Antipsychotics Flashcards
MOA of Lithium
inhibits inositol monophosphate, to decrease PIP2, IP3 and DAG
side effects of Lithium
chronic interstitial nephritis
tremor
Nephrogenic DI
Teratotgen
Cardiac abnormalities
Hypothyroidism/ Goiter
worsened psoriasis
acne
leukocytosis
hair thinning
contraindications of Lithium
renal insufficiency
Hypovolemia
Low GFR/ Elderly
Pregnancy
which drugs cause an increase in renal lithium concentrations
thiazides
NSAIDS
ACE inhibitors
which drugs cause a decrease in renal lithium concentrations
Potassium-sparing diuretics
which drugs alter renal lithium levels
Loop Diuretics can cause an increase or decrease in lithium levels
indications of Lithium
Bipolar disorder
acute mania
indications of antipsychotics
positive schizophrenia symptoms
psychosis
mania
bipolar
OCD
Tourette syndrome
Huntington Disease
what do typical (first generation) antipsychotics usually end with
-azine
what do atypical (2nd generation) antipsychotics usually end with
- idone
- apine
what are high potency typical antipsychotics known for
Extrapyramidal symptoms- symptoms affecting the basal ganglia, causing movement disorders:
dystonia: stiffness and spasm
akathisia: restlessness and urge to move
Bradykinesia
Tardive dyskinesia: choreoathetosis, lip-smacking, grimacing
why are extrapyramidal symptoms more pronounced in high potency typical antipsychotics?
D2>A2>5HT>H1
when D2 receptors are antagonized, neurotransmitters won’t be released from the caudate, leading to movement disorders
What are Dopamine antagonist symptoms
Extrapyramidal signs
hyperprolactinemia
galactorrhea
amenorrhea
anti-emetic actions
what are histamine antagonist symptoms
sedation
constipation
what are muscarinic antagonist symptoms
dry mouth
constipation
what are alpha-1 antagonist symptoms
hypotension
which antipsychotics have more antimuscarinic symptoms and why
Low potency typical antipsychotics
A1= 5HT> D2
most serious side effect of all antipsychotics
(what does it look like and what is its antagonist)
Neuroleptic malignant syndrome
increased CK
fever
rigidity
rhabdomyolysis
Dantrolene or Bromocriptine
which high potency typical antipsychotic shows prolonged QT intervals
Haloperidol
Chlorpromazine
class
specific side effects
low potency typical antipsychotic
corneal deposits
Thioridazine
class
specific side effects
low potency typical antipsychotic
retinal deposits
browning of vision
why are second-generation (atypical) antipsychotics thought to be better at treating psychosis
5HT>D2 blocking
which atypical antipsychotics have the greatest anticholinergic effects and highest risk of metabolic syndrome
Clozapine
Olanzapine
Quetiapine
which atypical antipsychotics cause abnormal thermal regulation
Olanzapine
Risperidone
which atypical antipsychotics cause hyperprolactinemia
Risperidone
Amisulpride
Paliperidone
which atypical antipsychotics are associated with prolonged QT
Ziprasidone
Iloperidone
Aripiprazole
MOA
class
side effects
atypical antipsychotic
partial D2 agonist- less dopamine blockade adverse effects
causes: akathisia
Clozapine
class
MOA
specific side effects
class: atypical antipsychotic
MOA: a1>5HT>D2
specific side effects: agranulocytosis, seizures, cardiac abnormalities, anticholinergic effects, metabolic syndrome
Olanzapine
class
MOA
specific side effects
class: atypical antipsychotic
MOA: 5HT>H1>D2>a1
specific side effects: elevated LFTs, orthostatic hypotension, anticholinergic effects, metabolic syndrome
Quetiapine
class
specific side effects
class: atypical antipsychotic
specific side effects: anticholinergic effects, metabolic syndrome, sedation
what is metabolic syndrome and what antipsychotics do you see it in
presence of the following symptoms: weight gain, hyperglycemia, dyslipidemia
Clozapine
Olanzapine
Quetiapine
