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Year 2 Pharmacology > Antipsychotics > Flashcards

Antipsychotics Flashcards

1
Q

definition: psychosis

A

denotes a variety of mental disorder with multiple causes and manifestations

systemic and psychiatric diseases
toxic manifestations of chemical agents

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2
Q

what are the positive symptoms of schizophrenia?

A 
delusions 
hallucinations (auditory) 
agitation 
paranoia 
aberrant thinking 
intrusion of thoughts
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3
Q

what are the negative symptoms of schizophrenia?

A

emotional apathy (flat affect)
socially withdrawn
inattentiveness

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4
Q

what is the dopamine hypothesis of schizophrenia pathophysiology?

A

hyperactivity of the mesolimbic / mesocortical system - excessive limbic DA activity leading to psychosis

cannot explain cognitive impairment

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5
Q

what is the key MOA of the main class of atypical antipsychotic drugs?

A

blockage of 5HT2a receptor

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6
Q

what is the glutamate hypothesis of schizophrenia pathophysiology?

A

hypofunction of NMDA receptors located on GABAergic interneurons

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7
Q

many antipsychotic drugs block what receptors?

A

D2

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8
Q

neuroleptic drugs have side effects on what brain system?

A

extrapyramidal

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9
Q

what are the main therapeutic indications for antipsychotic drugs?

A

schizophrenia
psychotic behavior
severe mania
antiemetic

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10
Q

what are the typical antipsychotic agents?

A

chlorpromazine
thioridazine
fluphenazine
haloperidol

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11
Q

what are the atypical antipsychotic agents?

A 
clozapine 
olanzapine 
risperidone 
aripiprazole 
quetiapine 
ziprasidone
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12
Q

chlorpromazine is what class of antipsychotic?

A

typical

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13
Q

olanzapine is what class of antipsychotic?

A

atypical

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14
Q

thioridazine is what class of antipsychotic?

A

typical

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15
Q

quetiapine is what class of antipsychotic?

A

atypical

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16
Q

ziprasidone is what class of antipsychotic?

A

atypical

17
Q

risperidone is what class of antipsychotic?

A

atypical

18
Q

fluphenazine is what class of antipsychotic?

A

typical

19
Q

haloperidol is what class of antipsychotic?

A

typical

20
Q

clozapine is what class of antipsychotic?

A

atypical

21
Q

aripiprazole is what class of antipsychotic?

A

atypical

22
Q

what are the pharmacokinetics of antipsychotics?

A

low bioavailability

depot forms

23
Q

what is the distribution of antipsychotics?

A

large volume of distribution

24
Q

how are the antipsychotics metabolized? what are the products?

A

CYP450 - liver

clinically significant metabolites

25
Q

what is the MOA of the typical antipsychotic drugs?

A

dopamine receptor antagonist (post synaptic D2)

26
Q

what is the MOA of the atypical antipsychotic drugs?

A

antagonist at 5HT2a and D2 receptors

27
Q

clozapine has strong binding to what receptor?

A

serotonin

28
Q

D2 affinity is correlated to what side effects?

A

extrapyramidal

29
Q

antipsychotic drugs act mostly on what brain system?

A

mesolimbic-mesocortical

VTA - limbic system and neocortex

30
Q

what are the anti-dopaminergic effects of antipsychotic drugs?

A 
cognitive 
motor - EPS - parkinsonian, dystonia, TDK 
nausea and vomiting 
endocrine - hyperprolactinemia 
weight gain - mostly with atypicals
31
Q

what are the pharmacologic effects of antipsychotic drugs?

A

anticholinergic
antihistaminic
antiadrenergic (primarily a1)

32
Q

neuroleptic malignant syndrome is a side effect of antipsychotic drugs acting on what system?

A

DA

33
Q

the newer atypical antipsychotics are better at relieving which side effects?

A

less EPS
less hypotensive
less sedation

34
Q

which antipsychotics are LEAST strongly associated with EPS effects?

A

clozapine and quetiapine

35
Q

which antipsychotic drug is MOST strongly associated with EPS effect?

A

risperidone

36
Q

which age group is higher risk for developing TDK following antipsychotic therapy?

A

older

37
Q

which antipsychotic drugs are heavily associated with weight gain? are they typicals or atypicals?

A

clozapine and olanzapine

atypicals

Year 2 Pharmacology (70 decks)

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