Antipsychotics Flashcards
What is an alternate name for antipsychotics
neuroleptics
What are the categories of antipsychotics
typical (first generation) and atypical (2nd and 3rd generation)
What is the general MOA of antipsychotics
blocking dopamine receptors
What common side effects of antipsychotics (6)
- parkinsonian-like symptoms like tremors, lip smacking, grimacing, etc
- Massive weight gain
- increased prolactin release
- tardive dyskinesia
- extrapyramidal signs
- dry mouth, eyes, constipation, urinary retention
What is dyskinesia
involuntary movement. Facial grimacing and involuntary movements of limbs are examples of dyskinesias. Tardive means it continues after discontinuation of the drug
What is neuroleptic malignant syndrome
catatonia, fluctuating BP, dysarthria, fever caused by antipsychotic drug
What is done for someone with neuroleptic malignant syndrome
administer a dopamine agonist like Bromocriptine
What drug class is chlorpromazine (thorazine)
typical neuroleptic
What is the MOA of chlorpromazine (thorazine)
D2 dopaminergic receptor site blockade and H1 histamine blocker, alpha adrenergic blocker
What is a common side effect of chlorpromazine
inceased prolactin d/t dopamin blockade
What drug class is prochlorperazine (compazine)
typical neuroleptic
What are the indications for prochlorperazine (compazine)
Psychosis as well as vertigo and nausea and vomiting, particularly when associated with migraine headaches
What category is prochlorperazine (compazine)
category C
what drug class is haloperidol (Haldol)
typical neuroleptc
What are the indications of haloperidol (Haldol)
Sun-downing, Psychosis, Tourette’s syndrome, Huntington’s disease, acute agitated behavior (combative)
What are the main side effects of haloperidol (haldol)
extrapyramidal effects, tremors, mb neuroleptic malignant syndrome
What drug class is clozapine (clozaril)
Atypical neuroleptic
What is the MOA of clozapine (clozaril)
D2 blockade and 5-HTP
What are side effects of clozapine
agranulocytosis, myocarditis, diminished extrapyramidal effects compared to others
What are the indications for clozapine
schizophrenia
What are the side effects of respiradone (risperdal)
Weight gain (40lb in a month), hyperglycemia, diabetes. increase stroke risk in elderly
What drug class is respiradone (risperdal)
Atypical neuroleptic
What is an important characteristic of respiradone
processed by cyp450
How does respiradone (risperdal) compare in side effects to typical neuroleptics
It causes much more significant weight gain, but was touted to cause fewer Parkinsonian and dyskinesia side effects
What tests should be run regularly for anyone on neuroleptic drugs
liver function
What drug class is Olanzapine (zyprexa)
atypical neuroleptic
What are the most common side effects of Olanzapine
Weight gain, hyperglycemia and diabetes. Increased risk for stroke in elderly patients. (same as respiradone)
What are the indications for Olanzapine (zyprexa)
Schizophrenia, especially when other antipsychotic agents have failed or have produced undesirable side effects
What is the MOA of Olanzapine (zyprexa)
Multiple receptor site blockade yet greatest effects at D2 and 5-HT2 receptor sites
What are the indications for lithium salts (Eskalith)
bipolar and maniac episodes. schizophrenia. Off-label for OCD
What are the dangers of using lithium
Very narrow TI, so blood levels must be checked frequently (every week)
What is the most common renal side effect of lithium
Impaired concentration capacity due to reduced renal response to antidiuretic hormone (ADH), causing nephrogenic diabetes insipidus
What side effect of lithium develops in 5-35% of patients
hypothyroidism
