Antipsychotics Flashcards
What class is haloperidol?
Typical
What class is olanzapine?
Atypical
What class is trifluoperazine?
Typical
What class is fluphenazine?
Typical
What class is clozapine?
Atypical
What class is thioridazine?
Typical
What class is quetiapine?
Atypical
What class is chlorpromazine?
Typical
What class is risperidone?
Atypical
What class is aripiprazole?
Atypical
What class is ziprasidone?
Atypical
What is the mechanism of typical antipsychotics?
Block dopamine2 receptors. (Increase cAMP)
Which are the clinical uses for typical antipsychotics?
Schizophrenia - primarily positive sx
Psychosis/acute mania
Tourette’s syndrome
Which typical antipsychotics have high potency?
Trifluoperazine, fluphenazine, haloperidol
TRI to Fly High
Which typical antipsychotics have low potency?
Chlorpromazine, thioridazine
CHeating THIeves are low
Why are typical antipsychotics slow to eliminate from body?
Highly lipid soluble, stored in body fat
What are “extrapyramidal side effects”?
Dyskinesias.
What EPS side effects of typical antipsychotics are seen within 4 hrs?
Acute dystonia - muscle spasm, stiffness, oculogyric crisis
What EPS side effects of typical antipsychotics are seen within 4 days?
Akathisia - restlessness.
What EPS side effects of typical antipsychotics are seen within 4 weeks?
bradykinesia/parkinsonism
What EPS side effects of typical antipsychotics are seen within 4 months?
Tardive dyskinesia - stereotypic oral facial movements
What medications control EPS side effects?
Benztropine or diphenhydramine
What are the endocrine side effects of typical antipsychotics caused by/manifest as?
Dopamine receptor antagonism –> hyperprolactinemia –> galactorrhea
What other side effects are associated with typical antipsychotics (non-dopamine receptor mediated)
Muscarinic block: dry mouth/constipation
Alpha1 block: hypotension
Histamine receptor block: Sedation
QT prolongation
What is neuroleptic malignant syndrome?
FEVER:
Fever, Encephalopathy, Vitals unstable, Enzymes Up (CK), Rigidity of muscles
*myoglobinuria
What is the treatment for NMS?
Dantrolene, D2 agonists (eg bromocriptine)
Which antipsychotic is associated with corneal deposits?
chlorpromazine
Which antipsychotic is associated with retinal deposits?
Thioridazine
What is the mechanism of atypical antipsychotics?
Not completely understood. Varied effects on 5HT-2, dopamine, alpha and H1 receptors.
What is the difference between 5HT-1 and 5HT-2?
5HT-1 couples to Gi. Decr cAMP.
5HT-2 couples to Gq. Incr IP3
What are the clinical uses for atypical antipsychotics?
Schizophrenia (pos and neg)
Bipolar disorder
OCD, anxiety disorder, depression, mania, tourettes
What antipsychotics are assoicated with weight gain?
Olanzapine, clozapine
Which antipsychotic is associated with agranulocytosis?
Clozapine. Requires weekly WBC monitoring.
What side effects are associated with clozapine?
Agranulocytosis, weight gain, seizure
Which side effects are associated with risperidone?
Increased prolactin: lactation/gynecomastia
Decr GnrH/LH/FSH:
irreg menstruation, fertility issues
Which types of antipsychotics may prolong QT interval?
All of them.
