Antipsychotics Flashcards
First generation antipsychotics
Haloperidol, Fluphenazine, perphenazine, Thioridazine, Chlorpromazine
First Gen MOA
D2 receptor antagonist
First gen ADR
weight gain, sedation, increased prolaction, increased EPS, anticholinergic
Second generation antipsychotics
Aripiprazole, Brexipiprazole, Asenapine, Clozapine, Iloperidone, Lurasidone, Olanzapine, Paliperidone, Quetiapine, Risperidone, Ziprasidone
2nd gen MOA
D2 receptor antagonist, 5HT1, 5HT2A
2nd gen ADR
weight gain, sedation, anticholinergic effects, Hypotension, diabetes, seizures
Antipsychotic black box warning
increased mortality in elderly patients with dementia related psychosis
Clozapine ADR
increased risk of agranulocytosis, myocarditis, orthostasis, bradycardia, lower seizure threshold
Monitoring SGA
PMH, FMH, CVH, BMI, Waist circumference, BO, fasting glucose, fasting lipid
Iloperidone
schizophrenia in adults
Iloperidone MOA
DA and 5-HT2 antagonist, alpha adrenergic antagonism
Iloperidone ADR
dizziness, somnolence, tachy, nause, dry mouth, impaired thinking, long QT, NMS, tardive, dyskinesia, orthostasis, hyperprolactinemia, priapism
Paliperidone
schizophrenia, schizoaffective disorder
Paliperidone MOA
DA, 5-HT2a, Hi, alpha receptor antagonist
Paliperidone ADR
HA, tachy, somnolence, anxiety, akathisia, EPS
Asenapine
manic or mixed bipolar episodes, acute or maintenance of schizophrenia
Asenapine MOA
DA, 5-HT, NE, H1
Asenapine ADR
insomnia, somnolence, NV, anxiety, agitation, HA, constipation, psychosis,
Brexipiprazole
schizophrenia, adjunct for MDD
Brexipiprazole warnings
increased mortality and CVA in elderly dementia patiens
Brexipiprazole ADR
hyperglycemia, hyperlipidemia, weight gain, blood dyscrasias, akathasia, somnolence, anxiety, restlessness
Acute dystonia
Benzotropine mesylate, diphenhydramine, trihexphenadryl
Akathisia
Clonazepam, lorazepam, pramipexole, propranolol, ropinerole
Neuroepiletic syndrome
dantrolene sodium, anticholinergics, dopamine agonists,
Parkinsonism
amantadine, anitcholinergics, pramipexole, ropinerole
Neuroepileptic induced catatonia
anitcholinergics, bromocriptine, dopamine agonists
Lithium
first line for manic episodes of bipolar disorder, first line for maintenance of bipolar disorder
Lithium contraindications
CV disease, renal disease, dehydration, sodium depletion, diuretics,
Lithium warnings
pregancy, renal toxicity
Lithium toxicity
> 1.4 meq/L. diarrhea, nausea, vomiting, drowsiness, muscle weakness, lack of coordination. at higher levels, giddiness, ataxia, blurred vision, tinnitus, dilute urine
Lithium ADR
Neuro, CV, GI (anorexia, NVD), GU (albuminuria, oliguria, polyuria) Derm (drying and thinning of hair, alopecia, folliculitis), ANS (blurred vision, dry mouth)