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Neuromusculoskeletal & Psychiatry I Exam #1 > Antipsychotics > Flashcards

Antipsychotics Flashcards

1
Q

What suffices are associated with first generation antipsychotics?

What are the 4 exceptions?

They are AKA what?

A

-azine

Haloperidol
Loxapine
Pimozide
Thiothixene

Conentional or Typical

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2
Q

What suffices are associated with second generation antipsychotics?

They are AKA what?

A
  • idone
  • azole
  • apine

Novel or Atypical

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3
Q

What’s the primary difference between the first and second generation antipsychotics?

A

Reduced movement disorder side effects.

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4
Q

What is the MOA of FGA’s in general?

A

Blockage of D2 post-synaptic receptors

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5
Q

Which other receptors can FGAs block, thus producing side-effects?

A

Muscarinic receptors

Histamine receptors (H1)

a1-adrenergic

D2 receptors in the nigrostriatal pathway (EPS and movements) and tubulofundibular (prolactin) pathway

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6
Q

What are the typical side-effects noted in FGAs?

A

Hyperprolactinemia (tubulofundibular pathway)
-amenorrhea, galactorrhea, gynecomastia, decreased libido

EPS/TD (Acute akathisia/dystonia/Parkinsonism-like + Tardive dyskinesia) (nigrostriatal pathway)

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7
Q

What are the 2 low potency FGAs?

What side effects are more common in them?

A

Chlorpromazine + Thioridazine

More sedation, hypotension and seizure-threshold reduction.

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8
Q

What are the 2 high potency FGAs?

What side effects are more common in them?

A

Fluphenazine + Haloperidol

More movement (EPS) and endocrine effects (prolactin).

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9
Q

What 2 anticholinergic drugs can be given as a treatment for the EPS side-effects from FGAs?

What antihistamine drug can be given as a treatment for the EPS side-effects from FGAs?

A

Benztropine + Trihexyphenidyl

Diphenhydramine

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10
Q

What 2 drugs can be given to treat the tardive dyskinesia side-effects from FGAs? What is their class?

A

VMAT2 inhibitors: Valbenazine + Deutetrabenazine

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11
Q

In general, what is the MOA of second generation antipsychotics?

A

Blockage of D2 post-synaptic receptors and 5HT2A receptors.

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12
Q

What are the 4 broad categories of SGAs based on their MOA?

Which suffices are associated with each class?

A
  1. 5HT-2A/DA receptor antagonists: -idone
  2. Partial DA/5HT-1A receptor agonists: -piprazole
  3. Multi-acting receptor-target agents: -apine
  4. Inverse serotonin agonist/antagonist: Pimavanserin
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13
Q

Under what condition should you use Pimavanserin?

A

In a patient with Parkinson’s disease

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14
Q

Which 2 broad categories of SGAs can Cariprazine fit into?

A

5HT-2A/DA receptor antagonists + Partial DA/5HT-1A receptor agonists

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15
Q

What are side-effects of SGAs?

A

Weight gain
DM/insulin resistance
CVD/dyslipidemia

QTC prolongation/ECG changes (greater risk for women, elderly and those on anti-arrhythmics)

Stroke (class warning)

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16
Q

What is a unique and rare side-effect of Clozapine?

A

Agranulocytosis - monitor WBC; REMS program

17
Q

What is a unique and rare side-effect of Olanzapine?

A

Drug reaction w/ eosinophilia and systemic symptoms (DRESS)

18
Q

What is Neuroleptic Malignant Syndrome?

In which meds can it be seen?

What is the antidote for it?

A

Rare, but potentially-fatal, severe Parkinson’s-like movement disorder w/ widespread muscle contraction.

SGAs

Dantrolene

19
Q

Baseline levels of which labs/vitals/etc. are monitored when taking SGAs? (5)

A 
Serum Glc
Lipids
Weight (BMI)
Waist circumference
Personal/family history of metabolic and CV disease
20
Q

What is the drug combo for treating Psychotic depression?

A

Olanzapine/Fluoxetine

21
Q

What is the drug combo for Mania w/ psychotic features?

A

Li+/anticonvulsant

22
Q

What is given in a patient with acute agitation?

A

Injectable (IR) and ODT or SL versions

23
Q

Which drugs is used if there is multi-drug resistance and/or Psychotic with anti-suidical thoughts/behaviors?

A

Clozapine

24
Q

With which meds can help manage adherence? (4)

A

Long-acting injectable agents (LAIAs) every 2-12 wks.

Risperidone
Olanzapine
Aripiprazole lauroxil
Paliperidone palmitate

Neuromusculoskeletal & Psychiatry I Exam #1 (20 decks)

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