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Psych Drugs > Antipsychotics > Flashcards

Antipsychotics Flashcards

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1
Q

chlorpromazine

A

typical

even worse EPS than olanapine

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2
Q

thioridazine

A

typical
worst autonomic effects (orthox htx, no ejac)
worst muscarinic block (urinary retention)/toxic confusional state

metabolite is more effective than active

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3
Q

trifluoperazine

A

typical

HUGE EPS RISK

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4
Q

fluphenazine

A

typical

HUGE EPS RISK

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5
Q

thiothixene

A

typical

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6
Q

haloperidol

A

typical
HUGE EPS RISK (most D receptor blockade)
weakest autonomic effects
@high dose-completely block D

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7
Q

clozapine

A 
atypical
agranulocytosis
bad weight gain
NO EPS
high affinity for D4 receptor and 5HT2 block
trx resistant schizo
CYP3a4
CYP2d6
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8
Q

risperidone

A

atypical
CYP3a4
CYP2d6

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9
Q

olanapine

A

atypical
worst weight gain
CYP2d6

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10
Q

quetiapine

A

atypical
QT prolongation
6 hour half life
CYP3a4

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11
Q

ziprasidone

A

atypical
QT prolongation
8 hour half life
CYP3a4

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12
Q

aripiprazole

A

atypical
partial D2 and 5HT agonist
-get to 25% Dopamine Emax=never completely block D (no bad EPS)

75 hour half life

CYP3a4
CYP2d6

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13
Q

typical vs atypical

A

Typicals=EPS and only positive sx

Atypical-reduced EPS risk, postitive and negative sx (5HT2R antagonism)

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14
Q

EPS

A

PD like sx=bradykinesia, rigidity, tremor
Akathisia, dystonias=painful

due to D receptor blockade (typicals)
small in all atypicals except clozapine

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15
Q

Tardive dyskinesia

A

choreatheoid movements of lips and buccal cavity=might be irreversible

  • @6 mo to several years
  • elim antichoniergics and add Diazepam (GABA agonist)
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16
Q

Neuroleptic Malignant Syndrome

A

muscle rigidity, excess switching, fever, life threatening autonomic instability (due to D in hypothalamus messed up)

@pts particularly sensitive to EPS

trx is dantrolene (muscle relaxant) and bromociptine (D agonist)

17
Q

Endocrine effects

A

Due to D2 pituitary blockade

hyperprolactinemia, gynecomastia, ammernoeria, infertility

18
Q

Metabolic effects

A

ESPICALLY ATYPICALS

sig weight gain and hyperglycemia and hyperlipidemia

DM

antagonized 5HT2c receptors/leptin disreg?

19
Q

D receptor blockade increase

A

EPS risk increase

20
Q

Autonomic effects

  • mech
  • typicals vs atypical
  • sx
A

due to block of peripheral alpha adrenergic/muscarinic receptors

typicals
thioridazine worst, haloperidol weakest

atypicals all have intermediate effects

ortho htx and ejaculation failure

21
Q

Muscarinic block

A

atropine like effects (PSNS up!) @ thiorzidaine/most

-toxic confessional state, urinary retention

22
Q

typical and atypical

  • protein binding
  • avg t1/2
A

bound

12-24 hours

Psych Drugs (4 decks)

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