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Pharmacology > Antipsychotics > Flashcards

Antipsychotics Flashcards

1
Q

Positive symptoms of psychosis/schizophrenia include:

A

Delusions, hallucinations, disorganized speech, catatonic behavior
(hyperactivity of the mesolimbic dopaminergic pathway=excess dopamine)

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2
Q

Negative symptoms of psychosis/schizophrenia include

A

Flat affect, alogia (lack of speech), avolition

hypoactivity of mesocortical dopaminergic pathway=insufficient dopamine

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3
Q

MOA Typical Antipsychotics:

A

Antagonize D2 receptors in the CNS

=Decreased positive s/s

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4
Q

On target AE of Typical Antipsychotics:

A

(d/t D2 antagonism)

  • EPS- Parkinsonian s/s
  • Tardive dyskinesia (chronic use- rep. involuntary movements of the face, arms, trunk)
  • Neuro Malignant Syndrome
  • Increased prolactin secretion (women- amenorrhea, galactorrhea, false + preg test, men- gynecomastia, decrease libido)
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5
Q

Off target AE of Typical Antipsychotics:

A

Muscarinic: anticholinergic effects
a-antagonism: Orthostatic hypotension, failure to ejaculate
H1-sedation

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6
Q

Which AE are more common with high potency typical antipsychotics?

A

Higher potency= more D2 related AE vs off target effects

Lower potency= more off target effects

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7
Q

Atypical antipsychotics are more effective at treating what type of symptoms?

A

Negative

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8
Q

What atypical antipsychotic that is effective at treating both negative and positive symptoms?

A

Resperidone (more effective than Haldol at tx of positive symptoms

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9
Q

MOA of Atypical Antipsychotics:

A

5HT2 and D2 antagonism

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10
Q

Why do atypical antipsychotics have less EPS?

A

They dissociate relatively fast from D2 receptors (this is why they are not generally used to treat positive symptoms)

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11
Q

What is Neuroleptic Malignant Syndrome?

A

Similar to serotonin syndrome but more severe (life-threatening)
Fever, muscle rigidity, increase CPK, myoglobin, delirium

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12
Q

Clozapine is what type of antipsychotic and when is it used?

A

Atypical antipsychotic

Used as last line for treatment-resistant patients

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13
Q

Clozapine AE(serious):

A

Life-threatening agranulocytosis

**monitor CBC weekly for 6mos, biweekly 6mos, qmonth)

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14
Q

Clozapine AE:

A 
Orthostatic hypotension
Weight gain
Hyperglycemia
Sedation
Constipation
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15
Q

Paliperidone(Invega) is the primary active metabolite for what atypical antipsychotic?

A

Risperidone

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16
Q

Which patients is paliperidone preferred in?

A

Those who have hepatic dysfunction (safter than risperiodone which has to be metabolized by liver). Mostly renally excreted
No identified DI
*osmotic delivery capsule, do not crush or chew

17
Q

What is the MOA of Aripiprazole (Abilify)

A 
Atypical antipsychotic
Partial agonist at D2 rc
Partial agonist at 5HT1a rc 
Antagonist at 5HT2a, H1, alpha 1 rc
(*Partial agonism leads to unpredictable levels of rc activity- not used with other antipsychotics)
18
Q

Olanazapine (Zyprexa) is what type of antipsychotic?

A

Atypical

19
Q

What is special about Olanazapine’s metabolism?

A

Metabolized by CYP1A2, smoking increases this metabolism

20
Q

Can Olanzapine tablets be cut?

A

If cut they must be taken immediately, drug oxidizes in are

21
Q

Quetiapine (Seroquel)is this type of antipsychotic and can be use for _____ at low doses?

A

Atypical Antipsychotic
Sleep aid
**causes weight gain

22
Q

Quetiapine (Seroquel) has a ______ dosing range.

A

Wide, few clinically significant drug interactions

23
Q

Respiradone can be given ____ every two weeks.

A

IM (continue oral for at least 3wks

24
Q

Aripiprazole, olanzapine, and risperidone can all be given as _____ to avoid patients ‘cheeking’ meds.

A

ODT

25
Q

Typical antipsychotics include:

A

Chlorpromazine
Thioroidazine
Haloperidol (Haldol)
Fluphenazine

26
Q

Atypical Antipsychotics include:

A 
Risperidone 
Quetiapine (Seroquel)
Apiprazole (Abilify)
Olanzapine (Zyprexa)
Clozapine (Clorazil)
27
Q

Main side effect of Olanzapine (Zyprexa)?

A

Weight gain

also hyperglycemia

28
Q

Last line atypical antipsychotics include:

A

Chlorpromazine
Thioridazine
Mesoridazine

29
Q

What do Haloperidol, Fluphenazine, and thiothixene have in common?

A

Typical antipsychotics
High potency= More EPS
Weaker H1, M1 antagonists

30
Q

Eszoplicone(Lunesta):

A

Site of action= GABA receptors

Used for insomnia

31
Q

Zolpidem(Ambien):

A

Effects reversed by Flumazenil
Site of action= GABA receptors
Used for insomnia

32
Q

Ramelteon is different than other sleep aids because it:

A

carries no risk of tolerance of dependency

Acts on melatonin receptors, used for insomnia

33
Q

Barbiturates:

A

Extensively met by CYP
Used for insomnia
Used for anesthesia and seizures

34
Q

Benzos:

A

Effects reversed with Flumazenil
Site of action= GABA receptors
USed for insomnia
Used for anesthesia and Seizures

Pharmacology (48 decks)

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