Antipsychotics Flashcards
What do antipsychotics do?
Have an immediate quieting effect in acute psychosis
Do antipsychotics delay relapses?
Yes
What are two indications for antipsychotics aside form the quieting effect?
- sedation (when benzo’s are contraindicated) 2. movement disorders (hunting tons/tourettes)
Are antipsychotics chosen based on efficacy or SE profile
SE profile
Low potency antipsychotics have the highest risk of causing _____ ______ (alpha blockade), dry mouth, acute _____ ______, blurry vision and _______ (anticholinergic)
Alpha blockade = orthostatic hypotension. Anticholinergic = acute urinary retention, delirium, dry mouth and blurry vision
Thioridiazine is associated with _________ __ and _____.
Prolonged QT and arrythmias
Thoridiazine is associated with _____ _____ pigmentation.
Abnormal retinal pigmentation. Routine eye exam for chronic therapy
What are common reasons for noncompliance in males on antipsychotics? (alpha blockade effects)
impotence and inhibition of ejaculation
What are common reasons for noncompliance in female on antipsychotics? (hyperprolactinemia)
weight gain. Also ask about galactorrhea and amenorrhea
What is an adverse effect of clozapine and what should you test?
agranulocytosis. CBC and diff before starting and during therapy.
Haloperidol is a _____ potency _____ (typical/atypical) antipsychotic.
Haldol = high potency/ typical
____ (antipsychotic) is less sedating, fewer anticholinergic effects, less hypotension, has depot injections available
Haldol
____ has the greatest association with extrapyramidal systems (EPS)
Haldol
Chlorpromazine is a ____ (atypical/typical) ____ potency (low/high) antipsychotic
Chlorpromazine = typical, low potency
Chlorpromazine is _____ (less/more) likely to cause EPS.
Chlorpromazine = less likely than haldol
________ has high anticholinergic effects, more sedation and more postural hypotension than haldol.
Chlorpromazine = increase anticholinergic, increase sedation, increase postural hypotension
Risperidone, olanzapine, quetiapine, clozapine are _____ (typical/atypical) antipsychotic.
atypical antipsychotics; Risperidone, olanzapine, quetiapine, clozapine
_____ (atypical/typical) antipsychotics are the drug of choice for initial therapy; what are some examples.
atypical; Risperidone, olanzapine, quetiapine, clozapine
_____ (atypical/ typical) antipsychotics have greater effect on negative symptoms and little or no risk of EPS
Atypical;Risperidone, olanzapine, quetiapine, clozapine
When is clozapine used and why?
treatment resistant patients because of risk of agranulocytosis
A newly diagnosed schizophrenic patient complains of insomnia. What is the most appropriate antipsychotic to initiate therapy?
olanzapine, quetiapine, ziprasidone, aripiprazole are first choice when insomnia is a problem
A schizophrenic patient has been maintained on olanzapine for the past 6 months. He complains of daytime sedation, and he has lost 2 jobs in the past month because of impaired performance. What is the next step in management?
Risperidone, a first choice tx option when sedation is an issue.
______ (drug) affects 5HT, D1, D2, alpha 1, alpha 2, H1
Risperidone
What 6 receptors does risperidone affect?
5HT, D1, D2, alpha 1, alpha 2, H1
