AntiPsychotics

Question 1

low potency neuroleptics

Answer 1

lower affinity for D2 receptors, therefore require higher dose
higher incidence anticholinergic, antihistaminic side effects
lower incidence EPS, NMS
more lethal in OD - QTc prolongation, heart block, tachycardia
rare risk agranulocytosis, higher seizure risk
Chlorpromazine
Thioridazine

Question 2

Chlorpromazine

Answer 2

Thorazine
low potency neuroleptic
SE: orthostatics, bluish-skin discoloration, photosensitivity
Treats n/v, intractable hiccups

Question 3

Thioridazine

Answer 3

Mellaril

SE: retinitis pigmentosa

Question 4

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           Midpotency neuroleptics

Answer 4

Loxapine
Thiothixene
Trifluoperazine
Perphenazine

Question 5

Loxapine

Answer 5

Lozitane
midpotency neuroleptic
higher seizure risk, metabolite = amoxapine (antidepressant)

Question 6

Thiotixene

Answer 6

Navane
Midpotency neuroleptic
se: occular pigment changes

Question 7

Trifluoperazine

Answer 7

Stelazine
Midpotency neuroleptic
can decrease anxiety

Question 8

High potency neuroleptics

Answer 8

require lower doses
less sedation, orthostatics, anticholinergics
greater risk of EPS, TD
haloperidol
Fluphenazine
pimozide

Question 9

Haloperidol

Answer 9

Haldol
high potency neuroleptics
IM decanoate form

Question 10

Fluphenazine

Answer 10

Prolixin
high potency neuroleptic
IM decanoate form available

Question 11

Pimozide

Answer 11

Orap
high potency neuroleptic
SE: heart block, ventricular tachycardia, cardiac

Question 12

IM long acting forms of antipsychotics

Answer 12

Consta (risperidone)
Sustenna (paliperidone)
Haldol
Prolixin

Question 13

Atypical antipsychotic

Answer 13

block D2 and serotonin receptors
maybe more effective for negative symptoms
treat: acute mania, bipolar, adjunct in unipolar depression
SE: metabolic syndrome, some antiHAM, wt gain, HLD, hyperglycemia, QTc prolongation
monitor yearly LFTs, ammonia
baseline wt, waist circumference, BP, fasting glucose, fasting lipids

Question 14

clozapine

Answer 14

clozaril
atypical antipsychotic
only antipsychotic shown to decrease risk of suicide
less likely to cause TD, se: tachycardia, hypersalivation, myocarditis
more anticholinergic se
1-2% agranulocytosis
2-5% seizure

Question 15

Risperidone

Answer 15

Risperdal
atypical antipsychotic
SE: increased PRL, orthostatics, reflex tachycardia
consta = long acting IM form

Question 16

Quetiapine

Answer 16

Seroquel
atypical antipsychotic
SE:most sedating, orthostatics

Question 17

Olanzapine

Answer 17

zyprexa
atypical antipsychotic
SE: wt gain

Question 18

Ziprazidone

Answer 18

Geodon
atypical antipsychotic
SE: less likely to cause wt gain

Question 19

Aripiprazole

Answer 19

Abilify
atypical antipsychotic - partial D2 agonism - more activating (akathisia)
less sedating, less wt gain

Question 20

Paliperidone

Answer 20

Invega
long acting IM form of atypical antipsychotic
metabolite of risperidone

Question 21

Typical/1st Generation/Neuroleptics

Answer 21

block D2 receptors
treat positive psychotic symptoms
SE: EPS, increased PRL, antiHAM, TD, NMS