Antipsychotics

Question 1

What are antipsychotics also known as?

Answer 1

Neuroleptics

Question 2

How are antipsychotics categorized?

Answer 2

First, second, or third generation

Question 3

What are first-generation antipsychotics (FGAs) also known as?

Answer 3

Typical antipsychotics

Question 4

Name four examples of first-generation antipsychotics.

Answer 4

• Chlorpromazine (Thorazine)
• Haloperidol (Haldol)
• Thioridazine (Mellaril)
• Fluphenazine (Prolixin)

Question 5

What disorders are FGAs used to treat?

Answer 5

Schizophrenia and other disorders with psychotic symptoms

Question 6

Are FGAs more effective for positive or negative symptoms?

Answer 6

Positive symptoms

Question 7

What is the primary action of FGAs?

Answer 7

Blocking dopamine (D2) receptors

Question 8

What are the three categories of major side effects of FGAs?

Answer 8

• Anticholinergic side effects
• Extrapyramidal side effects
• Neuroleptic malignant syndrome (NMS)

Question 9

What are common anticholinergic side effects of low potency FGAs?

Answer 9

• Dry mouth
• Blurred vision
• Urinary retention
• Constipation
• Tachycardia

Question 10

What are common extrapyramidal side effects of high potency FGAs?

Answer 10

• Parkinsonism
• Dystonia
• Akathisia
• Tardive dyskinesia

Question 11

What is tardive dyskinesia?

Answer 11

A potentially life-threatening side effect that begins after long-term drug use

Question 12

What are the initial symptoms of tardive dyskinesia?

Answer 12

Involuntary, rhythmic movements of the tongue, face, and jaw

Question 13

How is tardive dyskinesia treated?

Answer 13

• Gradually withdrawing the drug
• Administering a benzodiazepine
• Switching to a second-generation antipsychotic

Question 14

What is neuroleptic malignant syndrome (NMS)?

Answer 14

A rare life-threatening side effect of antipsychotics

Question 15

What are symptoms of neuroleptic malignant syndrome?

Answer 15

• Muscle rigidity
• High fever
• Autonomic dysfunction
• Altered mental state

Question 16

What is the treatment for NMS?

Answer 16

Stop taking the drug and provide supportive therapy

Question 17

What are second-generation antipsychotics (SGAs) also known as?

Answer 17

Atypical antipsychotics

Question 18

Name four examples of second-generation antipsychotics.

Answer 18

• Clozapine (Clozaril)
• Risperidone (Risperdal)
• Olanzapine (Zyprexa)
• Quetiapine (Seroquel)

Question 19

What disorders are SGAs used to treat?

Answer 19

Schizophrenia and other disorders with psychotic symptoms

Question 20

What additional conditions are some SGAs FDA-approved for?

Answer 20

Adjunctive treatment for major depressive disorder and/or bipolar disorder

Question 21

Are SGAs as effective as FGAs for treating positive symptoms of schizophrenia?

Answer 21

Yes, they are as effective or more effective

Question 22

What unique FDA approval does clozapine have?

Answer 22

For treatment-resistant schizophrenia

Question 23

What is the mechanism of action for SGAs?

Answer 23

Dopamine-serotonin antagonists

Question 24

How do SGAs alleviate positive symptoms?

Answer 24

By blocking dopamine (especially D2, D3, and D4) receptors

Question 25

How do SGAs alleviate negative and cognitive symptoms?

Answer 25

By blocking serotonin (5-HT2A) receptors

Question 26

Are SGAs more or less likely to cause extrapyramidal side effects compared to FGAs?

Answer 26

Less likely

Question 27

What side effects can SGAs cause?

Answer 27

* Anticholinergic effects * Neuroleptic malignant syndrome * Metabolic syndrome

Question 28

What does metabolic syndrome involve?

Answer 28

* Substantial weight gain * High blood pressure * Insulin resistance * Hyperglycemia * Increased risk for diabetes mellitus and heart disease

Question 29

What serious blood condition can clozapine cause?

Answer 29

Neutropenia and agranulocytosis

Question 30

What is required for patients taking clozapine?

Answer 30

Regular blood tests

Question 31

What actions may be taken if neutrophil levels are too low in clozapine patients?

Answer 31

* Discontinuing the drug * Prescribing an antibiotic for infections * Medications to improve neutrophil production

Question 32

What are the third-generation antipsychotics (TGAs)?

Answer 32

Aripiprazole (Abilify), brexpiprazole (Rexulti), and cariprazine (Vraylar) ## Footnote TGAs are a class of medications used primarily for mental health disorders.

Question 33

What conditions are treated with TGAs?

Answer 33

Schizophrenia, bipolar disorder, and major depressive disorder ## Footnote TGAs can be used as adjunctive treatment for these conditions.

Question 34

What are TGAs also known as?

Answer 34

Dopamine-serotonin stabilizers ## Footnote This term reflects their mechanism of action in the brain.

Question 35

How are TGAs categorized in terms of receptor action?

Answer 35

Partial agonists ## Footnote This means they activate receptors but to a lesser degree than full agonists.

Question 36

What is the mechanism of action of TGAs?

Answer 36

Act as antagonists and partial agonists at different receptors ## Footnote This dual action helps balance dopamine and serotonin levels.

Question 37

How do TGAs compare to second-generation antipsychotics (SGAs) in terms of side effects?

Answer 37

Fewer side effects ## Footnote TGAs are similar in effectiveness but generally have a better side effect profile.

Question 38

What side effects are TGAs less likely to cause?

Answer 38

Extrapyramidal side effects, tardive dyskinesia, anticholinergic effects, and metabolic syndrome ## Footnote These are common side effects associated with many antipsychotic medications.

Question 39

What side effects can TGAs still produce?

Answer 39

Akathisia, fatigue, headache, nausea, and anxiety ## Footnote These are potential adverse effects that patients may experience.

Question 40

What unique risk is associated with aripiprazole?

Answer 40

Addictive gambling and other impulse control disorders ## Footnote This highlights a specific concern with this particular TGA.