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CPTP stage 4 > Antipsychotics > Flashcards

Antipsychotics Flashcards

1
Q

Which antipsychotic is used in pts under 18

A

Aripiprazole

doesnt give side effects, but less effective

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2
Q

1st line antipsychotic

A

Olanzapine

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3
Q

Which antipsychotics give extrapyramidal side effects

A

Typical antipsychotics: Haloperidol, Chlopromazine

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4
Q

Which antipsychotic causes agranulocytosis

A

Clozapine

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5
Q

Which antipsychotics cause insulin resistance/ diabetes/ weight gain

A

Risperidone and Olanzapine

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6
Q

Which antipsychotics cause sexual dysfunction

A

Risperidone and Olanzapine

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7
Q

Nigro-striatal extrapyramidal side effects

A
  1. Parkinsonism (tremor, muscle rigidity, blank face)

2. Tardive dyskinesia (eg lip smacking, rocking)

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8
Q

Tubero-infundibular extrapyramidal side effects

A

Gynaecomastia in men

Galactorrhoea in women

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9
Q

Which antipsychotics are safe in pregnancy

A

ALL of them

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10
Q

Which antipsychotics are safe in breastfeeding

A

NONE of them

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11
Q

Which dopamine pathways are the target for anti-psychotics

A

Mesolimbic/ Mesocortical in cortex

not Nigrostriatal or Tubero-infundibular pathways in striatum

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12
Q

Why do atypical antipsychotics have less extra-pyramidal side effects compared to typical ones

A

Atypicals dissociate from D2 receptor in striatum faster (due to phasic bursts of dopamine transmission)

Reduces unwanted striatum side effects while not compromising therapeutic cortex effects

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13
Q

Difference between vs typical antipsychotics

A

Typical

  • Only effective against negative symptoms
  • Worse extrapyramidal side effects

Atypical

  • effective against both positive and negative symptoms
  • Extrapyramidal side effects not so bad
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14
Q

Significant side effect of Haloperidol

A

QT prolongation

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15
Q

Side effects of typical antipsychotics

A

NIGROSTRIATAL

  • Parkinsonism
  • Tardive dyskinesia

TUBEROINFUNDIBULAR

  • Galactorrhoea in women
  • Gynaecomastia in men
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16
Q

Side effects of atypical antipsychotics

A
  • Weight gain (worse in Olanzapine)
  • Insulin resistance/ hyperglycaemia/ diabetes
  • Sexual dysfunction
17
Q

Why do atypical antipsychotics have less unwanted side effects than typical ones + which pathways are relevant

A

Relevant pathways:
Target: mesolimbic/mesocortical pathways
Unwanted: nigrostrial side effects (Parkinsonism, tardive dyskinesia)

Atypicals have faster dissociation rate from D2 receptor in striatum.
Due to phasic bursts of dopa transmission.
Less nigrostriatal side effects .
Cortex therapeutic effects not affected.

CPTP stage 4 (21 decks)

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