Antipsychotics

Question 1

What are the high potency typical antipsychotics? (5)

Answer 1

1. Haloperidol (Haldol)
2. Fluphenazine (Prolixin)
3. Pimozide (Orap)
4. Thiothixene (Navane)
5. Trifluoperazine (Stelazine)

Question 2

What are the 3 mid-potency typical antipsychotics?

Answer 2

1. Perphenazine (Trilafon)
2. Molindone (Moban)
3. Loxapine (Loxitane)

Question 3

What are the 3 low-potency typical antipsychotics?

Answer 3

1. Chlorpromazine (Thorazine)
2. Mesoridazine (Serentil)
3. Thioridazine (Mellaril)

Question 4

Mechanism of typical/1st gen antipsychotics?

Answer 4

Blocks D2 receptors

Question 5

Mechanism of atypical/2nd gen antipsychotics?

Answer 5

Blocks BOTH D2 and serotonin (2A) receptors

Question 6

Which dopamine pathway leads to positive symptoms?

Answer 6

Mesolimbic

Question 7

What is the diff. between the “potency” of typical antipsychotics?

Answer 7

Refers to the ACTION on dopamine receptor

Question 8

What are the symptoms of neuroleptic malignant syndrome (NMS)? (8)

Answer 8

FALTERED

• Fever
• Autonomic instability
• Leukocytosis
• Tremor
• Elevated CPK (creatine phosphokinase)
• Rigidity (lead pipe rigidity)
• Excessive sweating (diaphoresis)
• Delirium

Question 9

Which potency groups are more lethal in overdose, and why?

Answer 9

Low-potency

- b/c of QTc prolongation and potential for heart block and ventricular tachycardia

Question 10

What are some side effects of chlorpromazine? (4)

Answer 10

• orthostatic hypotension
• bluish skin discoloration –> photosensitivity
• deposits in lens and cornea

Question 11

Which drug is associated w/ retinitis pigmentosa?

Answer 11

Thioridazine (Mellaril)

Question 12

Which typical antipsychotic has least EPS?

Answer 12

Thioridazine (Mellaril)

Question 13

What is a side effect of loxapine? (loxitane)

Answer 13

Higher risk of seizure

Question 14

Which antipsychotics are available as depot IM (decanoate) form? (4)

Answer 14

Haloperidol 
Fluphenazine 
Risperidone (Consta) 
Paliperidone

Question 15

Which dopamine pathway causes the negative symptoms of schiz?

Answer 15

Mesocortical

Question 16

What is the treatment of EPS? (3)

Answer 16

Anticholinergic medication = Benztropin (Cogentin)

Antihistaminergic med = Diphenhydramine (Benadryl)

Question 17

What is tardive dyskinesia?

Answer 17

Choreoathetoid (writhing) mvts of mouth and tongue, or other body parts, that may occur in pts who have used neuroleptic for > 6 months

Question 18

Treatment for TD?

Answer 18

Discontinuation of current antipsychotic and change to one with less potential to cause TD

Question 19

Treatment of NMS?

Answer 19

discontinuation of current medication and supportive care (hydration, cooling etc)

Question 20

Which potency are more likely to cause seizures?

Answer 20

low potency

Question 21

Which atypical antipsychotics are approved for treatment of acute mania? (5)

Answer 21

1. Risperidone
2. Olanzapine (Zyprexa)
3. Quetiapine (Seroquel)
4. Ziprasidone (Geodon)
5. Aripiprazole (Abilify)

Question 22

Side effects of clozapine? (6)

Answer 22

1. Tachycardia
2. Hypersalivation
3. Anticholinergic s/es (more than other atypicals or high-potency typicals)
4. Myocarditis
5. Agranulocytosis (1-2%)
6. Seizures (2-5%)

Question 23

What is the only antipsychotic shown to decrease the risk of suicide?

Answer 23

Clozapine

Question 24

Side effects of Risperidone? (3)

Answer 24

Orthostatic hypotension, reflex tachy, hyperprolactinemia

Question 25

Side effects of Quetiapine? (2)

Answer 25

sedation, orthostatic hypotension

Question 26

Which atypicals are less likely to cause weight gain?

Answer 26

Ziprasidone, Abilify