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antipsychotics Flashcards

(PH-1) List the prototype antipsychotic drugs for the following classes of drugs: phenothiazines, thioxanthenes, and butyrophenones. (PH-2) Describe the mechanism of action of the prototype phenothiazine, thioxanthene, and butyrophenone drugs, categorize them according to potency, and describe their clinical uses and side effects. (PH-3) Describe the motor fluctuations seen both early and late during treatment with the first generation (Typical) antipsychotics. (PH-4) List the prototype atypi

1
Q

typical antipsychotics

A

chlorpromazine, thioridazine, fluphenazine, thiothixene, haloperidol

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2
Q

use of typical antipsychotics

A

schizophrenia and manic bipolar

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3
Q

most potent typical antipsychotics

A

thoridazine,fluphenazine,

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4
Q

least potent typical antipsychotics

A

chloropramazine

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5
Q

most sedating typical antipsychotics

A

chloropramazine and thoridazine

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6
Q

least sedating chloropramazine

A

thiothixene, fluphenazine, halperidol

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7
Q

typical antipsychotics with most antipyrimidal effects

A

fluphenazine, halperidol

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8
Q

typical antipsychotics good for hiccups

A

chlorpromazine

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9
Q

MOA of typical antipsychotics

A

block dopamine receptors in mesolimbic-mesocortical system

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10
Q

type of dopamine receptor blockage giving anti-psychotic use

A

D2

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11
Q

typical antipsychotics with active metabolites

A

cholorpromazine, thioridazine, fluphenazine

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12
Q

SE of typical antipsychotics

A

motor sx(acute dystonia, akathisia, parkinsonian syndrome, motor fluctations, periobital tremor), endocrine disturbances, edema and weight gain, sedation, covulsions, autonomic SE, skin effects

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13
Q

treatment for motor SE of typical antipsychotics

A

anticholergenics

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14
Q

drug class to avoid in epileptics

A

typical antipsychotics

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15
Q

typical antipsychotics that can be used in epileptcis

A

fluphenzine

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16
Q

rare, but severe SE of typical antipsychotics

A

neuroleptic malignant syndomre

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17
Q

sx of neuroleptic malignant syndomre

A

severe parkinsonism with autonomic instability, stupor

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18
Q

drug for neuroleptic malignant syndomre

A

dantrolene

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19
Q

causes blue-grey skin

A

typical antipsychotics

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20
Q

typical antipsychotics + CNS depressents/opioids/antihistamines

A

potentates effects of 2nd drug

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21
Q

typical antipsychotics + L-dopa

A

less effect of L dopa

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22
Q

typical antipsychotics + TCA

A

additive anticholergenic effects

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23
Q

classic Atypical

A

clozapine

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24
Q

use of clozapine

A

refreactory schizophrenia

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25
Q

major, serious SE of clozapine

A

agranulocytosis

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26
Q

most potent antipsychotic of any class

27
Q

advantages of clozapine

A

less extrapyrimidal disfunction and hyperprolactinemia

28
Q

receptor used by clozapine

29
Q

higher plasma levels of clozapine in users of

A

cigarettes

30
Q

SE of clozapine

A

sedation, weight gain, diabetes, orthostatic hypotension, n/v, tachycardia,

31
Q

contraindications of clozapine

A

bone marrow disorder, leukpenia, carbamazapine

32
Q

atypical antipsychotics

A

risperidonw, olanzapine, quetiapine, ziprasidone

33
Q

MOA of atypical antipsychotics

A

possibly acts at D2/serotinin receptors

34
Q

SE of risperidone

A

high extrapyrimidal effects, weakness, sleep problems, sexual dysfunction

35
Q

olanzipine SE

A

postural hypotension, somnolence, weightgain, akathisia

36
Q

quietiapine SE

A

increased QT interval, possible cataracts

37
Q

ziprasidone SE

A

possible weight loss, monot QT prolongment

38
Q

prototype partial agonist antipsychotics

A

aripiprazole

39
Q

use of aripiprazole

A

schizophrenia, actute mania

40
Q

MOA of aripiprazole

A

partial D2 and 5-HT agonist

41
Q

extensivly metabolized by CYP3A4 and CYP2D6

A

aripiprazole

42
Q

SE of aripiprazole

A

anxiety, headache, sleep problems, GI problems

43
Q

drug interactions with aripiprazole

A

CYP2D6 inhibitors (fluoxetine, paroxetine, quinadine)

44
Q

advantages of aripiprazole

A

no extrapyrimidal sx, no weigh gain or male milk,

45
Q

ways doc determine effective drug regimen

A

trial and error, prior history, premedical conditions, previoulis doc experience

46
Q

time frame to see if drug(s) will work

47
Q

new 2nd generation antipstchotics

A

asenapine,iloperidone, lurasidone

48
Q

first line bipolar drugs

A

lithium, valproic acid

49
Q

most commonly effective bipolar drug

50
Q

first drug used to treat acute manic attack

A

antispychotic

51
Q

drug used prophalacitly in bipolar

52
Q

most likely MOA of Li

A

dereases IP3 and DAG

53
Q

SE of Li (therputic dose)

A

nausea, diarreha, drowiness, hypothyroidism, polydipsea/polyuria, bluntng of cognition,

54
Q

bipolar drug not to be used in nursing moms

55
Q

contraindicated drug with Li

A

NSAID, thiazides

56
Q

clinical uses of valproic acid

A

anti-convulsant, manic phase of bipolar

57
Q

black box warning of valprosic acid

A

possible hepatic failure (esp in kids)

58
Q

tetragenic effects of valproic acid

A

neural tube defects

59
Q

SE of valproic acid

A

possible liver failure, thrombocytopenia,

60
Q

carbamazepine use

A

anti-convulsant also used in bipolar, aggressive behavior, anxiety

61
Q

first line drug in mixed bipolar

A

carbamazepine

62
Q

black box warnings of carbazepine

A

asian ancenstry, aplastic anemia/agranulocytosis, dermatigical tox

63
Q

non black box SE of carbazepine

A

diplopia, ataxia

CNS I (36 decks)

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