS r/t 5HT2A inhibition

Question 7

S/E of 2nd generation antipsychotics (4)

Answer 7

metabolic syndrome, weight gain, increased diabetes, increased cholesterol

Question 8

Risperidone can cause what ADR?

Answer 8

Hyperprolactinemia (highest incidence) milk out of breast

Question 9

HTN with MAOIs why? (4)

Answer 9

isocarboxiazid
phenelzine
selegiline
tranylcypromine foods

tyramine is a precursor to NE

Question 10

Hypertensive crisis is life threatening how to reverse it? (3)

Answer 10

Stop MAOI
give phentolamine
stabilize fever

Question 11

s/s of hypertensive crisis (7)

Answer 11

BP 180/120 mmhg or >
explosive headache (occipital region)
facial flushing (redness)
Palpitations
pupil dilation
diaphoresis
fever

Question 12

How do most antipsychotics work

Answer 12

decrease dopamine in mesolimbic pathway

Question 13

What makes an antipsychotic medication “atypcial”

Answer 13

a 5HT2A antagonist means the drug binds to the 5-HT2A receptor and prevents serotonin from activating it

Question 14

Antipsychotics that cause least weight gain (ZAL)

Answer 14

Ziprasidone
Aripiprazole
Lurasidone

Question 15

Least sedating antipsychotic

Answer 15

Ariprazole

Question 16

for weight gain from antipsychotics what routine labs must be checked (4)

Answer 16

BMI
Hip to waist ratio (measures abdominal obesity)
glucose
lipid panel

Question 17

non-pharmacologic interventions for managing antipsychotic weight gain (2)

Answer 17

exercise and nutritional counseling

Question 18

Pharmacological interventions for AIWG

Answer 18

Switch to one of the ZAL medications

Question 19

most important adverse effects of antipsychotic medications

Answer 19

urinary incontinence

Question 20

What is the only antipsychotic that has been shown to reduce risk of suicide for schizophrenic patients

Answer 20

Clozaril

Question 21

What drugs can cuase mania?

Answer 21

Steroids- flonase and prednisone ***
antabuse
INH
antidepressants with bipolar

Question 22

there are two types of antipsychotics atypical and typical both of them have dopamine antagonism but the atypical have in addition?

Answer 22

5HT2A receptor antagonism (serotonin)

Question 23

why are atypicals less likely to cause EPS symptoms?

Answer 23

due to the serotonin receptor antagonisms

Question 24

if patient is coming in with first time psychotic episode what do you want to start them off with atypical or typical?

Answer 24

atypcials

Question 25

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?

Answer 25

intramuscular atypicals such as invega, abilify, geodon