antipsychotics Flashcards
classical vs atypical antipsychotic: chlorpromazine
classical
classical vs atypical antipsychotic: fluphenazine
classical
classical vs atypical antipsychotic: haloperidol
classical
classical vs atypical antipsychotic: thioridazine
classical
classical vs atypical antipsychotic: clozapine
atypical
classical vs atypical antipsychotic: risperidone
atypical
classical vs atypical antipsychotic: olanzapine
atypical
classical vs atypical antipsychotic: quetiapine
atypical
classical vs atypical antipsychotic: ziprasidone
atypical
classical vs atypical antipsychotic: aripiprazole
atypical
classical vs atypical antipsychotic: paliperidone
atypical
classical antipsychotics
high potency - higher chance for EPRs
- fluphenazine
- haloperidol
low potency - more likely to cause sedation, postural hypotension
- chlorpromazine
- thioridazine
atypical antipsychotics
higher affinities for receptors other than D2
commonly:
- antagnoize 5HT2a and D2
- less likely to cause tardive dyskinesia, inc prolactin
- effective in treating negative sxs
clozapine
prototype for atypicals
risperidone
causes EPR - rare at normal dose
paliperidone
9-hydroxyrisperidone (active metabolite of risperidone)
which antipsychotics are least likely to induce EPR
clozapine
quetiapine
aripiprazole
patial agonist at D2 and 5HT1a
antag at 5HT2a
all antipscyhotics except which 2 don’t have anti-emetic effects
aripiprazole
thioridazine
mediated via D2 blocking
neurological AE of anti-psychotics
EPS = with high D2 potency
(haloperidol, fluphenazine - high D2 affinities)
also less likely with strong anticholinergics (thioridazine/chlorpromazine) and atypicals
tx for parkinsonism AE of antipsychotics
benztropine
trihexyphenidyl
diphenhydramine/amantadine
never give levodopa = will aggravate psychosis
tx for dystonia AE of antipsychotics
benztropine
trihexyphenidyl
diphenhydramine
tx for akathisia AE of antipscyhotics
clonazepam
propranolol
tx for tardive dyskinesia AE of antipsychotics
(may be due to dopamine receptor up regulation)
may be irreversible
eliminate drugs with central anticholinergic actions (anti-parkinsonian drugs and TCAs)
diazepam may help
pt with tardive dyskinesia who require antipsychotics - what drug to use
clozapine
neuroleptic malignant syndrome
rigidity, tremor, hyperthermia
inc WBC, inc CK
myoglobinemia
tx: dantrolene, bromocriptine
what causes sedation as an AE of antipsychotics
blockade of central H1
autonomic AE of antipsychotics
orthostatic hypotension
impaired ejaculation
which antipsychotic causes agranulocytosis
clozapine
regular blood counts are mandatory
NOT first line
AE prolactin elevation with antipsychotics
blockade of D2
amenorrhea, galactorrhea
loss of libido, infertility in men
which antipsychotics can cause cardiac toxicity
thioridazine = QT elongation, T wave changes
ziprasidone = can elongate QT
which antipsychotics cause ocular AE
chlorpromazine = cornea, lens deposits
thioridazine = retinal spots
non pysch use for antipsych meds
nausea and vomiting
droperidol used in neurolept-anesthesia
DOC antipsychotics
atypical
risperidone is most prescribed
antipsych in pregnancy
category C
only clozapine is category B
risk of hyperglycemia and weight gain are greater with use atypicals
