AntiPsychotics Flashcards
Most anti-psychotics function by which mechanism?
Blocking D2 receptors
Positive symptoms of psychosis correlate with which type of receptor activity?
Hyperactivity of mesolimbic D2 receptors
Negative symptoms of psychosis correlate with which type of receptor activity?
Hypoactivity of mesocortical neurons
Typical antipsychotics influence which symptoms of schizophrenia
Alleviate positive but not negative symptoms of schizophrenia
Atypical antipsychotics influence which symptoms of schizophrenia
Reduce positive and negative symptoms of schizophrenia
Clozapine: mechanism & side effects?
Atypical anti-psychotic; Antagonist at D4 receptor; decreased risk of EPS but induces agranulocytosis (requires weekly WBC monitoring) and seizures
How does the lipid solubility of anti-psychotics influence their pharmacokinetics?
Readily enter CNS; can sequester in lipid compartments increasing their duration of action
How are anti-psychotics metabolized
Metabolized by P450s; metabolites not important for therapeutic action
What is mesoridazine
Metabolite of thioriadazine - more active than parent compound
How are anti-psychotics excreted
Bc extensively metabolized, little drugs are excreted
Which drugs have higher risk for extrapyramidal symptoms (EPS)? How are these symptoms treated?
Trifluoperazine, fluphenazine, haloperidol (Try to fly high); treat via benztropine (anti-muscarinics) or diphenhydramine
What is the most important unwanted side effect of antipsychotic drugs?
Tardive dyskinesias! Usually develop after several years but can be irreversible
Which drugs have higher risk for autonomic side effects?
Chlorpromazine, thioridazine (Cheating thieves are low)
Weight gain and hyperglycemia are common side effects in which anti-psychotics?
Atypicals - mostly clozapine and olanzapine
Which type of drugs is neuroleptic malignant syndrome seen in? How is it treated?
Most severe adverse effect of typical agents. Treated by dantrolene (Ca channel blocker) and dopamine agonist (bromocriptine)
What toxicities are associated with overdosage of anti-psychotics?
Usually not fatal (except thioridazine); most typicals may cause seizures
Chlorpromazine: type of drug, adverse effects?
Typical; Corneal deposits, anticholinergic, anti-histamine and alpha adrenergic blockade effects
Sedation is more common with which type of drugs
Phenothiazines - chlorpromazine
Thioridazine: type of drug, adverse effects
Typical; reTinal deposits, anticholinergic, anti-histamine, and alpha adrenergic blockade effects
Haloperidol: type of drug, adverse effects, clinical uses
Typical; neurologic effects including NMS; for delirium & dementia
Risperidone: type of drug, adverse effects, clinical uses
Atypical; may increase prolactin (causing lactation & gynecomastia) –> decreased GnRH, LH, FSH (irregular menstruation and fertility issues); delirium & dementia
Olanzapine: type of drug, adverse effects, clinical uses
Atypical; can cause significant weight gain, hyperglycemia, possibly diabetes; depression w/ SSRI
Paliperidone: type of drug
Atypical
Quetiapine: type of drug, clinical uses
Atypical; depression w/ SSRI
