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bmp > antipsychotics > Flashcards

antipsychotics Flashcards

1
Q

antipsychotic MOA

A

block DA receptors

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2
Q

typical antipsychotics (1st gen)

A

block DA receptors
block muscarinic ACh receptors
block alpha1 NE receptors
block H1 histamine recptors

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3
Q

typical antipsychotic effects

A

sedation, tranquilization
inhibit vomiting

antipsychotic effects take weeks to take effect

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4
Q

typical antipsychotic use

A 
acute treatment of psychotic episodes
prophylaxis of recurrence
manic episodes
psychotic depression
augmentation agent in depression
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5
Q

typical antipsychotic black box warning

A

elderly patients w/dementia-related psychosis are at increased risk of death

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6
Q

typical antipsychotic SE

A 
excessive lethargy
decrease seizure threshold
hyperprolactinemia
amenorrhea
orthostatic hypotension, fainting
cardiac toxicity
antimuscarinic effects
inhibit ejaculation
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7
Q

extrapyramidal syndrome

A

early course of Tx

blockade of DA receptors

Parkinsonian syndrome - goes away with time
Akathisia - motor restlessness
Acute Dystonic Reactions - abnormal contraction of muscle groups

Tx: stop antipsychotic, give antimuscarinic (benzotropine, trihexyphenidyl) or histamine antagonist (diphenhydramine)

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8
Q

tardive dyskinesia

A

months/years after treatment

women/elderly at risk

sucking/smacking lips, chewing movements, tongue protrusions
choreoathetoid limb movements

Tx: gradually reduce dose, change to atypical antipsychotic

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9
Q

neuroleptic malignant syndrome

A

similar to malignant hyperthermia

Tx: immediately stop antipsychotic, DA agonist, dantrolene (muscle relaxant)

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10
Q

typical antipsychotic Rx interactions

A

additive effects

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11
Q

phenothiazines “azine”

A

oldest class of typical AP

chlorpromazine
perphenazine
trifluoperazine
thioridazine - pigmentary retinopathy, longer QT interval
fluphenazine

less likely to produce EPS

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12
Q

thioxanthene

A

typical AP

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13
Q

butyrophenone (haloperidol)

A

produces EPS

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14
Q

atypical antipsychotics (2nd gen)

A

may not be more effective than typical AP
less likely to produce EPS
less likely to cause hyperprolactinemia

block 5HT2A inhibition of DA release

> > increase DA release

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15
Q

Aripiprazole MOA

A

partial agonist at DA and 5HT receptors

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16
Q

Clozapine

A

gold standard atypical AP

SE:
weight gain
agranulocytosis 1%

17
Q

atypical antipsychotic SE

A 
DM Type 2
dyslipidemia
orthostatic hypotension
lengthen QT interval
weight gain
18
Q

risperidone

A

atypical AP

SE:
hyperprolactinemia

19
Q

ziprasidone

A

atypical AP

SE:
lengthen QT interval

20
Q

olanzapine

A

atypical AP

SE:
weight gain

bmp (7 decks)

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