Antipsychotics Flashcards
What are the high potency typical antipsychotics? (5)
- Haloperidol (Haldol)
- Fluphenazine (Prolixin)
- Pimozide (Orap)
- Thiothixene (Navane)
- Trifluoperazine (Stelazine)
What are the 3 mid-potency typical antipsychotics?
- Perphenazine (Trilafon)
- Molindone (Moban)
- Loxapine (Loxitane)
What are the 3 low-potency typical antipsychotics?
- Chlorpromazine (Thorazine)
- Mesoridazine (Serentil)
- Thioridazine (Mellaril)
Mechanism of typical/1st gen antipsychotics?
Blocks D2 receptors
Mechanism of atypical/2nd gen antipsychotics?
Blocks BOTH D2 and serotonin (2A) receptors
Which dopamine pathway leads to positive symptoms?
Mesolimbic
What is the diff. between the “potency” of typical antipsychotics?
Refers to the ACTION on dopamine receptor
What are the symptoms of neuroleptic malignant syndrome (NMS)? (8)
FALTERED
- Fever
- Autonomic instability
- Leukocytosis
- Tremor
- Elevated CPK (creatine phosphokinase)
- Rigidity (lead pipe rigidity)
- Excessive sweating (diaphoresis)
- Delirium
Which potency groups are more lethal in overdose, and why?
Low-potency
- b/c of QTc prolongation and potential for heart block and ventricular tachycardia
What are some side effects of chlorpromazine? (4)
- orthostatic hypotension
- bluish skin discoloration –> photosensitivity
- deposits in lens and cornea
Which drug is associated w/ retinitis pigmentosa?
Thioridazine (Mellaril)
Which typical antipsychotic has least EPS?
Thioridazine (Mellaril)
What is a side effect of loxapine? (loxitane)
Higher risk of seizure
Which antipsychotics are available as depot IM (decanoate) form? (4)
Haloperidol Fluphenazine Risperidone (Consta) Paliperidone
Which dopamine pathway causes the negative symptoms of schiz?
Mesocortical
What is the treatment of EPS? (3)
Anticholinergic medication = Benztropin (Cogentin)
Antihistaminergic med = Diphenhydramine (Benadryl)
What is tardive dyskinesia?
Choreoathetoid (writhing) mvts of mouth and tongue, or other body parts, that may occur in pts who have used neuroleptic for > 6 months
Treatment for TD?
Discontinuation of current antipsychotic and change to one with less potential to cause TD
Treatment of NMS?
discontinuation of current medication and supportive care (hydration, cooling etc)
Which potency are more likely to cause seizures?
low potency
Which atypical antipsychotics are approved for treatment of acute mania? (5)
- Risperidone
- Olanzapine (Zyprexa)
- Quetiapine (Seroquel)
- Ziprasidone (Geodon)
- Aripiprazole (Abilify)
Side effects of clozapine? (6)
- Tachycardia
- Hypersalivation
- Anticholinergic s/es (more than other atypicals or high-potency typicals)
- Myocarditis
- Agranulocytosis (1-2%)
- Seizures (2-5%)
What is the only antipsychotic shown to decrease the risk of suicide?
Clozapine
Side effects of Risperidone? (3)
Orthostatic hypotension, reflex tachy, hyperprolactinemia
Side effects of Quetiapine? (2)
sedation, orthostatic hypotension
Which atypicals are less likely to cause weight gain?
Ziprasidone, Abilify
