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HBHD > Antipsychotics > Flashcards

Antipsychotics Flashcards

1
Q

What is the dopamine receptor target for antipsychotics?

A

D2

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2
Q

What is the serotonin receptor target for antipsychotics?

A

5-HT2a

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3
Q

What is the off target receptor that antipsychotics hit in parasympathetic system?

A

M2/3

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4
Q

What is the off target receptor that antipsychotics hit in histamine?

A

H1

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5
Q

What is the off target receptor that antipsychotics hit in the heart?

A

K+c channels

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6
Q

Name the two first generation high potency anti psychotics

A

Fluphenazine

Haloperidol

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7
Q

Name the low potency first gen anti psychotic

A

Chlorpromazine

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8
Q

Name the four second generation antipsychotics

A

Risperidone
Olanzapine
Clozapine
Aripiprazole

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9
Q

What is the main difference between first and second generation antipsychotics?

A

First hit only dopamine, second hit dopamine and serotonin

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10
Q

What pathway do antipsychotics work in that inhibits positive symptoms of schizophrenia?

A

Mesocortical dopamine pathway

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11
Q

What characteristic of the antipsychotics helps minimize their toxicity?

A

They only have to occupy 60% of the receptors to achieve a 100% response

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12
Q

Do first generation or second generation have worse extrapyramidal symptoms?

A

First generation

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13
Q

What pathway leads to the EPS?

A

Inhibition of the nigrostriatal pathway

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14
Q

Inhibition of the tuberoinfundibular pathway from antipsychotics leads to what issue?

A

Hormonal effect of prolactinemia because dopamine inhibits the production of it so without dopamine you get more prolactin

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15
Q

What are the effects of hyperprolactinemia?

A

Gynecomastia
Amenorrhea
Decreased libido

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16
Q

Do first or second generation Aps cause worse prolactinemia?

A

First

17
Q

What is neuroleptic malignant syndrome?

A

Hyperthermia, rigidity, mantal status changes, autonomic instability caused by antipsychotic medication

18
Q

Do first or second generation Aps cause neuroleptic malignant syndrome?

A

Both cause it

19
Q

What can you treat the muscle rigidity and hyperthermia with in neuroleptic malignant syndrome?

A

Dantrolene…calcium channel blocker to inhibit muscle

20
Q

What side effect can be caused by the inhibition of serotonin receptors in AP meds?

A

Metabolic syndrome

21
Q

What is metabolic syndrome symptoms?

A

Weight gain, dyslipidemia, hyperglycemia

22
Q

Is metabolic syndrome more common in first or second gen Aps?

A

Second gen

23
Q

Do AP drugs antagonize or agonize M2/M3 parasympathetic receptors?

A

Antagonize

24
Q

What first gen antipsychotics cause antiparasympathetic issues?

A

Chlorpromazine (low potency)

25
Q

What second gen antipsychotic is especially bad at causing antiparasympathetic issues?

A

Clozapine

26
Q

Name the symptoms of anti parasympathetic issues caused by APs

A

Blurred vision
Xerostomia
Constipation
Urinary retention

27
Q

What generation antipsychotics lead to orthostatic hypotension?

A

Low potency first gen and second generation

28
Q

What second gen AP is really bad for orthostatic HypoTN?

A

Clozapine

29
Q

Why do APs (low potency first gen and second gen) cause orthostatic HypoTN?

A

They can block alpha1 receptors which vasodilate

30
Q

What classes of APs have issue with sedation?

A

First gen low potency and second gen

31
Q

Why do APs cause sedation?

A

Because they block H1 (histamine) receptors and are in the brain

32
Q

What first gen AP leads to prolonged QT ??

A

Haloperidol

33
Q

What second generation APs leads to prolonged QT?

A

Risperidone

Olanzapine

34
Q

What causes prolonged QT from first and second generation APs?

A

Inhibit K+efflux in the cardiac muscle therefore slowing repolarization

35
Q

What AP drug has toxicity of agranulocytosis/neutropenia?

A

Clozapine

HBHD (17 decks)

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