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Pharm 2 (AB) > Antipsychotics > Flashcards

Antipsychotics Flashcards

1
Q

Neuroleptic dug MOA?

A

Blockade of dopamine receptors in the brain.

Atypical neuroleptics also act as antagonists or partial antagonists to serotonin receptors.

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2
Q

The chief antipsychotic effects of neuroleptic drugs appear related to the dopamine blockade at which receptor site?

A

D2 receptors

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3
Q

Psychotic experiences have been linked to excess release of __________ in the ___________ pathway?

A

Psychotic experiences have been linked to excess release of dopamine in the mesolimbic pathway?

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4
Q

Common SE of neuroleptic drugs

A 
Tremors/Parkinsonian effects
Tardive dyskinesia
Blurred vision, dry mouth, constipation
Urinary retention
Increased prolactin release
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5
Q

What is tardive dyskinesia?

A

Facial grimacing and inappropriate posturing of the tongue, neck, trunk and limbs

Tardive = continues on or first appears after drugs are no longer being taken.

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6
Q

What is neuroleptic malignant syndrome?

A

Additional SE that rarely occurs. Characterized by catatonia, fluctuating BP, dysarthria and fever.

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7
Q

What is the protocol when a case of neuroleptic malignant syndrome comes on?

A

Immediately discontinue drug and tx with dopamine agonist like BROMOCRIPTINE.

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8
Q

Neuroleptic drugs can also be helpful in tx this condition due to the fact that they block D2 receptors in the chemoreceptor trigger zone of the medulla?

A

Severe nausea

Neuroleptics are anti-emetic

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9
Q

Chlorpromazine/Thorazine
Class:
Ind:
MOA:

A

Chlorpromazine/Thorazine
Class: Neuroleptic
Ind: Psychosis, mania, schizophrenia, N/V, intractable hiccoughs
MOA: D2 dopaminergic receptor site blockade.

Add’l MOA: alpha-adrenergic blockade and H1 blockade

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10
Q

What hormone commonly has an increased release as a result of the dopamine blockade?

A

Prolactin

SE: galactorrhea and amenorrhea in women and infertility in both sexes

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11
Q

Prochlorperazine/Compazine
Class:
Ind:
MOA:

A

Prochlorperazine/Compazine
Class: Typical neuroleptic
Ind: Psychosis, vertigo, N/V associated with migraine HA
MOA: Primarily H1-histamine receptor antagonist as well as alpha-adrenergic receptor antagonist and D2 dopaminergic receptor antagonist

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12
Q

Prochlorperazine/Compazine
Char:
SE:

A

Prochlorperazine/Compazine
Char: Less orthostatic hypotension, fewer extrapyramidal signs, better anti-emetic than other neuroleptics
SE: Lowers seizure threshold

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13
Q

Haloperidol/Haldol
Class:
Ind:
MOA:

A

Haloperidol/Haldol
Class: Typical neuroleptic
Ind: Psychosis, tourette’s, Huntington’s dz, ACUTE AGITATED BEHAVIOR
MOA: D2 dopaminergic receptor site blockade

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14
Q

Haloperidol/Haldol
Char:
SE:

A

Haloperidol/Haldol
Char: Careful administration to reduce excessive sedation and tardive dyskinesia
SE: Parkinsonian-like sx, extrapyramidal effects, tremor, NEUROLEPTIC MALIGNANT SYNDROME

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15
Q 
Clozapine/Clozaril
Class:
Ind:
MOA:
Char:
A

Clozapine/Clozaril
Class: Atypical neuroleptic
Ind: Schizophrenia
MOA: Receptor site blockade at D2 and 5-HT2 (serotonin) receptors
Char: PO, rapid absorption and extensive metabolism

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16
Q

Clozapine/Clozaril

SE

A

Diminished extrapyramidal SE comparatively.

AGRANULOCYTOSIS in 1-2% of pt. (discontinue use of granulocyte count is

17
Q 
Respiradone/Risperdal
Class:
Ind:
MOA:
Char:
A

Respiradone/Risperdal
Class: Atypical neuroleptic
Ind: Psychosis
MOA: unknown….presumed dopamine and serotonin receptor blockade
Char: Metabolized via P450 enzymes (dose reduced in pt with liver dysfunction)

18
Q

Respiradone/Risperdal

SE (in addition to common)

A

Weight gain
Hyperglycemia
DM
Increased risk for stroke

19
Q 
Olanzapine/Zyprexa
Class:
Ind:
MOA:
Char:
A

Olanzapine/Zyprexa
Class: Atypical neuroleptic
Ind: Schizophrenia
MOA: Receptor site blockade (D2 and 5-HT2)
Char: PO, rapid absorption and metabolism

20
Q

Olanzapine/Zyprexa

SE

A

Weight gain
Hyperglycemia
DM
Increased risk for stroke

21
Q

Which to atypical neuroleptics have SE of weight gain, hyperglycemia, DM and increased risk for stroke?

A

Respiradone/Risperdal

Olanzapine/Zyprexa

22
Q

What is used to prophylactically treat manic episodes of bipolar disorder?

A

Lithium salts

23
Q

What is a major char of Lithium carbonate/Eskalith?

A

Very small therapeutic index, cleared by the kidneys

24
Q

Major SE of Lithium carbonate/Eskalith?

A

MC renal effect: impaired concentration capacity due to reduced renal response to ADH.

Nephrogenic Diabetes Insipidus (20% w/chronic tx)

Hypothyroidism (5-35% w/chronic tx)

Pharm 2 (AB) (8 decks)

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