Antipsychotics

Question 1

Chlorpromazine

Answer 1

thorazine (typical or traditional)

Question 2

Prolixin

Answer 2

fluphenazine (typical or traditional)

Question 3

Haldol

Answer 3

haloperidol (typical or traditional)

Question 4

Stelazine

Answer 4

trifluoperazine (typical or traditional)

Question 5

Navane

Answer 5

thiothixene (typical or traditional)

Question 6

Mellaril

Answer 6

thioridazine (typical or traditional)

Question 7

Orap

Answer 7

pimozide (typical or traditional)

Question 8

Loxitane

Answer 8

loxapine (typical or traditional)

Question 9

Moban

Answer 9

molindone (typical or traditional)

Question 10

Serentil

Answer 10

mesoridazine (typical or traditional)

Question 11

Trilafon

Answer 11

perphanazine (typical or traditional)

Question 12

Clozaril

Answer 12

clozapine (atypical or novel)

Question 13

Risperdal

Answer 13

risperidone (atypical or novel)

Question 14

Zyprexa

Answer 14

olanzapine (atypical or novel)

Question 15

Seroquel

Answer 15

quetiapine (atypical or novel)

Question 16

Geodon

Answer 16

ziprasidone (atypical or novel)

Question 17

Abilify

Answer 17

ariprazole (atypical or novel)

Question 18

(older or newer) - basically equally effective in controlling psychosis, treating positive symptoms more effectively than negative symptoms

Answer 18

older; traditional; typical

Question 19

positive symptoms treated by antipsychotics

Answer 19

hallucinations, delusions, disorganized thinking

traditional or typical antipsychotics generally are better at targeting positive symptoms

Question 20

negative symptoms treated by antipsychotics

Answer 20

affective flattening, lack of motivation, poverty of speech

Question 21

high potency antipsychotics are:

Answer 21

less sedating and have fewer initial side effects. these are generally tried first.

these require a lower dosage (e.g., 2 mg of Haldol is equal to 100 mg of Chlorpromazine)

Question 22

More potent antipsychotics

Answer 22

Haldol
Prolixin
Navane
Stelazine

Question 23

Novel antipsychotics….

Answer 23

generally effective for both positive and negative symptoms.

Exert stronger effects as antiserotonergic, antiadrenergic, anticholinergic, and antihistaminergic than as a dopamine antagonist.

Do not cause EPS (Extrapyramidal symptoms)

Question 24

Depot neuroleptics (decanoate)

Answer 24

antipsychotics administered intramuscularly (by injection).

doses last for 2 to 4 weeks.

useful when patients have poor or inconsistent compliance.

Question 25

Depot Neuroleptics, aka…..

Answer 25

Decanoate is added to the name of these types of antipsychotics

Example: Prolixin and Haldol decanoate

Question 26

Mechanism of Action

Answer 26

Dopamine Antagonists via blocking dopamine receptors.

Question 27

Dopamine hypothesis

Answer 27

This hypothesis states schizophrenia results from an excess of dopamine. This is not fully confirmed.

Question 28

Side effects of antipsychotics differ between drug profiles. In general, most significant of LOWER potency medications include:

Answer 28

Sedation
Anticholinergic effects
Orthostatic hypotension
Lowering of the seizure threshold

Question 29

Side effects of antipsychotics differ between drug profiles. In general, most significant of HIGHER potency medications include:

Answer 29

Extrapyramidal symptoms (movement disorders such as acute dystonic reactions, pseudoparkinsonism, akathisia)

Question 30

Akathisia

Answer 30

syndrome characterized by unpleasant sensations of inner restlessness that manifests itself with an inability to sit still or remain motionless.

Sometimes caused by antipsychotics, as well as any physically-addictive drug during drug withdrawal.

Question 31

Extrapyramidal Symptoms (EPS)

Answer 31

movement-related symptoms, some of which are the most potentially damaging side effects of antipsychotics. EPS symptoms can be treated through the use of anticholinergic agents (ACAs)

Question 32

Cogentin (benztropine)

Answer 32

Anticholinergic Agent, used to treat EPS symptoms that result from antipsychotics

Question 33

Artane (trihexylphenidyl)

Answer 33

Anticholinergic Agent, used to treat EPS symptoms that result from antipsychotics

Question 34

Dystonia

Answer 34

Acute and painful muscle spasms of the neck, back, tongue, eyes, and/or larynx. Dis = problem; tonia = tone. Also considered an EPS.

Question 35

Parkinsonism (pseudoparkinsonism)

Answer 35

involves a mask-like face, shuffling gait, drooling, resting tremor, rigidity, and akinesia. These symptoms persist throughout treatment and afflict 12-45% of all patients. This condition is treated by lowering dose, switching drugs, or using an anticholinergic agent.

Question 36

Neuroleptic Malignant Syndrome

Answer 36

(NMS) - affects 1% of all patients treated with antipsychotics and potentially lethal. It involves severe muscle rigidity, altered consciousness, autonomic instability (e.g., heart rate and blood pressure changes), and high fever. NMS requires emergency medical attention and is often treated by stopping all neuroleptics using an IV for hydration, administering anti-fever medications, and treating any lung complications.

Question 37

Tardive Dyskinesia

Answer 37

involves abnormal movements of the lips, tongue, jaw, limbs, and trunk. TD generally arises after at least six months of treatment and typically plateaus after 3-6 years without worsening any further. Occasionally, the symptoms only emerge after the antipsychotic as been terminated or dosage is lowered. This condition is not believed to be progressive and may be reversible. 50% of patients who develop this condition after antipsychotics have been stopped experience a full remission of symptoms.

Question 38

Agranulocytosis

Answer 38

potentially lethal side effect most associated with Clozaril (clozapine), and is usually the reason why this drug is tried only after others have failed.

this condition is a sudden drop in the granulocyte count, usually occurring within hours to 12 weeks of initial administration, and manifesting as a sore throat and high fever.

Question 39

Dependence/withdrawal/overdose

Answer 39

antipsychotics do not cause addiction, dependence, or tolerance. Withdrawal is only caused when a high dose is suddenly stopped. Symptoms include:
gastrointestinal distress, headaches, insomnia, and nightmares.

Overdoses are generally not highly lethal except if >30 supply is taken at one time. More lethal when combined with another drug such as a Tricyclic antidepressant.