antipsychotics Flashcards
low potency typical antipsychotics list
chlorpromazine
thioridazine
high potency typical antipsychotics list
haloperidol
fluphenazine
atypical antipsychotics group 1 list
Olanzapine risperidone paliperidone, iloperidone quetiapine, clozapine
atypical antipsychotics group 2 list
ziprasaidone
aripiprazole
lurasidone
more atypical antipsychotics list
asenapine
iloperidone
brexpiprazole
cariprazine
mood stabilizer antiseizure drug list
valproate
lamotrigine
carbamazepine
lithium
chlorpromazine
lots of sedation and adverse effects hold back neurological processing good for positive symptoms bad because movement disorder
thioridazine
extensive 1st pass metabolist
good for positive symptoms
bad because cardiotoxicity and retinopathy
haloperidol use
initial antipsychotic for rapid onset in acute psychosis
also maintenance therapy for pts refractory to other antipsychotics
Strong D2 receptor inhibitor
side effects of haloperidol
extrapyramidal toxicity
very little hypotension
low rates of metabolic effects
low sedation rates
extrapyramidal adverse effects
acute dystonia and parkinsonism onset early
tradive dyskinesia occur late
treatment of tardive dyskinesea
switch to an atypical agent
early recognition and lowest dose
reducing dose or chaning to low risk drug is best long term
fluphenazine
sedating but avalible in long lasting injections
postive symptoms
uses of group 1 atypical antipsychotics
good for postive and negative symptoms
low risk for movement disorders
risperidone
low extrapyramidal toxicity; cheapest of all atypical antipsychotics low risk for TC
FDA for MDD
side effects of group 1 atypical antipsychotics
metabolic side effects
weight pain
worsening lipid profile
dm or Cv disease development
clozapine use
clozaptine first atypical drug important role in txtment of schziophrenia refractory to other txtment
clozapine advantages
low risk for extrapyramidal toxicity
low rates of sedation
may effective in txtment of refractor schizophrenia
clozapine disadvantages
agranulocytosis
seizures
myocarditis
orthostatic hypotension
requires CBC monitoring
black box for all antipsychotics
increased momrtality in elderly dementia patients on conventional or atypical antipsychotics due to CV or infectious events
group 2 benefits
low risk of weight gain and low risk of extrapyramidal side effects
moa of ziprasidone
D2 antagonists and NE reuptake inhibitor and is weight neutral
take with food
aripiprazole
lower rates of weight gain and lipid disorders than group 1 but slightly higher than ziprasidone
Aripiprazole and ziprasidone are more commonly used as
mood stabilizers or for other various behavioral therapies than for schizophrenia
aripiprazole FDA approval
for adjunct for MDD with an SSRI
Lurasidone and ziprasidone must be taken with a
meal to maximize oral bioavailability
use of lamotrigine
antiseizure med good for depressive phase of bipolar; acute mania and prophylaxisi of manis
use of carbamzepine
bipolar acute mania prophylaxisi of acute mania
use of valpromate
acute mania combo with lithim
use of lithium
acute mania
used as maintenance of decrease frequency and severity of swing between depression and mania
what reduces lithium clearance
renal clearance reduced by diuretics acei arbs nsaids so must monitor serum lithium levels
s/s of lithium tox
Minor toxicity begins at levels between 1 to 2 mEq/L
Diarrhea, vomiting, drowsiness, muscular weakness, and a lack of coordination.
Moderate toxicity between 2 to 3 mEq/L
Giddiness, blurred vision, ataxia, tinnitus, copious dilute urine.
Major toxicity if over 3 mEq/L
High morbidity.
May require IV fluids and hemodialysis, depending on the clinical situation.
ADE of lithium
tremor, increased thirst, edema
causes of TD
D2 hypersensitivity
neuroleptic malignant syndrome symptosm
fever regitidty AMS autonomic dysfunctiion tachy tachypnea incontinence
Carbamazepine and lamotrigine are both used in
acute mania and for mania prophylaxis during euthymic or depressive phases
